A review of the primary dysautonomias of domestic animals

Equine grass sickness (a multiple systems neuropathy) is associated with alterations in the gastrointestinal mycobiome

BACKGROUND

Equine grass sickness (EGS) is a multiple systems neuropathy of grazing horses of unknown aetiology. An apparently identical disease occurs in cats, dogs, rabbits, hares, sheep, alpacas and llamas. Many of the risk factors for EGS are consistent with it being a pasture mycotoxicosis. To identify potential causal fungi, the gastrointestinal mycobiota of EGS horses were evaluated using targeted amplicon sequencing, and compared with those of two control groups. Samples were collected post mortem from up to 5 sites in the gastrointestinal tracts of EGS horses (EGS group; 150 samples from 54 horses) and from control horses that were not grazing EGS pastures and that had been euthanased for reasons other than neurologic and gastrointestinal diseases (CTRL group; 67 samples from 31 horses). Faecal samples were also collected from healthy control horses that were co-grazing pastures with EGS horses at disease onset (CoG group; 48 samples from 48 horses).

RESULTS

Mycobiota at all 5 gastrointestinal sites comprised large numbers of fungi exhibiting diverse taxonomy, growth morphology, trophic mode and ecological guild. FUNGuild analysis parsed most phylotypes as ingested environmental microfungi, agaricoids and yeasts, with only 1% as gastrointestinal adapted animal endosymbionts. Mycobiota richness varied throughout the gastrointestinal tract and was greater in EGS horses. There were significant inter-group and inter-site differences in mycobiota structure. A large number of phylotypes were differentially abundant among groups. Key phylotypes (n = 56) associated with EGS were identified that had high abundance and high prevalence in EGS samples, significantly increased abundance in EGS samples, and were important determinants of the inter-group differences in mycobiota structure. Many key phylotypes were extremophiles and/or were predicted to produce cytotoxic and/or neurotoxic extrolites.

CONCLUSIONS

This is the first reported molecular characterisation of the gastrointestinal mycobiota of grazing horses. Key phylotypes associated with EGS were identified. Further work is required to determine whether neurotoxic extrolites from key phylotypes contribute to EGS aetiology or whether the association of key phylotypes and EGS is a consequence of disease or is non-causal.

Alterations in amino acid status in cats with feline dysautonomia

Feline dysautonomia (FD) is a multiple system neuropathy of unknown aetiology. An apparently identical disease occurs in horses (equine grass sickness, EGS), dogs, rabbits, hares, sheep, alpacas and llamas. Horses with acute EGS have a marked reduction in plasma concentrations of the sulphur amino acids (SAA) cyst(e)ine and methionine, which may reflect exposure to a neurotoxic xenobiotic. The aim of this study was to determine whether FD cats have alterations in amino acid profiles similar to those of EGS horses. Amino acids were quantified in plasma/serum from 14 FD cats, 5 healthy in-contact cats which shared housing and diet with the FD cats, and 6 healthy control cats which were housed separately from FD cats and which received a different diet. The adequacy of amino acids in the cats’ diet was assessed by determining the amino acid content of tinned and dry pelleted foods collected immediately after occurrences of FD. Compared with controls, FD cats had increased concentrations of many essential amino acids, with the exception of methionine which was significantly reduced, and reductions in most non-essential amino acids. In-contact cats also had inadequate methionine status. Artefactual loss of cysteine during analysis precluded assessment of the cyst(e)ine status. Food analysis indicated that the low methionine status was unlikely to be attributable to dietary inadequacy of methionine or cystine. Multi-mycotoxin screening identified low concentrations of several mycotoxins in dry food from all 3 premises. While this indicates fungal contamination of the food, none of these mycotoxins appears to induce the specific clinico-pathologic features which characterise FD and equivalent multiple system neuropathies in other species. Instead, we hypothesise that ingestion of another, as yet unidentified, dietary neurotoxic mycotoxin or xenobiotic, may cause both the characteristic disease pathology and the plasma SAA depletion.

