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==Introduction==

 

Equine Serum Hepatitis (ESH) is the most common cause of acute hepatitis in horses. It is often associated with prior administration of an equine biologic product, most commonly tetanus antitoxin (TAT). In some cases, the affected horse may not have received the antitoxin but may have been in contact with another horse that received TAT. Other biologic products that have been implicated include encephalitis vaccines and equine serum. Other aetiologies such as alkaloid toxicity and mycotoxins have been reported. Several cases have been reported occurring in groups of horses in which no biologic product had been administered, indicating that there may be an infectious or viral component to the disease.  A [[Type III Hypersensitivity|Type III (immune-complex mediated) hypersensitivity]] reaction has also been proposed.  

 

Equine Serum Hepatitis (ESH) is the most common cause of acute hepatitis in horses. It is often associated with prior administration of an equine biologic product, most commonly tetanus antitoxin (TAT). In some cases, the affected horse may not have received the antitoxin but may have been in contact with another horse that received TAT. Other biologic products that have been implicated include encephalitis vaccines and equine serum. Other aetiologies such as alkaloid toxicity and mycotoxins have been reported. Several cases have been reported occurring in groups of horses in which no biologic product had been administered, indicating that there may be an infectious or viral component to the disease.  A Type III (immune-complex mediated) hypersensitivity reaction has also been proposed.  

==Signalment==

==Signalment==

==Treatment==

==Treatment==

The aims of treatment are mainly to support liver function until hepatic compromise can occur. Affected horses should be housed in a quiet, darkened stable in order to minimise stimulation. Sedation may be required if signs of hepatic encephalopathy are present. Stressful situations such as moving the horse or separation from field mates should be avoided.

The aims of treatment are mainly to support liver function and minimise any neurological signs. Affected horses should be housed in a quiet, darkened stable in order to reduce stimulation. Sedation may be required if signs of hepatic encephalopathy are present. Stressful situations such as moving the horse or separation from field mates should be avoided.

If the horse is still able to eat, a low protein, high carbohydrate diet should be fed. In order to reduce the severity of neurological signs, the protein should be high in branched-chain amino acids; corn and molasses are often used to achieve this. If the horse is anorexic, a [[Nasogastric intubation of the horse|naso-gastric tube]] can be passed and high energy foods given directly into the stomach.

If the horse is still able to eat, a low protein, high carbohydrate diet should be fed. In order to reduce the severity of neurological signs, the protein should be high in branched-chain amino acids; corn and molasses are often used to achieve this. If the horse is anorexic, a [[Nasogastric intubation in the horse|naso-gastric tube]] can be passed and high energy foods given directly into the stomach.

==Prognosis==

==Prognosis==

Use of tetanus antitoxin in pregnant mares should be avoided. TAT should only be adminstered to horses with an unknown or absent tetanus toxoid vaccination history.

Use of tetanus antitoxin in pregnant mares should be avoided. TAT should only be adminstered to horses with an unknown or absent tetanus toxoid vaccination history.

==References==

==References==

[[Category:Liver_-_Inflammatory_Pathology]][[Category:Horse]]

 

 

[[Category:Liver_-_Inflammatory_Pathology]]

 

 

[[Category:To_Do_-_SophieIgnarski]]

[[Category:Expert_Review]]

[[Category:Liver Diseases - Horse]]