Haemoabdomen secondary to granulomatous periarteritis due to parasitism with Halicephalobus gingivalis in a mare

A 22‐year‐old Quarter Horse mare exhibited neurological signs consisting of head pressing, central blindness, minimal ataxia and dysphagia. Despite treatment, the mare collapsed and died shortly after onset of signs. On necropsy, there were approximately 15 l of free blood in the abdominal cavity. A 12 × 4 cm diameter, irregularly‐shaped, nodular, firm, tan/yellow mass was found adhered to the outer surface of the right lateral aspect of the caudal abdominal aorta. A similar mass also affected the caudal aspect of the right kidney. Histopathology of the aortic and renal masses revealed multiple coalescing granulomas containing intralesional nematodes compatible with Halicephalobus gingivalis. Inflammatory cells disrupted the aortic tunica adventitia as well as the outer tunica media. Similar exudate also affected the cerebrum, cerebellum and brainstem. Polymerase chain reaction amplification and sequencing of a portion of the large subunit ribosomal ribonucleic acid gene were performed using previously published primers for H. gingivalis to confirm the identity of the nematode. Although rupture of a blood vessel could not be demonstrated grossly, the histological findings suggest that inflammation may have breached a small calibre artery and caused the haemoabdomen.     

The distribution pattern of Halicephalobus gingivalis in a horse is suggestive of a haematogenous spread of the nematode

The majority of Halicephalobus gingivalis-infections in horses have been fatal and are usually not diagnosed before necropsy. Therefore, knowledge about the nematode and the pathogenesis of infection in horses is limited. This has resulted in an on-going discussion about the port of entry and subsequent dissemination of H. gingivalis within the host. The present case of H. gingivalis-infection in a horse was diagnosed ante mortem. Post mortem findings, the distribution pattern of H. gingivalis nematodes in the brain, a high prevalence of inflammation in close relation to blood vessels, and the presence of the nematode in multiple organs with a disseminated pattern of distribution strongly suggested a haematogenous spread of the nematode in the horse.     

Equine multisystemic eosinophilic epitheliotropic disease: A case report and review of literature

CASE HISTORY: A 2-year-old Standardbred gelding presented with a history of fever over 1 week, anorexia and skin lesions on all four legs. The lesions were associated with severe pruritus and oedema, and there was no response to therapy.

CLINICAL FINDINGS: The horse was in poor body condition, was lethargic and severely pruritic. Skin lesions consisted of diffuse alopecia and crusting of the distal extremities. Initially it was slightly febrile, but subsequently its temperature increased up to 40°C. Ten days after admission it developed profuse watery diarrhoea and the skin lesions progressed. Skin biopsies revealed superficial and deep perivascular dermatitis with lymphoplasmacytic and eosinophilic predominance. Based on the poor prognosis the horse was subject to euthanasia.

PATHOLOGICAL FINDINGS: The most notable lesions included ulcerative gastritis, typhlitis and colitis with prominent oedema of the intestines, marked subcutaneous oedema and severe thickening of the large bile ducts. Histopathology showed marked eosinophilic and lymphoplasmacytic infiltration of various tissues including the skin, gastrointestinal tract, mesenteric lymph nodes, large bile ducts, pancreatic duct and kidney. Immunohistochemistry revealed a clear predominance of CD3-positive cells in the lymphocytic infiltrations.

DIAGNOSIS: Based on the clinical findings and histopathology a diagnosis of multisystemic eosinophilic epitheliotropic disease (MEED) was made.

CLINICAL RELEVANCE: Multisystemic eosinophilic epitheliotropic disease is rare in horses, and usually chronic. In the current case the horse showed an apparently acute onset with high fever and rapid clinical deterioration. A diagnosis of MEED should be considered in horses presenting with weight loss and skin lesions with or without fever. A final diagnosis is based on histological results of biopsy specimens from affected organs.     

Characterisation of the inflammatory reaction in equine idiopathic focal eosinophilic enteritis and diffuse eosinophilic enteritis

REASONS FOR PERFORMING STUDY: Idiopathic focal eosinophilic enteritis (IFEE) and diffuse eosinophilic enteritis (DEE) are primary eosinophilic intestinal conditions without a known cause that are associated with an increasing number of surgical colic cases. Histology may be helpful in defining disease aetiology and pathogenesis. OBJECTIVES: To characterise further the inflammatory infiltrate in equine IFEE and to compare the condition with DEE. METHODS: Twenty-three IFEE cases and 5 DEE cases were examined by light microscopy including immunohistology to identify infiltrating leucocytes. Inflammatory infiltrates in mucosa and submucosa were characterised in IFEE lesions (Group 1), the intestine distant from the lesions in IFEE (Group 2) and DEE (Group 3). RESULTS AND CONCLUSIONS: IFEE lesions represented an accumulation of leucocytes in submucosa and muscularis, with dominance of eosinophils and macrophages and smaller numbers of lymphocytes, plasma cells and neutrophils. T cells represented the dominant lymphocytes. The mucosa overlying the lesion and both mucosa and submucosa in IFEE nonlesion sites and in DEE exhibited a similar composition, with different prevalence of various cell types. Macrophages were significantly more prevalent in the mucosal and submucosal infiltrates in IFEE nonlesion sites than in DEE, and lymphocytes significantly more prevalent in the mucosa in DEE than in IFEE nonlesion sites. The findings confirm IFEE as a primary eosinophilic intestinal disorder and indicate that IFEE represents a focally exacerbated inflammatory reaction in horses with DEE, possibly due to functional changes in the macrophage and T cell components, with subsequent excessive recruitment of both eosinophils and macrophages.     

