Serratia spp infection in 21 horses

Twenty-three isolations of Serratia spp were made from 21 horses at the University of Florida Veterinary Medical Teaching Hospital between Jan 1, 1979 and July 1, 1983. Three Serratia spp were involved in single-organism and mixed infections of various tissues. Eight horses of this group died. All horses that died had massive, mixed, gram-negative infection. The other 13 responded to treatment, including systemic antibiotic therapy. Most of these horses were stressed and under antibiotic therapy prior to the time of culture. Possible nosocomial infection, variable antibiotic sensitivity, and a trend toward decreased antibiotic sensitivity after antibiotic administration were noted.     

Bacterial isolates and antimicrobial susceptibilities in equine bacterial ulcerative keratitis (1993--2004)

REASONS FOR PERFORMING STUDY: Bacterial ulcerative keratitis is a common and often vision-threatening problem in horses. Emerging bacterial resistance to commonly used topical antibiotics has been demonstrated. Previous antibiotic use may alter the antimicrobial susceptibility of bacterial isolates. OBJECTIVES: To document aerobic bacterial isolates and associated bacterial susceptibilities from horses with ulcerative keratitis treated at the University of Tennessee between January 1993 and May 2004 and determine whether prior antibiotic therapy affected antimicrobial susceptibility of the isolates. METHODS: Medical records from horses with ulcerative keratitis and positive aerobic bacterial cultures and antimicrobial susceptibility were evaluated. Clinical history regarding antibiotic therapy prior to culture was documented. RESULTS: Fifty-one aerobic bacterial isolates from 43 horses were identified. Streptococcus equi subspecies zooepidemicus was the most commonly isolated organism, accounting for 33.3% of all isolates, followed by Pseudomonas aeruginosa (11.8%), Staphylococcus spp. (11.8%) and Gram-negative nonfermenting rods (7.8 %). No resistance was noted amongst S. equi ssp. zooepidemicus to cephalothin, chloramphenicol or ciprofloxacin. Only 64 % of S. equi ssp. zooepidemicus isolates were sensitive to bacitracin. No resistance was noted among P. aeruginosa to gentamicin, tobramycin or ciprofloxacin. Antibiotic therapy with neomycin-polymixin B-bacitracin prior to presentation and culture was documented in 11/17 horses in which S. equi ssp. zooepidemicus was isolated and in 4/6 horses in which P. aeruginosa was isolated. Three horses received topical corticosteroids prior to culture, of which 2 had polymicrobial infections. CONCLUSIONS: S. equi ssp. zooepidemicus and P. aeruginosa were the most frequently isolated bacterial organisms in equine ulcerative keratitis. No significant trends in aminoglycoside or fluoroquinolone resistance were noted among these organisms. However, the resistance of S. equi ssp. zooepidemicus to bacitracin with common use of this antibiotic suggests that previous antibiotic therapy probably affects antimicrobial resistance. POTENTIAL RELEVANCE: Therapy prior to culture may play an important role in antimicrobial susceptibility of corneal bacterial isolates. Corticosteroid use may increase the risk of polymicrobial infections of corneal ulcers, leading to a worse prognosis. Although significant fluoroquinolone resistance has not been documented in the veterinary literature, these antimicrobials should be reserved for known infected corneal ulcers and not used for prophylaxis. Empirical antibiotic therapy should not only be guided by clinical signs, but also take into consideration previous antimicrobial and corticosteroid therapy.     

