Symptoms and prognosis of Clostridioides colitis

Vet Rec. 2020 Mar 22.
Mortality, clinical findings, predisposing factors and treatment of Clostridioides difficile colitis in Japanese thoroughbred racehorses.
Nomura M1, Kuroda T2, Tamura N2, Muranaka M3, Niwa H4.

Author information:
1. The Horse Racing School, Japan Racing Association, Shiroi, Chiba, Japan Motoi_Nomura@jra.go.jp.
2. Clinical Science & Pathobiology Division, Equine Research Institute, Japan Racing Association, Shimotsuke, Tochigi, Japan.
3. Racehorse Hospital, Miho Training Center, Japan Racing Association, Inashiki, Ibaraki, Japan.
4. Microbiology Division, Equine Research Institute, Japan Racing Association, Shimotsuke, Tochigi, Japan.
Abstract
BACKGROUND:

Although Clostridioides difficile-associated diseases (CDAD) is considered to be associated with colitis in horses, few studies have been performed with a focus on the characteristics of CDAD in thoroughbred racehorses.
METHODS:

Between 2010 and 2018, a test for C. difficile was performed using faecal samples from 137 thoroughbred racehorses with colitis presenting with diarrhoea and fever. The mortality rate, clinical findings, predisposing factors and the selected treatments were investigated in a retrospective manner.
RESULTS:

Twenty-four cases were diagnosed as CDAD and 113 as non-CDAD. The mortality rate was significantly higher in the CDAD group (83 per cent) than that in the non-CDAD group (34 per cent). The levels of serum amyloid A, blood urea nitrogen and packed cell volume at initial presentation were also significantly higher, and those of total protein and albumin were significantly lower in the CDAD group. The development of CDAD was associated with the administration of antimicrobials, surgery and hospitalisation. No significant improvement in mortality was observed for any of the selected treatment in both groups.
CONCLUSION:

CDAD in thoroughbred racehorses was identified as a high mortality disease with rapid progression of systemic inflammation and deterioration of the circulatory state. Further investigation is required to improve the treatment.