Subconjunctival nodule due to Setaria equina erratic migration in a horse: First case report

An 18‐month‐old Arabian‐English filly resident in southwest France was referred for evaluation of a conjunctival mass in the right eye (OD). A pink, solid, and mobile nodular formation, measuring approximately 1.2 × 0.8 cm was found under the superior nasal bulbar conjunctiva during an ophthalmic examination that was otherwise normal. The mass was surgically removed using a standing procedure. Cytological examination of fine‐needle aspirates from the mass revealed a mixed eosinophilic‐lymphocytic inflammation. Histological examination confirmed the dense and diffuse eosinophilic‐lymphocytic infiltrate of the mass, and it revealed several cross sections of a parasitic nematode. The morphometric diagnosis identified an immature form of a filarial worm, and molecular analysis of the mitochondrial cytochrome c oxydase subunit 1 (cox1) and 12S rRNA gene sequences led to further identification of the specimen as Setaria equina. Microfilaremia was not observed on fresh blood smears. There have been no signs of local recurrence after 18 months, nor any evidence of intraocular involvement. To the authors’ knowledge, this is the first documented case of subconjunctival setariasis due to S equina in a horse.     

Interstitial brachytherapy in the management of haemangiosarcoma of the rostrum of the horse: Case report and review of the literature

Sarcomas arising in the equine species are rare tumours, and treatment is generally surgical. Radiotherapy has been used in the management of malignancies of large animals; however, conventional external radiotherapy delivery is difficult. Interstitial brachytherapy has been used in the management of human sarcomas with reasonable success, although equine experience is minimal. We report a case of equine haemangiosarcoma treated with brachytherapy demonstrating the feasibility of the procedure and the highly malignant natural history of haemangiosarcoma. An 8‐year‐old American Saddlebred gelding presented for evaluation of a soft tissue mass on the forehead which had been present for at least 6 months. Initial surgical attempts at management were unsuccessful; therefore a radiation oncologist specialising in brachytherapy was consulted. The radiation oncologist and veterinary surgeon performed an interstitial implant of the tumour mass on the rostrum of the horse under general anaesthesia. The procedure was well tolerated by the horse. The tumour demonstrated immediate response and was noted to have completely regressed within 6 weeks of the implant removal. Unfortunately, the horse developed widespread metastatic disease and required euthanasia. At the time of necropsy, no visible tumour was identified at the implant site. Interstitial brachytherapy is feasible in soft tissue sarcomas of the horse; however, supportive demands are great with this procedure and we recommend it only be done at large speciality centres.     

Canine mycetoma: a case report and review of the literature

This paper describes a mycetoma of the fourth tarsal bone of a 5-year-old spayed Corgi-cross bitch caused by the eumycete Curvularia geniculata. The condition was treated successfully by surgical excision, followed by chemotherapy using iodine, trimethoprim-sulphadiazine, amphotericin B. dimethyl sulphoxide. thiabendazole and nystatin. An attempt was made to establish the in vitro minimum inhibitory concentration of various antifungal drugs on the causative organism. No clinical or radiological evidence of recurrence was found 3 years after initiation of treatment, despite the original poor prognosis.     

A practitioner's guide to understanding equine infectious disease diagnostics in the United Kingdom. Part 1: How to optimise sampling approaches and a guide to agent detection testing methods

Diagnostic testing is routinely performed by the equine clinician when dealing with suspected infectious disease cases and outbreaks. Optimal sample timing, choice and handling are fundamental to attain an accurate diagnosis, and a good understanding of laboratory-based sample analysis techniques, and their validation is necessary for effective diagnostic test result interpretation. This two-part series highlights the importance of interpreting results bearing testing limitations and specific clinical findings in mind, and on these foundations, the treating clinician should always be well placed to deal with equine infectious diseases. Part 1 in this series will provide a treating clinician with an overview of the importance of testing horses in infectious disease outbreaks and how this is achieved. The different laboratory testing options available for agent detection and their methods will also be discussed. Part 2 will summarise serological (antibody) testing techniques, sample processing (including how tests are performed and validated) and result interpretation.     

