BackgroundDiagnosing IBD in horses is challenging and requires a multimodal approach, since no conclusive diagnostic test is available.The objectives of this study were to provide an overview of population characteristics, results of applied diagnostic tests, treatment modalities and outcome in a large group of horses thought to have IBD and that were presented to four large equine referral hospitals, and to provide an exploratory investigation of possible associations between results of applied diagnostic tests, applied treatment modalities and outcome.A retrospective case series was performed across four large equine referral hospitals. Seventy-eight horses, thought to have IBD were included. Case history, clinical findings, diagnostic test results including oral glucose tolerance test (OGTT) and enteral biopsies (both duodenal and rectal), applied therapy and outcome were studied. A Chi-Square test was used to identify associations between results of diagnostic tests, treatment and outcome. P-values < 0.05 were considered significant.ResultsLethargy, diarrhoea, recurrent colic and weight loss were recorded in respectively 21,8%; 14,1%; 28,2% and 78,2% of cases. Over 70% of horses thought to have IBD had an abnormal OGTT. Only weight loss was significantly associated with aberrant enteral biopsy results, but not with abnormal OGTT results or low blood total protein. There was no association between an aberrant biopsy result and a disturbed OGTT. There was no association between either OGTT results or enteral biopsy results and a low blood total protein content, presence of gastric ulcer disease or an aberrant endoscopic aspect of the duodenal entrance.ConclusionsWeight loss is a highly prevalent symptom in IBD suspected horses. Enteral biopsies may be a useful diagnostic aid in the work-up of horses thought to suffer from IBD, however further research is required to demonstrate their true diagnostic value. Until more standardized scientific research is available, one should be careful with the interpretation of enteral biopsy results There is a need for better standardization of enteral biopsy procedures and the histopathological scoring of biopsies.Electronic supplementary materialThe online version of this article (10.1186/s12917-018-1343-1) contains supplementary material, which is available to authorized users.

A female Standardbred yearling was presented at the Faculty of Veterinary Medicine, Ghent University, with a history of recurrent respiratory problems characterized by tachypnea, nasal discharge, and intermittent coughing since birth. During 1st year of life, the horse had been examined on 4 occasions in a veterinary hospital. On each occasion, tracheal aspirates revealed numerous neutrophils and bacteriological culture yielded 3 times Streptococcus equi subsp. zooepidemicus and once Streptococcus equi subsp. equi. After treatment with antibiotics and bronchodilators, the foal improved, but relapsed when medication was stopped.At the time of examination the horse had bilateral mucopurulent nasal discharge and was in poor body condition (body condition score 3/9). Rectal temperature was normal, respiratory rate was slightly increased, and on auscultation generalized ''moist'' lung sounds were heard. Hematology and serum biochemical values were within normal limits. Endoscopic examination showed mucopurulent exudate in the trachea and in the large bronchi, but no other upper or lower respiratory tract abnormalities were seen. An aspirate of the tracheal mucus revealed a leukocyte count of 52,000/mm 3 with a differential count of 90% neutrophils and 10% macrophages. On bacteriological examination of the aspirate, Streptococcus equi subsp. zooepidemicus was isolated. Differential cell count of bronchoalveolar lavage fluid revealed 45% macrophages, 38% lymphocytes, 16% neutrophils, and 1% eosinophils. Ultrasonographic examination of the lungs revealed a relatively smooth visceral pleural surface, but in the ventral part of the lungs radiating comet-tail artifacts were seen.Because of the recurrent respiratory infections without obvious underlying causes, the possibility of an immune deficiency was investigated. No major dysfunction of the immune system could be detected. Serum concentrations of IgA, IgM, and IgG were within reference range, and analysis of the numbers of circulating IgM1, CD21, CD41, CD81, or CD11a1 cells did not reveal significant imbalances in these cell populations. The horse continued to suffer from recurrent respiratory disorders and remained in a poor body condition. Therefore a problem in mucus composition, mucociliary clearing, or both was included in the differential diagnosis and the horse was re examined.An ultrasound examination of the thorax revealed a laterally reversed heart without any other cardiac malformations. On abdominal ultrasound, all abdominal organs were found in a complete mirror image of the normal situs. Rectal palpation confirmed the location of the spleen and a kidney on the right side, the caecum on the left side, whereas on the left side no kidney could be palpated. Nasogastric intubation showed the esophagus to be located on the right side of the trachea. The diagnosis of situs inversus totalis was made. Because of the coexistence of situs inversus totalis and mucus accumulation in the respiratory tract, the latter was supposed to be caused by a defective mucociliary...

