NAVLE Gastrointestinal and Digestive

Equine Chronic Diarrhea and Granulomatous Enteritis – NAVLE Study Guide

Chronic diarrhea in horses, defined as diarrhea persisting longer than one month, represents a significant diagnostic and therapeutic challenge.

Overview and Clinical Importance

Chronic diarrhea in horses, defined as diarrhea persisting longer than one month, represents a significant diagnostic and therapeutic challenge. Unlike acute diarrhea, chronic cases often involve inflammatory or infiltrative bowel diseases rather than infectious etiologies. Granulomatous enteritis (GE) is one of several idiopathic inflammatory bowel diseases (IBD) affecting horses, characterized by macrophage and epithelioid cell infiltration of the intestinal wall.

Understanding the differential diagnosis, diagnostic approach, and management of chronic diarrhea is essential for NAVLE success, as these conditions require systematic clinical reasoning and integration of multiple diagnostic modalities.

Category Conditions Key Features
Inflammatory Bowel Disease Granulomatous enteritis (GE) Lymphocytic-plasmacytic enteritis (LPE) MEED IFEE Weight loss, hypoalbuminemia, young horses (less than 5 years)
Neoplasia Intestinal lymphosarcoma Adenocarcinoma Weight loss, older horses, 100% mortality with lymphosarcoma
Drug-Induced Right dorsal colitis (NSAID toxicosis) History of phenylbutazone use, hypoproteinemia, RDC wall thickening on ultrasound
Parasitic Larval cyathostominosis Young horses, late winter/spring, hypoalbuminemia, larvae in feces
Environmental Sand enteropathy Coastal/sandy regions, radiographic sand accumulation

Definition and Classification of Chronic Diarrhea

Chronic diarrhea is defined as loose or watery feces persisting for greater than 1 month. The causes differ substantially from acute diarrhea, which is typically infectious. Chronic diarrhea results from inflammatory, infiltrative, or neoplastic conditions, or from disruption of normal intestinal physiology.

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