1,721,001 research outputs found
Onicomicosi equina nell'italia settentrionale : indagine rivolta all'identificazione degli eziologici
No full textIl notevole interesse condiviso da medici veterinari e maniscalchi nei confronti delle patologie della linea bianca dello
zoccolo equino è da imputare al rilevante e costante aumento di casi manifestatosi negli ultimi decenni, sia nel
vecchio che nel nuovo continente, in animali di qualsiasi razza, sesso, età e disciplina sportiva. Approfondite
ricerche dimostrano che esiste uno stretto rapporto tra i funghi cheratinofilici e l’insorgenza della malattia. Sulla
scorta di questi studi, il termine “onicomicosi” viene oggi correntemente utilizzato per descrivere la natura
parassitaria fungina della patologia. Il lavoro da noi compiuto rappresenta un ulteriore sforzo finalizzato ad
identificare l’agente eziologico responsabile della malattia, fornendo nel contempo migliori tecniche di indagine
diagnostica per il corretto isolamento di funghi di importanza medico-veterinaria dallo zoccolo equino. Lo scopo
conclusivo di questa ricerca è quello di indagare sulla relazione esistente tra l’infestazione fungina dello zoccolo e
l’insorgenza della malattia, rivolgendo particolare attenzione a quei fattori predisponenti il cui controllo può essere
d’aiuto per ridurre l’incidenza della stessa
Le masse mediastiniche nel cavallo : studio epidemiologico e descrizione di due casi clinici
No full textDiagnosi di un caso di disfunzione della pars intermedia dell'ipofisi (PPID) complicata da laminite endocrina in un pony shetland
No full textUn pony Shetland di sette anni, di sesso femminile, è stato presentato alla visita clinica a causa di un costante aumento di peso, letargia e difficoltà di movimento. La visita clinica, gli esami di laboratorio e le indagini di diagnostica per immagini hanno evidenziato un quadro di epatopatia, alterazione del metabolismo glucidico e laminite cronica. In base ai risultati delle indagini endocrinologiche effettuate si è emessa diagnosi di disfunzione della pars intermedia dell’ipofisi (Pituitary Pars Intermedia Dysfunction, PPID). La sintomatologia di questa endocrinopatia è variegata e, in alcuni casi, di difficile interpretazione. In particolar modo la laminite e l’irsutismo rappresentano le alterazioni più importanti in pazienti geriatrici e sono, nella maggior parte dei casi, il motivo per cui si richiede la visita del Medico Veterinario. La difficoltà diagnostica si evidenzia in particolar modo quando ad essere colpiti da PPID sono animali più giovani, che non presentano i classici segni clinici patognomonici della malattia. Lo scopo di questo case report è quello di descrivere il complesso iter diagnostico cui questi soggetti devono essere sottoposti per giungere ad una diagnosi, terapia e prognosi accurate.A 7 year old Shetland pony mare was presented with a history of obesity, lethargy and reluctance to move. The physical examination, laboratory evaluation and diagnostic imaging investigations showed a picture of liver disease, impairment in glucose metabolism and chronic laminitis. According to the endocrinology investigations carried out, a diagnosis of PPID was made. The clinical signs of PPID are variable and sometimes difficult to interpret. Particularly, laminitis and hirsutism in older patients are frequently observed and, in most cases, the reason for veterinary intervention.The diagnosis is particularly difficult when younger animals, not showing the typical signs of disease, are presented for veterinary evaluation. The aim of this case report is to accurately describe the complex diagnostic procedures that these patients have to undergo in order to achieve an accurate diagnosis, treatment and prognosis
Effects of inhaled amikacin in bacterial tr-IAD affected racehorses and comparison with intravenous administration
No full textPurpose of the work. Inflammatory Airway Disease (IAD) is a syndrome characterized by inflammation
of lower airways without systemic implication such as fever or dyspnea. The abbreviation
“tr” indicates IAD diagnosed by tracheal wash (TW)[1]. IAD is defined as “bacterial” when more
than 100 Colony Forming Units (CFU) are isolated from TW[2]; in this case antibiotic therapy is
recommended. Efficacy of antibiotic therapy in respiratory disease is directly correlated with the
minimal inhibitory concentration (MIC) reached in the respiratory tract[3]. Studies have shown
that inhaled antibiotics, used at lower dosage, could reach higher concentration in horses respiratory
fluids than systemic administration[3]. A recently published study reports the clinical efficacy
of inhaled amikacin in human patients[4].