Objectives The aim of this study was to describe the anatomy of the nerves supplying the cervical articular process joint and to identify relevant anatomical landmarks that could aid in the ultrasound-guided location and injection of these nerves for diagnostic and therapeutic purposes. Study Design Twelve cadaveric equine necks were used. Five necks were dissected to study the anatomy of the medial branch of the dorsal ramus of the cervical spinal nerves 3 to 7. Relevant anatomical findings detected during dissections were combined with ultrasonographic images obtained in one other neck. Six additional necks were used to assess the accuracy of ultrasound-guided injections of the medial branch with blue dye. Results Each examined cervical articular process joint, except for C2 to C3, presented a dual nerve supply. The articular process joints were found to be in close anatomical relationship with the medial branch of the dorsal ramus of the cervical spinal nerve exiting from the intervertebral foramen at the same level, and with the medial branch of the dorsal ramus of the cervical spinal nerve exiting from the intervertebral foramen one level cranial to the articular process joint of interest. A total of 55 nerves were injected under ultrasonographic guidance, 51 of which were successfully stained. Conclusion The current study provided new detailed information regarding the innervation of the cervical articular process joint. The medial branches of the dorsal rami of the cervical spinal nerves were injected with an accuracy that would be of clinical value. Our study offers the foundations to develop new diagnostic and therapeutic techniques for pain management in cervical articular process joint arthropathy in horses.

The purpose of this study was to describe the radiographic and ultrasonographic appearance of the esophagus of ten healthy horses. Contrast radiography showed variations in the long-axis shape of the esophagus at the thoracic inlet. Administration of a large volume contrast medium by intubation showed stasis of contrast material for several minutes in two of the ten horses. The wall thickness of the non-distended esophagus on ultrasound was 2.6 ± 0.3 mm with significant differences depending on the location. Distention of the esophagus by intubation or by a bolus of water or concentrate resulted in a decrease in wall thickness and it facilitated measuring with less variation. Stasis at the thoracic inlet was seen in five of the ten horses, when a water bolus was administered. Ultrasonographic evaluation of 100g spontaneously swallowed commercial concentrate was better than fluid (water bolus or 2.5mL/kg contrast medium) administration via intubation to assess esophageal motility at the thoracic inlet. Stasis seen at the thoracic inlet after bolus administration by intubation should not be regarded as an abnormal finding, and swallowing, with the subsequent peristaltic wave, has a positive influence on the bolus passage time.

Equine atypical myopathy (AM) is caused by hypoglycin A (HGA) and methylenecyclopropylglycine (MCPG) intoxication resulting from the ingestion of seeds or seedlings of some Acer tree species. Interestingly, not all horses pasturing in the same toxic environment develop signs of the disease. In other species, it has been shown that the intestinal microbiota has an impact on digestion, metabolism, immune stimulation and protection from disease. The objective of this study was to characterize and compare fecal microbiota of horses suffering from AM and healthy co-grazers. Furthermore, potential differences in fecal microbiota regarding the outcome of diseased animals were assessed. This prospective observational study included 59 horses with AM (29 survivors and 30 non-survivors) referred to three Belgian equine hospitals and 26 clinically healthy co-grazers simultaneously sharing contaminated pastures during spring and autumn outbreak periods. Fresh fecal samples (rectal or within 30min of defecation) were obtained from all horses and bacterial taxonomy profiling obtained by 16S amplicon sequencing was used to identify differentially distributed bacterial taxa between AM-affected horses and healthy co-grazers. Fecal microbial diversity and evenness were significantly (p < 0.001) higher in AM-affected horses as compared with their non-affected co-grazers. The relative abundance of families Ruminococcaceae, Christensenellaceae and Akkermansiaceae were higher (p ≤ 0.001) whereas those of the Lachnospiraceae (p = 0.0053), Bacteroidales (p < 0.0001) and Clostridiales (p = 0.0402) were lower in horses with AM, especially in those with a poor prognosis. While significant shifts were observed, it is still unclear whether they result from the disease or might be involved in the onset of disease pathogenesis.

