Diarrhea, Clostridial
Basic Information 
Clinical Presentation
Disease Forms/Subtypes
Physical Exam Findings
• As for other causes of colitis (see “Colitis/Diarrhea, Acute”).
• Hemorrhagic diarrhea is seen frequently (but not always) in horses with colitis caused by C. perfringens.
• In some cases, the initial findings are more consistent with proximal enteritis than colitis (see “Enteritis, Proximal” in this section), with moderate- to large-volume gastric reflux and small intestinal distension on rectal examination.
Etiology and Pathophysiology
• Clostridial organisms are anaerobic, spore-forming, gram-positive rods.
• Many clostridial species, including some strains of C. difficile and C. perfringens, may be normal enteric flora in horses.
• Clinical disease occurs as a result of overgrowth of, or infection with, toxin-producing strains.
• C. difficile can produce at least five toxins, of which type A (enterotoxin) and type B (cytotoxin) are best understood.
• C. perfringens can also produce several toxins. The two most common isolates identified in clinical disease in horses include type A, which produces the α toxin, and type C, which produces the α and β toxins. Some strains may also produce enterotoxin, which has also been associated with clinical disease.
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