Retropharyngeal lymph node infection in horses: 46 cases (1977–1992)

SUMMARY A retrospective study of 46 horses with retropharyngeal lymph node (RPLN) infection presented to the Rural Veterinary Centre between 1977 and 1992 was undertaken. Horses aged less than one year were most commonly represented (46%). Thirty-nine percent of cases had been exposed to horses with confirmed or suspected strangles (Streptococcus equi subsp equi infection) within the previous 8 weeks. Most frequent signs were unilateral or bilateral swelling of the throat region (65%), respiratory stertor/dyspnoea (35%), purulent nasal discharge (20%), inappetence and signs of depression (15%), and dysphagia (9%). All horses had a soft tissue density in the retropharyngeal region on radiographs. Rhinopharyngoscopy, ultrasonography, haematology as well as cytological and microbial analysis of material aspirated from the soft tissue swelling facilitated diagnosis in some horses. Fifteen horses (33%) were treated with procaine penicillin intramuscularly for 4 to 7 days followed by oral trimethoprim-sulphadimidine for 7 to 14 days. Non-steroidal anti-inflammatory drugs were administered to 6 horses. Four required tracheostomy for severe respiratory distress. The 15 horses treated medically responded to treatment and were discharged from hospital. Three horses (6%) with mild signs received no treatment and recovered uneventfully. Twenty-eight horses (61%) underwent general anaesthesia and surgical drainage of a RPLN abscess. Nineteen received procaine penicillin G for 4 to 7 days. Four of the nine horses that did not receive antibiotic treatment after surgery required further surgical drainage 10 days to 7 weeks after the initial surgery . Limited follow-up information was available for 37 horses. Thirty-two horses were considered to have made complete recovery, 3 horses had died through misadventure and 2 had been euthanased because of chronic ill-thrift .     

Pasteurella multocida isolation in a horse with retropharyngeal infection

Retropharyngeal infections in horses normally induce local painful swelling of the retropharyngeal area, which may lead to dyspnea, dysphagia, and systemic manifestations. Differential diagnosis of local painful swelling of the retropharyngeal area includes retropharyngeal lymph node infection, neoplasm, cellulitis, hematoma, guttural pouch empyema, parotiditis, and jugular thrombosis. Apart from Streptococcus equi ssp. equi, other bacteria are rarely reported as a cause of retropharyngeal abscesses. The reason for this might be a lack of specific sampling to identify the causative agent. This work deals with a case of retropharyngeal infection in an 11-year-old Standardbred stallion with acute depression, fever, tachycardia, asymmetric painful swelling in the throat area, ptyalism, and respiratory distress. Endoscopy, radiography, ultrasonography, blood analysis, and cytological examination of a puncture sample taken from the throat mass were consistent with a pyogenic to pyogranulomatous retropharyngeal inflammation. The clinical evolution was initially satisfactory in response to treatment with nonsteroidal anti-inflammatory drugs and antibiotics, but clinical signs relapsed twice, each time a few weeks after cessation of antibiotic therapy. The bacteriologic finding in this case was unusual and consisted of the isolation of a Pasteurella multocida strain that was obtained after the second relapse (ie, 79 days after initial admission), using a brain heart infusion (BHI) medium, and after two successive negative bacteriological cultures performed on day one of clinical signs and at the first relapse of clinical signs, respectively.     

Anaerobic bacterial pneumonia with septicemia in two racehorses

Anaerobic bacterial pneumonia with septicemia was diagnosed in 2 Thoroughbred racehorses referred with respiratory tract disease that had failed to respond to initial treatment with various antibiotics including penicillin and trimethoprim-sulfamethoxazole. Multiple anaerobic organisms, including Bacteroides spp and Fusobacterium spp, were isolated from blood and transtracheal aspirates obtained from both horses and from aspirates of cutaneous nodules obtained from 1 horse. The latter horse responded to metronidazole treatment followed by procaine penicillin G administration and regained its health over the following 6 months. The other horse did not respond as favorably to a similar antibiotic regimen and died following an acute episode of pulmonary hemorrhage after remaining intermittently febrile for 7 weeks. Although in vitro antimicrobial susceptibility tests indicated that all anaerobic organisms isolated from both horses were susceptible to penicillin, the infection in these horses responded poorly to initial treatments with this drug. We speculated that adequate penicillin concentration was not attained in the deep foci of infection in the lungs. Animals with anaerobic bacterial infections that fail to respond to penicillin or from which penicillin-resistant anaerobes are isolated may benefit from treatment with metronidazole.     