Puncture Wounds of the Navicular Bursa in 38 Horses A Retrospective Study

The medical records of 38 horses with puncture wounds of the navicular bursa were reviewed. Only 12 horses had a satisfactory outcome (breeding or riding). Of the remaining 26 horses, 19 were euthanized, five were sold due to persistent severe lameness, one died, and one was lost to long-term follow-up. Different combinations of conservative management prior to surgical debridement and drainage of the navicular bursa were unsuccessful in resolving the condition. Horses that were treated surgically within 1 week of the injury and had a hind leg affected had the best chance of a satisfactory outcome. Additional wound debridement was necessary in 15 horses after initial surgical treatment. The most common complications encountered were navicular bone osteomyelitis and sepsis of the deep digital flexor tendon. Thirteen of 14 horses that had rupture of the deep digital flexor tendon and subluxation of the distal interphalangeal joint had an unsatisfactory outcome. One mare subsequently developed ankylosis of the distal interphalangeal joint and was a useful brood mare. Two horses that had biaxial palmar digital neurectomy because of persistent lameness were later euthanized because of navicular bone fracture and rupture of the deep digital flexor tendon. Results from limited numbers of bacterial cultures and antibiotic sensitivities suggest that penicillin and an aminoglycoside antibiotic should be used as initial antibiotic therapy. Immediate surgical debridement and appropriate antibiotic treatment are recommended as the minimum therapy for penetrating wounds of the navicular bursa in horses.     

Caprine serum fraction immunomodulator as supplemental treatment of lower respiratory disease in the horse

Suppurative lower airway disease is a common debilitating disease in performance horses and, while rarely fatal, is often recalcitrant to conventional therapy. A variety of treatments have been used to combat this condition and we conducted two types of studies to determine if caprine serum fraction--immunomodulator (CSFI), a nonspecific immunomodulator, improved recovery from lower respiratory disease. Two dose response studies were performed to ascertain the efficacy of CSFI. Horses were maintained daily on conventional antibiotic therapy. Respiratory tract exudate, nasal discharge, dyspnoea, chest auscultation and cough frequency were monitored weekly. One hundred percent of the horses treated with 2 i.m. injections of either 60 or 120 mg CSFI one week apart showed significant improvement with each weekly evaluation and were fully recovered by week 3. Horses treated with 15 or 30 mg CSFI did not differ significantly from the control group. Only 10% of the control horses responded to conventional antibiotic therapy. An expanded field trial utilising 80 horses diagnosed with lower respiratory disease and housed at 4 equine clinics was conducted. Thirty-five percent of the 40 control horses, treated solely by conventional antibiotic therapies, recovered while 75% of the horses treated with a supplemental administration of 60 mg CSFI as described above recovered. The combined data from these studies showed that CSFI was able to promote an overall recovery from lower respiratory disease of 86%.     

Mycoplasma felis pleuritis in two show-jumper horses.

Mycoplasma felis was identified as the cause of acute pleuritis in 2 show-jumping horses. The pleural exudate was proteinaceous, contained large numbers of neutrophils, and had a markedly increased lactate concentration. M. felis was isolated in pure culture from pleural fluid. Rising serum antibody titers to M. felis as well as a precipitous decline in titers to equine influenza virus were demonstrated in both horses. Pleural effusion in both horses and a pneumothorax detected in one of the horses resolved following a single drainage of pleural fluid and intravenous fluid, antibiotic, and analgesic therapy.     

Clostridium difficile: prevalence in horses and environment,and antimicrobial susceptibility