Pylorogastric intussusception in the dog: a case report and literature review

A 10-month-old, neutered male Saint Bernard presented for evaluation of acute, severe vomiting. A soft-tissue mass was noted within the stomach on survey abdominal radiographs. The diagnosis of pylorogastric intussusception was made during exploratory celiotomy. The intussusception was manually reduced at surgery, the pyloric antrum was enlarged, and the duodenum was permanently affixed to the abdominal wall in an attempt to prevent recurrence of the intussusception. The dog recovered, has gained weight (5 kg), and has had only one isolated episode of vomiting during the one year since discharge from the hospital. This report documents the fourth reported case of pylorogastric (i.e., duodenogastric, gastrogastric) intussusception in the veterinary literature and is the first report that details the surgical management of the disease.     

Mast cell tumours (mastocytosis) in the horse: A review of the literature and report of 11 cases

Mast cell tumours are uncommon tumours in horses, compared to some other species of domesticated animals. They are most frequently located in the skin, but they can also arise at other sites, including the upper respiratory tract and eye. Cytology or histopathology is required for diagnosis. Treatment options include surgical excision, laser ablation, cryotherapy, intralesional injection of corticosteroids or water, and radiotherapy. Malignant and systemic forms are very rare.     

Rickets in a Thoroughbred-cross foal: case report and review of the literature

Rickets is a metabolic bone disease associated with failure of endochondral ossification and impaired osteoid mineralization in growing animals. As a consequence, affected individuals can develop gross and microscopic bone malformations. The most common causes of rickets in domestic species include vitamin D and phosphorus deficiency. Rickets has been described in multiple species; however, comprehensive postmortem characterizations with confirmatory histopathology in equids have not been published. A 6-mo-old, Thoroughbred-cross foal was diagnosed with rickets based on gross autopsy findings and microscopic examination of the ribs and long bones. Grossly, all costochondral junctions of the ribs were enlarged with a “rachitic rosary” appearance, and there were multiple fracture calluses in the rib bodies. Epiphyses and metaphyses of the long bones appeared widened on sagittal section, and their physes were irregularly thickened. Histologically, there were poorly organized columns of hypertrophic chondrocytes within the physes of affected bones, islands of chondrocytes embedded within the primary and secondary spongiosa, and faintly eosinophilic seams of poorly mineralized osteoid within the bone trabeculae. Areas of focally increased osteoclastic activity were observed in some of the sections, perhaps pointing to a more complex metabolic bone disease in a growing animal. Low serum concentrations of calcium and 25-hydroxyvitamin D were detected in an antemortem sample. The pathogenesis of these imbalances was not definitively established, but lack of sunlight exposure, low concentration of vitamin D precursors in the diet (perhaps secondary to malnutrition), or both, were suspected; a genetic basis cannot be ruled out.     

Olfactory ganglioneuroblastoma in a dog: case report and literature review

A 7-y-old, intact male Alaskan Malamute was presented with a 3-mo history of stertor and epistaxis. Computed tomography of the skull revealed generalized loss of gas throughout both nasal passages with replacement by a soft tissue mass that traversed the cribriform plate. Histopathology revealed neoplastic neuroblast cells arranged in anastomosing cords, as well as separately located aggregates of ganglion cells. Both neoplastic cell populations demonstrated immunoreactivity to MAP-2, TuJ-1, and synaptophysin. Neuroblastic cells additionally exhibited punctate immunoreactivity to MCK and CK8/18. We document here both the positive neural immunohistochemical markers for this neoplasm, as well as propose possible histomorphologic variants.     

Prevalence of equine polysaccharide storage myopathy and other myopathies in two equine populations in the United Kingdom

The aim of this study was to determine the prevalence of equine polysaccharide storage myopathy (EPSM) in two populations of horses in the UK. Biopsy specimens from 94 horses presented to an abattoir (population 1), and 46 horses with neuromuscular disorders presented to a university referral hospital (population 2) were obtained over a period of 4 years. Histological sections were examined by a veterinary pathologist for lesions including abnormal polysaccharide inclusions in myofibres.In population 1, a diagnosis of EPSM was made in 8% and non-specific myopathy in 33% of horses. In population 2, a diagnosis of EPSM was made in 22%, equine motor neurone disease (EMND) in 15% and non-specific myopathy in 37%. Within each population there was no difference in age, sex or breed distribution and muscle disease diagnosis. However, populations differed from each other in age and breed distributions and muscle disease diagnosis. EPSM was found in draft, Warmblood and related breeds and was diagnosed for the first time in cob-types. EMND was reported in 7/46 horses presented for neuromuscular disease and weakness, representing an important diagnosis in the UK. This study showed a high prevalence of EPSM and other myopathies in typical breeds of horses in the UK.