Due to decreasing use over the years, I have decided to disable the forum functionality of the site.

Forums will still be available to view but new posts are no longer allowed.

Strangles or Not?

Maigray March 18, 2011 March 18, 2011

Forums

Okay guys, I have a serious situation at my barn. I'm just going to give you all the details and let you run with it. I want thoughts, impressions, opinions, whatever... This is a huge barn, about 50-60 boarders + the owner's 20 horses. I brought a horse in exactly 21 days ago. Arrived on Friday at 7am. He's a coming 3 year old gelding, out of Missouri. He had a rough transit. Was picked up on the preceding Tuesday, and trailered down to Kentucky, where he overlaid for 2 days at a farm in Lexington. Haulers were switched, but both professional rigs. He begins trailering to me on Thursday. Rig is late and horse overnights in trailer and comes in at 7am on Friday morning. I take him off that trailer personally and walk him to his isolation paddock. There are 2 isolation paddocks. There is another horse in the adjoining paddock, a chestnut gelding who was taken out of an auction. Paddocks are ringed with hot wire on all sides and have an aisle between them. The two horses cannot touch. After a day or two, barn owner informs me she has heard my horse cough. She believes it is only transport stress. Cough seems to disappear after another day. Two weeks to the day after he came in, he and his neighbor are released from their isolation paddocks and put in the arena field, which borders the field where the main herd is kept. This is preliminary to them being released into the main body of the herd. The next day, I see them pulling a nose swab off his pasturemate, the chestnut gelding. I am IMMEDIATELY concerned. I am told strangles was already ruled out based on a previous swab, but this horse still has a respiratory "thing" and they doing another swab and a culture. I question why they were turned out together and exposed to the herd if this is still going on? No real answer. On Sunday, I notice my horse has a runny nose, but fluid is minimal and mostly transparent. I leave the barn owner a message. Fast forward to this Wednesday. I get a message in the late afternoon to call the barn owner on her cell phone. I call. She gives the news - they think my horse strangles. Of course, my heart sinks to the bottom of my shoes. I go and talk to her. Dentist was out that day, and they pulled my gelding in to check his teeth. She says he was coughing, had a temperature and enlarged nodes. They lanced them, gave him antibiotics, left flush, cephalexin and naxcel for me. The attending veterinary left notes that they pulled tan colored pus and chunks from the nodes. Barn is under voluntary quarantine while we wait for the culture results. Meanwhile, as you can imagine, I am HITTING THE ROOF. I question barn owner closely about my gelding's pasturemate. He was tested, she said, for strangles off a nose swab when he first came, as well as with the follow up the past weekened. Results say he has Strep. zooepidemicus and is currently on antibiotics. She claims she had the vet look at both horses and it was the vet who said they could be released from isolation. She thinks my horse carried it in from his haul. My horse is back in isolation. His pasturemate stays in the arena field. I have talked to the vet who was on hand at the time. She believes it is strangles and was dormant until now. My horse has a temperature. I have not heard him cough. He has no nasal discharge and is not off his feed or acting sick. If it is strangles, it appears to be a mild case, at least. I am in favor of letting the infection run its course and keeping him comfortable. She wants to treat with the naxcel and flush the nodes with cephalexin. I am questioning whether this is an alternate strep infection picked up from his pasturemate, as it appeared 5 days after they were turned out together.

Monsterpony Fri, 03/18/2011 - 12:27

OK, I must preface this with saying I wasn't there and didn't actually see what was going on or what the vet saw, but I would agree with you on the treatment. Given the swollen, abscessed lymph nodes, strangles would be my top differential. The fact that he didn't show signs until >2 weeks after arrival make it more likely that he picked it up at your facility, but not necessarily. Antibiotics are rarely needed in strangles cases, in fact, they could even be contraindicated as they may increase the risk of developing bastard strangles and increase the time it takes to recover. Unless he is incredibly ill with a severe fever and difficulty breathing, I would not use antibiotics. Flushing the nodes with antibiotics is also something I would question as that is really just going to pour a bunch of antibiotic on the ground. If I were the barn manager, I would not allow the other horse out of isolation either. He has been at least exposed to it (if not the source) and is a ticking timebomb. Let's hope that he is not infecting the rest of the herd while out in the pasture. Also, what kind of nasal swab did they do? Only one that swabs the guttural pouches is really accurate enough to say that the horse isn't likely a carrier.

