Equine Pneumonia And Long
Each year, from mid-fall into early January, equine pneumonia cases rise in South Florida as horses arrive for the winter equestrian season. Meg Miller Turpin, DVM, talks about the causes and the role long distance shipping plays as well as symptoms, prevention and treatment of equine pneumonia.
Q. What is equine pneumonia?
A. Pneumonia is an infection of the lungs most commonly caused by a virus, bacteria, fungus, or any combination of the three.
Q. Why the increase from mid-to late Fall and into early January?
A. The reason for this is because South Florida has a seasonal migration of horses from the rest of the United States as well as from Canada and other countries that travel to Wellington for the Winter Equestrian Festival, Thoroughbred and Standardbred horse racing, Polo Games, and other horse events. Horses also come to South Florida in the winter just to escape the cold winter climates of our northern neighbors.
The horses are arriving after long distance transportation which makes them very susceptible to developing pneumonia, especially on horse trailers but also with air travel. Horses immune systems become compromised due to the stress of transportation as well as high levels of dust and particulate inhalation during transport in a horse trailer.
Q. Are some horses more susceptible to pneumonia then others?
Q. How can horse owners lower the risks of long-distance trailering?
Q. What symptoms should caretakers be looking for when the horses arrive?
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How To Prevent Respiratory Infection And Fever While Hauling Horses
All long-distance travel can cause shipping fever in horses, but you can reduce the risk of respiratory infections and shipping fever during traveling by:
- Taking frequent breaks: This step gives the horse a chance to move out of the trailer and exercise its legs. The lungs will expand, and fluid wont accumulate in them.
- Provide adequate water: Many horses become dehydrating during travel, opening them up to infection.
- Administering a dose of Zesterra®: Zesterra® is a natural immune booster. It helps to neutralize the excess gastric acid released due to stress. It also encourages the growth of beneficial microbes, while improving their appetite and ability to eat and drink immediately after the trip.
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What Is Aspiration Pneumonia
Aspiration pneumonia has a high fatality rate, so it is better to prevent it than treat it, but if it is caught early enough, aggressive treatment may be successful. In fact, the survival rate has been getting better and there is now a 75% survival rate compared to less than 50% about 10 years ago. An otherwise healthy horse may recover within a few months with antibiotics and daily treatment. The way aspiration pneumonia happens is can be from inhalation during eating , or inhaling foreign materials when being worked or ridden at high speeds. The pneumonia damages the cilia in the trachea and it can take several months for new cilia to grow, causing the lengthy recovery time.
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Immunity To Infection In Horses
The incidence of the disease peaks in foals at 6-12 weeks this coincides with the period when maternal antibody, derived from colostral milk, has largely declined and before antibody produced by the foal has developed. It is thus important to ensure that foals get their full share of colostral antibody immediately after birth.
In future, scientists may be able to find ways to promote antibody production by mares or foals to protect them during what is apparently a time of critical susceptibility to the disease. In the first 4 months of life, foals must be protected from potentially serious damage to the lung caused by inhalation of the Rhodococcus equi bacteria. Why young foals are so prone to this organism, compared to other offspring is not known, but they grow out of this susceptibility by 5-6 months of age. Probably, most foals develop antibodies to the organism, without the disease being apparent. The development of natural immunity appears to be slow and is inadequate in the young foals in the face of heavy challenge by inhalation. No vaccines are available to control this infection and it seems unlikely that an effective vaccine will be produced in the near future. Although the basis of immunity to this pneumonia in foals is not adequately understood, it is difficult to produce vaccines to promote the cellular type of immunity which is thought to be particularly important in immunity to Rhodococcus equi pneumonia.
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How Do You Treat Foal Pneumonia
R. equi pneumonia is often not recognized until it is well advanced and, therefore, difficult to treat. It has been proven that catching the disease early in its course dramatically improves the odds of curing it. A variety of screening techniques have been used to detect the disease early, including close observation for increased respiratory rates or failure to nurse, monitoring rectal temperatures twice daily, frequent blood samples, and ultrasounding the foals chest weekly.
Over the past 10-15 years, control of R. equi infections at many farms, where the disease commonly occurs each year, has relied on ultrasounding the foals chest and the initiation of antibiotics prior to the development of clinical signs. Additional diagnostic tools your veterinarian may use not only to diagnose R. equi pneumonia but also to differentiate it from other diseases include transtracheal wash where a small needle is passed through the foals trachea and a tube inserted to collect fluid samples from the lung. The collected fluid is then cultured and checked for R. equi DNA as other common bacteria may cause pneumonia. Radiographs of the chest can also confirm the disease by locating lung abscesses caused by R. equi.
For additional information on R. equi infections in foals, go to the AAEPs guides for infectious diseases at aaep.org/guideines/ infectious-disease-control/using-guidelinesor talk to your local veterinarian.