Description of an epizootic and persistence of Streptococcus equi infections in horses

The age-specific attack rates of Streptococcus equi infections of the upper respiratory tract and lymph nodes (strangles) in horses for the different age groups were 17.6% for broodmares, 47.5% for 1-year-old horses, and 37.5% for foals. Streptococcus equi was isolated from nasal, pharyngeal, or lymph node specimens in 31 (60.8%) of 51 sick horses. A male 1-year-old horse, shipped from Kentucky to farm A, was considered to be the index case. Six (19.4%) of 31 horses with strangles remained as shedders of S equi after clinical signs of the disease had ended. Shedders of S equi were not identified from horses that were exposed to infected horses but never developed strangles.     

Malignant edema in horses

Malignant edema (clostridial myositis) was diagnosed in 9 horses with signs of illness that included fever, depression, painful muscular swellings, and toxemia. The infection followed intramuscular injections in 8 horses and developed in a puncture wound in 1 horse. Treatment consisted of surgical fenestration of the involved muscle, high doses of penicillin, nonsteroidal anti-inflammatory agents and analgesics, and supportive fluid therapy. Five horses recovered and 4 died. Those that died had advanced signs of the disease at admission.     

Complications associated with Streptococcus equi infection on a horse farm

Complications associated with Streptococcus equi infection developed in 15 (20.3%) of 74 horses on one farm included death, guttural pouch empyema, purpura hemorrhagica, upper respiratory tract obstruction, pneumonia, pleuropneumonia, agalactia, mesenteric lymph node abscessation, and periorbital abscessation. Death was attributed to pneumonia in 3 horses and to upper respiratory tract obstruction in 2 horses. One horse was euthanatized because of severe purpura hemorrhagica.     

PCR for antigen receptor rearrangement (PARR) clonality testing in a horse with a solitary retropharyngeal lymphoma

A 19-year-old Quarter Horse gelding was evaluated for respiratory distress and a rapidly enlarging retropharyngeal mass. Initial evaluation revealed severe respiratory distress, and a large, firm mass, visibly appreciable as 12 × 12 cm, in the left retropharyngeal and perilaryngeal region, with surrounding left and right retropharyngeal swelling. No significant abnormalities were present on complete blood count and serum biochemistry analyses. Endoscopy revealed severe pharyngeal collapse restricting airflow without gross abnormalities of the pharyngeal mucosa other than inflammation and irritation. A multilobular retropharyngeal mass, diffusely heterogeneous in echogenicity, was present adjacent to, but not occluding, the carotid artery as assessed by ultrasonography. Initial needle aspirate suggested lymphoma. Tissue biopsy and histopathology confirmed a round cell tumour. A temporary tracheotomy was performed to provide respiratory relief, and the horse was managed on oral antibiotics and anti-inflammatory medications while awaiting histopathological results. The decision was made to humanely euthanise the horse after biopsy results indicated lymphoma. Definitive diagnosis of T cell rich, large B cell lymphoma was made by combination of cytology, immunohistochemistry and molecular clonality PCR (PARR) testing. Lymphoma should be considered in horses with focal masses of the retropharyngeal region. Although treatment was not pursued, PARR testing was successful in this case and may be helpful for accurate characterisation of lymphoma in horses to more precisely determine prognosis and the most effective treatment plans, as it has been in human patients and small animals.     