Aim of the present work is to evaluate the effect of inhaled amikacin, compared to systemic administration,
on TW cytology and bacteriology and on clinical scoring in bacterial tr-IAD affected
racehorses.
Materials and used methods. Thoroughbred racehorses, aged between 3 to 4 years old, affected
with bacterial tr-IAD with a sensitivity testing positive for amikacin, were selected.
In all horses a clinical evaluation was performed and, using a modified respiratory clinical scoring
system[5], a score was assigned to each horse at the beginning and the end of the trial.
TW was endoscopically (Olympus) performed into the thoracic portion of trachea and 60 ml of
saline at 37°C was flushed, through a sterile Teflon catheter passed into the biopsy channel, and
then immediately collected.
The sample was cytocentrifuged (Rotofix 32, Hettich Zentrifugen) and stained with May Grumwald
Giemsa for differential cell count and also cultured on blood agar plate for CFU/ml count and agar
diffusion amikacin sensitivity test.
Horses were then randomly divided in 2 groups; the horses of group A were treated with 3,3 mg/Kg
of amikacin (Amikavet® Merial), diluted in 0,45% NaCl solution at 50 mg/ml, administered by a jet
nebulizer (Fiac F3000) and Equine Aeromask®, q24h for 10 days, while horses of group B received
10 mg/Kg of amikacin (Amikavet® Merial) intravenously q24h for 10 days.
Clinical scoring and TW cytology and bacteriology were performed in all horses at the end of the
treatment.
Values of clinical score, TW neutrophils count and CFU/ml before and after the treatment in both
groups were compared by Student-T test. Rate of recurrence of bacteria isolation after therapy between
the two groups was compared with chi-squared test.
Outcomes. In group A, a statistically significant decrease in clinical score (p<0.01), TW neutrophils
count (p<0.05) and CFU (p<0.01) was found after inhaled amikacin treatment. In group B a statistically
significant decrease in clinical score (p<0,05) and CFU (p<0.01) was recognized after intravenous
amikacin administration. Although, no significant difference was found in TW neutrophils
count for group B, a decrease in their count was evident.
No statistically significant difference in bacteria isolation after the treatment was found between the
two groups.
358
Conclusions. Inhaled amikacin at dosage of 3,3 mg/Kg q24h for 10 days administered by jet nebulizer
and Equine Aeromask® seems to be effective in the reduction of clinical signs, TW neutrophils
count and bacterial CFU.
