Findings and Prognosis in 149 Horses with Histological Changes Compatible with Inflammatory Bowel Disease.
Authors: Kranenburg Lieuwke Cecilia, Bouwmeester Bo F, van den Boom Robin
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary Inflammatory bowel disease (IBD) in horses remains diagnostically challenging, and this 2024 retrospective review of 149 cases provides valuable insights into presentation, histological patterns and short-term prognosis. Duodenal biopsies collected during routine endoscopy were histologically graded (mild to severe) and classified by predominant infiltrating cell type, with clinical outcomes tracked via owner questionnaire at six weeks post-biopsy and one-year survival data. Weight loss, reduced performance and abdominal pain were the cardinal presenting signs, whilst malabsorption was evident in most horses on oral glucose testing; those with severe IBD showed significantly lower serum protein concentrations. Lymphoplasmacytic infiltration accounted for 78.5% of cases, with only six horses presenting neutrophilic patterns, and notably, 71% of horses improved clinically within six weeks, predominantly following corticosteroid treatment. The practical takeaway is particularly valuable for practitioners: early clinical improvement at six weeks reliably predicted one-year survival, whereas repeat biopsy results did not correlate with clinical progress, suggesting that clinical response and biomarkers warrant closer attention than sequential histological assessment in monitoring IBD management.
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Practical Takeaways
- •Duodenal biopsy via endoscopy is useful for confirming IBD in horses presenting with weight loss, poor performance, and abdominal pain; corticosteroid treatment shows good short-term response rates (71% improvement at 6 weeks)
- •Monitor serum protein and perform glucose absorption tests to assess disease severity, particularly in cases with severe histological changes
- •Early clinical response to treatment at 6 weeks is a reliable prognostic indicator for long-term survival; repeat biopsies alone do not predict clinical improvement
Key Findings
- •Lymphoplasmacytic enteritis was the most common histological type of IBD, occurring in 78.5% of 149 cases with duodenal biopsies
- •71% of horses improved clinically within 6 weeks, predominantly following corticosteroid treatment
- •Horses with severe IBD showed lower serum protein concentrations and partial malabsorption on glucose absorption testing
- •Clinical improvement at 6 weeks was a stronger predictor of one-year survival than repeat biopsy results