Grass sickness, alternatively termed equine dysautonomia, is a rare but predominantly fatal illness in horses. Grass sickness may affect all types of horse, pony and donkey, and has affected some well known horses including the thoroughbred stallions Dubai Millennium, Moorestyle and Mister Baileys.
Grass sickness is a polyneuropathy affecting the central, peripheral and enteric nervous systems. [1] The majority of visible clinical signs are related to paralysis within the digestive tract although nerve damage occurs throughout the body. There are three forms of grass sickness:
Clinical signs common to all subsets include: depression, anorexia, colic (moderate with AGS/SAGS and mild with CGS), paralysis of the intestines, excess salivation, constipation, nasogastric fluid secretion, patchy sweating, muscle tremors and eyelid drooping.
The cause remains unknown, but the toxin produced from the bacterium Clostridium botulinum type C may be involved. [2]
Clostridium botulinum is a soil-borne bacterium, which may be better known for producing clinical signs of botulism. It may cause grass sickness when the spores of C. botulinum type C are ingested and produce their toxin locally within the intestine.
It is also linked to pasture mycotoxicosis, which comprises a very large and diverse population of fungi. [3]
The Dick Vet research finally isolated a neurotoxic enzyme similar to the snake venom and discovered it as the probable cause of the sickness. [4]
The main risk factor for grass sickness, as the name may suggest, is grass. The disease is almost always seen in grazing animals, although there are isolated reports of the condition occurring in stabled horses. Grass sickness is most frequently seen in young horses aged between two and seven, and is particularly prevalent during April, May and June, and later in the autumn, after a spurt of grass growth.
Diagnosis of grass sickness in the live animal requires a thorough clinical examination including a rectal examination. Definitive diagnosis can only be made at surgery (where biopsies of the gut are taken) or at post-mortem (where samples from the nerves are taken). Differential diagnoses for grass sickness are varied and include any other cause of colic and weight loss, tying-up, laminitis, botulism, choke and dental problems.
There is no treatment for grass sickness. A proportion of EGS cases survive following periods of intensive nursing. Overall, the mortality rate of equine grass sickness is over 95%.
The first cases of grass sickness were recorded in eastern Scotland in 1909. [5]
Botulism is a rare and potentially fatal illness caused by botulinum toxin, which is produced by the bacterium Clostridium botulinum. The disease begins with weakness, blurred vision, feeling tired, and trouble speaking. This may then be followed by weakness of the arms, chest muscles, and legs. Vomiting, swelling of the abdomen, and diarrhea may also occur. The disease does not usually affect consciousness or cause a fever.
Botulinum toxin, or botulinum neurotoxin, is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction, thus causing flaccid paralysis. The toxin causes the disease botulism. The toxin is also used commercially for medical and cosmetic purposes. Botulinum toxin is an acetylcholine release inhibitor and a neuromuscular blocking agent.
Clostridium botulinum is a gram-positive, rod-shaped, anaerobic, spore-forming, motile bacterium with the ability to produce botulinum toxin, which is a neurotoxin.
Tetanus toxin (TeNT) is an extremely potent neurotoxin produced by the vegetative cell of Clostridium tetani in anaerobic conditions, causing tetanus. It has no known function for clostridia in the soil environment where they are normally encountered. It is also called spasmogenic toxin, tentoxilysin, tetanospasmin, or tetanus neurotoxin. The LD50 of this toxin has been measured to be approximately 2.5–3 ng/kg, making it second only to the related botulinum toxin (LD50 2 ng/kg) as the deadliest toxin in the world. However, these tests are conducted solely on mice, which may react to the toxin differently from humans and other animals.
The Clostridia are a highly polyphyletic class of Bacillota, including Clostridium and other similar genera. They are distinguished from the Bacilli by lacking aerobic respiration. They are obligate anaerobes and oxygen is toxic to them. Species of the class Clostridia are often but not always Gram-positive and have the ability to form spores. Studies show they are not a monophyletic group, and their relationships are not entirely certain. Currently, most are placed in a single order called Clostridiales, but this is not a natural group and is likely to be redefined in the future.