The absence of a significant difference between the two groups in the isolation of bacteria after
treatment suggests that, despite a lower inhaled dose, amikacin may be equally effective for both
routes of administration. However, inhaled amikacin in group A, seems to be able to induce a lower
chemotactic action on neutrophils, less damage of the lower respiratory tract mucosa, and consequently
a reduction of clinical signs. In contrast, the absence of a statistically significant decrease
in TW neutrophils count of group B, after intravenous administration of amikacin, may be related
to the achievement of a lower drug concentration in the lung or simply due to the smaller number
of cases of group B. In addition, the use of jet nebulizer and Equine Aeromask® was well tolerated
by the horses and during or after the inhalation therapy none of the horses showed any side effects;
therefore, amikacin at dilution of 50 mg/ml seems to be safe for aerosol administration in equine
patients
Atypical erythema multiforme in a female Donkey
Full text linkSIGNALMENT, HISTORY AND CLINICAL PRESENTATION
A five year old French female donkey was referred for a chronic skin disorder of six months duration. The patient was stabled on straw with other donkeys, fed with grass hay and had free access to pasture. She was regularly dewormed and vaccinated against equine Influenza, tetanus, EHV-1, and EHV-4. An additional vaccination against West Nile Disease (WND) was administered for the first time in the previous late spring. Acute onset of clinical signs appeared during the early following summer. No other cohabitant donkey was involved. Clinical signs consisted of severe pruritus with self mutilation, generalized scaling, crusting, erosions, and ulcerations. A partial improvement of clinic al signs was obtained only with systemic administration of high doses of corticosteroids but the donkey developed acute laminitis. Once steroids were discontinued, clinical signs worsened and the donkey was referred. On admission, the patient was lethargic and reluctant to move; no significant alterations were detected on physical examination, with the exception of a mild submandibular lymphadenomegaly. Clinical pathology showed a mild leukocytosis (16.300/mm3). Radiographic examination revealed sinking, palmar rotation and remodeling of the third phalanx due to chronic laminitis in both the forelimbs. Dermatologic examination revealed patchy but symmetrical hypotrichosis/alopecia with crusts, ulcerations and some areas of lichenification.PROBLEM SUMMARY: Chronic, severe and generalized dermatitis haracterized by severe hitching and associated secondary lesions (scales, crusts, erosions, ulcerations) that improved after steroid
administration. The dermatologic condition was complicated by development of bilateral forelimb laminitis related to systemic administration of high doses of corticosteroids. DIFFERENTIAL DIAGNOSES, ANCILLARY DIAGNOSTIC TESTS AND DEFINITIVE
DIAGNOSIS Differential diagnoses included generalized ectoparasitic diseases (such as manges and pediculosis), suppurative pyoderma, dermatophytosis, dermathophylosis, lupus erythematosus andpemphigus. Brushing and skin scraping were performed
and ruled out ectoparasitic diseases (mange and pediculosis). Skin scrapings and impression smears were submitted for
cytologic evaluation; bacterial and fungal cultures were performed as well as histopathologic examination of multiple punch
biopsy specimens of the skin. .Histopathology revealed lymphocytic interf ace dermatitis with multilevel apoptosis and satellitosis which is consistent with erythema multiforme. Staphylococcus aureus was cultured and multifocal suppurative epidermitis and suppurative crusts supported a diagnosis of superficial bacterial pyoderma Interestingly there was also significant follicular atrophy which likely was the cause for the alopecia. A final diagnosis of erythema multiforme complicated by secondary superficial S. aureus pyoderma and follicular atrophy, was achieved. To investigate possible causes of EM, intradermal skin testing and nasal swab PCR for EHV-5 were performed; PCR was negative and skin test results were negligible, therefore the administration of the WND vaccination was considered as the most likely triggering factor for the onset of the disease. TREATMENT AND OUTCOME: The goal of early treatment was to stabilize the patient for laminitis and pyoderma by corrective trimming and shoeing, administration of phenylbutazone (2.2 mg/Kg IV SID for 14 days) and ceftiofur (4 mg/Kg SID IM for 7 days). Once the patient was stabilized,
