Disseminated Halicephalobus gingivalis infection in a horse

A 19-y-old American Saddlebred gelding was evaluated for epiphora of the right eye and generalized cachexia. Initial examination revealed anterior uveitis without ulceration, for which treatment was initiated. Despite the initial response to treatment, the signs progressively worsened to blindness. Histologic examination of the enucleated eye revealed granulomatous panuveitis and optic neuritis with intralesional nematode larvae identified as Halicephalobus gingivalis. Over time and despite anthelmintic treatment, blindness developed in the left eye along with neurologic signs, and the horse was euthanized. Disseminated halicephalobosis was diagnosed on postmortem examination, involving the heart, spleen, kidneys, oral cavity, tongue, left eye, lungs, CNS, adrenal glands, liver, and lymph nodes. Splenic involvement has not been reported previously, to our knowledge. Halicephalobosis is a sporadic parasitic disease that affects equids mostly and for which prognosis is poor despite aggressive systemic anthelmintic treatment. Parasitic granulomatous disease should be included as a differential diagnosis in equids with ocular or neurologic disease.