Diagnostic and Clinical Course of Small Colon Recurrent Impaction Associated with Severe Myenteric Ganglionopathy in A Mare

Lymphocytic myenteric ganglionitis associated with equine herpesvirus infection: A cause of chronic intestinal pseudo‐obstruction and recurrent colic in an adult horse

“…Full‐thickness biopsy samples can be obtained during exploratory laparotomy or laparoscopic intestinal exploration under standing sedation in horses as an option for small intestinal biopsy (Bracamonte et al., 2008; Coomer et al., 2016; Schambourg & Marcoux, 2006). All described equine MG case reports consistently revealed ganglionitis lesions in the small intestine among other levels of the GI tract (Blake et al., 2012; Chénier et al., 2011; Ortolani et al., 2021; Pavone et al., 2013), meaning laparoscopic biopsies of the small intestine under sedation could be a less invasive option for the diagnosis of equine ganglionitis. However, MG lesions were not found on the small intestinal sections examined in our case.…”

“…All described equine MG case reports consistently revealed ganglionitis lesions in the small intestine among other levels of the GI tract (Blake et al, 2012;Chénier et al, 2011;Ortolani et al, 2021;Pavone et al, 2013), meaning laparoscopic biopsies of the small intestine under sedation could be a less invasive option for the diagnosis of equine ganglionitis. However, MG lesions were not found on the small intestinal sections examined in our case.…”

“…In veterinary medicine MG has been previously described in dogs and cats (Mortier et al., 2016; Petrus et al., 2001) with similar clinical signs of discomfort related to CIPO (Couraud et al., 2006; Eastwood et al., 2005; Petrus et al., 2001; Zacuto et al., 2016). In horses, MG has been rarely reported as the base of recurrent colic and CIPO (Barros et al., 2022; Blake et al., 2012; Burns et al., 1990; Chénier et al., 2011; Ortolani et al., 2021).…”

“…The sole reported case of CIPO associated with enteric ganglionitis in a cat was successfully treated with pyridostigmine (Mortier et al., 2016). In horses with signs of CIPO associated with myenteric ganglionitis, despite feed restrictions, medical treatment with prokinetics, corticosteroids (Blake et al., 2012; Chénier et al., 2011; Pavone et al., 2013) and in some cases surgical colon resection (Barros et al., 2022; Chénier et al., 2011; Ortolani et al., 2021; Pavone et al., 2013) all horses were euthanised due to recurrent pain and in two cases due to intestinal rupture (Barros et al., 2022).…”

The subtle link between myenteric ganglionitis and inflammatory bowel disease

“…The first case of CIPO described in a horse dates back to the 90s when myenteric ganglionitis (MG) of unknown origin was diagnosed in a 4-year-old mare (Burns et al, 1990). Since then, an increasing number of cases have been reported (Barros et al, 2022;Blake et al, 2012;Chénier et al, 2011;Ortolani et al, 2021;Pavone et al, 2013), including the one described in this issue by Magalhães et al (2024). Neurotropic viruses, such as equine herpesvirus, were suspected in most cases and confirmed in some of them (Barros et al, 2022;Magalhães et al, 2024;Pavone et al, 2013).…”