immunomodulatory treatment for EM was established. In order to limit dosage of corticosteroids because of the concurrent laminitis, a multimodal protocol was set up, consisting in a combination of pentoxifylline (10 mg/kg BID per os), azathiopirine (3 mg/kg SID per os) and prednisolone (1 mg/kg every 48 hours per os). Improvement of the general clinical and dermatologic condition was observed, throughout a period of approximately 3 months. Increase in body weight, significant reduction of pruritus and skin lesions, and gradual hair coat regrowth led to almost complete recovery. Tapering of drugs was attempted, but there was recurrence of clinical signs, therefore, a lifelong treatment was advised. The patient was finally discharged and no recurrence of the disease has so far been reported. DISCUSSION AND REFERENCES EM is a rare condition in equine patients and, to our knowledge, it has never been reported in donkeys. Immune-mediated skin disorders, are rarely reported in donkeys. Localized pemphigus-like disease is the most frequently recognized condition. EM is a cutaneous reaction pattern of multifactorial etiology. It is believed to be a host -specific T cell mediated hypersensitivity reaction in which the cellular immune response is directed against various keratinocyte-associated antigens, including those associated with drugs and vaccine administration, infection (including EHV-5), neoplasia, and connective tissue disease. In this case, the most likely triggering factor hypothesized was vaccination against WND, since there was an apparent correlation between vaccine administration and onset of clinical signs, and other possible causes such as hypersensitivity reactions and EHV-5 infection were ruled out. The present case shows an unusual clinical presentation of equine EM, since severe pruritus was present and EM associated primary lesions such as urticarial plaques, annular type lesions with a central depression, vesicular/bullae type lesions were absent at the time of hospitalization. In this case, the severe pruritus and self mutilation, related to the chronic pyoderma, may have produced the severe secondary lesions which hid the primary lesions. Therapeutic dose ranges for azathio prine and pentoxifylline are defined in horses but there are no studies concerning their use in donkeys. Pharmacokinetics of drugs may differ in donkeys, since their evolutionary adaptation to water deprivation led to different absorption and distribution kinetics. In our experience, improvement of the patient’s clinical condition,
without onset of side effects, was evident only after the administration of a multimodal immunomodulatory protocol administered for a prolonged period of time, using a dose regimen reported for horses
Intossicazione da clostridium botulinum di tipo B nel cavallo adulto nel nord Italia: 1 caso clinico
No full textIntroduzione. Il botulismo è una rara affezione caratterizzata da paralisi simmetrica dei nervi cranici seguita da paralisi della muscolatura volontaria in seguito al blocco delle sinapsi colinergiche a livello delle giunzioni neuromuscolari. Nell’uomo e nei mammiferi domestici è causata dall’esposizione a 7 differenti neurotossine prodotte dal Clostridium botulinum. Diversi autori riportano come la specie equina sia particolarmente sensibile agli effetti della tossina botulinica; negli ultimi anni la patologia è stata frequentemente segnalata in molti paesi dell’UE oltre a USA, Canada, Australia, Nuova Zelanda, Israele e Senegal. In Italia, fatta eccezione per due casi clinici riportati nel 2008, non esistono segnalazioni relative al cavallo nel quale il mancato obbligo della notifica non consente una raccolta di dati epidemiologici utili. Inoltre, l’assenza di un siero antibotulinico registrato per questa specie nonché la mancata disponibilità sul mercato italiano di un vaccino, rappresentano delle limitazioni che non facilitano il clinico qualora si trovi ad affrontare questa malattia allo stato attuale in questo paese. Descrizione del caso. Un pony castrone di 10 anni è stato riferito d’urgenza per disfagia acuta, accompagnata da atonia e ptosi laterale della lingua. L’alimentazione era base di insilati di produzione aziendale. La temperatura rettale era di 38°C e le mucose esplorabili apparivano congeste. Si rilevava tachisfigmia (96 bpm) e frequenza respiratoria pari a 12 atti al minuto, con respiro lento e profondo. All’esame neurologico lo stato mentale risultava nella norma mentre lo stato del sensorio appariva depresso. Si rilevava un’alterazione della postura con abbassamento della testa, arti posteriori mantenuti sotto di sé e continua alternanza di carico al bipede posteriore. All’esame dei nervi cranici si rilevava midriasi persistente e marcato rallentamento del riflesso pupillare, sia diretto che consensuale, bilateralmente (II e al III paio). A carico della lingua, si evidenziavano ptosi con deviazione laterale, atonia e paralisi flaccida (XII paio). Si evidenziavano, infine, marcato rallentamento nel riflesso di deglutizione e dubbia risposta allo slap test (IX e X paio). L’esame dinamico, eseguito al