Disseminated alimentary mycobacteriosis in the horse: a retrospective study of nine cases

Summary This paper summarises the clinical findings of 9 cases of disseminated alimentary mycobacteriosis in horses presented at a Finnish referral equine hospital 2009–2014. Four of 9 horses were Standardbreds and 8/9 horses were male. The median age was 2 years, ranging from 6 months to 15 years. The duration of clinical signs before admission ranged from 2 weeks to 6 months. All horses demonstrated deterioration of the clinical signs after a protracted period of the disease and were finally subjected to euthanasia after poor response to multiple medical therapies. The most common complaints on admission were weight loss and diarrhoea (9/9), pyrexia (7/9), ventral oedema (7/9), lethargy (7/9) and inappetance (6/9). The most common clinicopathological abnormalities were hypoalbuminaemia and hyperfibrinogenaemia, which were present in all horses. Rectal biopsy specimens were examined from 5/9 horses and specimens were stained with Ziehl‐Nielsen (ZN). At rectal biopsy, mild multifocal neutrophilic or mild granulomatous proctitis was recognised in all 5 horses, but the ZN stain for mycobacteria was positive in only one biopsy. A liver biopsy was taken from one horse in which hepatomegaly was observed clinically and revealed marked granulomatous hepatitis with the presence of mycobacteria. The rectal biopsy from this horse was ZN negative. At post mortem examination, chronic, multifocal to coalescing granulomatous typhlocolitis and lymphadenitis were found in all horses with the small intestine less frequently involved. At histopathological examination of post mortem samples, a ZN stain was performed and intracellular acid‐fast bacilli were identified in macrophages and multinucleated giant cells in the large intestine, liver and lymph nodes in 9/9 horses and in the small intestine in 5/9 horses. Mycobacterium avium ssp. hominissuis was isolated in 5/9 horses from post mortem samples.