Abstract
BackgroundIdiopathic focal eosinophilic enteritis (IFEE) is an emerging cause of abdominal pain (colic) in horses that frequently requires surgical intervention to prevent death. The epidemiology of IFEE is poorly understood and it is difficult to diagnose pre-operatively. The aetiology of this condition and methods of possible prevention are currently unknown. The aims of this study were to investigate temporal and spatial heterogeneity in IFEE risk and to ascertain the effect of horse age on risk.Methodology/Principal FindingsA retrospective, nested case-control study was undertaken using data from 85 IFEE cases and 848 randomly selected controls admitted to a UK equine hospital for exploratory laparotomy to investigate the cause of colic over a 10-year period. Generalised additive models (GAMs) were used to quantify temporal and age effects on the odds of IFEE and to provide mapped estimates of ‘residual’ risk over the study region. The relative risk of IFEE increased over the study period (p = 0.001) and a seasonal pattern was evident (p<0.01) with greatest risk of IFEE being identified between the months of July and November. IFEE risk decreased with increasing age (p<0.001) with younger (0–5 years old) horses being at greatest risk. The mapped surface estimate exhibited significantly atypical sub-regions (p<0.001) with increased IFEE risk in horses residing in the North-West of the study region.Conclusions/SignificanceIFEE was found to exhibit both spatial and temporal variation in risk and is more likely to occur in younger horses. This information may help to identify horses at increased risk of IFEE, provide clues about the aetiology of this condition and to identify areas that require further research.
Highlights
Gastrointestinal disorders that result in development of acute abdominal pain are one of the most frequent causes of death in domesticated horses and have a significant impact on equine health and welfare
Some specific forms of colic have been shown to be associated with different risk factors such as bowel obstruction by a pedunculated lipoma [6], simple colonic obstruction/distention (SCOD) colic [7], epiploic foramen entrapment of small intestine [8, 9] and large intestinal volvulus [10]
P-value,0.001,0.0001 0.3431 0.9477 0.0353. This is the first published study investigating the epidemiology of Idiopathic focal eosinophilic enteritis (IFEE), a relatively new and important form of intestinal disease in horses that appears to be increasingly seen in some hospital populations and whose aetiology is currently unknown
Summary
Gastrointestinal disorders that result in development of acute abdominal pain (colic) are one of the most frequent causes of death in domesticated horses and have a significant impact on equine health and welfare. Some specific forms of colic have been shown to be associated with different risk factors such as bowel obstruction by a pedunculated lipoma [6], simple colonic obstruction/distention (SCOD) colic [7], epiploic foramen entrapment of small intestine [8, 9] and large intestinal volvulus [10] This knowledge can facilitate diagnosis of these specific lesions in conjunction with the results of clinical examination and adjunctive diagnostic tests. Conclusions/Significance: IFEE was found to exhibit both spatial and temporal variation in risk and is more likely to occur in younger horses This information may help to identify horses at increased risk of IFEE, provide clues about the aetiology of this condition and to identify areas that require further research
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