Retropharyngeal infections in five horses

Five horses with retropharyngeal (RP) infections had clinical signs of dysphagia and/or dyspnea. Diagnosis was confirmed, using pharyngeal endoscopy and lateral radiography of the pharynx. One horse responded to surgical drainage of a RP abscess and was sound at light work. One horse responded to medical management after the site of infection was surgically explored. Two horses recovered after medical management; the RP abscess of 1 of these 2 horses ruptured spontaneously into the pharynx and the other horse became racing sound. The fifth horse remained dysphagic and had left laryngeal hemiplegia after medical treatment.     

Pathogenicity for horses of original Sagiyama virus, a member of the Getah virus group

Sagiyama virus is a member of the Getah virus group. Its pathogenicity for horses was examined. All the horses infected with the original 4 strains of Sagiyama virus (M6/Mag 33, Mag 121, Mag 132 and Mag 258) developed pyrexia ranging from 39.0 to 40.0 degrees C. Other clinical signs, characterized by eruptions, edema in the hind legs, enlargement of the submandibular lymph node and mild leukopenia, were also manifested. Viremia occurred 1-4 days post-inoculation (p.i.). Virus was recovered from spleen, liver, lung and various lymph nodes of a horse autopsied on Day 4 p.i. The maximum titer of virus (10(6.0) TCID50 g-1) was detected in the inguinal lymph node. Seroconversion was demonstrated in all the infected horses on Day 5 p.i. These clinical signs and virological findings were similar to those of horses infected naturally. The results indicate that Sagiyama virus has pathogenicity for horses and is similar to that of Getah virus.     

Effect of viral inoculum size on appearance of clinical signs in equine Getah virus infection.

A study was performed to examine the effect of viral inoculum size on the appearance of clinical signs in equine Getah virus (GV) infection by intramuscular inoculation with 10(1.3) to 10(6.3) TCID50 of the MI-110 strain in 6 experimental horses. When inoculated with more than 10(3.3) TCID50 of the virus, every horse developed pyrexia, edema in the hind legs, serous nasal discharge, lymphopenia and viremia in the relatively early stage of disease. On the other hand, enlargement of the submandibular lymph node was observed only in horses inoculated with 10(5.3) and 10(6.3) TCID50 of the virus, while typical eruptions were developed in every horse inoculated with 10(4.3) TCID50 or less. These results demonstrated that the appearance of clinical signs in equine GV infection was dependent on viral inoculum size. Besides, it was assumed to be rare chance that eruptions and enlargement of the submandibular lymph node were developed simultaneously in a horse.     

Ocular manifestations of a metastatic adenocarcinoma in a horse

A 10‐year‐old German Warmblood gelding was referred to the Equine Department of the Vetsuisse Faculty, University of Zurich, Switzerland, for an iris mass OD, lethargy, intermittent fever, and coughing. Ophthalmic examination revealed a 7 × 9 mm raised, fleshy, whitish to pinkish, vascularized iris mass at the 2 o`clock position OD. Fundic examination showed multifocal round, brown to black, slightly raised lesions with indistinct margins and a surrounding hyperreflective zone OU. Physical examination revealed a temperature of 39.2 °C, sinus tachycardia, preputial and ventral edema, and an enlarged right mandibular lymph node. Results of a complete blood count and plasma biochemical profile showed mild anemia, leukocytosis, and thrombocytopenia. Severe splenopathy, moderate splenomegaly, and severe pulmonary pathology with nodules and large areas of consolidated lung parenchyma were observed on abdominal ultrasound and thoracic radiographs, respectively. Fine needle aspirates of the enlarged mandibular lymph node showed malignant epithelial neoplastic cells. The horse was euthanized because of the poor prognosis and subsequently underwent postmortem examination. Macroscopic necropsy and histopathology revealed an adenocarcinoma of suspected pulmonary origin with involvement of eyes, heart, liver, kidneys, spleen, diaphragm, skeletal muscles, mandibular, pulmonary, and internal iliac lymph nodes. Metastatic adenocarcinoma should be considered as a differential diagnosis in horses with iris masses, multifocal chorioretinal infiltrates, and clinical signs that conform to a paraneoplastic syndrome.     

