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Knottenbelt Discusses Large Colon Pathology in Horses [VIDEO]

Since 2014, Professor Derek Knottenbelt and a team of researchers at the University of Glasgow, Scotland, have been studying gastrointestinal diseases in horses. Knottenbelt, an equine internal medicine specialist, is one of the most respected veterinary researchers and foremost experts worldwide.

While much research exists for understanding gastric ulcers, until now very little has been done to evaluate conditions beyond the horse’s stomach. The hindgut, and large colon specifically, has been the primary subject of this ongoing study.

In this video, Professor Knottenbelt shares the findings of the research to date.

“We were able to establish that there was definitely pathology in a significant proportion of horses that showed no other signs of gastrointestinal disease. These were horses that were destroyed for other reasons without any other history of gastrointestinal disease. We were able to find a very significant portion, probably up to 60 or 70%, have large colon pathology.”
Watch the video to hear more from Professor Knottenbelt about this research and what his team has learned so far:

Here are some of the key points and highlights from the video.

Limited Studies on Colonic Disease in Horses

Prior to the University of Glasgow team’s work, only one other study had ever been performed regarding disease in the equine large colon. Published by the Journal of Equine Veterinary Science in 2005 by Dr. Franklin L. Pellegrini, this study found conclusive evidence of colonic disease in over 60% of horses during post mortem. While the study established the presence of colonic ulceration, it did not delve into the pathologies that caused it.

Professor Knottenbelt says Pellegrini’s study reveals that there is serious concern regarding the horse’s large colon that needs to be better understood.

Taking the Research Further

Unfortunately, as Professor Knottenbelt says, “The difficulty is the same old thing: if we have to do a post mortem to diagnose the disease, we’re in trouble in terms of the horse.”

Thus, he and his team are working to further understand the range of diseases that affect the horse’s large colon. This includes identifying the causes, the associated symptoms, and methods to better diagnose, treat and prevent these conditions.

“If there are issues, there are clinical signs that we should be able to identify,” Professor Knottenbelt explains.

Too Much Emphasis on Gastric Ulcers in Horses

Gastric ulceration is widespread, especially among performance horses. But we know it exists in up to 80% of horses kept domestically, and can understand and manage it, because we can see it with a gastric endoscope. As Professor Knottenbelt explains, gastric ulceration syndrome is a huge issue for veterinarians and owners, but “solely because we can see it, so it becomes important.”

Unfortunately, the vast majority of race horses and high performance horses are on permanent treatment for gastric ulceration. And horses maintained on omeprazole will have a “downstream effect,” meaning that the hindgut is negatively affected.

But, “historically we haven’t paid any attention further down because we can’t get further down.”

Shifting Focus to Prevention of GI Disease in Horses

Professor Knottenbelt urges vets and horse owners to reconsider their approaches, as too much emphasis is placed on treatment, and not enough on prevention, as well as on the stomach. He says that we “attribute too much to gastric ulceration – more than we should.”

“We need to find fundamental ways of restoring the health of the GI tract of the horse to something like normal.”

The message ends on an encouraging note, though. As the Glasgow team continues to work out how to detect issues in the hindgut and correlate those conditions to symptoms we can observe and test, “for horses and their owners, the future looks bright, indeed.”

This video is a segment taken from a 30-minute discussion with Professor Knottenbelt on “Equine Digestive Health: New Research Challenges Common Practices”. Veterinarians may view the full video at

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