Acute colitis is a potentially life-threatening condition characterised by hypersecretion of fluid, altered motility and an impaired mucosal barrier resulting from direct injury, inflammation and/or dysbacteriosis (Sanchez, 2017). It is responsible for approximately 5% of admissions to equine veterinary hospitals with a mortality of about 40% (Prescott, 2020). Horses with acute colitis present with diarrhoea and potentially other signs such as fever, depression, and colic. It is commonly associated with severe dehydration and electrolyte abnormalities. They can develop SIRS (systemic inflammatory response syndrome) secondary to bacterial translocation, absorption of endotoxin or other bacterial products in the blood stream through a compromised gastrointestinal mucosa (Sanchez, 2017). A variety of infectious and non-infectious aetiologies exist, yet many of the clinical and clinicopathological features are similar regardless of the underlying cause (Sanchez, 2017). In addition, the underlying aetiology remains undetermined in over 50% of the cases (Prescott, 2020). Furthermore, therapeutic principles are similar regardless of the cause and include (1) replacing fluid and electrolyte losses, (2) minimising colonic inflammation and sepsis, (3) promoting mucosal repair and (4) re-establishing normal flora. Some horses require specific therapy aimed at the underlying aetiology (Sanchez, 2017).The routine use of antimicrobials in equine colitis is controversial as antimicrobials may further alter the already compromised normal protective gastrointestinal flora. Additionally, high-level evidence supporting antimicrobial therapy in equine colitis has been previously reported to be lacking (Dunkel & Johns, 2015;Sanchez, 2017).
Pyelonephritis is a serious condition that is rarely described in horses. In contrast, urinary tract infections are common in humans and small animals, and multi‐drug‐resistant urinary infections are an emerging threat. In this report, we describe a horse with unilateral pyelonephritis caused by extended‐spectrum beta‐lactamase‐producing bacteria belonging to the Enterobacter cloacae complex. [Correction added on 9 August 2023, after first online publication: The preceding sentence was corrected.] An 11‐year‐old Swedish warmblood gelding was diagnosed with a cystolith and a cystotomy through an open left para‐inguinal approach was performed. Seven days after surgery the horse presented with pyrexia, dullness and colic. Diagnostic testing and renal transabdominal ultrasonography confirmed the presence of a right‐sided pyelonephritis. Culture and antimicrobial susceptibility testing revealed a pure growth of extended‐spectrum beta‐lactamases‐producing E. cloacae complex bacteria with resistance against beta‐lactams, aminoglycoside and trimethoprim–sulphonamide classes. Treatment included prolonged oral antimicrobials according to susceptibility testing results (enrofloxacin), judicious use of non‐steroidal anti‐inflammatory drugs, fluid therapy and gastric ulcer prophylaxis. The horse recovered successfully and is currently in good health (follow‐up of 5 years). Once the infection resolved, unilateral renal scarring occurred. Multidrug‐resistant upper‐urinary infections occur in horses and should be considered in a post‐surgical patient that develops fever. Early diagnosis, urine bacterial culturing and antimicrobial susceptibility testing were crucial in this case to successful management.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.