Changes

==Description==

==Introduction==

Colitis X (so-called due to its unknown aetiology) is a peracute and highly fatal disease of horses. Is characterised by severe oedematous colitis, sudden watery diarrhoea and death within 24 hours. A number of possible underlying causes have been described, including drug or parasite hypersensitivity, salmonellosis and high-protein, low-cellulose diets. Recently a link has been demonstrated with the current human epidemic strain of ''C. difficile'' (ribotype 027/toxinotype III) clostridial enterocolitis. Stress (such as surgery or transport) has also been reported as a predisposing factor.

Colitis X (so-called due to its unknown aetiology) is a peracute and highly fatal disease of horses. Is characterised by severe colitis, sudden watery diarrhoea and death within 24 hours. A number of possible underlying causes have been described, including drug or parasite hypersensitivity, stress and transport. [[Clostridium perfringens type A|''Clostridium perfringens'' Type A]] has been hypothesised to be a cause of Colitis x, and high-protein, low-cellulose diets or antimicrobial treatment may predispose to Clostridial overgrowth. Recently a link has been demonstrated with the current human epidemic strain of ''[[Clostridium difficile]]'' (ribotype 027/toxinotype III) clostridial enterocolitis.  

==Signalment==

==Signalment==

* Tachycardia (Heart rate often greater than 100bpm)

* Tachycardia (Heart rate often greater than 100bpm)

* Dehydration

* Dehydration

* Signs relating to hypovolaemic or endotoxic shock, e.g. congested mucous membranes, prolonged capillary refill time, cold extremities.  

* Signs relating to hypovolaemic or endotoxic shock, ''e.g.'' congested mucous membranes, prolonged capillary refill time, cold extremities.  

* Dilated pupils

* Dilated pupils

* Collapse

* Collapse

* Bowel sounds may be absent

* Bowel sounds may be absent

The clinical signs are similar to those described for other forms of acute- peracute colitis, therefore a number of differential diagnoses may need to be considered.

The clinical signs are similar to those described for other forms of acute- peracute colitis, particularly [[Salmonellosis|salmonellosis]]. [[Rectal Examination of the Horse|Rectal examination]] may often be normal. Other diagnoses that must be considered include [[Grass Sickness|grass sickness]], acute small intestinal obstructions and intestinal thromboembolic infarctions.  

 

==Diagnosis and Pathology==

==Diagnosis and Pathology==

Diagnosis is often made post-mortem, where a hyperaemic or oedematous caecum and ventral colon may be seen with necrosis of the intestinal in the later stages of the disease. Numerous gram negative bacteria may be identified in the mucosa and submucosa. The intestinal tract may be filled with a foul smelling and watery content. Macroscopic and microscopic findings include signs of disseminated intravascular coagulation and large numbers of bacteria in the devitalized parts of the intestine.

Colitis x is a diagnosis of exclusion. The above examination findings may be reported combined with an increased plasma urea concentration (greater than 10 mmol/l), increased PCV, leucopaenia, metabolic acidosis, hypokalaemia and hyponatraemia.  

==Treatment==

==Treatment==

Treatment is often unsuccessful and horses may often require euthanasia. Treatment methods previously reported include aggressive fluid therapy with electrolyte replacement, antibiotics and analgesics. It is recommended that flunixin is used for both its analgesic and anti-endotoxic properties.

Treatment is often unsuccessful and affected horses usually require euthanasia. If treatment is to be attempted, aggressive fluid therapy and electrolyte replacement must be initiated using a wide bore catheter. Pain is often severe and potent analgesics such as flunixin meglumine are required. The administration of sodium benzyl penicillin may be beneficial as [[:Category:Clostridium species|''Clostridium'' spp]] are sensitive to this type of antibiotic.  

==Prognosis==

==Prognosis==

The prognosis is usually poor, with a mortality rate approaching 90-100%. This may be lower for horses receiving intensive treatment.  

The prognosis is usually poor, with a mortality rate approaching 90-100%. This may be lower for horses receiving intensive treatment.  

==References==

==References==

* Diakakis, N. (2008) '''Equine colitis X''' ''Journal of the Hellenic Veterinary Medical Society (Hellenic Veterinary Medical Society) 59:23–28(6)''

* Diakakis, N. (2008) '''Equine colitis X''' ''Journal of the Hellenic Veterinary Medical Society (Hellenic Veterinary Medical Society) 59:23–28(6)''

* Schiefer HB (1981). '''Equine colitis "X", still an enigma?''' ''The Canadian Veterinary Journal. La Revue Vétérinaire Canadienne 22 (5):162–5''

* Schiefer H.B. (1981). '''Equine colitis "X", still an enigma?''' ''The Canadian Veterinary Journal. La Revue Vétérinaire Canadienne 22 (5):162–5''

* White, N.A., Edwards, G.B. (1999) '''Handbook of Equine Colic''' ''Reed Educational and Professional Publishing Ltd''   

* White, N.A., Edwards, G.B. (1999) '''Handbook of Equine Colic''' ''Reed Educational and Professional Publishing Ltd''   

* Knottenbelt, D.C. '''A Handbook of Equine Medicine for Final Year Students''' ''University of Liverpool''

* Knottenbelt, D.C. '''A Handbook of Equine Medicine for Final Year Students''' ''University of Liverpool''

* Edward Robinson, N and Sprayberry, K. A. (2009) '''Current Therapy In Equine Medicine Sixth edition''' ''Saunders Elsevier''  

* Rose, R.J. and Hodgson, D.R. '''Manual of Equine Practice''' ''Saunders Elsevier''  

* Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''

* Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''

[[Category:To_Do_-_SophieIgnarski]]

[[Category:Expert_Review]]

[[Category:Horse]]

[[Category:Enteritis,_Bacterial]][[Category:Enteritis,_Fibrinous/Haemorrhagic]]

[[Category:Enteritis,_Bacterial]][[Category:Enteritis,_Fibrinous/Haemorrhagic]]

[[Category:To_Do_-_Clinical]]

[[Category:Small Intestinal Diseases - Horse]]