Abomasal Emptying Defect of Sheep may be an Acquired Form of Dysautonomia

Abomasal emptying defect (AED) is a disease syndrome that primarily affects Suffolk sheep and is characterized by distension and impaction of the abomasum. No histologic lesion has been consistently associated with this condition. There is no known etiology. In this study, nine cases of AED were identified by necropsy, including three rams and six ewes between 2 and 6 years of age. Four of the cases occurred sporadically, and five ewes were submitted on the same day from a single flock. Histologic examination of celiacomesenteric ganglia from six of the affected sheep revealed scattered chromatolytic or necrotic neurons, without inflammation. Chromatolytic neurons were observed more frequently in AED-affected sheep than in seven healthy Suffolk sheep ( P < 0.08, weak statistical support). Neuronal necrosis was not observed in any of the healthy sheep. Lineage records of the flock that suffered an outbreak were incompatible with the possibility of a simple inheritance pattern for this disease; furthermore, the very occurrence of AED in outbreak form is inconsistent with transmission solely by inheritance. Only one of the six tested sheep showed concurrent immunohistochemical evidence of scrapie. The lesion pattern in celiacomesenteric ganglia is suggestive of a neurotoxicosis. Neuronal lesions of AED resemble dysautonomic diseases of humans and other animals.

Key-Gaskell syndrome in Brazil: first case report

Feline dysautonomia is a devastating disease characterized by neuronal degeneration in autonomic ganglia that results in clinical signs related to dysfunction of the sympathetic and parasympathetic nervous systems. The cause is unknown and this disease has a poor prognosis and no definitive treatment. Most reports have been described in few countries around the world, but the prevalence may be underestimated in countries like Brazil. This study describes the progression and clinicopathological changes of dysautonomia in a 17-month-old female Brazilian shorthair cat.

A histopathological study of bovine ganglia

One hundred and sixty-eight ganglia from 54 cattle aged 10 days to 10 years were examined microscopically. Samples from six autonomic ganglia and one sensory ganglion were represented. Thirteen animals were clinically normal and 41 were submitted for post-mortem examination. Neuronal vacuolation, spheroid formation, lipofuscin accumulation and central chromatolysis were observed sporadically and were of varying magnitude. Neuronal vacuolation and spheroid formation were not age-related changes, while lipofuscin accumulation was more common in older animals and central chromatolysis was more common in younger cattle. Non-suppurative inflammation and neuronophagia were also common findings (23 out of 54 animals, 42.6%) in autonomic ganglia that did not contain herpesvirus DNA as determined by polymerase chain reaction. Renaut bodies, features of peripheral nerves, were most commonly noted in the vagus. None of the histopathological findings were related to any particular disease in which loss of autonomic nervous system function might be expected. Furthermore, all changes were as common in clinically normal animals as in animals with disease.

Effects of equine grass sickness on sympathetic neurons in prevertebral and paravertebral ganglia

Acute equine grass sickness (EGS) is a fatal disease of horses that is thought to be due to ingestion of a neurotoxic agent causing extensive damage to autonomic neurons. The aim of this study was to compare the effects of EGS on neurons in two sympathetic ganglia, the paravertebral cranial cervical ganglion (CCG) and the prevertebral coeliac/cranial mesenteric ganglion (CG/CMG). Specimens from horses with EGS and controls were obtained post mortem and processed using single and double immunofluorescence labelling for PGP 9.5 and HuC/HuD (pan-neuronal markers), TUNEL and caspase 3 (markers for apoptosis), vasoactive intestinal polypeptide (VIP) and galanin (markers of the cell body response to injury following axotomy or exposure to sympathetic neurotoxins) and tyrosine hydroxylase (TH, marker for noradrenaline synthesis). In control horses, all neurons contained PGP 9.5 and HuC/HuD. There was a significant loss of PGP 9.5 and HuC/HuD expression in samples from horses with EGS that occurred to a greater extent in the CG/CMG than the CCG. The number of caspase 3-positive neurons increased significantly in both ganglia, but TUNEL staining of sympathetic neurons was only significantly increased in the CG/CMG in EGS. No VIP was observed in any ganglia; however, there was a significant increase in galanin-positive neurons in both ganglia in EGS. In the CCG, there was a significant shift towards increased fluorescence intensity for TH, possibly indicating an initial accumulation of TH within the cell body. In contrast, TH fluorescence intensity was significantly reduced in the CG/CMG in EGS correlating with the greater loss of neurons. These results demonstrate that EGS can induce a cell body response that is similar to the response of sympathetic neurons to a chemical neurotoxin. EGS also causes loss of sympathetic neurons, some of which occurs via apoptosis. Changes were more marked in the CG/CMG than the CCG indicating that the prevertebral ganglia were affected earlier than the paravertebral ganglia in the pathological process and had undergone greater neurodegeneration.

