JPC SYSTEMIC PATHOLOGY
DIGESTIVE SYSTEM
August 2018
D-B02

 

Signalment (AFIP#1946317):  4-day-old Thoroughbred foal

HISTORY:  The foal presented with bloody diarrhea (frank blood) 12 hours prior to death

HISTOPATHOLOGIC DESCRIPTION:  Small intestine:  There is diffuse, transmural, circumferential coagulative necrosis of the intestinal mucosa (villi) which extends through the muscularis mucosa and into the submucosa; the necrosis is characterized by loss of differential staining and retention of the cellular architecture of the mucosal epithelium and lamina propria, multifocal loss of villi and crypts, and blunting and fusion of remaining villi. Bacilli that range in size from 1-2 x 3-7um line denuded, necrotic  villi and form colonies within remaining crypts admixed with necrotic debris.  The lamina propria, submucosa, and serosa are markedly expanded by abundant hemorrhage, increased clear space, ectatic lymphatics (edema) and fibrin. Multifocally, the tunica intima and tunica media of small and medium sized blood vessels are expanded and disrupted by fibrin, edema, karyorrhectic debris and hemorrhage (necrotizing vasculitis), and occasionally contain organizing eosinophilic, beaded and fibrillar material (fibrin thrombi) which are adherent to often disrupted endothelium and either partially or completely occluding the vessel.  Less affected vessels are lined by hypertrophied, reactive endothelium.  The adjacent section of mesentery is edematous and lined by hypertrophied mesothelium.

MORPHOLOGIC DIAGNOSIS:  Small intestine: Enteritis, necrohemorrhagic, acute, diffuse, marked, with vasculitis, edema, and numerous bacilli, Thoroughbred, equine.

ETIOLOGIC DIAGNOSIS:  Clostridial enteritis

CAUSE:  Clostridium perfringens type C

GENERAL DISCUSSION:

PATHOGENESIS:

TYPICAL CLINICAL FINDINGS:

TYPICAL GROSS FINDINGS:

TYPICAL LIGHT MICROSCOPIC FINDINGS:

ADDITIONAL DIAGNOSTIC TESTS:

DIFFERENTIAL DIAGNOSIS:

Acute diarrhea or sudden death with intestinal necrosis and mucosal thrombosis - horses:

Other equine bacterial enteritides:

COMPARATIVE PATHOLOGY:

Clostridium perfringens - Types, toxins and diseases

 

Type

Toxin

Diseases

Alpha

Beta

Epsilon

Iota

A

++

-

-

-

Gas gangrene

Food Borne Illness - humans

Necrotic enteritis - chickens

Gastroenteritis - ferrets

Yellow lamb disease - enterotoxemia, western US

Colitis horses

Canine hemorrhagic gastroenteritis

Hemorrhagic bowel syndrome - dairy cattle

Necrotizing enterocolitis in piglets

Antibiotic enteritis- horses, rabbits

B

+

++

+

-

Lamb dysentery

Hemorrhagic enteritis - calves, foals, guinea pigs - UK, S. Africa, Middle East

Sheep-hemorrhagic enterotoxemia

C

+

++

-

-

Enterotoxic (necro)hemorrhagic enteritis - neonatal lambs, goats, cattle, pigs, foals, occasionally adult horses

Struck - Adult sheep, hemorrhagic enteritis and peritonitis due to endothelial damage by angiotoxin

Necrotic enteritis of birds

Note:  Trypsin (low in neonates) inactivates beta toxin

D

+

-

++

-

Overeating disease/pulpy kidney (due to angiotoxin) - Sheep, cattle, goats

Focal symmetric encephalomalacia – Sheep, goats

Enterocolitis in goats

Note: Trypsin activates Epsilon toxin

E

+

-

-

++

Enterotoxemia - calves, lambs. guinea pigs, rabbits

Canine hemorrhagic gastroenteritis

Table adapted from Barker et al, 1993 p.237 & Jones et al, 1997 p. 421

References:

  1. Diab SS, Kinde H, Moore J, et al. Pathology of Clostridium perfringens Type C enterotoxemia in horses. Vet Pathol. 2012;49(2):255-263.
  2. Dors A, Czyzewska-Dors E, Wasyl D, Pomorska-Mol M. Prevalence and Factors Associated with the Occurrence of Bacterial Enteropathogens in Suckling Piglets in Farrow-to-Finish Herds. Vet Rec. 2016; 179(23):598.
  3. Filho EF, Carvalho AU, Assis RA, et al. Clinicopathologic Features of Experimental Clostridium perfringens Type D Enterotoxemia in Cattle.Vet Pathol. 2009;46:1213-1220.
  4. Gelberg HB. Alimentary system and the peritoneum, omentum, mesentery, and peritoneal cavity. In: McGavin MD, Zachary JF, eds. Pathologic Basis of Veterinary Disease. 6th ed. St. Louis, MO: Elsevier-Mosby; 2017:379.
  5. Jones TC, Hunt RD, King NW. Veterinary Pathology. 6th ed. Baltimore, MD: Williams and Wilkins; 1997:420-422.
  6. Li M, Zhang X, Zhu L, Zhao N, et al. Identification, Isolation, and Phylogenetic Analysis of Clostridium perfringens Type A and Type C from Wild Boar (Sus scrofa) in the People’s Republic of China. J Wildl Dis. 2017; 53(3):642-648.
  7. Michelsen PGE, Smith BP. Diseases caused by Clostridium perfringens toxins (enterotoxemia, yellow lamb disease, lamb dysentery, necrotic enteritis). In: Smith BP, ed. Large Animal Internal Medicine. 4th ed. St. Louis, MO: Mosby-Elsevier; 2009:870-874.
  8. Schumacher VL, Marrtel A, Pasmans F, Van Immerseel F, Posthaus Endothelial Binding of Beta Toxin to Small Intestinal Mucosal Endothelial Cells in Early Stages of Experimentally Induced Clostridium Perfringens Type C Enteritis in Pigs. Vet Pathol. 2013;50(4):626-629.
  9. Uzal FA, Plattner BL, Hostetter JM. Alimentary system. In: Maxie MG, ed. Jubb, Kennedy, and Palmer’s Pathology of Domestic Animals. 6th ed. Vol 2. Philadephia, PA: Elseveier; 2016:99-114, 185-188.


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