REASONS FOR PERFORMING STUDY: Clostridium difficile has been associated with acute colitis in mature horses. OBJECTIVES: To survey C. difficile colonisation of the alimentary tract with age, occurrence of diarrhoea and history of antibiotic therapy; and to study the occurrence and survival of C. difficile in the environment and antimicrobial susceptibility of isolated strains. METHODS: A total of 777 horses of different breeds, age and sex were studied. Further, 598 soil samples and 434 indoor surface samples were examined. Antimicrobial susceptibility of 52 strains was investigated by Etest for 10 antibiotics. RESULTS: In horses that developed acute colitis during antibiotic treatment, 18 of 43 (42%) were positive to C. difficile culture and 12 of these (28%) were positive in the cytotoxin B test. Furthermore, C. difficile was isolated from a small number of diarrhoeic mature horses (4 of 72 [6%]) with no history of antibiotic treatment, but not from 273 healthy mature horses examined or 65 horses with colic. An interesting new finding was that, in normal healthy foals age < 14 days, C. difficile was isolated from 1/3 of foals (16 of 56 [29%]). All older foals (170) except one were negative. Seven of 16 (44%) nondiarrhoeic foals treated with erythromycin or gentamicin in combination with rifampicin were also excretors of C. difficile. On studfarms, 14 of 132 (11%) outdoor soil samples were positive for C. difficile in culture, whereas only 2 of 220 (1%) soil samples from farms with mature horses were positive for C. difficile (P = < 0.001). By PCR, it was demonstrated that strains from the environment and healthy foals can serve as a potential reservoir of toxigenic C. difficile. The experimental study conducted here found that C. difficile survived in nature and indoors for at least 4 years in inoculated equine faeces. The susceptibility of 52 strains was investigated for 10 antibiotics and all were susceptible to metronidazole (MIC < or = 4 mg/l) and vancomycin (MIC < or = 2 mg/l). CONCLUSIONS: C. difficile is associated with acute colitis in mature horses, following antibiotic treatment. Furthermore, C. difficile was isolated from 1 in 3 normal healthy foals age < 14 days. POTENTIAL RELEVANCE: Strains from healthy foals and the environment can serve as a potential reservoir of toxigenic C. difficile.     

Alternative antimicrobial agents in the treatment of proliferative enteropathy in horses

Seven young horses 5 to 12 months old, each diagnosed with proliferative enteropathy, were studied. All seven cases responded to alternative antimicrobial therapy to the traditional treatment of erythromycin ± rifampin. Three cases were treated with chloramphenicol, two cases with doxycycline, one with azithromycin, and one with clarithromycin and rifampin. All showed resolution of clinical and clinicopathological abnormalities within 8 weeks of initiation of treatment. Proliferative enteropathy is an increasingly recognized malabsorptive and maldigestive disease of young horses. Supportive care and antimicrobial therapy are the mainstays of therapy with erythromycin being the traditional antibiotic of choice. The knowledge that alternative therapeutic antimicrobials are clinically efficacious in the treatment of Lawsonia intracellularis broadens the therapeutic options for this potentially fatal condition.     

Bronchoalveolar lavage for the diagnosis and treatment of pneumonia associated with transport in Thoroughbred racehorses.

To evaluate a hypothese that use of bronchoalveolar lavage (BAL) for early treatment of pneumonia would improve their prognosis by reducing bacterial numbers and excessive numbers of neutrophils in the lung, initial experiences with BAL in the diagnosis and treatment of pneumonia were performed in 36 racehorses that became ill within 24 hr of long distance travel (1,200-1,600 km, 26-32 hr) by road. Comparisons were made of the outcomes of the 36 horses and those of 42 horses (81.0% recovered, 50.0% returned to racing) treated for transport associated pneumonia without BAL. The total amount of BAL fluid injected during hospitalization varied from 700 to 3,700 ml and the duration of antibiotic treatments ranged from 5 to 40 days. Clinical symptoms after lavages showed good results with no side effects. None of the horses required thoracic drainage. Horses treated with BAL required shorter period of antibiotic therapy, a greater percentage recovered (100%, 36/36) and a greater percentage returned to racing (77.8%, 28/36). Eight (22.2%) never raced because of lameness or other considerations.     

Case Control and Historical Cohort Study of Diarrhea Associated With Administration of Trimethoprim-Potentiated Sulphonamides to Horses and Ponies

