Lactose intolerance diarrhea in a Quarter-Horse Foal

Ana Luisa Holanda De Albuquerque,Jose Paes Oliveira-Filho,Simone Biagio Chiacchio,Alexandre Secorun Borges,Rogerio Martins Amorim,Thaís Gomes Rocha

doi:10.7213/1981-4178.2018.162506

Ana Luisa Holanda De Albuquerque, Jose Paes Oliveira-Filho + Show 4 more

Open Access

https://doi.org/10.7213/1981-4178.2018.162506

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Abstract

Among diarrhea etiologies in horses, lactose intolerance is a less common or undiagnosed condition. Primary (congenital) lactase deficiency has never been diagnosed in foals, and lactose intolerance secondary to bowel injury has never been described in Brazil. Former bacterial or viral infections that cause severe lesions in the intestinal brush border, the area responsible to produce lactase, will be followed by diarrhea due to a lack of enzyme activity. The present report describes the case of secondary lactase deficiency in a 3-month-old foal with chronic watery diarrhea. The foal had been treated with several antibiotics and dewormed without clinical improvement. Complementary exams made were complete blood count (CBC), white blood cell (WBC) count, fibrinogen levels, serum biochemistry (serum proteins, renal and hepatic functions), blood gas analysis, parasite egg count, abdominal ultrasonography, rectal swab culture for three consecutive days and transtracheal wash. Therapeutic diagnosis was performed through administration of 8 mg/kg of lactase (PO), every 4 hours, and stool normalization was observed in about eight hours after starting treatment. Lactose intolerance is an important differential diagnosis of diarrhea in young foals.

Highlights

Diarrhea is a relevant cause of mortality and morbidity in foals (Magdesian, 2005)
It is a clinical manifestation that results from several non-infectious conditions and infectious agents that can range from "foal heat diarrhea” without additional clinical signs to a severe clinical condition that might include the development of sepsis, metabolic acidosis, and hypovolemic shock (McGovern, 2014)
This paper describes a case of a three-month-old foal with chronic diarrhea, therapeutically diagnosed as secondary lactose intolerance

Summary

Introduction

Diarrhea is a relevant cause of mortality and morbidity in foals (Magdesian, 2005). It is a clinical manifestation that results from several non-infectious conditions and infectious agents that can range from "foal heat diarrhea” without additional clinical signs to a severe clinical condition that might include the development of sepsis, metabolic acidosis, and hypovolemic shock (McGovern, 2014). One of the causes of diarrhea in foals is lactose intolerance, in most cases (if not all) secondary to infectious pathogens that injure the small intestine, specially Rotavirus and Clostridium difficile (C. difficile) (Magdesian, 2005). Severe enteritis with impairment of the function of the brush border epithelium, where the lactase enzyme is produced, will implicate in inadequate lactose hydrolyzation, and diarrhea (Lomer et al, 2008).

Results

Conclusion