Changes

The '''chronic form''' occurs when ingested third stage larvae develop to the fourth stage without interruption, leading to inflammation and thickening of the intestinal mucosa. Larval emergence may occur throughout the summer and autumn, leading to the clinical signs associated with a 'wormy' horse. This type of cyathostomosis is more commonly seen in younger horses who have not yet developed full immunity against the parasite.

The '''chronic form''' occurs when ingested third stage larvae develop to the fourth stage without interruption, leading to inflammation and thickening of the intestinal mucosa. Larval emergence may occur throughout the summer and autumn, leading to the clinical signs associated with a 'wormy' horse. This type of cyathostomosis is more commonly seen in younger horses who have not yet developed full immunity against the parasite.

==Signalment==

==Signalment==

All horses may be affected but most are less than five years old. Geriatric animals also have an increased susceptibility. Clinical disease commonly occurs in late winter or early spring and usually affects only one or two horses in a herd. A history of an unthrifty or 'poor do-er' young horse, combined with identification of larvae in faeces may be sufficient to arouse clinical suspicion of cyathostomosis.  

All horses may be affected but most are less than five years old. Geriatric animals also have an increased susceptibility. Clinical disease commonly occurs in late winter or early spring and usually affects only one or two horses in a herd. A history of an unthrifty or 'poor do-er' young horse, combined with identification of larvae in faeces may be sufficient to arouse clinical suspicion of cyathostomosis.  

==Clinical Signs==

==Clinical Signs==

* Increased or decreased appetite

* Increased or decreased appetite

* Recurrent colic

* Recurrent colic

Other clinical features of the disease include ventral oedema due to a [[Protein Losing Enteropathy|protein-losing enteropathy]]. Adult and larval worms may cause damage to the intestinal mucosa through plug feeding, resulting in ulcer formation.

Other clinical features of the disease include ventral oedema due to a [[Protein Losing Enteropathy|protein-losing enteropathy]]. Adult and larval worms may cause damage to the intestinal mucosa through plug feeding, resulting in ulcer formation.

==Diagnosis==

==Diagnosis==

A definitive diagnosis of cyathostomosis may be made following identification of larvae in the gastrointestinal tract; either in the faeces, from an intestinal biopsy via laparotomy, or at post mortem. Biopsy of the intestine may occasionally reveal a massive eosinophilic infiltration of the mucosa.  

A definitive diagnosis of cyathostomosis may be made following identification of larvae in the gastrointestinal tract; either in the faeces, from an intestinal biopsy via laparotomy, or at post mortem. Biopsy of the intestine may occasionally reveal a massive eosinophilic infiltration of the mucosa.  

==Pathology==

==Pathology==

Post mortem examination of the large intestine may reveal larvae in the mucosa, seen as small grey to red mucosal nodules (the characteristic 'pepper-pot' lesion). Mass emergence results in mucosal erosions, ulcers and fibrinous exudate. A catarrhal and haemorrhagic colitis and typhlitis may be seen, with hyperaemia or necrosis of the tissue. In chronic cases, thickening of the intestinal wall may be present. Adult worms (approximately 1.5cm in length) may be seen within the intestinal lumen.  

Post mortem examination of the large intestine may reveal larvae in the mucosa, seen as small grey to red mucosal nodules (the characteristic 'pepper-pot' lesion). Mass emergence results in mucosal erosions, ulcers and fibrinous exudate. A catarrhal and haemorrhagic colitis and typhlitis may be seen, with hyperaemia or necrosis of the tissue. In chronic cases, thickening of the intestinal wall may be present. Adult worms (approximately 1.5cm in length) may be seen within the intestinal lumen.  

==Treatment==

==Treatment==

Treatment is indicated for horses with faecal egg counts greater than 200 eggs per gram. Cyathostomins are widely resistant to anthelmintics, particularly benzimidazoles. Moxidectin PO is effective against these resistant strains and also against encysted larvae. Five daily doses of Fenbendazole followed by a single dose of Ivermectin may be administered as an alternative. Refractory cases may benefit from concurrent corticosteroid therapy with prednisolone.  

Treatment is indicated for horses with faecal egg counts greater than 200 eggs per gram. Cyathostomins are widely resistant to anthelmintics, particularly benzimidazoles. Moxidectin PO is effective against these resistant strains and also against encysted larvae. Five daily doses of Fenbendazole followed by a single dose of Ivermectin may be administered as an alternative. Refractory cases may benefit from concurrent corticosteroid therapy with prednisolone.  

==Prognosis==

==Prognosis==

Approximately 40% of cases with severe signs of cyathostomosis recover over a period of 2 or 3 months following treatment with prednisolone and anthelmintics. The prognosis is poorer if weight loss and/or diarrhoea have been present for more than three weeks  prior to initiation of treatment.  

Approximately 40% of cases with severe signs of cyathostomosis recover over a period of 2 or 3 months following treatment with prednisolone and anthelmintics. The prognosis is poorer if weight loss and/or diarrhoea have been present for more than three weeks  prior to initiation of treatment.  

==Prevention==

==Prevention==

Good grazing management such as regular manure removal, harrowing, pasture rotation and grazing horses with ruminants all aid in reducing cyathostomin pasture contamination. Anthelmintic programs should only be used as an adjunct to good hygiene and management practices.  

Good grazing management such as regular manure removal, harrowing, pasture rotation and grazing horses with ruminants all aid in reducing cyathostomin pasture contamination. Anthelmintic programs should only be used as an adjunct to good hygiene and management practices.  

==References==

==References==

[[Category:To_Do_-_SophieIgnarski]]

[[Category:To_Do_-_SophieIgnarski]]

[[Category:Expert_Review]]

[[Category:Expert_Review]]

[[Category:Alimentary_Disorders_-_Horse]]

[[Category:Large Intestinal_Disorders_-_Horse]]