Trimethoprim-potentiated sulphonamides (TPS) are among the most frequently administered antimicrobials in equine medicine. Anecdotally, TPS has been implicated as a cause of mild to moderate diarrhea in horses. The purpose of this study was to document the prevalence of diarrhea in horses receiving TPS, to characterize the severity of the diarrhea, and to identify any other factors associated with the development of diarrhea. A 2–part study was designed to identify the prevalence of diarrhea associated with TPS in our clinic population. Part I was a case-control retrospective study of 135 records over a 10.5–year period from January 1, 1980 through June 30, 1990. Part II was a historical cohort study of 784 records over a 37–month period from July 1, 1990 through July 31, 1993. There was no significant difference in the occurrence of diarrhea associated with TPS therapy in either study. The occurrence of diarrhea was 21% and 3% in parts I and II, respectively. Significant factors identified in association with diarrhea in part I were duration of hospital stay, and antibiotic therapy other than TPS or penicillin. Significant factors identified in part II included other antibiotic therapy, penicillin therapy, and combined penicillin and TPS therapy. Diarrhea does occur after the administration of antibiotics, most likely because of the alteration of the patient's normal intestinal flora. Diarrhea was noted in association with administration of TPS in this study; however, its prevalence was not significantly different than that in horses receiving other antibiotics, such as penicillin and its derivatives. J Vet Intern Med 1996;10:258–264. Copyright © 1996 by the American College of Veterinary Internal Medicine .     

New drugs for horses and production animals in 2010

In 2010, three new active pharmaceutical ingredients were released on the German market for horses and food-producing animals. These were gamithromycin (Zactran?), a new macrolide antibiotic, Monepantel (Zolvix?), a broad spectrum anthelmintic with a novel mechanism, and Pergolide (Prascend?), the first dopamine receptor agonist for animals. Two substances have been approved for additional species. The tetracycline antibiotic doxycycline is now also authorized for turkeys and the nonsteroidal anti-inflammatory drug firocoxib from the group of cyclo-oxygenase-2 (COX-2) inhibitors is now available for horses. Furthermore, four new preparations with an interesting new pharmaceutical form, one drug with a new formulation and two drugs, which are interesting because of other criteria, were added to the market for horses and food producing animals.     

Septic arthritis in 15 standardbred racehorses after intra-articular injection.

Case histories, results of synovial fluid analyses, treatment regimens and outcome are described for 15 adult Standardbred horses with confirmed post-injection septic arthritis. Joint sepsis followed injection of corticosteroids, hyaluronic acid, polysulphated glycosaminoglycan, or local anaesthetic. The median interval from injection to appearance of clinical signs was 2.5 days, and median interval from injection to referral was 9 days. The median initial synovial leucocyte count on admission was 57 x 10(9)/litre, but there was a wide range of values (18-258 x 10(9)/litre). The median synovial neutrophil percentage was 95% (77-99%). All bacterial isolates were Gram-positive cocci, 86% of which were staphylococci. All treated horses (12/15) initially received broad-spectrum parenteral antibiotic therapy, and the articulations of all horses except one were lavaged, either with non-surgical through-and-through techniques only (N = 3), or surgically with arthrotomy (N = 1) or arthroscopy (N = 7). The owners of all treated horses were contacted and racing records were consulted. Eleven of 12 horses returned to racing. Outcome was judged as either satisfactory (3/12) if the horse had returned to racing levels similar to or better than before treatment, or unsatisfactory (9/12) if the horse had poorer performance or could not return to racing. The 3 horses with satisfactory follow-up had been treated with arthroscopy and post-surgical closed suction drainage. The results of bacterial cultures suggest that the initial antimicrobial agents used should be effective against penicillin-resistant staphylococci.     

The diagnosis and treatment of arthritis in horses

In this paper on the diagnosis and treatment of arthritis in horses, both degenerative arthritis and septic arthritis are considered. Diagnosis should be made on the combination of clinical examination together with the use of diagnostic aids such as radiology, intra-articular local anaesthesia and synovial fluid analysis. Intra-articular therapy appears to be the most effective in the treatment of degenerative arthritis. Excellent responses to therapy have been reported with corticosteroids, sodium hyaluronate, orgotein and synovial fluid transfer, where joints showed an absence of degenerative changes on radiographs. In septic arthritis, systemic treatment with the appropriate antibiotic, following bacterial culture and sensitivity testing, can produce good results if prompt diagnosis is made.     