Maigray Sat, 03/19/2011 - 14:20

They only did a nasal swab, which I also questioned. The attending vet and I are at loggerheads. Thank you for your opinion. The culture did come back positive for strep. equi.

Rusti Sat, 03/19/2011 - 18:31

I really can't be of any help as I've never dealt with strangles, but I just wanted to tell you I'm wishing the best for you and your new gelding! Poor guy has been through quite an ordeal. I'm glad that he isn't feeling terribly bad. Keep us posted.

critterkeeper Sat, 03/19/2011 - 19:27

I'd find another vet to do a second opinion...I have seen too many over worked individuals make questionable diagnosis and then get testy when it is questioned - insisting that THEY are right |( (not just vets, but MD's too). Your horse's health is at stake so it is worth the investment...

Maigray Sat, 03/19/2011 - 22:06

Thank you both. I have a second vet coming for another opinion and I have requested another culture to confirm. I have also solicited 2 other vets by phone and several I know personally through internet/email. In the meantime, I refused all antibiotic treatment on my horse. The barn owner would rather follow her own vet's recommendation, and this is causing tension between us. Sadly, it was also a very nice Saturday and all the boarders were coming out to ride. No one had been warned about the situation, as the barn owner wanted to wait until diagnosis was confirmed. So she had to intercept them all before hitting the trails. It's not a great situation.

rabbitsfizz Mon, 03/21/2011 - 13:25

I have had so many strangles cases over the years- I do not see what the fuss is, I really don't, I used to put my youngsters in with the sufferers so that they would catch it- it was easier to deal with it when they were healthy and I was ready for it than stand the chance of them going down with it when they were older, possible;y infirm or in foal.
Anyway, stick with the "no antibiotics" they can be really dangerous and are of no practical use unless the horse is ill with a secondary infection.
It is quite possible that your horse brought this in with him, the Vet is right about that, it could have laid dormant and something just triggered it- possibly something as silly as moving him form one pasture to another just pushed the stress level over the threshold et voilà.
Good luck with him, I think you will be fine, though.

rodeoratdogs Mon, 03/21/2011 - 13:41

I've never had a horse get it, but I don't board whet there are other horses. I heard there was some cases of pigeon fever in eastern wa. I wonder are they a similar virus.

Monsterpony Mon, 03/21/2011 - 19:23

Neither strangles nor pigeon fever is viral; both are caused by bacteria. Both diseases are defined by nasty discharge, but they work in different ways on different body systems. Strangles is caused by [i]Streptococcus equi equi[/i] and causes disease in the upper respiratory system and associated lymph nodes. Pigeon Fever is caused by [i]Corynebacterium pseudotuberculosis[/i] and results in infected soft tissue and abscesses in legs and pectoral region; the swollen pectorals are where the disease gets its nickname as the horse's chest looks like a pigeon's.

rodeoratdogs Mon, 03/21/2011 - 19:54

Hmmmmmm, thanks MP, I knew you would educate me on the subject better. I'd just like to say to Maigray so sorry, hope your horse gets better soon, somthing like that would drive me up a wall, I'm a real germaphobe. I don't like my animals being sick anymore than I like being sick.

On the Pigeon fever MP, is it more common in dryer climants?

Monsterpony Tue, 03/22/2011 - 00:19

Pigeon fever is spread by flies so it tends to occur in warm, dry areas following rainfall. You normally see it in fall or spring when the weather is temperate. Basically, it spikes when manure stays damp enough to support eggs, but warm enough for adults to survive. It is endemic in the rocky mountain dryland region (Colorado has the highest incidence).

