Ulcerative Duodenitis
Basic Information 
Clinical Presentation
History, Chief Complaint
• Colic (usually mild and recurrent, but may be acute)
• Inappetence, fever, diarrhea, and weight loss (most frequently described)
• ± Spontaneous nasal reflux of gastric contents
• ± Signs associated with concurrent gastroesophageal ulceration (bruxism, hypersalivation, colic associated with eating; see “Gastric Ulceration in Foals” in this section)
Physical Exam Findings
• No significant abnormalities may be identified or poor body condition, dehydration, or variable tachycardia (caused by pain associated with gastric distension) may be present.
• If duodenal stricture and pyloric outflow obstruction have occurred, large-volume gastric reflux is usually obtained on passage of a nasogastric tube, although this may not be present if a concurrent gastric impaction is present.
Etiology and Pathophysiology
• The specific cause of ulcerative duodenitis is unknown.
• Damage to the duodenal mucosa as a result of exposure to excess gastric acid and pepsin, as in gastric ulceration (see “Gastric Ulcers in Foals” and “Gastric Ulcers in Adult Horses” in this section), has been theorized to play a role in the development of ulcerative duodenitis.
• However, reports of possible outbreaks of ulcerative duodenitis in several foals on a single farm suggest an infectious cause may be involved in some cases, although a specific pathogen has not been identified to date.
• Clinical signs of abdominal pain and fever are associated with duodenal inflammation in the early stages of the disease.
• In the later stages, fibrosis occurs as a result of chronic inflammation and may lead to duodenal stricture and gastric outflow obstruction (see “Pyloric Stenosis” in this section).
Diagnosis 
Initial Database
• Complete blood count: Evidence of chronic inflammation, with leukocytosis, hyperfibrinogenemia
• Transabdominal ultrasonography
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