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Yellow Fat Disease (Steatitis): Description of 20 Cases with Emphasis on Typical Ultrasonographic Findings

Loon, G., Lefère, L., Bauwens, C., Kleyn, K., Broux, B., De Clercq, D., Deprez, P.
Equine veterinary journal 2015 v.47 Suppl S48 pp. 19
appetite, asses, biopsy, creatinine, dexamethasone, edema, ethics, fever, funding, gait, geldings, hematocrit, inflammation, lactate dehydrogenase, mares, neck, oral administration, patients, pericardium, prednisolone, retrospective studies, selenium, stallions, steatitis, ultrasonics, ultrasonography, vitamin E, weight loss
REASONS FOR PERFORMING THE STUDY: Yellow fat disease or steatitis is characterised by a local or general inflammation of fat tissue and is occasionally found in horses. Diagnosis is challenging because of the wide range of nonspecific clinical signs. OBJECTIVES: To describe clinical signs, treatment, outcome and ultrasonographic findings in horses with steatitis. STUDY DESIGN: Retrospective study (January 2008 to January 2015). METHODS: History, clinical signs, ultrasonographic findings, diagnosis, treatment and outcome were recorded. RESULTS: Twenty cases (18 horses, 2 donkeys; 9 mares, 9 stallions, 2 geldings) were retrieved from 13,707 patient records. Mean age was 1.6 (± 0.8) years (range 1 month–3.5 years). All cases appeared between October and February except for one (August). History included dullness, recumbency, decreased appetite and weight loss. Fever, ventral oedema, stiff/painful gait and painful neck were found. Low haematocrit, low vitamin E and selenium and increased levels of creatinine kinase and particularly lactate dehydrogenase were almost consistent findings. On ultrasound, ventral oedema was found. Subperitoneal, perirenal, mesenteric, coronary and caudal mediastinal fat showed homogenously increased echogenicity. Especially the subperitoneal fat was surrounded by oedema or free fluid. Increased amounts of abdominal, thoracic and pericardial fluid were often found. Fat biopsies were taken in the neck or from the retroperitoneal fat in the ventral flank. In all horses where fat biopsy was taken (n = 13), steatitis was confirmed. Treatment consisted of selenium and vitamin E (intra‐muscular injection followed by oral treatment) supplementation and anti‐inflammatory treatment (dexamethasone or prednisolone parenteral or oral) for at least 1–4 weeks. Fourteen animals (70%) survived. Full recovery took about 2–6 months. CONCLUSIONS: Yellow fat disease may be underdiagnosed because of the nonspecific clinical signs. Ultrasound was extremely helpful for making a diagnosis. Recovery was rather slow but was achieved in 70% of the animals. Ethical animal research: Research ethics committee oversight not currently required by this conference: retrospective study of clinical records. Explicit owner informed consent for inclusion of animals in this study was not stated. Source of funding: Ghent University (institutional). Competing interests: None declared.