Screening for Gastrointestinal Tract Conditions

by Emma Hardy, PhD, R. Anim. Technol (Cert)

THE work of the para professional is crucial in maintaining the ongoing health of the horse, ensuring that all systems are working correctly and in balance. While physiotherapists, osteopaths and chiropractors are typically focused on muscular/skeletal issues, the digestive health of the horse is worth their consideration, given the potential impact of the latter on the former.

Gastrointestinal Tract health problems aren’t always easy to spot

It is an unfortunate dilemma that the lifestyle required for performance can be a significant departure from how the horse has evolved to live. The often-unavoidable management routines, dietary needs and stress of training and competition leaves the horse at a significant risk of gastrointestinal disease. Disturbances to the health of the gastrointestinal tract can elicit a range of symptoms and signs. Some are easily recognised, such as weight loss, diarrhoea, and poor condition, but others may masquerade as something very different. Increasingly, signs such as hind limb lameness, changes in gait quality and back pain are being identified as originating from gastrointestinal discomfort. These particular issues may lead the horse owners to consulting the paraprofessional. As a result, physiotherapists, osteopaths and chiropractors should include an assessment of a horse’s GI health as part of their overall evaluation.

The proficiency at which chiropractors, osteopaths and physiotherapists can investigate, evaluate and arrive at a carefully considered diagnosis is in no doubt, but when it comes to the gastrointestinal tract, making a differential diagnosis can be more difficult. Ruling in or out a gastrointestinal tract issue can be a vital step in establishing what is wrong with the horse, and how best to formulate an effective recovery plan. However, even the very best para professional can be limited in his or her licensed capacity to investigate an internal problem, which is where veterinary advice and involvement may become necessary.

Current methods of detection are “not bad, but not good”

It has been well established that gastric ulcers are nearly ubiquitous in horses used for competition. Digestive disorders beyond the stomach also bear significant consideration for the horse and demand attention from owners and professionals alike. Indeed, ongoing research by Professor Derek Knottenbelt at Glasgow vet school shows that large colon pathology is known to be more significant and widespread than many believe (Knottenbelt, 2015).

Much is still yet to be learnt, but Knottenbelt emphasises that for effective resolution, accurate and reliable methods of initial detection are key. “The sooner we can detect something, the earlier we can focus treatment and limit the possibility of significant long-term effects,” Knottenbelt says. He comments that the current methods of identifying intestinal pathology are generally “not bad, but not good” and notes that some limitations exist with a lack of sensitivity, non-specificity, subjectivity of images and data, and difficulty in the physical reach and access to areas of interest without involving surgical procedures. Clearly, developing noninvasive methods for definitive early diagnosis is crucial in taking the necessary proactive steps to correct it and achieve full recovery.

Initial Gastrointestinal Tract screening using the SUCCEED® Equine Fecal Blood Test™

Should a gastrointestinal tract condition be suspected, a quick and easy way to investigate this further is by screening the horse with the SUCCEED® Equine Fecal Blood Test™ (FBT). The FBT is a lateral flow assay which detects albumin and haemoglobin within a fresh faecal sample.

The blood components serve as markers of inflammation and bleeding which can facilitate diagnosis of many gastrointestinal tract disorders, from suspected ulceration, colitis, IBD, protein losing enteropathy, or colic, to investigating the causes of more generalised loss of weight/ condition/performance and changes in temperament. Furthermore, due to the nature of degradation of albumin within the tract, the FBT can help to locate the point of source, being gastric or at a point thereafter.

Despite its simplicity of use, the FBT is available through veterinary practices only due to the range of gastrointestinal tract disorders that may be reflected in the results..

Evaluation of these test results, combined with other diagnostic tests and the vet’s expertise, facilitates a differential diagnosis, which is vital in devising a targeted and effective plan for resolution. The FBT is the only test which enables the vet to perform an initial screening for gastrointestinal tract conditions, being affordable, completely non-invasive and returning results within 15 minutes, stable-side.

The FBT can help narrow down options for further testing and therapy

The initial information gained about the gastrointestinal tract from using the FBT equips the vet to consider or negate further diagnostic techniques or medication options. For example, a positive result for gastric bleeding may warrant subsequent gastroscopy to visualise and score gastric ulceration, whilst a positive result for inflammation beyond the stomach may rule out this procedure and initiate a hindgut-directed drug therapy or a gastrointestinal nutritive supplement course. The test can also be carried out over the duration of recovery to assess treatment efficacy, as well as to simply monitor ongoing gastrointestinal tract health as part of a wellness program.

The FBT gives all those involved in the health and welfare of the horse a window into the gastrointestinal tract. By knowing what is going on inside the horse, perhaps even before symptoms become overtly apparent additional diagnostics, treatment strategies and preventative measures can be rapidly implemented, securing a fast and long-term resolution.

Knottenbelt DC, Kerbyson N, Parkin TDH (2015) The prevalence of large intestinal mucosal pathology in horses being euthanized for non-gastrointestinal reasons. In: Proceedings of the 2015 ACVIM Forum. American College of Veterinary Internal Medicine Forum, Indianapolis, Indiana.

 

Animal Therapy Magazine