D. L. Doxey

A case-control study of grass sickness (equine dysautonomia) in the United Kingdom

A case-control study was performed to investigate the epidemiology of grass sickness in the United Kingdom from 1992 to 1995. Data were collected by means of postal questionnaire when cases of grass sickness were identified. Sets of three questionnaires were posted to owners of, or veterinary surgeons attending, cases of grass sickness, with a request to provide information on the case, on one healthy animal on the same premises as the case and on another healthy animal on other premises. Controls were matched to cases by date of onset. After univariate analyses, the probability of grass sickness in horses was modelled using conditional logistic regression techniques. Young animals were found to be at increased rick of grass sickness and females were less likely to become affected, as were animals that had a history of contact with previous cases of the disease. The probability of grass sickness was higher in animals that were on premises where grass sickness had previously occurred, particularly if this was recent. Animals were at particular risk of disease if they changed fields within the previous 2 weeks; the risk thereafter reduced with time. The disease had a seasonal pattern, with a peak from April to June. More than 95% of cases had access to grazing, and 66% occurred after 2 week periods of predominantly dry weather.

Autonomic neurone degeneration in equine dysautonomia (grass sickness)

Histological investigations were undertaken on four sympathetic autonomic ganglia and on the myenteric and sub-mucosal plexuses of the jejunum in healthy animals, in naturally occurring cases of acute, sub-acute and chronic equine dysautonomia and in ponies in which neuronal damage had been induced by the injection of acute grass sickness sera. The degree of neuronal damage is related to the type of dysautonomia. The coeliac-mesenteric ganglion reacts differently from other ganglia and is less severely damaged in cases of short duration. Extensive experimentally induced damage to the coeliac-mesenteric ganglion, even when jejunal damage is also present, is not associated with clinical illness. It is proposed that the rate of autonomic neurone loss and the extent of the damage may both influence the clinical manifestations of grass sickness.

CLINICAL EQUINE DYSAUTONOMIA AND AUTONOMIC NEURON DAMAGE

Damage to the neurons of selected autonomic ganglia was quantified in relation to the severity of the clinical signs shown in acute, subacute and chronic cases of dysautonomia (grass sickness). No connection between the clinical severity of acute or subacute dysautonomia and the amount of neuronal damage in the superior cervical, stellate and coeliaco-mesenteric ganglia could be demonstrated. However, a higher proportion of normal neurons were found in chronic cases. Jejunal submucosal neuronal damage was correlated with clinical severity but further work is required to confirm this finding and to establish how widespread the alimentary neuronal lesions are in dysautonomia of different severities.

Species characteristics of serum proteins demonstrated after agarose gel electrophoresis

Serum samples from five species of domestic animals were subjected to protein electrophoresis on commercially prepared agarose gel films. After processing, the stained electrophoretic patterns and densitometric traces exhibited certain characteristics for each species. The features which were considered distinctive of each species are illustrated.

Small intestine and small colon neuropathy in equine dysautonomia (grass sickness)

The number of neurons in the coeliacomesenteric ganglia and the myenteric and submucosal plexuses of the jejunum, ileum and small colon, and the pathological changes induced in them, were studied in various types of equine dysautonomia. In all forms of dysautonomia, severe and extensive neuron loss and damage occurred in the ileum. In acute and subacute dysautonomia, jejunal neuron loss and damage were severe, but in chronic cases significantly less loss or damage occurred. The damage followed the same pattern in the small colon but it was always less obvious than in the jejunum. The distribution of the damage was uniform within a segment of the intestine. In fatal cases of dysautonomia, the clinical severity and duration of illness seems, in most instances, to be related to the amount of neuronal disruption occurring in the jejunum. Severe disruption results in acute/subacute dysautonomia, while milder damage leads to the chronic form.No case of dysautonomia was encountered in which enteric neuron loss and damage occurred without significant neuronal disruption also occurring in the coeliacomesenteric ganglia.Ileal neuronal damage and loss are not invariably worse than that in the jejunum, and the possible reasons for this, together with the relationship between neuronal damage and possible causes of dysautonomia, are discussed.

Acute phase proteins in grass sickness (equine dysautonomia).

