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      Duodenitis‐Proximal Jejunitis in Horses After Experimental Administration of Clostridium difficile Toxins

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          Abstract

          Background

          Duodenitis‐proximal jejunitis ( DPJ) is an acute sporadic gastrointestinal disorder of horses of unknown cause.

          Hypothesis/Objectives

          We hypothesize that Clostridium difficile toxins are involved in the pathogenesis of DPJ in horses. The objective of this study was to determine whether experimentally delivered C. difficile toxins cause clinical signs and histologic lesions similar to those of naturally occurring DPJ.

          Animals

          Six healthy mature mixed breed horses.

          Methods

          Experimental study: animal model of animal disease. Fasted horses were administered crude C. difficile toxins via gastroscopy and monitored for up to 48 hour. Blood was collected for complete blood cell count, biochemistry profile, and plasma fibrinogen assay, and abdominal fluid was collected for cytologic analysis and total solids before and after toxin administration. Physical examination and abdominal ultrasonography were performed throughout the study period. Tissues were collected from the gastrointestinal tract and processed for routine histologic analysis, and lesions were scored.

          Results

          Clinical signs were observed in 2 of 6 horses that are typical although not specific for horses with naturally occurring DPJ. Histopathologic lesions were observed in 6 of 6 horses and were similar to those reported in horses with naturally occurring DPJ. Two horses were severely affected.

          Conclusions and Clinical Importance

          Duodenitis‐proximal jejunitis is likely a syndrome with multiple causes that result in the same clinical and pathologic findings, and our data suggest that the toxins of C. difficile represent one cause of this syndrome. Toxin dose and variation in individual animal susceptibility might affect the clinical signs and lesions after administration of C. difficile toxins.

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          Most cited references18

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          Clostridium difficile small bowel enteritis occurring after total colectomy.

          Clostridium difficile infection is usually associated with antibiotic therapy and is almost always limited to the colonic mucosa. Small bowel enteritis is rare: only 9 cases have been previously cited in the literature. This report describes a case of C. difficile small bowel enteritis that occurred in a patient after total colectomy and reviews the 9 previously reported cases of C. difficile enteritis.
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            Clostridium difficile infections in animals with special reference to the horse. A review.

            V Båverud (2002)
            In human medicine, Clostridium (C.) difficile is since many years a well-known cause of nosocomial diarrhea induced by antibiotic treatment. In horses, C. difficile was recently suggested as a possible enteric pathogen. The bacterium is associated with acute colitis in mature horses following treatment with antibiotics. C. difficile, and/or its cytotoxin, is also associated with acute colitis in mares when their foals are being treated with erythromycin and rifampicin for Rhodococcus equi pneumonia. The colitis can have resulted from an accidental ingestion of erythromycin by the mares. In an experimental study it was also demonstrated in mature horses that erythromycin can induce severe colitis associated with proliferation of C. difficile. A new interesting finding was that in healthy foals younger than 14 days, C. difficile was isolated from every third foal whereas older foals proved negative. In this paper the current state of knowledge of C. difficile infections in animals, especially in horses, is reviewed. A short description is given of the historical background of Clostridium difficile and the antibiotic-associated colitis and diarrhea caused by infection with this bacterium. The taxonomy of Clostridium difficile is described extensively. A summary is given of the diseases associated with clostridia infections in animals. Special attention is paid to the pathogenesis, epidemiology, clinical symptoms, laboratory diagnosis, and pathology of Clostridium difficile infections in horses. Finally, some other bacterial causes of colitis in horses are discussed shortly.
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              Use of a selective enrichment broth to recover Clostridium difficile from stool swabs stored under different conditions.

              The recovery of Clostridium difficile from the stools of patients with C. difficile-associated diarrhea was evaluated by use of an enrichment broth (cycloserine-cefoxitin fructose broth supplemented with 0.1% sodium taurocholate [TCCFB]) and was compared to that from selective agar (cycloserine-cefoxitin fructose agar [CCFA]) and alcohol shock followed by inoculation onto blood agar (AS-BA). TCCFB was superior to CCFA and AS-BA, and neither the storage time nor the storage temperature affected the recovery rate.
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                Author and article information

                Contributors
                larroyo@uoguelph.ca
                Journal
                J Vet Intern Med
                J. Vet. Intern. Med
                10.1111/(ISSN)1939-1676
                JVIM
                Journal of Veterinary Internal Medicine
                John Wiley and Sons Inc. (Hoboken )
                0891-6640
                1939-1676
                01 December 2016
                Jan-Feb 2017
                : 31
                : 1 ( doiID: 10.1111/jvim.2017.31.issue-1 )
                : 158-163
                Affiliations
                [ 1 ] Department of Clinical Studies Ontario Veterinary CollegeUniversity of Guelph Guelph ONCanada
                [ 2 ] Department of Pathobiology Ontario Veterinary CollegeUniversity of Guelph Guelph ONCanada
                Author notes
                [*] [* ]Corresponding author: L.G. Arroyo, Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada; e‐mail: larroyo@ 123456uoguelph.ca .
                Article
                JVIM14624
                10.1111/jvim.14624
                5259639
                27906466
                20068f79-287f-41b2-873c-a0ff10601e6e
                Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 17 May 2016
                : 13 September 2016
                : 03 November 2016
                Page count
                Figures: 2, Tables: 0, Pages: 6, Words: 5061
                Funding
                Funded by: Equine Guelph
                Funded by: Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA)
                Funded by: Ontario Veterinary College
                Categories
                Standard Article
                EQUID
                Standard Articles
                Gastroenterology
                Custom metadata
                2.0
                jvim14624
                January/February 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.0.2 mode:remove_FC converted:24.01.2017

                Veterinary medicine
                enteritis,exotoxins,gastrointestinal
                Veterinary medicine
                enteritis, exotoxins, gastrointestinal

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