Difference between revisions of "Colitis X"

Revision as of 15:35, 22 July 2010

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 diarrhoea 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 (such as surgery or transport) has been reported as a predisposing factor to colitis X.

Signalment

Colitis X affects adult horses, usually between one and ten years old.

Clinical Signs

The clinical signs are similar to those described for other forms of acute- peracute colitis

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 made post-mortem, where a hyperaemic, oedematous caecum and ventral colon may be seen. The intestinal wall may become necrotic in the later stages of the disease. Macroscopic and microscopic findings include signs of disseminated intravascular coagulation and large numbers of bacteria in the devitalized parts of the intestine.

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) Equine colitis X associated with infection by Clostridium difficile NAP1/027. Journal of Veterinary Diagnostic Investigation 21:377–380

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

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

@@ Line 1: / Line 1: @@
-{{OpenPagesTop}}
+==Description==
-==Introduction==
-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.
+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, high-protein low-cellulose diets and clostridial enterocolitis. Stress (such as surgery or transport) has been reported as a predisposing factor to colitis X.
 ==Signalment==
@@ Line 9: / Line 8: @@
 ==Clinical Signs==
+The clinical signs are similar to those described for other forms of acute- peracute colitis
 * Abdominal pain
@@ Line 14: / Line 15: @@
 * 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.
+* Signs relating to hypovolaemic or endotoxic shock, e.g. congested mucous membranes, prolonged capillary refill time, cold extremities.
 * Dilated pupils
 * Collapse
@@ Line 20: / Line 21: @@
 * Bowel sounds may be absent
-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==
-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.
+Diagnosis is often made post-mortem, where a hyperaemic, oedematous caecum and ventral colon may be seen. The intestinal wall may become necrotic in the later stages of the disease. Macroscopic and microscopic findings include signs of disseminated intravascular coagulation and large numbers of bacteria in the devitalized parts of the intestine.
-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.
+==Pathology==
 ==Treatment==
-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.
+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%. This may be lower for horses receiving intensive treatment.
+The prognosis is usually poor, with a mortality rate approaching 90-100%.
+==Prevention==
-{{Learning
-|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]
-}}
 ==References==
-* 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''
+* 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'''
-* 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 H.B. (1981). '''Equine colitis "X", still an enigma?''' ''The Canadian Veterinary Journal. La Revue Vétérinaire Canadienne 22 (5):162–5''
+* Schiefer HB (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''
@@ Line 52: / Line 52: @@
 * Knottenbelt, D.C. '''A Handbook of Equine Medicine for Final Year Students''' ''University of Liverpool''
-* Rose, R.J. and Hodgson, D.R.  '''Manual of Equine Practice''' ''Saunders Elsevier''
+* 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''
-{{review}}
+* 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''
-{{OpenPages}}
-[[Category:Expert_Review]]
+[[Category:To_Do_-_SophieIgnarski]]
+[[Category:Horse]]
 [[Category:Enteritis,_Bacterial]][[Category:Enteritis,_Fibrinous/Haemorrhagic]]
-[[Category:Small Intestinal Diseases - Horse]]
+[[Category:To_Do_-_Clinical]]