Equine grass sickness (EGS) is a degenerative polyneuropathy affecting postganglionic parasympathetic and sympathetic neurons. The major clinical signs relate to dysfunction of the gastrointestinal tract and the condition is frequently fatal. EGS has been reported in different parts of the world including Europe. This paper describes the first case of equine dysautonomia in the Czech Republic. The ante mortem diagnosis was based on typical clinical signs and a positive phenylephrine eye-drop test and was confirmed at necropsy following observation of pathognomic histopathological lesions in the enteric neural system of the ileum. Equine grass sickness (EGS), also known as equine dysautonomia, is a degenerative polyneuropathy affecting the autonomic and enteric nervous systems and some lower motor neurons in the central nervous system (Hahn et al. 2001). The condition affects grazing equids and is largely fatal. EGS occurs most frequently in Great Britain and has also been sporadically reported in other European countries (Wylie and Proudman 2009;Protopapas et al. 2012;Schwarz et al. 2012) and in the United States (Wright et al. 2010). A similar condition "mal seco" is regularly observed in South America and is generally considered as the same disease (Wylie and Proudman 2009). The major clinical signs, which relate to the dysfunction of the gastrointestinal tract, include colic, dysphagia, sweating and muscle tremors. EGS can be classified according to the duration and severity of the clinical signs as the acute, subacute or chronic form (Hudson and Pirie 2005).The purpose of this report is to describe a clinical case of equine grass sickness in a horse born and kept in the Czech Republic, outside the typical region of occurrence of this devastating disorder.
Case descriptionA nine-year-old Standardbred mare was examined by a private practitioner because of an acute onset of fever, weakness, patchy sweating and lethargy. Muscle fasciculation and trembling developed four days later. The mare was used for pleasure riding and kept at pasture with other horses. None of the other horses showed clinical signs of illness. The affected mare had been in a suboptimal body condition for more than one year. The mare was treated with procaine penicillin, trimethoprim-sulfadiazine and flunixin meglumin for seven days. The general condition of the mare deteriorated despite treatment and the animal was referred to the clinic.At the time of presentation the mare had a poor body condition (BCS 2/9) and was depressed and weak. She showed a tucked-up abdomen and a base-narrow stance. Muscle fasciculations were observed in the flank region and in the triceps and quadriceps muscles. Patchy flank sweating was also noted. Clinical examination revealed a mild tachycardia (46 beats/min), slightly elevated rectal temperature (38.3 °C) and a respiratory rate