Eosinophilic intestinal diseases of the horse
Authors: Schumacher J., Legere R.
Journal: Equine Veterinary Education
Summary
Eosinophilic infiltration of equine intestinal tissue remains poorly characterised despite recognised parallels with human eosinophilic gastroenterology, limiting clinicians' ability to anticipate presentation and trajectory. Schumacher and Legere reviewed cases of horses with intestinal eosinophilia, stratifying outcomes according to whether eosinophilic infiltration was localised to the gut or occurred as part of multi-organ disease affecting skin, pancreas, lungs, or liver. Horses with isolated intestinal eosinophilia demonstrated good prognosis for clinical resolution, with some requiring surgical intervention including decompression or resection alongside corticosteroid therapy. By contrast, multi-organ eosinophilic disease carried a grave prognosis for survival, fundamentally altering case management and owner expectations. For equine practitioners, establishing whether eosinophilic changes are intestine-restricted or systemic—through examination of affected tissues and appropriate diagnostic sampling—becomes critical for prognostication and determining whether aggressive intervention is warranted.
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Practical Takeaways
- •When eosinophilic intestinal disease is confined to the GI tract, expect reasonable recovery outcomes with medical and/or surgical management; however, prognosis becomes grave if eosinophilic infiltration extends to other organs
- •Corticosteroid therapy combined with surgical intervention (decompression or resection) represents current treatment approach, though evidence base is limited
- •Early diagnosis and determination of whether disease is isolated to intestine versus multi-organ involvement is critical for setting realistic owner expectations
Key Findings
- •Eosinophilic intestinal diseases are poorly understood in horses and rarely reported
- •Horses with eosinophilic infiltration restricted to the intestine have good prognosis for clinical sign resolution
- •Multi-organ eosinophilic disease involving skin, pancreas, lungs, or liver carries very poor prognosis for survival
- •Treatment may include celiotomy with intestinal decompression/resection and corticosteroid administration