Feline dysautonomia in the Midwestern United States: A retrospective study of nine cases

Dysautonomia of domestic animals is pathologically characterized by chromatolytic degeneration of the neurons in the autonomic nervous ganglia that results in clinical signs related to dysfunction or failure of the sympathetic and parasympathetic nervous systems. The exact cause is unknown. It has a poor prognosis among all species reported and no definitive treatment is available currently. To date, most reported feline cases have occurred in the United Kingdom and Scandinavia. The cases reported here highlight the clinical signs, physical examination findings, and results of autonomic nervous system function testing in nine cats with dysautonomia in the US. Feline dysautonomia is uncommon in the US, but may have a regional prevalence, as is seen in dogs with most cases reported in Missouri and Kansas.

Five cases of canine dysautonomia in England (2004 to 2006)

Canine dysautonomia was diagnosed definitively in five dogs by histopathology. All dogs were seen between June 2004 and July 2006 and originated from south-east England; four dogs originated from an urban area and one from a rural area. Of the urban dogs, one had recently visited Scotland and one had visited a kennel in a rural area nearby. Acute-onset but progressive vomiting, diarrhoea, depression and inappetence were the most common presenting clinical signs. Reduced or absent anal tone, dysuria, absence of pupillary light reflexes with intact vision, mydriasis, decreased corneal sensitivity and nictitating membrane protrusion were among the most frequent neurological findings. Abnormalities in pharmacological autonomic and physiological function testing (including orthostatic hypotension in two dogs) and diagnostic imaging studies were detected in some of the animals. All dogs failed to respond adequately to treatment, and given the poor prognosis, they were eventually euthanased. Histopathology identified marked chromatolysis of ganglion cell bodies. This case series emphasises that dysautonomia should be considered when a dog is presented in the UK with acute- or subacute-onset gastrointestinal signs and compatible physical and neurological abnormalities.

Endotoxin-induced Injury of the Central, Autonomic and Enteric Nervous Systems and Intestinal Muscularis in Thoroughbred Horses

To evaluate the effects of endotoxin on the morphology of the equine central, autonomic and enteric nervous system and intestinal muscularis, six Thoroughbred horses with experimentally induced endotoxaemia were examined. The lesions in the central nervous system consisted of perivascular oedema around arterioles, suggesting brain oedema, and ring haemorrhages around veins, similar to those in human patients with septic shock. In the cranial mesenteric ganglia, neuronal cell bodies became pink or red, with shrinkage of cytoplasm indicative of ischaemic changes; intramural and perivascular infiltration by erythrocytes and neutrophils occurred around arterioles in the epineurium (acute focal interstitial inflammation). In addition, transmission electron microscopy revealed oedema of the endoneurium and mesoaxon in the nerve fascicles running inside or outside the ganglia. Myenteric neurons showed shrinkage of the cytoplasm with multiple cytoplasmic vacuoles, suggesting ischaemic changes. Oedematous degeneration and coagulation necrosis of smooth muscle cells, with dissociation of the cells, were prominent in the tunica muscularis. It is suggested that arterionecrosis elicited by endotoxin and frequently observed in the autonomic and enteric nervous system and intestinal muscularis, was the result of vasoconstriction or vasospasm.

