Multisystemic eosinophilic epitheliotropic disease is rare in horses, and usually chronic. In the current case the horse showed an apparently acute onset with high fever and rapid clinical deterioration. A diagnosis of MEED should be considered in horses presenting with weight loss and skin lesions with or without fever. A final diagnosis is based on histological results of biopsy specimens from affected organs.
A ten-year-old Warmblood dressage gelding was presented with acute instability of the nuchal ligament after paddock turnout. Based on the clinical signs, orthopedic and neurologic examination, diagnostic imaging and electromyography, cervical neuromuscular dysfunction of the M. obliquus capitis caudalis on the right side of the neck was diagnosed. Conservative treatment including steroidal anti-inflammatory medication in combination with oral supplementation with vitamin B1 and box rest resulted in complete recovery of the horse within six months.
A 20-year-old horse was evaluated for symptoms of weight loss, anorexia, fever and lethargy. Clinical examination revealed tachypnea, poor body condition and increased breath sounds on auscultation. Ultrasound showed multiple consolidations on the lungs. Thoracic radiography revealed a severe nodular pattern. The horse was treated with antibiotics, corticoids and supportive medication. Since no improvement was observed, the horse was euthanized.At necropsy, numerous coalescing fibrous nodules were present in the lungs. Histology revealed diffuse interstitial fibrosis and macrophages containing abundant eosinophilic cytoplasm and oval eosinophilic to amphophilic intranuclear inclusion bodies. Tissue samples tested positive for the presence of equine herpes virus 5 (EHV 5) on the basis of the polymerase chain reaction (PCR) test. A diagnosis of equine multinodular pulmonary fibrosis (EMPF) was made. This is the first report of EMPF in Belgium. EMPF can be suspected based on the ultrasonographic, radiographic and histological changes. EMPF is associated with EHV 5, but the etiological role of EHV 5 still remains to be proven.
Equine proliferatieve enteropathie, veroorzaakt door Lawsonia intracellularis, werd pas op het einde van de vorige eeuw voor het eerst beschreven en werd initieel beschouwd als een sporadisch voorkomende aandoening, maar ze komt tegenwoordig steeds vaker voor. Als kenmerkende klinische symptomen worden vermageren, lethargie, ventraal oedeem, koorts en eventueel diarree en koliek vermeld bij veulens van twee tot acht maanden oud. Bij bloedonderzoek valt vooral een uitgesproken hypoalbuminemie op. De diagnose kan gesteld worden aan de hand van serologie en een PCR-analyse van de mest. Sinds een paar jaar wordt het duidelijk dat een zeer groot deel van onze veulens en paarden seropositief is voor Lawsonia, hetgeen wijst op een sterke verspreiding van het agens in de omgeving. Daarom moet equine proliferatieve enteropathie (EPE) momenteel als een belangrijke differentiaal diagnostische mogelijkheid aanzien worden bij veulens met gewichtsverlies of andere digestieve klachten.
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