Acute diarrhea in horses: A multicenter Canadian retrospective study (2015 to 2019)

This study describes the clinicopathological findings, diagnostic approach, treatment, and factors associated with non-survival of diarrheic horses admitted to 4 Canadian university teaching hospitals between 2015 and 2019. A total of 300 horses, ≥1-year-old, with acute diarrhea were included and represented 1.6% (300/18 481; range: 0.7 to 3%) of admissions during that period, 70% of the horses survived to discharge. Testing for enteropathogens was limited to a single fecal culture for Salmonella spp. in most cases. An enteropathogen was identified in 14% (42/300) of the horses, but in the hospital with higher testing rates enteropathogens were detected in 29% (16/55) of cases. Neorickettsia risticii was the pathogen most frequently detected (31%, 32/102). Antimicrobial drugs and plasma were administered to 57 and 8% of the cases, respectively. Laminitis occurred in 24/298 (8%) of the horses. A multivariable regression model identified an association between non-survival of diarrheic horses and colic signs, increased heart rate, packed cell volume, creatinine concentration, and decreased total protein concentration. A standardized approach for pathogen detection in diarrheic horses is not consistent among Canadian veterinary teaching hospitals, and testing for known pathogens is limited. Signs of colic, severe dehydration, endotoxemia, and hypoproteinemia are associated with non-survival of diarrheic horses.