Longitudinal study of Clostridium difficile and antimicrobial susceptibility of Escherichia coli in healthy horses in a community setting

Point prevalence studies have reported carriage rates of enteric pathogens in healthy horses, but longitudinal data are lacking. Commensal E. coli is an indicator organism to evaluate antimicrobial resistance of enteric bacteria, yet there are limited data for horses. The objectives of this study were to investigate and molecularly characterize isolates of Clostridium difficile, Clostridium perfringens and Salmonella, collected sequentially over a one year period, and to determine the antibiotic susceptibility profile for E. coli. Fecal samples were collected monthly from 25 adult horses for one year. Selective cultures were performed for all above bacteria. C. difficile isolates were characterized via PCR toxin gene profiling and ribotyping. Broth microdilution was performed to assess antimicrobial susceptibility profiles of E. coli. Toxigenic Clostridium difficile was isolated from 15/275 (5.45%) samples from 10/25 (40%) horses. Four horses were positive at multiple sampling times but different ribotypes were found in three. Ribotypes included 078 (n=6), 001 (n=6) and C (n=3). C. perfringens was not isolated, nor was Salmonella. E. coli was isolated from 232/300 (77%) fecal samples. Resistance to ≥1 and ≥ 3 antimicrobials was present in 31/232 (13.4%) and 6/232 (2.6%) respectively. Only two horses shed the same strain of toxigenic C. difficile for more than one month, indicating that shedding is transient. The high number of ribotype 078 is consistent with recent emergence of this strain in the local horse population. The low prevalence of antibiotic resistance in commensal E. coli suggests that healthy horses are not likely a major reservoir of resistance for enteric bacteria.     

Typing of Brachyspira spp. from rodents, pigs and chickens on Swedish farms

Rhodococcus equi is a soil borne bacterium that causes severe morbidity and death in young foals. The economic costs of the disease include loss of life, treatment expenses, veterinary monitoring expenses and, perhaps most importantly, potential reduction in future athletic performance in horses that suffer severe lung abscessations caused by R. equi. Current standard of care for pneumonia caused by R. equi is treatment with a macrolide antimicrobial and rifampicin. However, the hallmark of pneumonia caused by R. equi is severe formation of pyogranulomas and a walling off effect that can prevent systemic antibiotics from reaching antimicrobial concentrations in lung tissues. It is hypothesized that streptolysin O (SLO) used as an adjunct therapy with antibiotics will reduce the duration and severity of disease caused by R. equi pneumonia compared to antibiotic therapy alone. Addition of SLO to the antibiotic enhanced clinical responses compared to the other groups, including the antibiotic alone group. Of particular significance were lower bacterial counts in the lungs and longer survival time in those foals treated with SLO and antibiotics.     

Subclinical leptospirosis may impair athletic performance in racing horses

The infection by Leptospira in horses, in both its acute disease and subclinical forms, is very common, particularly in endemic regions. Therefore, the objective of this study was to evaluate the effects of subclinical leptospirosis in the athletic performance of racing thoroughbred horses. Athletic performance of 119 racing Thoroughbred horses from Rio de Janeiro, Brazil, was calculated by assigning a point value for the results in racing (performance index (PI)), and serology for leptospirosis was conducted. A total of 85 (71.4?%) horses showed reactive titers (??100), and of which 52 had high titers (34 with 400 and 18 with ??800). Although those animals had high titers against Leptospira, no clinical signs associated with leptospirosis were observed. Seventeen (89.5?%) out of the 19 horses with substandard performance were seroreactive with high titers, in contrast with 35?% of seroreactivity in horses with good athletic performance (P?<?0.0001). Additionally, seroreactivity to leptospirosis was more often observed in horses with substandard athletic performance in contrast to those with good performance (P?<?0.0001, odds ratio 15.8). The Average PI of this group increased to 133?% after treatment (P?<?0.0001). Leptospirosis may impair performance in racing horses, and antibiotic therapy may improve the performance of affected animals.     

Equine external beam radiation therapy: Techniques and challenges

Radiation therapy is becoming increasingly more available and in demand for small animal veterinary cases. Although there is a demand for radiation therapy in large animal cases, there are certain limitations of external beam radiation therapy for horses that restrict treatment options. Currently, there are only five veterinary teaching hospitals in the United States where external beam radiation therapy can be performed on horses and other large animals. This is in contrast to the roughly 80 facilities, both academic and private, available for small animals. The goal of this commentary is to give a brief overview of external beam radiation therapy and highlight the steps involved, and the technical difficulties faced, while treating horses with external beam radiation therapy.     

