title: Duodenitis-Proximal Jejunitis in Horses After Experimental Administration of Clostridium difficile Toxins.
abstract: BACKGROUND
  Duodenitis-proximal jejunitis (DPJ) is an acute sporadic gastrointestinal disorder of horses of unknown cause.
  
  
  OBJECTIVE
  We hypothesize that Clostridium difficile toxins are involved in the pathogenesis of DPJ in horses. The objective of this study was to determine whether experimentally delivered C. difficile toxins cause clinical signs and histologic lesions similar to those of naturally occurring DPJ.
  
  
  METHODS
  Six healthy mature mixed breed horses.
  
  
  METHODS
  Experimental study: animal model of animal disease. Fasted horses were administered crude C. difficile toxins via gastroscopy and monitored for up to 48 hour. Blood was collected for complete blood cell count, biochemistry profile, and plasma fibrinogen assay, and abdominal fluid was collected for cytologic analysis and total solids before and after toxin administration. Physical examination and abdominal ultrasonography were performed throughout the study period. Tissues were collected from the gastrointestinal tract and processed for routine histologic analysis, and lesions were scored.
  
  
  RESULTS
  Clinical signs were observed in 2 of 6 horses that are typical although not specific for horses with naturally occurring DPJ. Histopathologic lesions were observed in 6 of 6 horses and were similar to those reported in horses with naturally occurring DPJ. Two horses were severely affected.
  
  
  CONCLUSIONS
  Duodenitis-proximal jejunitis is likely a syndrome with multiple causes that result in the same clinical and pathologic findings, and our data suggest that the toxins of C. difficile represent one cause of this syndrome. Toxin dose and variation in individual animal susceptibility might affect the clinical signs and lesions after administration of C. difficile toxins.
authors.affiliation: Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
authors.forename: L G
authors.initials: LG
authors.lastname: Arroyo
authors.affiliation: Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
authors.forename: M C
authors.initials: MC
authors.lastname: Costa
authors.affiliation: Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
authors.forename: B B
authors.initials: BB
authors.lastname: Guest
authors.affiliation: Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
authors.forename: B L
authors.initials: BL
authors.lastname: Plattner
authors.affiliation: Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
authors.forename: B N
authors.initials: BN
authors.lastname: Lillie
authors.affiliation: Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
authors.forename: J S
authors.initials: JS
authors.lastname: Weese
mesh_terms: D000818:Animals; D016360:Clostridioides difficile / Q000472:pathogenicity*; D003015:Clostridium Infections / Q000382:microbiology / Q000473:pathology / Q000662:veterinary*; D004382:Duodenitis / Q000382:microbiology / Q000473:pathology / Q000662:veterinary*; D005260:Female; D006734:Horse Diseases / Q000382:microbiology* / Q000473:pathology; D006736:Horses; D007579:Jejunal Diseases / Q000382:microbiology / Q000473:pathology / Q000662:veterinary*; D008297:Male
keywords: Enteritis; Exotoxins; Gastrointestinal