Pancytopenia Secondary to Lymphoid Leukemia in Three Horses

Pancytopenia was observed in two 3-year-old geldings and one 11-year-old mare. All horses had a brief history (2 days to 4 weeks) of fever, anorexia, and depression. One of the three horses had blast cells present on a peripheral blood smear. Examination of the bone marrow showed substantial infiltration with neoplastic lymphoid cells. At necropsy, neoplastic cells were restricted to the bone marrow in one horse, present in bone marrow, liver, and spleen in the second horse, and reported in multiple tissues in the third horse, including bone marrow, kidneys, lung, myocardium and lymph nodes. The value of a bone marrow aspirate and core biopsy in the investigation of pancytopenia is highlighted. (Journal of Veterinary Internal Medicine 1993; 7:360–363. Copyright © 1993 by the American College of Veterinary Internal Medicine.)     

African Horse Sickness Fever in Vaccinated Horses: Short Communication

Our investigation has shown that multiple vaccinations with inactivated African horse sickness (AHS) vaccines containing all 9 serotypes and produced at the Central Veterinary Research Laboratory in Dubai, UAE, protect horses from AHS. However, the immunization did not prevent African horse sickness fever (AHSF) in approximately 10% of the vaccinated horses despite high enzyme-linked immunosorbent assay and virus neutralizing antibodies. African horse sickness fever is a very mild form of AHS with similar clinical signs. From all 6 horses which had developed AHSF, no virus was isolated from EDTA blood withdrawn during the acute phase of infection. Despite high neutralizing antibodies, serotype 9 was detected by polymerase chain reaction in 4 of them. All 6 horses recovered within 72 hours, after they developed mild clinical signs of AHS.     

Levator Nasolabials Muscle Transposition to Prevent an Orosinus Fistula after Tooth Extraction in Horses

The ventral part of the levator nasolabialis muscle was transposed to the alveolar defect after sinusotomy and tooth extraction in five normal horses and six horses with a tooth root abscess and sinusitis. In the normal horses at weeks 6, 10, 14 and 18, the transposed muscles remained viable and were incorporated into the recipient sites, and orosinus fistulae did not form. Histologically, there was a progressive transition from muscle to fibrous tissue. There was no facial deformity or loss of nasal function at the donor site. A localized abscess was associated with incomplete removal of tooth root fragments in one horse. After 1 year or more, five horses treated for dental disease had complete resolution of clinical signs. One horse continued to have intermittent mild nasal discharge.     

Plexiform vascularisation of a retropharyngeal lymph node in a cat

Plexiform vascularisation of a retropharyngeal lymph node is described in an adult cat. The cat presented with a chronic history of inspiratory stridor and a slowly growing mass in the cranial cervical area. Clinical signs resolved after excision of the affected node. This appears to be the first clinical report of plexiform vascularisation of a retropharyngeal lymph node and its treatment in a cat.     

P-83 Intradermal testing in cattle: evaluation of sensitization to Dermatophagoides extracts in healthy cattle and cattle infected with Psoroptes or Chorioptes

The purpose of this retrospective study was to evaluate six cases of equine sarcoidosis for initial presenting symptoms, response to therapy and actual outcome. Dermatologists and dermatopathologists from Europe, the United States, Australia and Canada were contacted to obtain these six cases, as this is a rare disease. Signalment, clinical signs, histological findings, clinical management and outcome were determined via a questionnaire and compared to former reports. There was no age or breed predilection, and four of six horses were geldings. Age of onset ranged from 3 months to 17 years. Onset of the disease was insidious or rapid. Interestingly, in five of six cases, scaling began on the trunk (girth and shoulder). Scaling, crusting and alopecia were seen in all six horses. In one horse, clinical signs of systemic disease were reported and included intermittent fever, prescapular lymphadenopathy, depression, poor body condition and nasal discharge. Treatment included phenylbutazone, deworming agents, antibiotics, short-term low-dose corticosteroids, and 1–1.5 mg/kg of prednisolone. One horse showed a partial response to trimethoprim and sulfonamide, and five of six went into clinical remission with corticosteroid treatment. Five of six horses were still alive 1 year after diagnosis; one horse was diagnosed <12 months ago. Two horses are in complete remission 4 and 8 years after diagnosis. In both horses, clinical signs recurred after cessation of therapy and went into remission again with reintroduction of treatment. Both of these horses have been in remission for several years without therapy.
Funding: Self-funded.     

