Sickbed Musings: Horses, Vomiting and Clostridium difficile
There's something ironic about traveling to a conference to speak about infectious diseases and coming down with food poisoning. As I lay in bed in Orlando in a relatively non-functional state Friday, I had lots of time to contemplate the good and bad points of vomiting. As much as it is unpleasant, the ability to vomit is useful, and it is something horses lack. As one of the many anatomical quirks that horses possess, horses are essentially unable to vomit, regardless of what in happening farther down the intestinal tract. This is serious problem, because unlike people who can relieve the pressure of a distended stomach by vomiting, the only thing a horse's stomach can do is get bigger and bigger until it finally bursts. Stomach rupture is fatal and kills numerous horses every year - it causes massive infection in the abdomen (peritonitis) due to the spillage of the bacteria-laden intestinal contents.
Stomach rupture typically occurs secondary to obstruction of the small intestine, which usually requires surgery to fix. It can also result from a condition called duodenitis/proximal jejunitis or anterior enteritis. This disease has been an enigma for years, with no clearly identifiable cause. Recently, the bacterium Clostridium difficile was implicated as the cause of this syndrome, at least in Ontario. This bacterium was found commonly in stomach fluid from horses with anterior enteritis, but not in that of horses with gastric distension from other causes. More study is needed to determine if these results are repeatable over time and in other regions, but it may be an important insight into this uncommon but potentially life-threatening condition.
More information about Clostridium difficile can be found on the equIDblog Resources section.
