Blake Karen R, Affolter Verena K, Lowenstine Linda J, Vilches-Moure Jose G, le Jeune Sarah S
William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA.
J Am Vet Med Assoc. 2012 Jun 15;240(12):1494-500. doi: 10.2460/javma.240.12.1494.
A 10-year-old Lipizzaner stallion was evaluated over the course of 1.5 years because of intermittent, recurrent colic.
The horse was initially treated medically for gastric ulcers; dietary changes were made, and a deworming protocol was instituted, without resolution of colic episodes. Subsequently, the horse underwent exploratory celiotomy and a large colon volvulus was identified with diffuse colonic wall thickening. A pelvic flexure biopsy sample was submitted for histologic examination, which revealed lymphocytic (CD3-positive T cells) myenteric ganglionitis (MG). The horse developed a cecal impaction after surgery, which did not resolve, despite aggressive medical management; subsequently a complete cecal bypass was performed. Cecal and colonic wall biopsy samples were evaluated histologically and confirmed the diagnosis of MG. After surgery, the horse developed a large colon impaction, which initially responded to aggressive medical treatment, and the horse was discharged.
Despite rigorous feed restrictions and prokinetic and corticosteroid treatment, the horse continued to have signs of colic and was euthanized 3 weeks after discharge from the hospital because of a recurrent large colon impaction. Intestinal biopsy samples obtained at the time of death revealed chronic changes in intramural ganglia consistent with generalized MG.
MG is a rare disease in horses, causing gastrointestinal motility dysfunction and signs of colic, which is challenging to diagnose and treat successfully. Further studies are needed to identify the etiology of this disease and to explore treatment options.
一匹10岁的利皮扎马种公马因间歇性、复发性腹痛在1.5年的时间里接受了评估。
这匹马最初接受了胃溃疡的药物治疗；调整了饮食，并制定了驱虫方案，但腹痛症状仍未缓解。随后，这匹马接受了剖腹探查术，发现了一个大结肠扭转，并伴有弥漫性结肠壁增厚。提交了一段骨盆曲部活检样本进行组织学检查，结果显示为淋巴细胞性（CD3阳性T细胞）肠肌层神经炎（MG）。这匹马术后出现了盲肠阻塞，尽管采取了积极的药物治疗措施，但仍未缓解；随后进行了完全性盲肠旁路手术。对盲肠和结肠壁活检样本进行了组织学评估，证实了MG的诊断。术后，这匹马又出现了大结肠阻塞，最初对积极的药物治疗有反应，随后这匹马出院。
尽管严格限制了饲料摄入，并进行了促动力和皮质类固醇治疗，但这匹马仍持续出现腹痛症状，出院3周后因复发性大结肠阻塞而实施了安乐死。死亡时获取的肠道活检样本显示壁内神经节有慢性变化，符合全身性MG。
MG在马匹中是一种罕见疾病，会导致胃肠动力功能障碍和腹痛症状，诊断和成功治疗具有挑战性。需要进一步研究以确定该疾病的病因并探索治疗方案。