Changes in nasal mucosal innervation in horses with grass sickness

REASONS FOR PERFORMING STUDY

Equine grass sickness is a dysautonomia characterised by widespread destruction of autonomic ganglia, resulting in the clinical signs of dysphagia, constipation, profuse sweating, tachycardia, rhinitis sicca and high mortality rate. Rhinitis sicca is a common finding in horses with the chronic form and we have postulated that alterations in autonomic innervation of the nasal mucosa might underlie this clinical presentation.

OBJECTIVES

In this study, the expression and distribution of nerve fibres immunoreactive for calcitonin gene-related peptide (CGRP), substance P (SP), the general neuronal marker protein gene-product 9.5 (PGP 9.5; ubiquitin) and the intermediate neurofilaments (PAN-N; neurorfilaments L, M and H) in the nasal mucosa of normal horses (n = 10) and horses with EGS (n = 18; acute n = 8, subacute n = 3, chronic n = 7) was assessed.

METHODS

Innervation density and distribution was investigated in the different groups using standard immunohistochemical techniques.

RESULTS

Significant differences were noted when comparing the density and distribution of nerve fibres immunoreactive for PGP 95 and PAN-N, with PGP 95 consistently giving better staining in all groups and at all sites in the nasal mucosa. An apparent increase in the density of innervation was noted for acute vs. normal cases. A significant reduction in the density of innervation was noted only with PAN-N when comparing normal horses and acute cases with the chronic group (P < 0.05). CGRP and SP immunoreactive nerve fibres were typically most abundant in the epithelial and subepithelial layers, but the quality of staining and nerve fibre density was greater for SP, achieving significant difference in several comparisons. The density of innervation for SP was significantly reduced in the chronic group compared to the normal and acute groups (P < 0.01). A significant decrease was noted for CGRP only for the acute and chronic groups (P<0.05).

CONCLUSIONS

These results demonstrate a reduction in the expression of the sensory neuropeptides in nasal mucosal innervation as a consequence of equine dysautonomia, and may underlie the clinical presentation of rhinitis sicca noted with this disease.

POTENTIAL RELEVANCE

Nasal biopsy may be of use in antemortem diagnosis of grass sickness and identification of mucosal denervation; and might also be useful in the treatment of rhinitis in EGS cases.

Incidence of canine dysautonomia in Missouri, USA, between January 1996 and December 2000

A cross-sectional survey of 217 veterinary facilities in Missouri, USA, was conducted to gather information about the occurrence of canine dysautonomia between January 1996 and December 2000. The state was divided into seven geographic regions for sampling, and 40 veterinary facilities from each region were selected randomly by computer-generated numbers to receive the questionnaire. Veterinarians from 74% (95% CI: 69, 79) of clinics in the state that saw canine patients were aware of dysautonomia prior to receiving the survey, and 43 respondents from five of the seven sampled regions stated that dysautonomia had been diagnosed in their practices during the study period. Respondents had diagnosed 182 cases of dysautonomia, leading to an estimated statewide total of 609 (95% CI: 272, 946) cases over the 5 years. Regional incidence estimates ranged from 0 to 1.91 cases per 10,000 dog years at risk. Case-fatality risk was 92%.

Dysautonomia in dogs: 65 cases (1993-2000)

OBJECTIVE

To determine signalment, history, clinical findings, results of autonomic function testing and other antemortem diagnostic tests, and pathologic findings in dogs with dysautonomia.

DESIGN

Retrospective study.

ANIMALS

65 dogs with dysautonomia.

PROCEDURE

Case records of 68 dogs with a diagnosis of dysautonomia were reviewed; inclusion criteria included histologic confirmation of dysautonomia or clinical signs and results of pharmacologic testing consistent with dysautonomia.

RESULTS

65 dogs fulfilled all criteria for dysautonomia. Dogs from rural environments were overrepresented, and cases of dysautonomia were reported for every month, although the highest number of cases was reported in February and March. Vomiting was the most common clinical sign, followed by diarrhea, signs of anorexia and depression, weight loss, and dysuria. The most common physical examination finding was decreased or absent anal tone, followed by absent pupillary light reflexes and elevated nictitating membrane. Results of pharmacologic testing were consistent with dysautonomia, although no single test was 100% sensitive. Histologic lesions consistent with dysautonomia were found in the autonomic ganglia, brainstem nuclei, and ventral horns of the spinal cord.

