Plus-Hex CLINICAL
Table 1 . Common clinical signs of L . intracellularis infection .
Clinical signs Lethargy Colic
Peripheral oedema : ventrum , sheath ( males ), throatlatch , distal limbs
Pyrexia (> 38.5 ° C ) Anorexia Diarrhoea Depression Weight loss
Transmission of L . intracellularis is believed to occur through the ingestion of faecal material from wild or domestic animals , such as pigs and rodents , but further investigation is needed to determine this [ 3 ] . It is not currently thought to be a zoonotic disease .
One study [ 4 ] has shown that clinically affected horses may play a role in the transmission of L . intracellularis , so it is recommended that horses diagnosed with EPE or infected with L . intracellularis should be kept apart from the rest of the herd until they have received at least 1 week of antimicrobial treatment [ 4 ] .
Case history
A 6-month-old Thoroughbred filly foal presented to a referral hospital for investigation and treatment of pyrexia and diarrhoea . The foal had been quiet for over a week and had deteriorated in the previous 24 hours ( Figure 1 ).
Clinical examination
On arrival , the patient was dull , responsive and exhibiting mild signs of colic – flank watching , pawing occasionally , and regularly changing position from sternal to lateral recumbency . There was no evidence of diarrhoea . The findings of the clinical examination are presented in Table 2 .
Table 2 . Findings of the patient ' s clinical examination on arrival .
Patient parameters
Heart rate ( beats per minute )
Capillary refill time ( seconds )
Findings
Mucous membranes Injected / moist
Respiratory rate ( breaths per minute )
Gastrointestinal borborygmi *
Reference range
72 ↑ 28 – 48
2 < 2
Pale pink / moist
16 8 – 16
1 – 3 over 60 seconds
Temperature 38.2 ° C 37 – 38.5 ° C
* Per quadrant : +/ - = hypomotile ; + = normal ; ++ = hypermotile .
The patient ' s heart rate was raised at 72 beats per minute . The mucous membranes were injected , and the capillary refill time was 2 seconds . Lung sounds were within normal limits and there was no apparent nasal discharge . Palpation of peripheral lymph nodes indicated they were within normal size limits . Gastrointestinal borborygmi were increased in all four quadrants . The temperature was within normal limits at 38.2 ° C .
The patient was admitted to the isolated medical intensive care unit ( ICU ), due to a history of pyrexia and diarrhoea . The patient ' s home farm had cases of L . intracellularis infection , so it was recommended that the rest of the herd be tested . The veterinary surgeon ( VS ) also advised that this be done on an annual basis .
Investigations
Figure 1 . Patient on presentation .
Following the clinical examination , blood samples were collected from the patient . Packed cell volume , total protein , glucose , lactate and triglyceride were analysed in-house , and samples were also submitted to an external laboratory for full haematology , biochemistry and electrolyte profiles . Serology tests for cyathostomin ( small red worm ), Anoplocephala perfoliata ( equine tapeworm ) and L . intracellularis were also performed . The results of the in-house laboratory analysis are detailed in Table 3 and the external laboratory results are in Table 4 , both on page 22 .
Volume 39 ( 2 ) • April 2024
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