Maigray Tue, 03/22/2011 - 10:13

Thanks for all the well wishes, everyone - and thank you Heather for offering to share the protocol. I sincerely hope it's not needed! I am really baffled about how it has all been handled. Chestnut gelding is still in the arena field. My gelding is fine back in his little isolation paddock, though depressed. I think it has as much to do with being yanked away from his buddy as anything. I have stood my ground on his treatment but everyone else seems to be of the opinion he should be hit with everything they've got and this will prevent complications and clear it up faster. I am of the exact opposite opinion. I am more than a little ticked they commenced treatment without clearing it with me first anyway - the lancing and medicating that happened at the first visit was done without my consultation. No one else I have ever spoken to has advocated treating a case like this.

rabbitsfizz Tue, 03/22/2011 - 12:00

I certainly think they jumped the gun with the lancing- you might want to consider some low grade a/bs in case this becomes infected?
I would also, just as pre-emptive damage control, take a moment to write it all down carefully with dates and maybe run it all by a solicitor who knows horses. I should want to know where I stood if my horse needed treatment due to their treatment, myself.
I should also need to know exactly where I stood if someone at the barn decides to sue you if their horse gets strangles- I [i]know[/i]that treatment would not prevent it being contagious but we all know horse people are CRAZY........(and I still miss our old smileys when are we going to get some decent ones??)

critterkeeper Tue, 03/22/2011 - 16:07

[quote=rabbitsfizz]I would also, just as pre-emptive damage control, take a moment to write it all down carefully with dates and maybe run it all by a solicitor who knows horses. I should want to know where I stood if my horse needed treatment due to their treatment, myself.
I should also need to know exactly where I stood if someone at the barn decides to sue you if their horse gets strangles- I [i]know[/i]that treatment would not prevent it being contagious but we all know horse people are CRAZY........(and I still miss our old smileys when are we going to get some decent ones??)[/quote]

I agree with RF on this issue...we live in a very litigious society and they will sue anyone for any reason at the drop of a hat...some don't even need a reason...

I also agree about the smilies...we need our old ones back and maybe even a few new ones...hehehe at the very least a good DNA-Man or the Sabino-Goat

Monsterpony Tue, 03/22/2011 - 19:56

I have to say that I was more than a little shocked that they wanted to hit this with hard core treatment when such treatment has been shown to prolong healing and worsen outcomes. Lancing the lymph node would depend on what I saw first hand, but the antibiotics goes against gold standard of treatment.

Maigray Wed, 03/23/2011 - 09:01

Thanks MP - I was really starting to wonder if I had lost my mind! And thank you to everyone who is wishing him well. Here he is - a sad sack. He is noticeably sick now. This was taken yesterday and his fever was down slightly. It peaked the day before. He is coughing. I was thinking as you suggested, RF, and did start pushing some local antibiotic into the nodes. Like you, I think they probably jumped the gun lancing, and I am worried it is a source of secondary infection. I do have my second opinion coming in this afternoon to look at him. I am hoping, though, that this is the hump, and once past it, he will start recovery. He is eating and drinking, but only picking at his hay, and has lost weight. That stuff in front of him I dumped under his nose about a minute beforehand. The next day or two should be the tipping point. I feel like this is a simple case that is just being blown out of context..

[url]http://www.youtube.com/watch?v=PcFC2ScS…]

Morgan Wed, 03/23/2011 - 13:18

I brought a horse home from auction a few years ago that picked up strangles along the way (possibly the stall at the arena?) I didn't have her actually isolated but she was kept separate with only 1 other horse to get her used to the new place when she came up with the symptoms. She was miserable for weeks but the vet just wanted it left alone and she eventually got better. 2 of my other horses got a slight snotty nose but otherwise fine, their immune systems were good while she was super stressed I think. I was more inclined to actually quarantine after that though. :(

Maigray Wed, 03/23/2011 - 21:42

We're past the worst. His fever plunged sharply today. A third abscess has appeared under the jaw, and has burst on its own. This is the real infection coming out. He was brighter, and calling to the other horses today. My second opinion came out and we were much more compatible in our treatment strategies. Our outlook - some bute to keep him comfortable, ichthamol on the abscesses, probiotics, and a good mineral supplement. She also gave me some hepar sulfur, and suggested echinacea and whole flax (which I may or may not do).

