By Sue Palmer
I’ve been wondering for a while now about the ‘diagnosis’ of ‘hind gut ulcers’ or ‘hind gut inflammation’ (there seems to be controversy over the name, but for ease of writing this I’ll call it hind gut inflammation). This is partly as a result of having a few client’s horses ‘diagnosed’ with hind gut inflammation towards the end of last year with the vet using the Succeed test. This isn’t something I’d come across before, so I’ve been asking around about it, and I think I may have found the answer. Hind gut inflammation is a completely different thing to gastric ulcers, which are able to be diagnosed with a gastroscope, and for which we have medical treatment and management strategies available. Hind gut inflammation can historically only be diagnosed on post mortem, which is clearly not great for the health of the horse! And it’s clinical relevance (what it actually means for the horse) is unclear (it’s worth noting that at a recent lecture I attended, it was reiterated by the very well qualified presenter that for many horses with gastric ulcers, there are no outwards signs – just in case you’ve heard something like ‘well, he can’t have gastric ulcers, he’s not girthy’ or similar).
In 2017, Nicola Kerbyson MRCVS presented a paper at the International Equine Colic Research Symposium. The paper was titled ‘Clinical Pathology as a Predictor for Colonic Mucosal Pathology’ (you can read the abstract here: http://onlinelibrary.wiley.com/doi/10.1111/eve.48_12792/full). Basically, they did post mortems on 42 horses, 40 of which were found to have colonic mucosal pathology, and in 28 of these it was deemed to be likely to be clinically significant (i.e. the horse would have been showing signs of problems). The researchers found that they were able to differentiate these clinically significant cases as they showed low serum albumin and the presence of faecal haemoglobin (although the paper doesn’t say, I think we can safely assume that these were both measured using the Succeed faecal blood test). This, I think, is really exciting news, and I will attempt to contact Ms Kerbyson direct to ask whether she’ll provide us with more information.
If you’d like more information on hind gut inflammation, there is a great video here (http://www.succeed-equine.com/succeed-blog/2017/10/18/professor-knottenbelt-discusses-equine-gi-diagnostics-video/) on the use of the Succeed equine faecal blood test. I particularly like the phrase “So if we find a decal occult blood test from the SUCCEED FBT as being positive, we say, ’this case deserves attention. This case deserves investigation. This case deserves understanding of the potential pathology’.” Basically, the Succeed test doesn’t tell you exactly what’s wrong, but it tells you that something is wrong, and motivates you to look further.
There’s another very useful video here (http://www.succeed-equine.com/succeed-blog/2017/03/01/knottenbelt-discusses-large-colon-pathology-horses-video/) discussion large colon disease, and the difficulties surrounding diagnosis and treatment.
Do you have a horse who has been diagnosed with colonic disease, hind gut inflammation, hind gut ulcers, colonic ulcers, or similar? We’d love to share your story, to help and encourage others who may be wondering whether or not to look into this for their horse. If so, please email us on firstname.lastname@example.org, we look forward to hearing from you and with your help, continuing to educate and enlighten for the benefit of horses across the world.