EQUINE VETERINARY EDUCATION / AE / MAY 2018


249


Haematocrit (L/L)


TABLE 2: Summary of significant findings on haematology and serum biochemistry profiles Reference range 0.24–0.44


Case 1 0.39


White cell count (9109/L) Neutrophils (9109/L)


Immature neutrophils (9109/L) Lymphocytes (9109/L) Platelets (9109/L)


Total serum protein (g/L) Albumin (g/L) Globulin (g/L)


6.00–12.00 3.54–7.08 0.0–0.24 1.80–3.60 200–600 66.0–78.0 28.0–39.0 18.0–38.0


12.50 10.25 0.00 1.75 161 62.3 23.2 39.1


Case 2 0.35


5.29 2.38 0.32 2.27 169 77.0 25.4 51.6


Case 3 0.39


N/P N/P N/P N/P N/P 70.0 N/P N/P


Case 4 0.39


17.10 N/P N/P N/P N/P 41.8 18.2 23.6


Case 5 0.36


7.24 N/R N/R N/R N/R 51.4 26.6 24.8


Case 7 0.36


7.59 6.38 0.30 0.53 169 68.2 32.5 N/P


Bold type indicates values or outside of reference range or qualitative assessment abnormal. No results presented for Case 6 as tabulated tests not performed. N/P, not performed, N/R, not recorded.


oil. The horse was discharged from the clinic. Four weeks after discharge the horse had a severe episode of colic and was subjected to euthanasia without referral. Necropsy by a private veterinarian in the field revealed caecocaecal intussusception, caecal ulceration and large numbers of adult G. aegyptiacus flukes in the ascending colon. No cestodes were observed. Histology was not performed.


Case 3 A 16-year-old Arabian mare was presented at the OVAH with a 24 h history of colic signs. The referring veterinarian observed abdominal pain and tachycardia, but no other abnormal findings. Flunixin (Finadyne2, 1.1 mg/kg bwt i.v. q. 12 h), butorphanol (Torbugesic6, 0.025 mg/kg bwt i.v.) and butylscopolamine bromide and metamizole (Buscopan Compositum7, 1 mg/kg bwt i.v.) had been administered prior to referral. On presentation, the mare was moderately to severely painful (rolling, pawing and lying down). The horse had pale oral mucous membranes, reduced borborygmi and abdominal distension. During transrectal palpation a firm soft tissue structure was identified in the right caudal abdomen. Ultrasonography demonstrated a thick walled circular structure with a double walled appearance (total diameter 110 mm, wall thickness not recorded). Caecocaecal or caecocolic intussusception was suspected. Exploratory laparotomy was declined and medical management initiated. Faecal sedimentation was positive for G. aegyptiacus ova. A faecal nematode egg count identified <200 epg. Faecal flotation for cestodes was not performed and faecal samples were not submitted for culture. Romifidine (Sedivet7, 0.025 mg/kg bwt i.v.), polyionic


crystalloid fluid therapy (Plasmavet8, bolus of 40 mL/kg bwt over 2 h i.v. followed by 5 mL/kg bwt/h i.v.), a lignocaine infusion (Lignocaine HCl9, bolus 1.3 mg/kg bwt i.v. followed by 0.05 mg/kg bwt/min i.v.) and dexamethasone (Kortico5, 0.1 mg/kg bwt i.v.) were administered. A combined oxyclozanide/levamisole product (Tramizan10, oxyclozanide 7.5 mg/kg bwt, levamisole 5.6 mg/kg bwt) was administered for treatment of G. aegyptiacus infestation. The mare


became progressively more painful. Further analgesia with flunixin (Finadyne2, 1.1 mg/kg bwt i.v.), morphine (Morphine11, 0.1 mg/kg bwt i.v.) and romifidine (Sedivet7, 0.025 mg/kg bwt i.v.) did not lead to significant improvement and the mare was subsequently subjected to euthanasia 8 h after presentation. Necropsy demonstrated caecocaecal intussusception with congestion of the caecal wall. Large


numbers of adult G. aegyptiacus flukes were present in the ascending colon and there were small numbers in the caecum (Fig 3). No cestodes were observed. Histology was not performed.


Case 4 An 8-year-old Thoroughbred mare was presented at the OVAH with a 1 week history of mild colic signs and a 3 day history of diarrhoea. On presentation, the mare had mild to moderate colic signs, blood-tinged diarrhoea, mild pyrexia (Table 1) and reduced borborygmi. Mucous membrane colour was normal, but capillary refill time was 2 s. Total white cell count was increased and total serum protein and albumin concentrations were low (Table 2). Abdominal ultrasonography revealed an abnormal structure with a thickened double walled appearance (wall thickness 15 mm) in the mid-right ventral abdomen. The caecal region was sensitive on transrectal palpation, but no abnormalities could be felt. Peritoneal fluid was mildly serosanguinous with an increased total nucleated cell count (10.5 9 109/L [reference range: <5 9 109/L] Nelson 1979). Faecal nematode egg count, trematode sedimentation and cestode flotation were not performed. A single faecal culture collected during necropsy was positive for Salmonella spp. Results of other diagnostic tests were within normal limits. Exploratory laparotomy was recommended and the mare


treated preoperatively with sodium benzylpenicillin (Novopen12, 10,000 iu/kg bwt i.v.), gentamicin (Genta5013,


Fig 3: Heavy burden of G. aegyptiacus in the colonic contents of a treated horse (Case 3) at necropsy.


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