Primary malignant pulmonary neoplasia in two horses

Although primary malignant pulmonary neoplasia of horses is rarely encountered, this diagnosis was confirmed in 2 horses on the basis of necropsy and histopathologic findings. One horse, with cystic mucinous adenocarcinoma, had respiratory tract and neurologic signs directly attributable to the neoplasm, and a tentative antemortem diagnosis of pulmonary neoplasia was made. The other horse, with anaplastic bronchogenic carcinoma, did not have clinical signs of pulmonary neoplasia.     

Cryptococcosis in ferrets: a diverse spectrum of clinical disease

Cryptococcosis was diagnosed in seven ferrets (five from Australia; two from western Canada) displaying a wide range of clinical signs. Two of the ferrets lived together. One (5-years-old) had cryptococcal rhinitis and presented when the infection spread to the nasal bridge. Its sibling developed cryptococcal abscessation of the right retropharyngeal lymph node 12 months later, soon after developing a severe skin condition. DNA fingerprinting and microsatellite analysis demonstrated that the two strains isolated from these siblings were indistinguishable. Two ferrets (2- to 3-years-old) developed generalised cryptococcosis: one had primary lower respiratory tract disease with pneumonia, pleurisy and mediastinal lymph node involvement, while in the other a segment of intestine was the primary focus of infection with subsequent spread to mesenteric lymph nodes, liver and lung. The remaining three ferrets (1.75 to 4-years-old) had localised disease of a distal limb, in one case with spread to the regional lymph node. Cryptococcus bacillisporus (formerly C. neoformans var gattii) accounted for three of the four infections in Australian ferrets where the biotype could be determined. The Australian ferret with intestinal involvement and the two ferrets from Vancouver had C. neoformans var grubii infections.     

Juvenile sterile granulomatous dermatitis and lymphadenitis in the dog

Juvenile sterile granulomatous dermatitis and lymphadenitis is a rare immune-mediated skin disease in young dogs. History, signalment, diagnostics, treatment, and outcome in 10 dogs are described. The age ranged from 8 - 36 weeks. The lymph nodes were enlarged in all dogs, especially the mandibular and prescapular lymph nodes. Systemic signs including fever were present in 8 dogs. Seven dogs suffered from blepharitis and painful edema of the muzzle with hemorrhagic discharge, pustules and papules. Cytology of pustules and lymph node aspirates revealed a pyogranulomatous inflammation. In 7 cases the diagnosis of juvenile sterile granulomatous dermatitis and lymphadenitis was confirmed by histology. Nine dogs were treated with prednisolone (0.5 - 1.25 mg/kg BID), H2-receptor antagonists and analgetics; all dogs were treated with antibiotics. Four dogs were treated with eye ointment containing antibiotics and glucocorticoids. The prednisolone dosage was tapered over 3 - 8 weeks. One dog had a relapse.     

Iliopsoas abscess with iliac and femoral vein thrombosis in an adult Siberian husky

A nine-year-old, male Siberian husky was presented with fever, decreased appetite and activity, non-weightbearing lameness, and oedematous swelling of the right inguinal and preputial area and the right hindlimb. An abscess within the right iliopsoas muscle, with severe thrombosis of the iliac and femoral vein, was diagnosed by haematology and diagnostic imaging. The abscess and adjoining lymph node were removed surgically through a median coellotomy. The isolated pathogen was Staphylococcus intermedius. Clinical signs resolved completely after surgery. Antimicrobial therapy was continued for four weeks. Within the follow-up period of six months, no recurrence of the clinical signs was detected.