passo, evidenziava marcata debolezza a carico del treno posteriore bilateralmente, con difficoltà di riposizionamento e sway test positivo. Il riscontro di leucocitosi neutrofilica, accompagnata da linfopenia, monocitosi ed iperglicemia erano compatibili con una condizione di stress acuto del soggetto, mentre l’aumento dell’attività sierica di LDH e CPK suggeriva una condizione di stress coinvolgente il sistema neuromuscolare. L’emogasanalisi arteriosa rilevava un quadro di grave ipossiemia riferibile a ridotta efficienza ventilatoria. Il quadro clinico appariva altamente suggestivo di una sindrome neuromuscolare conseguente ad intossicazione alimentare da tossina botulinica. Nonostante venisse tempestivamente predisposto un protocollo terapeutico di tipo intensivo, comprensivo della somministrazione del siero polivalente anti tossina botulinica umana, il pony giungeva a morte per insufficienza respiratoria acuta il giorno successivo al ricovero. La conferma del sospetto diagnostico di botulismo è avvenuta tramite isolamento delle spore di Clostridium botulinum tipo B nelle feci e nel contenuto ciecale del paziente mediante real time PCR. La ricerca delle tossine tramite prova biologica ha fornito invece esito negativo su campioni intra-vitam e postmortem. L’assenza, all’esame autoptico, di rilievi specifici macroscopici ed istologici ha permesso di escludere con certezza le altre diagnosi differenziali possibili. Conclusioni. Il caso clinico descrive un grave episodio di intossicazione acuta da Clostridium botulinum tipo B causata dall’ingestione della tossina preformata nell’insilato somministrato come alimento. La diffusione del botulismo equino da sierotipo B nei paesi del nord Europa e negli USA (“forage poisoning”) è strettamente associata all’utilizzo di insilato; la recente introduzione di questo alimento nel razionamento dietetico del cavallo in Italia potrebbe rappresentare un fattore di rischio considerando il clima caldo-umido, favorevole allo sviluppo delle tossine, che caratterizza il territorio italiano per buona parte dell’anno. La gravità della sintomatologia manifestata dal soggetto ha imposto l’attuazione di un protocollo terapeutico d’emergenza, comprensivo di tempestiva somministrazione dell’antisiero unitamente al trattamento di sostegno. Le complessità burocratiche necessarie ll’ottenimento del siero antibotulinico, disponibile in Italia unicamente a Roma, presso il Ministero della Salute, rendono le tempistiche inadeguate. È auspicabile che una futura registrazione del siero antibotulino per il cavallo in Italia lo renda più immediatamente disponibile. La vaccinazione a scopo preventivo nelle aree in cui è diffuso l’utilizzo dell’insilato è vivamente consigliata
The effect of Exercise Induced Pulmonary Hemorrhage on some performance indices in Standardbred racehorses: preliminary results
No full textIntroduction
Exercise-induced pulmonary hemorrhage (EIPH) is an important disease of horses, characterized by bleeding from the pulmonary capillaries during or after exercise. EIPH is mostly identified in racehorses, affecting over 80% of Thoroughbreds and Standardbreds performing high-speed exercise.
Objective
There is a moderate evidence that EIPH can have a negative impact on horses performance. However, there is very low quality evidence that horses affected by EIPH have impaired fitness parameters such as blood lactate. Aim of the present work is to evaluate some performance indices in a population of Standardbred racehorses with EIPH by means of treadmill exercise testing.
Material and Methods
Sixteen Italian Standardbred racehorses (average age 3.1±1.0 y.o., 10 males, 6 females), at the same level of performance and at the same stage of their training, were selected. All horses underwent an accurate clinical examination, that allowed to rule out any overt disorder. After two days of familiarization, they underwent a treadmill endoscopy, which ruled out the presence of any dynamic upper airway obstruction, and an endoscopy after the exercise. The latter allowed the categorization of the horses in two groups: 8 horses with no evidence of EIPH, and 8 horses with grade ≥1 of EIPH. Then the horses performed an incremental exercise test on a high speed treadmill. During the test heart rate was monitored with a pulsometer. Blood samples were taken with a 14G teflon venous catheter placed in the jugular vein, and plasma lactate was measured with an enzymatic colorimetric method. Data were analyzed by a specific software and the speed at 4 mmol/L (VLa4), the speed at 200 bpm of heart rate (V200), the maximum heart rate (HRmax), the peak of lactate (Lamax), and the lactate and heart rate at 1, 5 and 30 minutes after exercise were calculated. Data for both groups were statistically compared by T-student test for unpaired sample, and statistical significance was set at p<0,05.
