Yellow fat disease (steatitis) in 20 equids : description of clinical and ultrasonographic findings

Diagnosis of steatitis can be challenging due to nonspecific clinical signs and ultrasonography might be a useful aid for making a diagnosis. The objective of this retrospective clinical case study was to describe history, clinical signs, ultrasonographic findings, treatment and outcome in equids with steatitis. The medical records of all equids presented to the Department of Large Animal Internal Medicine, Ghent University between January 2008 and December 2015 were reviewed retrospectively to identify horses suffering from steatitis. A total of 20 cases with steatitis were reviewed. History included dullness, recumbency, decreased appetite and weight loss. Fever, ventral oedema, stiff/painful gait and a 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. Ventral extraperitoneal, perirenal, mesenteric, coronary and caudal mediastinal fat showed homogenously increased echogenicity. The ventral extraperitoneal fat in particular 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 ventral extraperitoneal fat in the ventral flank. Steatitis was confirmed in all horses where a fat biopsy was taken (n = 13). Treatment consisted of selenium and vitamin E (intramuscular injection followed by oral treatment) supplementation and anti-inflammatory treatment (dexamethasone or prednisolone parenteral or oral) for at least 1-4 weeks. A total of 15 animals (75%) survived. Full recovery took about 2-6 months. In conclusion, steatitis is an uncommon disease in young horses usually seen during winter. It may be underdiagnosed because of nonspecific clinical signs. Ultrasonography is a useful aid for the diagnosis of yellow fat disease based upon the increased echogenicity of ventral extraperitoneal, perirenal, mesenteric, coronary and caudal mediastinal fat and increased amount of surrounding fluid.