Colic in horses is defined as abdominal pain, but it is a clinical symptom rather than a diagnosis. The term colic can encompass all forms of gastrointestinal conditions which cause pain as well as other causes of abdominal pain not involving the gastrointestinal tract. What makes it tricky is that different causes can manifest with similar signs of distress in the animal. Recognizing and understanding these signs is pivotal, as timely action can spell the difference between a brief moment of discomfort and a life-threatening situation. The most common forms of colic are gastrointestinal in nature and are most often related to colonic disturbance. There are a variety of different causes of colic, some of which can prove fatal without surgical intervention. Colic surgery is usually an expensive procedure as it is major abdominal surgery, often with intensive aftercare. Among domesticated horses, colic is the leading cause of premature death. The incidence of colic in the general horse population has been estimated between 4 and 10 percent over the course of the average lifespan. Clinical signs of colic generally require treatment by a veterinarian. The conditions that cause colic can become life-threatening in a short period of time.
Polyneuropathy in dogs and cats is a collection of peripheral nerve disorders that often are breed-related in these animals. Polyneuropathy indicates that multiple nerves are involved, unlike mononeuropathy. Polyneuropathy usually involves motor nerve dysfunction, also known as lower motor neuron disease. Symptoms include decreased or absent reflexes and muscle tone, weakness, or paralysis. It often occurs in the rear legs and is bilateral. Most are chronic problems with a slow onset of symptoms, but some occur suddenly.
Exogenous bacteria are microorganisms introduced to closed biological systems from the external world. They exist in aquatic and terrestrial environments, as well as the atmosphere. Microorganisms in the external environment have existed on Earth for 3.5 billion years. Exogenous bacteria can be either benign or pathogenic. Pathogenic exogenous bacteria can enter a closed biological system and cause disease such as Cholera, which is induced by a waterborne microbe that infects the human intestine. Exogenous bacteria can be introduced into a closed ecosystem as well, and have mutualistic benefits for both the microbe and the host. A prominent example of this concept is bacterial flora, which consists of exogenous bacteria ingested and endogenously colonized during the early stages of life. Bacteria that are part of normal internal ecosystems, also known as bacterial flora, are called Endogenous Bacteria. A significant amount of prominent diseases are induced by exogenous bacteria such as gonorrhea, meningitis, tetanus, and syphilis. Pathogenic exogenous bacteria can enter a host via cutaneous transmission, inhalation, and consumption.
Equine nutrition is the feeding of horses, ponies, mules, donkeys, and other equines. Correct and balanced nutrition is a critical component of proper horse care.
Flaccid paralysis is a neurological condition characterized by weakness or paralysis and reduced muscle tone without other obvious cause. This abnormal condition may be caused by disease or by trauma affecting the nerves associated with the involved muscles. For example, if the somatic nerves to a skeletal muscle are severed, then the muscle will exhibit flaccid paralysis. When muscles enter this state, they become limp and cannot contract. This condition can become fatal if it affects the respiratory muscles, posing the threat of suffocation. It also occurs in the spinal shock stage in complete transection of the spinal cord occurring in injuries such as gunshot wounds.
Clostridium tetani is a common soil bacterium and the causative agent of tetanus. Vegetative cells of Clostridium tetani are usually rod-shaped and up to 2.5 μm long, but they become enlarged and tennis racket- or drumstick-shaped when forming spores. C. tetani spores are extremely hardy and can be found globally in soil or in the gastrointestinal tract of animals. If inoculated into a wound, C. tetani can grow and produce a potent toxin, tetanospasmin, which interferes with motor neurons, causing tetanus. The toxin's action can be prevented with tetanus toxoid vaccines, which are often administered to children worldwide.
Microbial toxins are toxins produced by micro-organisms, including bacteria, fungi, protozoa, dinoflagellates, and viruses. Many microbial toxins promote infection and disease by directly damaging host tissues and by disabling the immune system. Endotoxins most commonly refer to the lipopolysaccharide (LPS) or lipooligosaccharide (LOS) that are in the outer plasma membrane of Gram-negative bacteria. The botulinum toxin, which is primarily produced by Clostridium botulinum and less frequently by other Clostridium species, is the most toxic substance known in the world. However, microbial toxins also have important uses in medical science and research. Currently, new methods of detecting bacterial toxins are being developed to better isolate and understand these toxins. Potential applications of toxin research include combating microbial virulence, the development of novel anticancer drugs and other medicines, and the use of toxins as tools in neurobiology and cellular biology.