Results
Concerning VLa4, HRmax, Lamax and lactate after exercise, no differences were observed between the two groups. There was a significant (p<0,05) lower V200 (Fig. 1) and a highly significant lower (p<0,01) heart rate at 30 minutes after exercise (Fig. 2) in EIPH group.
Conclusion
As already described, very few parameters differ between EIPH and non EIPH horses.
The lower V200 in EIPH horses may suggest a negative impact of the disease on performance
Echocardiographic and serum biochemistry abnormalities in 17 horses with atrial fibrillation successfully treated
No full textPurpose of the work. Atrial fibrillation (AF) is the most common pathological cardiac arrhythmia in horses (de Clercq et al. 2007) and typically is associated with exercise intolerance at higher levels of performance (Reef et al. 1995). High resting vagal tone, large atrial mass and transient potassium
(K+) depletion are predisposing factors in the development of AF in horses without structural heart disease (Reef and Marr 2010). Horses with AF usually present normal laboratory evaluation
(LE), but reduced level of serum K+, fractional excretion (FE) of K+ or red blood cells (RBC) K+ could be found. In horses without structural heart disease echocardiographic evaluation
(ECC) is usually normal but it is not uncommon to find a slightly reduced left ventricular shortening fraction (LVSF) that return within normal limits after treatment (Bonagura et al. 2010). Aim
of the present study is to present the results of LE and ECC pre and post cardioversion (CV) in 17 horses with AF.
Materials and used methods. The horses had an history of poor performance (6 cases) and cardiovascular disorders (11 cases). The symptoms were present for less than 1 month in 16 horses and
for longer in 1 horse. The horses were 14 standardbreds and 3 warmblood; 7 males, 7 females and
3 geldings with a mean age of 5±3 years. All horses underwent a thorough diagnostic protocol including
a complete LE (haematology, complete blood biochemistry and evaluation of electrolytes FE) and ECC before and 24 hours after treatment. CV was obtained in 15 horses with 22 mg/kg quinidine
sulfate (QS) by nasogastric tube every 2 hours for a maximum of 6 doses or until CV (13/15 horses); 2 horses received two times this protocol, with an interval of one week, because the first time
it was ineffective; in 1 horse, since QS was ineffective, amiodarone cloridrate (Am) was administered
intravenously (De Clercq et al. 2006) until CV and in 1 horse spontaneous resolution of AF
was recorded.
Outcomes. All horses had normal body temperature (37,7±0,3 °C); on pulse palpation 11 had reduced intensity and/or amplitude and all had irregular rhythm. In all cases, heart auscultation revealed an irregularly irregular rhythm and murmurs were detected in 3 horses. The ECG confirmed the arrhythmia and a diagnosis of FA was made. The only alterations detected by ECC before treatment were reduced LVSF in 6 horses (from 21% to 29%) and one or more valvular insufficiencies (VI) of different gravity in 12 horses (10 grade I/IV, 2 grade II/IV, 1 grade III/IV). LE showed one or multiple electrolyte alterations such as a reduced K+ concentration ([K]) in 5 horses, an increased calcium concentration ([Ca]) in 6 horses, an increased magnesium concentration ([Mg]) in 2, a decreased [Mg] in 1 horse; a decreased phosphorus concentration ([P]) in 7 and an increased [P] in 1 horse. FE showed increased excretion of K+ (FEK) in 4 horses associated to increased
FE of sodium in 1 of them, and a decrease of FEK in 2 cases. ECC after treatment showed a maintained low LVSF (24%) in 1 horse and one or more VI of different gravity in 8 horses (6 grade
I/IV, 2 grade II/IV). In the QS treated horses CV was achieved after different number of treatments: 2 doses in 1 case, 3 doses in 4 cases, 4 doses in 2 cases, 5 doses in 1 case and 6 doses in 5
cases. Two horses received a double QS treatment at 1 week interval and CV was obtained after a total of 6+5 and 6+6 doses. In the QS+Am case CV was obtained after 26 hours of Am administration.
