Authors: Pusterla N, Gebhart C
Journal: Equine veterinary education
Summary
Lawsonia intracellularis, an obligate intracellular bacterium, causes equine proliferative enteropathy (EPE), a disease predominantly affecting weanling foals that presents with fever, lethargy, peripheral oedema, diarrhoea, colic and weight loss. Pusterla and Gebhart's comprehensive review synthesised current understanding of EPE's aetiology, epidemiology, clinical presentation, diagnostic protocols and management strategies across the existing literature. Diagnosis requires demonstration of hypoproteinaemia, ultrasonographic evidence of small intestinal wall thickening, positive serology, and molecular identification of the organism in faecal samples—though the authors emphasise that epidemiological data for this emerging disease remains poorly characterised. Despite established clinical recognition and treatment protocols, practitioners should appreciate that EPE's prevalence, transmission patterns and risk factors across different populations warrant greater investigation to inform targeted prevention strategies. Understanding both the diagnostic framework and the gaps in our epidemiological knowledge is essential for early identification and appropriate management of affected foals.
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Practical Takeaways
- •Suspect EPE in weanling foals presenting with diarrhoea, colic, lethargy and peripheral oedema; use combination of blood work, abdominal ultrasound, serology and faecal PCR for definitive diagnosis
- •Clinical management and treatment protocols for EPE are established and available, making this a manageable condition if diagnosed promptly
- •Monitor at-risk foal populations around weaning time and maintain awareness of this emerging disease in your region
Key Findings
- •EPE is caused by obligate intracellular organism Lawsonia intracellularis and primarily affects weanling foals
- •Clinical signs include fever, lethargy, peripheral oedema, diarrhoea, colic and weight loss
- •Diagnosis relies on hypoproteinaemia, small intestinal wall thickening on ultrasonography, positive serology, and molecular detection of L. intracellularis in faeces
- •While clinical entity, diagnostic work-up and treatment are well-established, epidemiology of EPE remains largely unaddressed