Equine Medical Guidelines – gastrointestinal

Acute diarrhoea

DIAGNOSTICS

Culture should be performed for Salmonella. Diagnosis of clostridial disease requires toxin test.

TREATMENT

Antimicrobial therapy rarely indicated. Only if:

• Confirmed clostridial cause
• Severe leukopaenia and neutropaenia

If clostridial: metronidazole

If leukopaenic: penicillin & gentamicin

DURATION OF THERAPY

• Clostridial: until diarrhoea resolves
• Leukopaenic: until leukopaenia resolves

Chronic diarrhoea

Antimicrobial therapy rarely indicated.

Peritonitis

DIAGNOSTICS

Abdominocentesis should be performed to collect fluid for cytological evaluation and culture and susceptibility testing. Differentiation between primary and secondary origins is critical as secondary peritonitis is typically due to leakage from the gastrointestinal or reproductive tracts and surgery should be considered.

TREATMENT

Systemic antimicrobial therapy should be instituted immediately following sample collection. Penicillin & gentamicin & metronidazole are appropriate.

DURATION OF THERAPY

Serial abdominocentesis should guide therapy. Treat for 1-2 weeks past resolution of disease

Lawsonia infection (proliferative enteropathy)

DIAGNOSTICS

Diagnosis can be made via serology (ELISA) or by faecal PCR.

TREATMENT

• Mild to moderate disease: doxycycline PO
• Severe disease: oxytetracycline IV 

DURATION OF THERAPY

• Mild to moderate disease: generally 3 weeks is recommended
• Severe disease: 3-4 weeks