Difference between revisions of "Colitis X"

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* Sudden onset with haemorrhages throughout body (shock) and sometimes acute foul smelling diarhoea.
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==Introduction==
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* [[Colon - Anatomy & Physiology|colon]] is acutely haemorhagic and oedematous with mucosal necrosis.
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* Associated with [[:Category:Enteropathogenic and Enterotoxaemic Clostridia|''Clostridium perfringens'']].
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* Possibly an enterotoxaemia.
  
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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.
 
  
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==Signalment==
 
  
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Colitis X affects adult horses, usually between one and ten years old.  
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==Description==
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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 diarrhea and death within 24 hours. A number of possible underlying causes have been described, including drug or parasite hypersensitivity, salmonellosis, high-protein low-cellulose diets and clostridial enterocolitis. Stress has been reported as a predisposing factor to colitis X.  
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==Clinical Signs==
 
==Clinical Signs==
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* Tachycardia (Heart rate often greater than 100bpm)
 
* Tachycardia (Heart rate often greater than 100bpm)
 
* Dehydration
 
* Dehydration
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* Signs relating to hypovolaemic or endotoxic shock, ''e.g.'' congested mucous membranes, prolonged capillary refill time, cold extremities.  
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* Signs relating to hypovolaemic or endotoxic shock, e.g. congested mucous membranes, prolonged capillary refill time, cold extremities.  
 
* Dilated pupils
 
* Dilated pupils
 
* Collapse
 
* Collapse
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* Bowel sounds may be absent
 
* Bowel sounds may be absent
  
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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.
 
  
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==Diagnosis and Pathology==
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==Diagnosis==
  
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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.  
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Diagnosis is often based on the peracute nature of clinical signs.
  
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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. A green diphtheritic membrane may cover the mucosal surface.
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==Pathology==
  
 
==Treatment==
 
==Treatment==
  
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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.  
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Treatment is often unsuccessful and horses may often require euthanasia. Treatment methods previously described include aggressive fluid therapy with electrolyte replacement, antibiotics and analgesics.  
  
 
==Prognosis==
 
==Prognosis==
  
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The prognosis is usually poor, with a mortality rate approaching 90-100%. This may be lower for horses receiving intensive treatment.  
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The prognosis is usually poor, with a mortality rate approaching 90-100%.
  
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{{Learning
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==Prevention==
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|literature search = [http://www.cabdirect.org/search.html?rowId=1&options1=AND&q1=%22Colitis+X%22&occuring1=title&rowId=2&options2=AND&q2=&occuring2=freetext&rowId=3&options3=AND&q3=&occuring3=freetext&x=39&y=10&publishedstart=yyyy&publishedend=yyyy&calendarInput=yyyy-mm-dd&la=any&it=any&show=all Colitis X publications]
 
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}}
 
  
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==References==
 
  
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* Glenn Songer, J., Trinh, H.T., Dial, S.M., Brazier, J.S., Glock, R.D. (2009) '''Equine colitis X associated with infection by Clostridium difficile NAP1/027''' ''Journal of Veterinary Diagnostic Investigation 21:377–380''
 
  
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* Diakakis, N. (2008) '''Equine colitis X''' ''Journal of the Hellenic Veterinary Medical Society (Hellenic Veterinary Medical Society) 59:23–28(6)''
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==References==
  
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* Schiefer H.B. (1981). '''Equine colitis "X", still an enigma?''' ''The Canadian Veterinary Journal. La Revue Vétérinaire Canadienne 22 (5):162–5''
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* Glenn Songer, J., Trinh, H.T., Dial, S.M., Brazier, J.S., Glock, R.D.  (2009) '''Journal of Veterinary Diagnostic Investigation 21:377–380 (2009)'''  
  
 
* 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''   
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* 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''
  
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* Rose, R.J. and Hodgson, D.R. '''Manual of Equine Practice''' ''Saunders Elsevier''  
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* Edward Robinson, N and Sprayberry, K. A. (2009) '''Current Therapy In Equine Medicine Sixth edition''' ''Saunders Elsevier''  
  
 
* Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''
 
* Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''
  
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* Giles, C.J., Urquhart, K.A. and Longstaffe, J.A. (1985) '''Larval cyathostomiasis (immature trichonema-induced enteropathy): A report of 15 clinical cases''' ''Equine Veterinary Journal 17, 196-201''
  
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{{review}}
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* Murphy, D., Keane, M.P. and Goulding, R. (1997) '''Cyathostome associated disease in the horse: investigation and management of four cases''' ''Equine Veterinary Journal 9 247-252''
  
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{{OpenPages}}
 
  
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[[Category:Expert_Review]]
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[[Category:To_Do_-_SophieIgnarski]]
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[[Category:Horse]]
 
[[Category:Enteritis,_Bacterial]][[Category:Enteritis,_Fibrinous/Haemorrhagic]]
 
[[Category:Enteritis,_Bacterial]][[Category:Enteritis,_Fibrinous/Haemorrhagic]]
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[[Category:Small Intestinal Diseases - Horse]]
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[[Category:To_Do_-_Clinical]]

Revision as of 15:12, 22 July 2010

  • Sudden onset with haemorrhages throughout body (shock) and sometimes acute foul smelling diarhoea.
  • colon is acutely haemorhagic and oedematous with mucosal necrosis.
  • Associated with Clostridium perfringens.
  • Possibly an enterotoxaemia.



Description

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 diarrhea and death within 24 hours. A number of possible underlying causes have been described, including drug or parasite hypersensitivity, salmonellosis, high-protein low-cellulose diets and clostridial enterocolitis. Stress has been reported as a predisposing factor to colitis X.


Clinical Signs

  • Abdominal pain
  • Acute onset watery to haemorrhagic diarrhoea
  • Tachycardia (Heart rate often greater than 100bpm)
  • Dehydration
  • Signs relating to hypovolaemic or endotoxic shock, e.g. congested mucous membranes, prolonged capillary refill time, cold extremities.
  • Dilated pupils
  • Collapse
  • Body temperature may vary from pyrexic to subnormal
  • Bowel sounds may be absent


Diagnosis

Diagnosis is often based on the peracute nature of clinical signs.

Pathology

Treatment

Treatment is often unsuccessful and horses may often require euthanasia. Treatment methods previously described include aggressive fluid therapy with electrolyte replacement, antibiotics and analgesics.

Prognosis

The prognosis is usually poor, with a mortality rate approaching 90-100%.

Prevention

References

  • Glenn Songer, J., Trinh, H.T., Dial, S.M., Brazier, J.S., Glock, R.D. (2009) Journal of Veterinary Diagnostic Investigation 21:377–380 (2009)
  • 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
  • Edward Robinson, N and Sprayberry, K. A. (2009) Current Therapy In Equine Medicine Sixth edition Saunders Elsevier
  • Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial
  • Giles, C.J., Urquhart, K.A. and Longstaffe, J.A. (1985) Larval cyathostomiasis (immature trichonema-induced enteropathy): A report of 15 clinical cases Equine Veterinary Journal 17, 196-201
  • Murphy, D., Keane, M.P. and Goulding, R. (1997) Cyathostome associated disease in the horse: investigation and management of four cases Equine Veterinary Journal 9 247-252
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