CONCLUSIONS AND CLINICAL RELEVANCE

Dysautonomia is an endemic disease in Kansas, and a high index of suspicion of the disease can be made by combining clinical signs, physical examination findings, and results of pharmacologic testing.

Canine dysautonomia: two clinical cases

Two clinical cases of canine dysautonomia are described. Two young female neutered dogs were presented with clinical signs including vomiting, diarrhoea, faecal tenesmus, dysphagia and urinary retention. Decreased tear production, dry mucous membranes, bilateral Horner's syndrome, decreased anal sphincter tone and gastrointestinal hypomotility were also observed. Presumptive diagnoses of dysautonomia were made based on the clinical presentation and investigations. Postmortem histopathological examination in one of the cases demonstrated marked depletion of neuronal cell bodies in the intestinal myenteric plexuses and parasympathetic ganglia, confirming the diagnosis in this case. Criteria for aiding the antemortem diagnosis of this rare condition based on clinical observations and diagnostic testing are proposed.

Dysautonomia in a family of German shorthaired pointers

Four, 5-week-old German shorthaired pointers from a litter of five puppies were presented for evaluation of vomiting and diarrhea. The dam was euthanized for suspected dysautonomia, and the fifth puppy died 1 day prior to presentation. On presentation, two puppies had vomiting and diarrhea, and the other two appeared healthy. The results of testing supported the diagnosis of dysautonomia in the two affected puppies but not in the healthy puppies. On day 5 of hospitalization, one apparently healthy puppy developed vomiting and diarrhea and had supportive testing for dysautonomia. Dysautonomia was confirmed at necropsy in affected dogs.

Epidemiology of equine grass sickness: a literature review (1909-1999)

The geographical spread of grass sickness between 1909 and 1999, particularly in England and Wales, is described, and the experimental investigations to identify a causal agent are summarised. The epidemiological techniques used to investigate grass sickness vary from clinical observations, to more advanced methods such as case-control studies using logistic regression analyses. Several risk factors for grass sickness have been reported consistently (age, time of year and recent movement to new pasture or premises) and several others have been reported for which the findings remain inconsistent (weather, pasture type, breed, supplementary feeding and use of anthelmintics).

Liver and biliary system pathology in equine dysautonomia (grass sickness)

Hepatocellular and hepatobiliary damage was assessed in equine acute, subacute and chronic grass sickness cases (AGS, SAGS, CGS). Histopathological analysis showed that even in some early AGS cases enlarged hepatocytes, hepatocyte vacuolation indicative of lipid accumulation (steatosis), intrahepatocyte, canalicular and periportal deposition of pigments, frequent leucocyte infiltration and cholangitis occurred. Analysis of serum indicated significantly increased levels of unconjugated bilirubin in all groups and conjugated bilirubin in AGS and SAGS groups, increased levels of bile acids in some individuals from each group and significantly increased levels of glutamate dehydrogenase (GLDH) in AGS and SAGS cases. Conjugated bilirubin was significantly elevated in urine of AGS and SAGS cases. The evidence suggests that abnormal liver function involving moderate hepatocellular pathology in conjunction with steatosis and cholestasis may contribute to the pathogenesis of GS.

Radiographic findings of canine dysautonomia in twenty-four dogs

Canine dysautonomia is an idiopathic condition resulting in loss of autonomic nervous system function. Recently, the prevalence of dogs diagnosed with dysautonomia in the mid-western United States has increased. In this study the medical records and radiographic findings in 24 dogs with dysautonomia were reviewed. A diagnosis of dysautonomia was made in 17 (71%) of the dogs in this study by postmortem examination, the remaining 7 (29%) dogs were diagnosed pharmacologically. The radiographic findings supportive of dysautonomia include aspiration pneumonia, megaesophagus, or a distended stomach, small bowel, or urinary bladder. In some instances, the disease radiographically mimicked other disorders of the gastrointestinal tract, including mechanical obstruction.