Treatment Of Viral Respiratory Diseases
Viral respiratory diseases can mimic more serious respiratory diseases. Your attending veterinarian will examine affected horses to determine the seriousness of the illness. The most important component of therapy for uncomplicated viral respiratory diseases is rest. Stress should be kept to a minimum. If possible, the horse should not be hauled long distances and forced exercise of any kind should be discontinued. Affected horses should be housed in an area with good ventilation, and dust should be kept to a minimum. Unless the weather is inclement, sunshine and fresh air may be the best environment for recovery.
It is important to remember antibiotics are not effective against viruses. However, for the horse with severe viral respiratory disease or one that is stressed for another reason, appropriate antibiotics may be administered prophylactically to decrease the chances of opportunistic bacteria causing a more severe disease. It also is important to remember it can take a prolonged period of time for the respiratory tract to heal from a viral infection. The typical recommendation for rest of the respiratory system after a viral infection is one week of rest for every day of fever.
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How Can Rhodococcus Equi Be Prevented
Since there are no available vaccines for the prevention of R. equi infection, farms may choose to perform regular screening, often by ultrasound, to detect foals in the early stages of disease. In the absence of definitive diagnoses, this can lead to antibiotic treatment of unaffected foals and potentially contribute to antibiotic resistance.
Hyperimmune plasma is sometimes administered to foals intravenously within the first week of life, but it does not necessarily prevent R. equi infection in all instances.
Good management includes limiting overcrowding of foals, and ensuring that they are housed in well-ventilated areas where dust is minimized. Dirt paddocks should be avoided. Foals that appear ill should be removed from group settings and their manure managed appropriately.
Therapy And Treatment By The Vet
Generally it is really helpful to describe all your observations in a detailed way to the vet. Referring to this the situation in which the horse coughs may have significance. You can ask yourself the following questions: when does my horse cough? Does he cough when he eats, in certain seasons or when he offers physical exertion? Through these details it will be much easier for the vet to guarantee the right diagnosis. Additionally he will examine the blood screening and auscultate the airways and lung. He localizes the inflammation and prescribes the right antibacterial which mitigates the irritation. In addition to this expectorant substances help to cure the cough. Vets advise an entire immobilization until the complete recovery of the horse. It is indispensible to behave like this because if you do not your horse can get a chronic situation of the respiratory disease.
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Bacterial Pneumonia In The Horse
Pneumonia refers to inflammation of the lungs. In horses, this is usually due to a bacterial infection, most commonly the streptococcal species.
Most horses get pneumonia by inhaling bacteria, which are often normal inhabitants of the upper airways. The lungs are usually able to clear the bacteria rapidly. However, if your horse has a depressed immune system, or has taken in an overwhelming dose of bacteria, then he may not be able to get rid of the bacteria, and pneumonia will develop.
There are many risk factors for bacterial pneumonia: those most important include a recent viral upper respiratory infection, moderate to severe exercise or overtraining, long-distance transport, overcrowded barns, and esophageal obstruction .
Treatment Of Affected Foals
Affected foals need prolonged treatment because of the persistence of the bacteria within abscesses in the lung and because immunity to lung infection is poor, the disease tends to recur. Recent research reveals the combination of the antibiotics, erythromycin and rifampin is effective in the treatment of the disease. These expensive drugs can be given orally, a definite advantage over alternative treatments. These drugs penetrate the phagocytic cells where Rhodococcus equi are found, and are not toxic when used over prolonged periods. The combination should be used for at least one week past cure, determined clinically by the use of x-rays or by blood tests for normal fibrinogen levels. Other drugs, such as gentamicin or trimethoprim-sulfamethoxazole, are effective but need to be injected. Because of its toxicity, gentamicin cannot be used for prolonged periods in foals suffering from this disease. However, controlling the infection on endemic farms solely by treating diseased foals is both an ineffective and expensive approach.
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How Can A Diagnosis Be Made
Specific blood tests can be used to determine if a respiratory infection is associated with EHV-I or 4 infection. In most cases, two blood samples are taken 10 days to two weeks apart and tested to see if antibodies have been produced to one of the viruses . While the horse is often well on the way to recovery by the time results are available, the information may help with the management of other horses in the same yard.
It is not possible to predict or diagnose an abortion due to EHV-1 or 4 on the basis of a blood test. The mare may have been infected several weeks before the abortion occurred and even when seroconversion is demonstrated, this cannot be differentiated from coincidental respiratory challenge. A specific postmortem examination must be performed on the dead fetus or foal to look for characteristic pathological changes and specific samples must be collected for laboratory examination to detect the virus.
Coital exanthema is usually diagnosed and acted upon on the basis of typical clinical signs . In some cases the infection maybe confirmed by demonstration of EHV-3 antibody seroconversion in paired blood samples collected 10 days apart and by isolation of EHV-3 virus from fluid collected from the blisters.
Vaccination in the face of disease, i.e., where an abortion or paralysis case has occurred is not recommended as horses who are incubating infection may react badly to vaccination.
The benefits of vaccination therefore include:
Equine Respiratory Infections And Shipping Fever
Equine respiratory infections affect the breathing, feeding and performance of horses. Common signs of a respiratory infection include a cough, runny nose, fever and depressed or listless behavior. Diseases of the respiratory tract are common in winter, spring and fall.
