4.4 Article

Right dorsal colitis in horses: A multicenter retrospective study of 35 cases

Journal

Publisher

WILEY
DOI: 10.1111/jvim.16884

Keywords

colic; diarrhea; nonsteroidal anti-inflammatory drugs; phenylbutazone

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Right dorsal colitis (RDC) is a gastrointestinal disease in horses caused by nonsteroidal anti-inflammatory drugs (NSAIDs), which can have serious consequences. Overdose of NSAIDs is a common cause, and clinical presentations include diarrhea, colic, and increased heart rate. According to the analysis of clinical data, increased heart rate, increased packed cell volume, and abnormal appearance of mucous membranes are associated with a significantly decreased survival rate.
BackgroundRight dorsal colitis (RDC) is a nonsteroidal anti-inflammatory drug (NSAID) induced, protein losing enteropathy in horses associated with a high case fatality rate.ObjectivesTo describe signalment, NSAID usage, clinical presentations, clinical pathology, ultrasonographic findings, treatments, outcomes, and factors associated with survival in horses diagnosed with RDC.AnimalsThirty-five horses from 7 Australian equine hospitals diagnosed with RDC.MethodsRetrospective case series. Clinical records of cases were accepted if definitively or presumptively diagnosed by an internist with RDC and had >= 3 of: hypoproteinemia or hypoalbuminemia; diarrhea with negative test results for infectious diseases; colic for which other diseases were excluded or right dorsal colon thickening on ultrasound. Descriptive data analysis was performed for categorical and continuous variables. Univariate binominal logistic regressions were used to assess factors associated with survival.ResultsAn overdose of NSAIDs occurred in 84% (21/25) cases where dose was known. Common clinical presentations included diarrhea (69%; 22/32), colic (61%; 20/33), and tachycardia (53%, 17/32). Common clinicopathological findings included hypoalbuminemia (83%; 26/31), hypocalcaemia (79%, 23/29), and hyperlactatemia (77%, 14/18). The right dorsal colon wall appeared subjectively thickened in 77% (24/31) cases using ultrasonography. Case fatality rate was 43% (15/35). Odds of survival significantly decreased with increasing heart rate (odds 0.84, 95% CI = 0.71-0.92, P = .01), packed cell volume (odds 0.91, 95% CI 0.82-0.98, P = .05) and abnormal appearance of mucous membranes (odds 0.05, 95% CI 0.005-0.28, P = .001) on hospital presentation.Conclusions and Clinical ImportanceAn overdose of NSAIDs is common in horses diagnosed with RDC. Serum albumin concentrations should be monitored in horses receiving a prolonged course of NSAIDs. Overall prognosis for RDC remains fair.

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