Page 6 - Clinical Connections- Autumn 2021

RVC RESEARCH STUDY VETERINARY SERVICES RVC.AC.UK
Equine
UPDATE ON GASTROINTESTINAL DISEASES

IN HORSES

Bettina Dunkel, Associate Professor in Equine Medicine
he most commonly described unreliable. operative pain and development of reflux
intestinal disease in horses is The mainstay of successful treatment for are recorded. This important investigation
T probably gastric ulcers and colic colic remains rapid recognition, immediate will contribute to answering the important
but other diseases such as colitis and assessment and, in cases with a high clinical question on best use of lidocaine in
inflammatory bowel disease also play likelihood of a strangulating lesion, timely post-operative colic care.
an important role. The article describes exploratory surgery. For horses undergoing Inflammatory bowel disease (IBD) is
selected recent developments in aetiology, exploratory laparotomy, post-operative increasingly recognised as a cause of
diagnosis and treatment of equine reflux remains a serious and potentially weight loss and hypoproteinaemia. Less
gastrointestinal diseases. life-threatening complication. During the well recognised presentations might include
Gastric ulcers remain a very common last two decades, a continuous intravenous poor weight gain and recurrent colic. IBD
condition in horses and knowledge about infusion of lidocaine has become a routine is an umbrella term for a variety of often
different types of ulcers and different treatment for horses recovering from small poorly defined inflammatory conditions
treatment options is rapidly expanding. It and occasionally also large intestinal that affect the small and large intestine of
is now firmly established that squamous surgery . Potential benefits include horses and may result in malabsorption.
[1]
ulcers are quite different from glandular prokinetic, anti-inflammatory and analgesic Diagnosis has long relied on abdominal
gastric ulcers in regard to predisposing properties which are all indicated in post- ultrasonography, oral glucose absorption
factors, clinical signs and response to operative patients. However, the clinical tests and duodenal/rectal biopsies. At RVC
treatment – but a lot remains still to be efficacy of lidocaine as prokinetic has been Equine, we have recently introduced a new
discovered. questioned and recent research suggests test for malabsorption. Instead of using
Recent research conducted at the RVC that it has minimal, if any, impact on post- a glucose absorption test a combination
by Dr Mike Hewetson and presented at operative reflux volume and duration [1, 2] . of xylose and iohexol is used to assess
the 2021 conference of the British Equine An international multi-centred double not only absorption but also intestinal
Veterinary Association found no correlation blinded study is currently underway to permeability. The test is more specific and
between clinical signs perceived by owners further investigate the proposed clinical has the potential for assessing both the
and the presence or absence of glandular properties of lidocaine and RVC Equine is small and large intestine, which significantly
lesions. This highlights the importance of one of the participating hospitals. If owners increases our ability to diagnose the
gastroscopy in confirming a diagnosis of agree to enrolment, horses with a small condition and initiate appropriate treatment.
gastric ulcers and evaluating response intestinal obstruction included in the trial will Colitis or typhlocolitis with or without
to treatment by repeated gastroscopy as receive either lidocaine or placebo (fluids) diarrhoea is less common than colic but
clinical signs and owners’ perception are at no additional cost to the client, and post- also a potentially life-threatening disease.

Equine gastroscopy py

6 Autumn 2021