Conclusions. In our cases AF was present in 16/17 horses for less than one month. The improvement of the LVSF and the reduced incidence of VI after treatment showed by ECC could be explained
by a possible correction of the atrial structural remodeling possibly induced by AF (Schwarzwald et al. 2007, De Clercq et al. 2008). Furthermore, the high rate of LVSF normalization after
treatment could be due to the short period of AF presence in our horses which can limit the anatomical
remodeling. According to the possible role of the reduction of and transient electrolyte disturbances in the AF pathogenesis, we found a moderate decrease of [K] in only 5/17 horses, an increased of the FE of K+ in 4/17 and variation in blood [Ca] and/or [Mg] and/or [P] in 11 horses.
Non other significant abnormalities were found on LE. In conclusion we would like to underline the importance of a complete diagnostic protocol that allow to recognize all the predisposing factors for AF. Moreover, the application of the more appropriate treatment as quickly as possible in AF affected horses could reduce the atrial remodeling effects of AF and could allow to obtain a better prognosis after treatment
Sensitivity and specificity of ultrasonography for the diagnosis of malabsorption syndrome in the horse
No full textMalabsorption syndrome in horses is frequently due to infiltrative bowel disease (IBD): the infiltration of the intestinal mucosa impairs the absorptive function with the onset of chronic wasting syndrome.
Histology represents the gold standard diagnostic procedure and it can be performed by surgical biopsy of
the small intestine, rectal biopsy or endoscopic duodenal biopsy. Biopsy techniques present many practical
disadvantages in equine practice, therefore finding more practical complementary diagnostic tests to be used for screening purposes is advisable. Abdominal ultrasonography is both easy to perform and capable
of detecting intestinal wall thickening that is a pathological feature of infiltrative disorders(1). The aim of the present study was to assess the sensitivity and specificity of ultrasonographic measurement of small intestinal wall thickness (UMSIT) to evaluate IBD, using the histology of rectal biopsies as the reference standard(2).
55 horses with a history of chronic wasting were retrospectively selected. In all patients, repeatability of UMSIT was statistically evaluated. All the UMSIT were analyzed and an “individual scoring system” defining
the distribution of thickened intestinal loops (>3 mm) in each horse was elaborated to subdivide the population into two groups: general group (GG) including all horses and subgroup A (SA) including only those horses which had a “diffuse” thickening of both duodenum and jejunum. Eventually, sensitivity (Se),
specificity (Sp) and ROC curve were statistically calculated both for GG and SA.
Since no statistical differences were observed among measurements, UMSIT resulted repeatable (p < 0.05).
For GG, the best UMSIT cut off was 5.7 mm with a Sp of 87.5% and a Se of 36.8%. For SA, the best UMSIT cut off was 5 mm with a Sp of 100% and a Se of 50%.
The repeatability of UMSIT, previously demonstrated under experimental conditions(3), was confirmed in
the present study in a clinical population. Specificity of UMSIT was high but linked to inclusion criteria.
Sensitivity of UMSIT was low due to variable ultrasonographic explorability of the small intestine and to the different extension of the thickening: sensitivity was higher for SA because only horses with “diffuse” lesions were included. Study limitations include the use of rectal biopsy as the reference standard (whose
selection was due to clinical practical reasons) and the absence of a standardized protocol for intestinal ultrasonographic evaluation (due to the retrospective nature of the study). However, this study demonstrates the UMSIT promising diagnostic potential, highlighting the necessity for more detailed perspective studies in the futur
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