Summary A bronchopleural fistula (BPF) consists of a direct communication between the bronchial tree and the pleural space, which can develop secondary to (pleuro) pneumonia. Thoracotomy has been reported as a viable treatment option in cases of nonresponsive pleuropneumonia, pleural abscess formation and necrotising pneumonia. The presence of a BPF can delay and even prevent healing of the thoracotomy site, with clinical signs of coughing and putrid purulent nasal discharge often seen. In this case report, we describe the diagnosis and localisation of a bronchopleural fistula using retrograde instillation of methylene blue through the thoracotomy site, followed by the successful closure of the BPF using endoscopic application of acrylate co‐monomer glue (Glubran 2®).

Background: Lung ultrasound (LUS) is poorly evaluated in horses, especially perioperatively.Objectives: (1) Describe LUS findings in healthy horses before and after general anesthesia (GA), (2) evaluate if GA induces ultrasonographic changes in healthy horses, (3) suggest a LUS scoring system, (4) identify horse variables that are associated to LUS changes after anesthesia.Animals: Twenty-five healthy adult horses undergoing elective surgery.Methods: Prospective hypothesis-driven observational study. LUS findings were recorded before anesthesia, 5 minutes in recovery, 15 minutes, 2H, 3H, 4H, 6H, and 24H after anesthesia in 8 lung regions. Clinical data were collected perioperatively.Results: There was a significant increase in amount of I-lines (10.8 ± 8.7 vs 15.28 ± 8.19), B-lines (3.2 ± 3.5 vs 8.72 ± 4.86), and coalescent B-lines (0.04 ± 0.2 vs 1.12 ± 1.45) after anesthesia compared to before anesthesia, and a significantly higher LUS score 2H after anesthesia (4.92 ± 8.40) compared to before anesthesia (0.9 ± 1.8; P = .02). The maximal LUS score after anesthesia was correlated to total procedure time (Pearson r = 0.4, P = .05; Spearman r = 0.44, P = .03) and was significantly higher in horses with abnormal cardiorespiratory values during anesthesia (P = .005).Conclusions: LUS changes can be induced by GA in healthy horses. This study did not investigate if and which LUS findings indicate lesions, however, this information can aid clinicians to identify pulmonary complications after anesthesia.

Aims High‐intensity training, racing and inappropriate antioxidant supply generates high levels of deleterious oxidative stress. This study aimed at comparing the effect of 2 commercial feeds on oxidative stress levels in steeplechasers, over a 3‐month period. Methods A random double‐blind study was undertaken to compare the effect of 2 diets in 40 racehorses. The first group received a regular pelleted commercial diet (R) and the second group received a low‐starch high‐fibre diet (L). The horses were examined after a 6‐week habituation period (T0) and after 6 (T6) and 12 weeks of reinforced training (T12). Horses were raced regularly. At each step, horses were weighed; body and clinical scores were attributed. Several blood markers were studied including vitamin A (Vit A), vitamin E (Vit E), beta‐carotene, superoxide dismutase (SOD), glutathione peroxidase (GPx), Coenzyme Q10 (CoQ10), copper (Cu), zinc (Zn), selenium (Se) and pre‐ and post effort creatine kinase (CK) activity. Data were analysed using an ANOVA for repeated measurements and a t test. Results In the L‐group, GPx levels were significantly higher than in the R‐group at all times and a progressive and constant increase in GPx was observed from T0 to T12. Vit E levels and CoQ10 increased at T6 in both groups but levels were significantly higher in group‐L. Selenium values were significantly higher at T0 in the L‐group vs. R‐group and remained stable in time in both groups. All other markers were not significantly different between groups and did not change with time. The CK levels did not differ between groups, however 2 horses from group‐R displayed severe episodes of rhabdomyolysis. Conclusions and practical significance The choice of an appropriate diet can effectively increase antioxidant protection and prevent training‐induced oxidative stress even in intensively trained racehorses during racing season. Acknowledgements The authors thank Mr E. Clayeux for his collaboration. Ethical animal research The trainer of all horses gave informed consent for this study. Sources of funding: Lambey SA, France. Competing interests: J‐L. Lambey is owner of Lambey SA and S. Benoit is a consultant for this feed company.