Good lord, I'm relieved.

Monsterpony Wed, 03/23/2011 - 23:47

Whole flax? You need to grind it or you are just going to produce a lot of expensive bird food :D I always love a vet that suggests mineral supplements.

NZ Appaloosas Thu, 03/24/2011 - 15:34

Perhaps she meant 'whole' as in buy it whole and grind it rather than buying the already ground or processed flax?

Diane

Maigray Thu, 03/24/2011 - 21:31

It's funny you should ask..I don't really know. I come out in the evenings, sometimes quite late, I treat my horse and I leave. I may go into the yard to socialize before I treat him, but this does not generally happen during the week. I presume he is not showing symptoms, but he could still be a carrier. Plus, he is on antibiotics for his strep. infection, which could be suppressing symptoms.

My main concern was actually always about spreading the infection. In such a large barn, it could run through like wildfire, and knock us out for the whole spring and into summer. Strangles on your own property is all well and dandy, but when you are boarding at such a large facility, there can be a huge economic cost attached. I could well be asked to leave if that happens, with hostility from other boarders and the barn owner. And it could still happen. RF brought up certain other consequences as well, especially considering I refused the barn vet's treatment.

Maigray Sat, 03/26/2011 - 23:04

I spoke too soon...His fever starting trending upward again and his weight loss has progressed. I saw him this afternoon to medicate him and offered him a warm mash, which he ignored. The barn owner calls that evening me to tell me he's off his feed. I'm en route to blanket him, because, incredibly, we're supposed to get snow tomorrow.

When I ge there, I check his hay - untouched. His grain - untouched. The chopped forage - untouched. The mash still sitting where I left if for him. I carry his grain bucket up to him and hold it for him while he eats. He eats about 2/3rds, then quits. I talk with the barn owner. He's never gone off his feed, not when his fever was 103.7 F and he was picking at his hay, the grain still got eaten. His fever is hovering now at 102.5 F (39.2 C).

We have a problem.

On the road back home, it's 9pm now, and I'm now worried enough to call my vet. She says hit him with the naxcel and the banamine. Tonight. So I go home, 'round them up, go back and medicate him. That's when I hear it - the classic "strangling" sound. It's starting to obstruct his breathing. That's why he won't eat.

I have no choice now but to hit him with everything I've got. His body condition is such that he can no longer afford to lose weight while we wait for abscessation, and a colic episode may well kill him.

Daylene Alford Sun, 03/27/2011 - 12:01

I'm sorry things have gotten worse. I hope things start looking better soon. Please keep us posted.

If you said I missed it, what breed is he?

rodeoratdogs Sun, 03/27/2011 - 14:11

Oh my, I'm so sorry things have gotton worse instead of better, saying prayers for your poor little guy, gosh :-S.

Dilutes Sat, 04/02/2011 - 20:46

Sending as many recovery vibes as I can ~~~
The poor boy and you too. I can imagine the stress this has put on you. Take care of him and yourself too.

Maigray Sat, 04/02/2011 - 22:49

He is in recovery...We think. His temperature has been fluctuating. It hit 103.5 on Wednesday, was back down to 102 on Friday. We believe the retropharyngeal nodes ruptured inwards. But he is definitely brighter and his appetite has improved markedly. I pray for no complications.

The quarantine on the barn has been lifted. No other horses seem to have caught it. A silver lining in the whole mess, at least. He is in isolation for at least another week. Took him off the Naxcel on Friday and put him on SMZs. An inward rupture and a prolonged recovery were the very things I was afraid of when we put him on the antibiotic regime, but it couldn't be helped.

Looking back, perhaps I should have tried to push him through it. But I was too afraid. I thought he was too underweight and had been fighting it for too long. My temper has not been helped by the various egos involved either...

[quote]If you said I missed it, what breed is he?[/quote]

Forgot to say - this is an Arabian/Warmblood cross.