What is Inflammatory Bowel Disease?
A collection of different diseases of the intestines make up inflammatory bowel disease, which is demonstrated by inflammatory cells (lymphocytes, plasma cells, macrophages, and eosinophils) infiltrating the small and large intestines of your horse. The inflammation may be present in just a short segment of the bowel of your horse, or can be spread out. Due to the inflammation, malabsorption and digestive problems will occur. Some horses will experience diarrhea. The diseases that make up inflammatory bowel disease include granulomatous enteritis, lymphocytic plasmacytic enterocolitis, eosinophilic colitis, eosinophilic enteritis, multisystemic eosinophilic epitheliotropic disease and idiopathic focal eosinophilic enteritis. Inflammatory bowel disease frequently impacts young horses, though older horses are not immune to the condition. Inflammatory bowel disease is thought to be a rare condition in horses.
A result of inflammatory cells in the small and large intestine of a horse, inflammatory bowel disease leads to difficulty absorbing nutrients as well as problems with digestion.
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Symptoms of Inflammatory Bowel Disease in Horses
Should your horse be experiencing inflammatory bowel disease, you may notice the following signs:
- Chronic weight loss
- Lack of appetite
- Peripheral swelling
- Skin lesions
- Recurring or intermittent stomach pain; may be related to changes in motility of the gut of your horse
- Poor condition of his body
Inflammatory bowel disease in horses encompasses a collection of intestinal diseases that occur as a result of leukocytes infiltrating the wall of the intestine of the horse, leading to a disturbance in the function of the intestines. Each of these diseases involves either a different group of white cells or a different portion of the intestinal tract. The diseases of inflammatory bowel disease include:
- Granulomatous Enteritis (GE)
- Lymphocytic-plasmacytic enterocolitis (LPE)
- Multisystemic eosinophilic epitheliotropic disease (MEED)
- Eosinophilic colitis (EC)
- Eosinophilic enteritis (EE)
- Idiopathic focal eosinophilic enteritis (IFEE)
The main symptom of GE, LPE and MEED is weight loss. Typically, these three conditions are not resolved with medication and the outcome is often poor. Stomach pain is the main symptom of EC, EE and IFEE. Horses with these diseases may be successfully treated with surgery or corticosteroids.
Causes of Inflammatory Bowel Disease in Horses
While the cause of inflammatory bowel disease is not well understood, it is thought that the condition is due to an atypical response of the horse’s immune system when confronted with bacterial, viral, parasitic or dietary antigens.
Diagnosis of Inflammatory Bowel Disease in Horses
Your veterinarian will conduct a physical examination of your horse and ask you about the symptoms you have noticed in your horse, when you first noticed them, and any changes that you have seen. In addition to the clinical signs that are seen in your horse, your veterinarian will likely conduct intestinal and rectal biopsies in order to look closely at tissue under a microscope, as well as blood tests. Your veterinarian will look at the serum protein concentration, and may conduct an ultrasound to see if the bowel of your horse has thickened. Diagnosis of inflammatory bowel disease will be made based on the amount of inflammation that is present as well as the main type of leukocyte cell that is invading the lining of your horse’s gut.
Treatment of Inflammatory Bowel Disease in Horses
Should your horse be diagnosed with inflammatory bowel disease, your veterinarian will consider the best treatment for his condition, which will be dependent upon the particular intestinal disease he is suffering from. A variety of treatments have been tried for horses experiencing inflammatory bowel disease, to include corticosteroids, dietary alterations, metronidazole, and azathioprine. Nutritional care is important for horses with the condition; horses should be provided with good-quality, high energy feeds and meals should be small and frequent. When surgery is a possibility for your horse, his prognosis will be improved. Should your horse be experiencing EC, EE or IFEE, there is a chance that he will improve with surgery or corticosteroids, or both.
Recovery of Inflammatory Bowel Disease in Horses
Unfortunately, many cases of inflammatory bowel disease are at an advanced stage by the time the horse is diagnosed, which makes a good prognosis difficult. It is typical for horses with the diagnosis to require steroid therapy for the rest of their life and long-term improvement is unusual. How your horse will respond to treatment will vary and while surgery can be successful, it is only a possibility when the problem is in a small portion of your horse’s bowel.
Should your horse have to take corticosteroids long-term, it can increase his susceptibility to infections, leading to additional issues for your horse. Euthanasia often is recommended, as the prognosis for horses with inflammatory bowel disease is guarded to poor.