Decision Making in Equine Grass Sickness

Equine grass sickness (EGS), a neurological disease associated primarily with degeneration of neurones of the autonomic (including enteric) nervous system, affects all equidae, is usually fatal (with the exception of some milder cases) and has an approximate incidence of 1% in some parts of the UK (Lyle and Pirie 2009). The subdivision of EGS into 3 forms (acute, sub-acute and chronic) largely reflects both the extent of neuronal degeneration and the associated degree of intestinal dysmotility.

With regard to decision making in EGS, there are 3 principal areas which warrant specific attention: (a) maximising diagnostic accuracy; (b) maximising prognostic accuracy and (c) choosing appropriate disease avoidance strategies.

Maximising diagnostic accuracy
Many cases of EGS are diagnosed on clinical grounds, based on the recognition of the classic clinical signs. With regard to acute cases, there is a degree of urgency required when making a clinical diagnosis, as the principal differential diagnoses include strangulating and nonstrangulating small intestinal obstructions, most of which require immediate surgical intervention. [...]