Similarly, shipping fever can occur due to a horses lungs being damaged during a long trip. The risk of this damage increases with the length of the trip and, in some cases, the damage could be fatal. Below are some important details about equine respiratory infections and shipping fever.
Foal Pneumonia: Symptoms Treatment And Prevention
Rhodococcus equi is a bacterium that causes pneumonia and death in young foals between 3 weeks and 5 months of age.
Note: The American Quarter Horse Foundation has funded research regarding foal pneumonia, including “Entry and Modulation of Signaling Pathways of Macrophages by Rhodococcus equi.” The Foundation fills a vital role by being just one of four private institutions funding research. Make a contribution at www.aqha.com/equine-research.
Rhodococcus equi is a bacterium that causes pneumonia and death in young foals between 3 weeks and 5 months of age.
R. equi can be cultured from the soil of virtually every horse property, but the disease tends to affect foals on some farms and not others. Infections in adult horses is extremely rare.
Respiration Of A Horse
Through the nostrils oxygen enters into the organism of the horse. Possible disturbing particles become filtered by the trachea and the nasal cavity so that the clean oxygen can float on. The trachea ends in the bronchus which is the root of the lung. The bronchia itself is divided into two main bronchia and plenty of bronchioles. These smaller bronchioles consist out of pulmonary alveoli which form the lung tissue. The lung consists out of thousands of these alveoli because they guarantee the most important function of the lung: the gas exchange. This means that oxygen is taken from the air and carbon dioxide which comes from the blood gets emitted from the organism .
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Preventing Spread Of Infections
In an ideal situation, any horse new to the ranch/farm would be isolated for at least two weeks, and any sick horse would immediately be put in isolation with no contact with other horses. In reality, this is rarely possible, and even if it were, theres a good chance that the sick horse had a fever and was shedding viruses or bacteria before he even developed the red-flag warning signs of nasal discharge or cough.
If the worst case scenario happens and a horse in your barn comes down with a respiratory illness, involve your vet immediately. Some sanitation measures and precautions will depend on exactly what the problem is. In general:
Adequate Rest. Just like a human patient, the horse with a respiratory infection needs a comfortable place to rest. Equally important is not to try to put the horse back on a full work or social schedule too soon. You need to give his tissues time to completely heal. Wait at least a week after coughing has stopped and nasal discharge dried up before you turn the horse out with other horses or resume riding, two weeks for influenza. Gradually build back up to your previous work schedule.
Prevention The single most important protection against respiratory infections is promoting a strong immune system in your horse through good management. Adequate intake of quality protein, vitamin C, vitamin E, and the trace minerals zinc, copper, and selenium is critical.
Acute Bronchointerstitial Pneumonia In Foals
Acute bronchointerstitial pneumonia is a sporadic, rapidly progressive disease of foals characterized by severe respiratory distress and high mortality. This sporadic disease has been reported in North America, Australia, and parts of Europe. The cause is not clear. It is likely that a number of different factors can start a chain of events resulting in severe lung damage and acute respiratory distress. Warm weather is a common factor. Many foals have a history of receiving antibiotics at the time signs developed. No virus is consistently isolated, and no bacterial agent has been consistently identified in infected foals.
The age of affected foals ranges from 1 week to 8 months. Acute bronchointerstitial pneumonia has a sudden onset and is accompanied by high fever. The disease progresses rapidly and may result in sudden death from respiratory failure. Foals are unable or reluctant to move and usually have bluish mucous membranes from lack of oxygen. Severe respiratory distress is the most striking clinical sign. Veterinary evaluation of foals with respiratory distress typically includes arterial blood gas, blood tests, chest x-rays, and culture of samples for identification of bacteria or viruses. The arterial blood gas findings measure the severity of respiratory impairment and are used to monitor the foals response to therapy.
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Diagnosis Of Pneumonia In Horses
Your veterinarian will need your horses medical history, vaccination records, recent illnesses or injuries, type of work performed, and what symptoms you have seen so far. A complete physical examination will need to be done, which should include palpation of the lungs and abdomen, listening to your horses lung sounds, and recording body temperature, weight, height, reflexes, capillary refill time , body condition score, personality, blood pressure, pulse, respiration rate, and conformation. You may need to trot, canter, and walk your horse while the veterinarian watches, analyzing behavior, muscle performance, and joint function while in motion. The veterinarian will start with a standing examination, checking your horse from head to tail looking for anything out of the ordinary such as swelling, warmth, redness, or lesions.
For any kind of pulmonary or respiratory illness in a horse, several thoracic radiographs , ultrasounds, and CT scans are necessary. Collecting samples of fluid through a bronchoalveolar lavage or tracheal wash are also important in determining the cause. Microscopic examination of lesions taken from tissue and sputum from the lungs and airway can be extremely helpful. However, the most definitive tests are microbiologic culture, immunohistochemistry, or polymerase chain reaction. In addition, a complete blood count , chemical panel, blood and urine cultures, and blood urea nitrogen will be done.