Enteroliths are one of the leading causes of severe colic in the state of California. The word enterolith is derived from the Greek terms “entero” meaning intestinal. Case File: Enterolith. SIGNALMENT AND HISTORY. Hand A Lee. 4 year-old, American Paint Horse, mare. 4 Working / performance horse / pet. 4 Owners. PDF | To characterize the texture, mineralogic features, and chemical features of enteroliths obtained from horses. Enteroliths from 13 horses.
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PDF | Background: Enteroliths are intestinal mineral calculi predominantly composed of struvite. In horses this material accumulates concentrically around a core. The current recommendations for horses at risk for enterolithiasis include Key Words. Enteroliths. horse. colic. risk by breed and location. alfalfa hay. colon pH. Geochemical Study of an Equine Enterolith,. Medina County, Ohio. Taylor, Karen S.; Faure, Gunter. The Ohio Journal of Science. v83, n1 (March, ),
In the present patient, the enterolith showed a multiple-layered structure, resembling annual rings of a tree Figure 2. Infrared spectroscopy analysis showed that the enterolith was mainly composed of fatty acid calcium and magnesium phosphate.
Moreover, scanning electron microscopy observation of the enterolith piece immersed in water revealed that calcium-containing layers and magnesium phosphate-containing layers constitute the multilayered structure of the enterolith Figure 5. Consequently, we speculate that the enterolith gradually increased diameter because of deposition of fatty acid calcium and magnesium phosphate in an alternating manner.
To our knowledge, this report is the first to investigate the in vitro dissolubility of calcified enteroliths induced by citric acid solution. The weight of the enterolith piece immersed in double-distilled water for h showed a We speculate that evaporation of water from the enterolith by air-drying is the main cause of the weight change, although some amount of substances might have been liquated from the cut surface into water.
Energy-dispersive X-ray spectroscopy revealed that the amount of calcium, magnesium, and phosphate was lower in the enterolith piece immersed in the citric acid solution, compared with that in water.
These results suggest that calcium, magnesium, and phosphate were eluted by the citric acid solution. Moreover, based on the results obtained using energy-dispersive X-ray spectroscopy, we consider that crystalloid microparticles in the enterolith piece immersed in water Figure 4 b were inorganic substances such as calcium, magnesium, and phosphate. As described above, calcified enteroliths are considered to be formed in alkaline environments.
An in vivo equine study revealed that horses with enteroliths had higher calcium, magnesium, phosphorus, and sulfur concentrations and higher pH in colonic contents than control horses [ 15 , 16 ]. Conversely, calcified enteroliths may partly dissolve in lower pH, as shown in the present study.
We also speculate that the residue that remained after immersion in the citric acid solution Figure 3 d was organic substances, since the enterolith piece contained fatty acid and a higher amount of carbon was detected Figure 6 b.
This study has several limitations. First, because of the small size of the removed enterolith, only two pieces were used in the dissolution experiment. Therefore, statistical analysis was inapplicable to compare weight changes between the enterolith piece immersed in double-distilled water and that in citric acid solution. Second, the composition of calcified enteroliths is probably diverse in each patient [ 1 , 17 ], so an acidic aqueous solution may not be useful in dissolving all calcified enteroliths.
Lastly, because we examined dissolubility of enteroliths in vitro, further study is required prior to the introduction of a citric acid solution into clinical practice.
A possible approach is infusing acidic solution into the diseased bowel via an ileus tube or endoscopy. Investigations with regard to the utility and safety of a citric acid solution for the treatment of enteroliths in clinical settings are required as well. This study revealed that inorganic substances constituting the enterolith were eluted and the weight of the enterolith piece was decreased after immersing it in a citric acid solution in vitro.
We believe that an acidic aqueous solution has potential for the treatment of enteroliths. Conflicts of Interest The authors state that they have no conflicts of interest. References M. Jones, B.
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