Four acute phase proteins were assayed in the serum of normal horses and those with acute, subacute and chronic grass sickness, colic and inflammatory conditions, in order to investigate their diagnostic value in grass sickness. The grass sickness and inflammation group had a significantly increased haptoglobin concentration (P less than 0.01-P less than 0.001). Orosomucoid was elevated in acute, subacute and chronic grass sickness and inflammation (P less than 0.001, P less than 0.001, P less than 0.05 and P less than 0.05, respectively). Highest concentrations of haptoglobin and orosomucoid were recorded in subacute grass sickness. Ceruloplasmin was significantly higher in acute grass sickness cases than all other groups except the colic group (P less than 0.05-P less than 0.01). alpha 2-macroglobulin was significantly higher in acute grass sickness than normal, colic and chronic grass sickness cases (P less than 0.01, P less than 0.05 and P less than 0.05). The time scale of changes suggests that the stimulus to haptoglobin and orosomucoid synthesis occurs at the onset of clinical signs whereas the increase in ceruloplasmin and alpha 2-macroglobulin is more likely to reflect haemoconcentration.

An evaluation of the use of cisapride in horses with chronic grass sickness (equine dysautonomia)

A clinical trial was carried out to determine the effect of cisapride on rate of passage of digesta and clinical parameters in horses with chronic grass sickness. Sixteen horses were given intramuscular cisapride (0.1 mg kg-1 three times daily) (group I), and 15 received oral cisapride (0.8 mg kg-1 three times daily) (group O). A liquid-phase marker (cobalt-EDTA) and a solid-phase marker (polystyrene pellets) were given by stomach tube at the beginning of each of three consecutive 7 day periods, i.e., before, during and after cisapride therapy. Seven horses in each group completed the rate of passage trial; the remainder provided clinical data only. The rate of passage was found to be significantly faster after cisapride therapy than before. Comparison with data from 20 normal animals showed a trend towards normal rates of passage after therapy. In cases that died during the trial, the caecum and large colon were the main sites of pellet retention. Dry matter intake was significantly higher after therapy than before in group O and dry matter output was higher after treatment than before in both groups. Gut auscultation score increased in both groups in the periods during and after cisapride administration but heart rate was unaffected. Diarrhoea and colic occurred in each group but its occurrence was not associated with cisapride therapy. The results suggest that by increasing gut motility, cisapride is of benefit in the management of selected cases of chronic grass sickness.

Long-term prospects for horses with grass sickness (dysautonomia)

Responses to questionnaires were received from 31 owners of horses or ponies treated for chronic grass sickness (dysautonomia). Contrary to previous opinions the respondents indicated that the majority of the animals were capable of strenuous work, had regained the weight they had lost and, apart from a few residual problems such as difficulty in coping with dry fibrous food, had returned to a normal life. They had recovered slowly and had involved the owners in considerable extra work, but all the owners indicated that they considered the effort to have been worthwhile.

The equine enteric nervous system?neuron characterization and distribution in adults and juveniles

A study of myenteric and submucosal plexuses was undertaken in the jejunum and ileum of horses and ponies in which no clinical or pathological evidence of intestinal abnormality was apparent. Complete transverse sections of the intestine, stained by a modified haematoxylin and eosin method, were examined using up to 20 sequential sections per animal. Information was gathered from adult, juvenile and fetal equidae. In adults, the longitudinal muscle layers were thinner than the circular muscle layers and the ileum had thicker layers compared to the jejunum. In adults, the submucosal plexus had more neurons per section than the myenteric plexus by mean ratios of 1:3 in the jejunum and 1:1.9 in the ileum. In juveniles, the ratios were respectively 1:1.8 and 1:1.5 and in the fetus 1:2.5 and 1:1.3. The three-dimensional distribution of neurons in both plexuses varied from animal to animal and no consistent pattern was observed. Groups of neurons contained between one and 42 cells per section examined and their length in a cranio-caudal direction varied from 10 to over, 100 µm. There were few statistical differences observed between the cranial, middle and caudal portions of either the jejunum or the ileum when neuron groups or neuron numbers per section were examined in 10 adult animals.

A COMPARISON OF THE SERUM PROTEIN ELECTROPHORETIC PATTERNS OF YOUNG AND ADULT ANIMALS

Samples of serum from both young and adult normal cattle, sheep and horses were subjected to protein electrophoresis on agarose gel films. After processing, the stained electrophoretic patterns and densitometric traces of each species exhibited certain specific characteristics. The separations also revealed differences between young and adult animals of the same species. These age-related differences are described here.