Ulcerative keratitis in thoroughbred racehorses in Japan from 1997 to 2008

Objective To describe the number of cases, etiologies, healing times, and results of microbial culture and susceptibility testing of corneal ulcers in thoroughbred racehorses in Japan. Procedure Retrospective study of the medical records of racehorses belonging to the Japan Racing Association (JRA) from 1997 to 2008. Results A total of 2846 horses suffered ulcerative keratitis. These horses accounted for 90.5% of all the corneal problems and 54.9% of the entire number of horses with ocular diseases. Running in races was the cause in 64.3% of the cases. The mean healing time of the ulcers developed in races was 5.5 ± 9.6 days, which was shorter than that of the ulcers unrelated to racing (8.6 ± 11.7 days). In horses presented for examination by the next day after the race, healing was even more rapid (4.1 ± 7.5 days) than in horses presented later (12.4 ± 14.7 days). Microbial culture was performed on 74 samples of 58 horses. Forty‐four bacterial and four fungal organisms were isolated from 35 samples of 29 horses. Pseudomonas aeruginosa (10) and Streptococcus equi subspecies zooepidemicus (5) were the bacteria most frequently isolated. There was no tendency of increasing antibiotic resistance of these organisms. Conclusions Ulcerative keratitis is the most frequent corneal and ocular disease of the racehorse in Japan. Careful observation of the eyes after racing is necessary as early diagnosis and treatment of corneal ulcers speeds healing. Many antibiotic have efficacy against the bacterial isolates, however, potent antibiotics should be reserved for the most severe corneal ulcers.     

Do horses suffer from irritable bowel syndrome?

Irritable bowel syndrome (IBS) in man is not a single entity but has several causes. One of the most common forms has similarities with colic and laminitis in horses. Undigested food residues may pass from the small intestine into the colon where bacterial fermentation produces chemicals that lead to disease. In horses the consequences may be disastrous, but in healthy humans such malabsorption may not be harmful. After events such as bacterial gastroenteritis or antibiotic treatment, an imbalance of the colonic microflora with overgrowth of facultative anaerobes may arise, leading to malfermentation and IBS. It is not known whether such subtle changes may likewise be present in the microflora of horses who are susceptible to colic and laminitis. Metabolomic studies of urine and faeces may provide a suitable way forward to identify such changes in the horse's gut and thus help to identify more accurately those at risk and to provide opportunities for the development of improved treatment.     

Perisuspensory abscessation in eight horses with hindlimb cellulitis

This study reports a distinct presentation of cellulitis, which involved formation of perisuspensory abscessation in eight horses. Medical records of horses presented for cellulitis unresponsive to medical treatment were reviewed. Cases in which perisuspensory abscesses were diagnosed were included. All abscesses formed between the cannon bone and suspensory ligament and extended around one or both suspensory branches. Abscesses were diagnosed via ultrasonography upon admission in three horses and developed within a few days following admission in five horses. All horses were treated with broad-spectrum antibiotics, anti-inflammatories, topical therapies and regional limb perfusions; however, only partial improvement of clinical signs was observed with medical therapy alone. Full resolution of clinical signs was obtained in all cases once the abscess was surgically lanced and drained. The surgical drainage was performed standing in seven cases and under general anaesthesia in one. In all cases, Staphylococcus aureus was cultured. Six out of eight isolates showed at least some level of antibiotic resistance, and penicillin and trimethoprim sulfonamides were most commonly involved. Short-term complications included skin necrosis in two cases and mild impaction colic in two cases and were successfully treated. All horses were discharged from the hospital within 4–13 days and were sound upon discharge. All Thoroughbreds (n = 7) were able to return to their intended use, and the Standardbred was unraced prior to the cellulitis event and remained unraced afterwards.