Diagnosis and management of urinary retention

Failure to empty the urinary bladder completely can be attributed to failure of detrusor contractile function, inappropriate outlet resistance, or both. For each of these mechanisms, anatomic, neurogenic, and end-organ (myogenic or idiopathic) abnormalities are possible. The approach to urinary retention involves systematic consideration of neurogenic, obstructive, and functional causes and requires understanding of the neurophysiology and pharmacology of micturation.

The neurology and enterology of equine grass sickness: a review of basic mechanisms

Autonomic dysfunction constitutes a prominent clinical feature of equine grass sickness (EGS). Significant injury to the nervous control of the alimentary system is life threatening, partly because of dysphagia but also because of the failure of the unique regulatory mechanisms in equine digestion involving water and electrolyte balance. The neuropathology also indicates the presence of a somatic polyneuropathy. The morphological features of EGS are similar to those of excitotoxic neuronal degeneration, which resembles neuronal apoptosis. It is difficult to ascertain from published accounts the degree of damage to central neurones: the distribution is well documented and selective but the proportion of damage is poorly quantified. If lesions involve a significant number of regulatory neurones they should produce functional deficits. Any clinical assessment of horses, especially those with chronic EGS, should include a thorough neurological examination. Although this will not necessarily improve the outcome of the case, it may enable the rational selection of animals with a reasonable prognosis for recovery which is partly determined by the extent of CNS lesions. The evidence supports the following pathogenesis. There is an initial lesion in the enteric nervous system of susceptible horses. In the acute form of EGS, massive enteric neuronal damage occurs first functionally, then structurally leading to generalized alimentary smooth muscle atony, enhanced secretions and altered fluid fluxes. Severe distension of the stomach and small intestines rapidly develops, which augments the intestinal ileus by intersegmental inhibitory reflexes and causes colic and dehydration. In subacute cases, failure of intestinal bicarbonate buffer together with alimentary stasis rapidly reduces caecal-colonic fermentation. Thus the osmolality of large intestinal digesta reduces and water travels out of the bowel along osmotic gradients. Water returns to the circulation, but is eventually lost in the gastric and small intestinal secretions. The observation that pathological lesions may not be seen in the prevertebral ganglia within the first few days of acute cases supports the view that a functional deficit precedes structural lesions which may be secondary to a retrograde degeneration. It is therefore possible to resolve the observations that less damage may be seen in prevertebral ganglia and elsewhere in peracute and acute cases with the more common finding that greater neuronal damage is present in acute than in chronic cases. These different observations are probably time dependent. Chronic EGS occurs when there is less initial enteric nerve damage which may lead to less secondary prevertebral ganglionic pathology, and more time for functional and structural compensatory mechanisms to develop. Denervation hypersensitivity develops at target sites both in the gut and in peripheral somatic nerves which may account, in part, for the clinical signs of patchy sweating and muscle tremors. Raised circulating adrenaline levels may also account for generalized sweating, may contribute to gastrointestinal atony and may affect pacemakers at the pelvic flexure. Many of the features of EGS make worthwhile the re-investigation of Clostridium botulinum Group III toxins, which are known to prevent vesicular exocytosis, stimulate neurosecretion, produce neuronal chromatolysis and inhibit neutrophil migration. Also, evidence from other species suggests that increased nitrergic neuronal activity can account for many of the clinical signs of EGS, namely dysphagia, generalized ileus, gastric dilatation, sweating, peripheral vasodilatation, tachycardia, salivary hypersecretion, muscle wastage and cachexia.

Functional intestinal hypomotility in association with neuronal damage in a dog

A young, crossbred dog with a 13-month history of progressively worsening, recurrent episodes of vomiting, anorexia, depression and dehydration was diagnosed as having a functional hypomotility disorder of the small intestines. During hospitalisation, the dog's condition improved only when total parenteral nutrition was administered. When fed orally, the dog developed severe gastric dilatation. Intestinal motility was minimal, but was induced by neostigmine. Post mortem findings included dilatation of the duodenum and progressive narrowing of the small bowel up to the ileum. Histopathology revealed various grades of neuronal degeneration and necrosis of the myenteric plexuses throughout the small intestine. Microscopic changes resembled those reported in dysautonomia, but were limited to small intestinal myenteric plexuses. A localised congenital neuronal defect causing a lack of parasympathetic tone is suspected.