Colitis X, equine colitis X or peracute toxemic colitis is a catchall term for various fatal forms of acute or peracute colitis found in horses, but particularly a fulminant colitis where clinical signs include sudden onset of severe diarrhea, abdominal pain, shock, and dehydration. Death is common, with 90–100% mortality, usually in less than 24 hours. The causative factor may be Clostridioides difficile, but it also may be caused by other intestinal pathogens. Horses under stress appear to be more susceptible to developing colitis X, and like the condition pseudomembranous colitis in humans, an association with prior antibiotic use also exists. Immediate and aggressive treatment can sometimes save the horse, but even in such cases, 75% mortality is considered a best-case scenario.
Clostridium argentinense is an anaerobic, motile, gram-positive bacterium. Some bacilli now identified as Cl. argentinense were previously classified as either Cl. subterminale, Cl. hastiforme, or Cl. botulinum toxin group G, respectively.
Neorickettsia risticii, formerly Ehrlichia risticii, is an obligate intracellular gram-negative bacterium that typically lives as an endosymbiont in parasitic flatworms, specifically flukes. N. risticii is the known causative agent of equine neorickettsiosis, which gets its name from its discovery near the Potomac River in Maryland and Virginia. N. risticii was first recovered from horses in this region in 1984 but was not recognized as the causative agent of PHF until 1979. Potomac horse fever is currently endemic in the United States but has also been reported with lower frequency in other regions, including Canada, Brazil, Uruguay, and Europe. PHF is a condition that is clinically important for horses since it can cause serious signs such as fever, diarrhea, colic, and laminitis. PHF has a fatality rate of approximately 30%, making this condition a concern for horse owners in endemic regions. N. risticii is typically acquired in the middle to late summer near freshwater streams or rivers, as well as on irrigated pastures. This is a seasonal infection because it relies on the ingestion of an arthropod vector, which is more commonly found on pasture in the summer months. Although N. risticii is a well known causative agent for PHF in horses, it may act as a potential pathogen in cats and dogs as well. Not only has N. risticii been successfully cultured from monocytes of dogs and cats, but cats have become clinically ill after experimental infection with the bacteria. In addition, N. risticii has been isolated and cultured from human histiocytic lymphoma cells.
The Botulism Antitoxin Heptavalent - (Equine), made by Emergent BioSolutions Canada Inc., is a licensed, commercially available botulism anti-toxin that effectively neutralizes all seven known botulinum nerve toxin serotypes. It is indicated for sporadic cases of life-threatening botulism and is also stockpiled for the eventuality of botulinum nerve toxins being used in a future bioterrorist attack.
Theiler's disease is a viral hepatitis that affects horses. It is one of the most common cause of acute hepatitis and liver failure in the horse.
Avian Botulism is a strain of botulism that affects wild and captive bird populations, most notably waterfowl. This is a paralytic disease brought on by the Botulinum neurotoxin (BoNt) of the bacterium Clostridium botulinum. C. botulinum can fall into one of 7 different types which are strains A through G. Type C BoNt is most frequently associated with waterfowl mortality. The Type E strain is also commonly associated with avian outbreaks and is frequently found in fish species which is why most outbreaks occur in piscivorous birds.
Equine gastric ulcer syndrome (EGUS) is a common cause of colic and decreased performance in horses. Horses form ulcers in the mucosa of the stomach, leading to pain, decreased appetite, weight loss, and behavioral changes. Treatment generally involves reducing acid production of the stomach and dietary management. Unlike some animals, however, stomach rupture is rare, and the main goal of treating is to reduce pain and improve performance of animals used for showing or racing.
First Flight was a thoroughbred horse used in the production of the first botulism antitoxin. The horse was used as a research animal between 1978 and 1993 to produce antitoxin for military and civilian personnel. Until the 1990s, serum derived from First Flight was the only source of the antitoxin in the United States.