[Diagnostic workup of chronic inflammatory bowel disease in the horse]. / Diagnostische Aufarbeitung der chronischen Darmentzündung beim Pferd.

The present retrospective study describes the diagnostic workup and collected findings in 7 horses with chronic inflammatory bowel disease over the years 2000-2006. The diagnosis could be confirmed histologically with biopsies taken during laparoscopy or laparotomy or during post mortem examination. Weight loss and chronic diarrhoea were the most commonly reported clinical findings. Among ancillary examinations (fecal analysis, gastroscopy, abdominal ultrasonography, rectal mucosal biopsy) the D-xylose absorption test provided the most useful information. Although clinical signs and laboratory findings are helpful diagnostic tools, a definitive diagnosis is only possible by histological analysis of the intestinal segment.

Infection with Mycobacterium avium subspecies avium in a 10 year old Freiberger mare.

In this case report a 10 year old Freiberger mare with a Mycobacterium avium subsp. avium infection is presented. This infection leads to a tuberculosis like disease with granulomatous alterations particularly of the intestines and lungs and is only sporadically reported in horses of Central Europe. Diarrhoea, mastitis and neck stiffness as well as dyspnoea and chronic cough are more specific symptoms of the infection, while weight loss, weakness and lethargy are nonspecific signs. As these clinical signs can occur in many other diseases, the diagnosis of mycobacterial infection is difficult and consists of rectum or distal colon biopsies and staining for acid-fast bacilli and bacteriological culture of granulomatous lesions. Classification of M. avium subsp. avium was achieved by PCR-RFLP. Even though an infection with Mycobacterium avium subsp. avium is rare, it belongs to the differential diagnosis of granulomatous diseases.

[Aorto-iliac thrombosis in a gelding: treatment with the anticoagulant Phenprocoumon (Marcoumar)]. / Aortenthrombose bei einem Wallach: Behandlung mit dem Antikoagulans Phenprocoumon (Marcoumar).

A 14-year old Swiss warmblood gelding was presented to the equine hospital of the University of Zurich because of therapy-resistant fever. An intermittent lameness suggested the presence of an intravascular aorto-iliac thrombus which was confirmed sonographically. Subsequently, treatment was initiated with Heparin s.c. and continued for 7 months with Phenprocoumon (Marcoumar). The dosage was monitored and adjusted according to the prothrombin time, which was initially measured every week, and later maximally biweekly. The lameness improved and the regression of the thrombus could be followed sonographically. Seven months later the horse had to be euthanized due to acute colic.

Efficacy of omeprazole powder paste or enteric-coated formulation in healing of gastric ulcers in horses.

BACKGROUND: GastroGard, an omeprazole powder paste formulation, is considered the standard treatment for gastric ulcers in horses and is highly effective. Gastrozol, an enteric-coated omeprazole formulation for horses, has recently become available, but efficacy data are controversial and sparse. OBJECTIVES: To investigate the efficacy of GastroGard and Gastrozol at labeled doses (4 and 1 mg of omeprazole per kg bwt, respectively, PO q24h) in healing of gastric ulcers. ANIMALS: 40 horses; 9.5 ± 4.6 years; 491 ± 135 kg. METHODS: Prospective, randomized, blinded study. Horses with an ulcer score ≥1 (Equine Gastric Ulcer Council) were randomly divided into 2 groups and treated for 2 weeks each with GastroGard followed by Gastrozol (A) or vice versa (B). After 2 and 4 weeks, scoring was repeated and compared with baseline. Plasma omeprazole concentrations were measured on the first day of treatment after administration of GastroGard (n = 5) or Gastrozol (n = 5). RESULTS: Compared with baseline (squamous score (A) 1.65 ± 0.11, (B) 1.98 ± 0.11), ulcer scores at 2 weeks ((A) 0.89 ± 0.11, (B) 1.01 ± 0.11) and 4 weeks ((A) 1.10 ± 0.12, (B) 0.80 ± 0.12) had significantly decreased in both groups (P < .001), independent of treatment (P = .7). Plasma omeprazole concentrations were significantly higher after GastroGard compared with Gastrozol administration (AUCGG = 2856 (1405-4576) ng/mL × h, AUCGZ = 604 (430-1609) ng/mL × h; P = .03). The bioavailability for Gastrozol was 1.26 (95% CI 0.56-2.81) times higher than for GastroGard. CONCLUSIONS AND CLINICAL IMPORTANCE: Both Gastrozol and GastroGard, combined with appropriate environmental changes, promote healing of gastric ulcers in horses. However, despite enteric coating of Gastrozol, plasma omeprazole concentrations after single labeled doses were significantly higher with GastroGard.

Enhanced IL-6 transcriptional response to adenosine receptor ligands in horses with lower airway inflammation.

REASONS FOR PERFORMING STUDY: Accumulation of extracellular adenosine has been closely associated with human asthmatic responses. However, the relevance of adenosine signalling in equine airways has not previously been investigated. OBJECTIVES: To determine the expression of adenosine receptors (AR) in bronchoalveolar lavage (BAL) cells and assess the reactivity of these cells to AR ligands ex vivo, employing IL-6 as readout of adenosinergic inflammatory signalling. METHODS: Eight horses with varying degrees of lower airway inflammation and 10 healthy controls were analysed. Expression of AR-subtypes in each BAL sample was determined by quantitative RT-PCR and compared to that in 13 other tissues. Bronchoalveolar lavage cells were stimulated either with the adenosine analogue NECA, CGS-21680 (A(2A) AR selective agonist) or with a combination of NECA and SCH-58261 (A(2A) AR antagonist) and IL-6 expression assessed. RESULTS: Bronchoalveolar lavage cells predominantly expressed A(2B) AR, with lower A(2A) AR levels and marginal A(3) AR expression; A(1) AR was not detected. This pattern was similar to that of PBMCs but different from the other tissues tested. No significant differences in AR expression in BAL cells from both groups were detected, although a trend for decreased A(2B) AR in airway-compromised horses was observed. Treatment of BAL cells with the nonselective agonist NECA upregulated IL-6 expression in cells from airway-compromised horses, but levels remained unchanged in control animals. Furthermore, blockage of A(2A) AR with SCH-58261 enhanced IL-6 mRNA induction by NECA in both groups, with higher levels in airway-compromised horses; the amplitude of this response correlated with neutrophil count. CONCLUSIONS: These results demonstrate the presence of an adenosine/IL-6 inflammatory axis in the bronchoalveolar milieu of airway-compromised horses. While A(2B) AR is the predominant proinflammatory AR subtype expressed, A(2A) AR appears to modulate inflammatory signalling (IL-6 expression) by adenosine. POTENTIAL RELEVANCE: This study supports selective AR targeting as a potential therapeutic approach for the modulation of inflammation in the equine lower respiratory tract.