Dysautonomia in dogs: a retrospective study

Dysautonomia was diagnosed in 11 young (median age, 14-months), predominantly medium- to large-breed dogs from 1988 to 1995. Clinical signs caused by autonomic dysfunction of the urinary, alimentary, and ocular systems were most common. Dysuria, mydriasis, absence of pupillary light reflexes, decreased tear production, dry mucous membranes, weight loss, and decreased anal tone were present in over 75% of affected dogs. Ocular pharmacological testing with a dilute (0.1%) solution of pilocarpine was used to demonstrate iris sphincter receptor function in all dogs. A low-dose (0.0375 mg/kg s.c.) bethanechol test and pharmacological testing with phenylephrine and epinephrine also demonstrated cholinergic and adrenergic receptor function in 4 dogs. All dogs died or were euthanized as a results of autonomic dysfunction. Neuronal depletion, with associated gliosis and minimal inflammation were noted histologically in the autonomic ganglia of each dog. The pelvic, ciliary, celiac, cranial cervical, and cranial and caudal mesenteric ganglia were affected in all dogs. The cause of autonomic failure in these dogs was not determined.

Cholinergic activity of intestinal muscle in vitro taken from horses with and without equine grass sickness

Equine grass sickness (EGS) is a pan-dysautonomia of horses that involves central and peripheral neuronal degeneration and ultimately depletion. This is the first reported functional study on the motility of equine intestine taken immediately post mortem from horses with EGS. Strips of smooth muscle from the small intestine of healthy and EGS-affected horses were suspended in an organ bath and their motility was measured isometrically. The activity of the cholinergic system was studied. Physostigmine enhanced the motility of all muscle strips. Tissues taken from horses suffering from acute grass sickness (AGS) had the longest latency before a measurable response could be obtained (p < 0.05). The ileum appeared to be damaged by EGS to a greater extent than the duodenum. For the duodenal strips the enhanced rate of spontaneous contractions was significant (p < 0.05) for both normal tissue and that affected by grass sickness but this was not the case for the ileal strips. Muscarinic receptor sensitivity investigation using bethanecol suggested a hypersensitivity of receptors with AGS material.

Immunocytochemical and lectin histochemical study of neuronal lesions in autonomic ganglia of horses with grass sickness

Equine grass sickness (EGS) is a primary dysautonomia characterised pathologically by lesions in autonomic ganglia, enteric plexi and specific nuclei in the CNS. Immunocytochemistry and lectin histochemistry of the autonomic ganglia were used to determine whether abnormalities can be detected in specific proteins or cellular organelles. EGS ganglia contained a mixture of morphologically normal and abnormal neurons, the former appearing identical to cells from control animals. Affected cells showed marked disturbances in neurofilament (NF) proteins and beta-tubulin, major components of the cytoskeleton; in most neurons immunoreactivity was reduced or absent while the distribution was altered in the remainder. Staining for neuron-specific enolase, a pan-neuronal marker, was severely reduced or absent, as was reactivity for the catecholaminergic enzyme tyrosine hydroxylase. However, affected neurons showed a marked increase in dopamine-beta-hydroxylase (D beta H), another enzyme associated with noradrenaline synthesis. Wheat germ agglutinin and Griffonia simplicifolia B4 lectin histochemistry was used to label membranes of the Golgi apparatus, which stained as discrete curvilinear perinuclear profiles. All affected neurons showed abnormalities with either complete loss of reaction or amorphous centrally located lectin staining. The results indicate perturbation in a wide variety of cytoplasmic and cytoskeletal proteins. In the majority of instances there is a decrease in stainable protein; the increase in D beta H may indicate a failure to be transported down the axon with resultant accumulation in the perikaryon. Loss of a recognisable Golgi structure appears to be an early event in the neuropathology of EGS.