Streptococcus equi Infections in Horses: Guidelines for Treatment,Control, and Prevention of Strangles—Revised Consensus Statement

This consensus statement update reflects our current published knowledge and opinion about clinical signs, pathogenesis, epidemiology, treatment, complications, and control of strangles. This updated statement emphasizes varying presentations in the context of existing underlying immunity and carrier states of strangles in the transmission of disease. The statement redefines the “gold standard” for detection of possible infection and reviews the new technologies available in polymerase chain reaction diagnosis and serology and their use in outbreak control and prevention. We reiterate the importance of judicious use of antibiotics in horses with strangles. This updated consensus statement reviews current vaccine technology and the importance of linking vaccination with currently advocated disease control and prevention programs to facilitate the eradication of endemic infections while safely maintaining herd immunity. Differentiation between immune responses to primary and repeated exposure of subclinically infected animals and responses induced by vaccination is also addressed.     

Exercising Blood Gas Analysis, Dynamic Upper Respiratory Tract Obstruction, and Postexercising Bronchoalveolar Lavage Cytology—A Comparative Study in Poor Performing Horses

Respiratory abnormalities are common causes of decreased performance in horses presumably because of impaired pulmonary gas exchange. The objectives of the present study were to describe respiratory abnormalities in poorly performing horses and to investigate the relationships between dynamic upper respiratory tract (URT) videoendoscopy, postexercising bronchoalveolar lavage (BAL) cytology, and exercising arterial blood gas analysis. Medical records of 93 horses with exercise intolerance, which presented for treadmill evaluation, were reviewed. Relationships between horse demographics, treadmill endoscopic findings, exercising blood gas values, and BAL cytology results were examined. A total of 25 (27%) horses had a URT obstruction and 91 (98%) horses had abnormal BAL cytology; 73 (78%) had evidence of inflammatory airway disease (IAD) and 83 (89%) had exercise-induced pulmonary hemorrhage (EIPH). In all, 39 (42%) horses had abnormal blood gas values. Dynamic URT obstruction was significantly associated with exercising hypoxemia (P = .036). There were no significant relationships between gas exchange and IAD or between EIPH. Out of 24 (26%) horses with combined URT obstruction and abnormal BAL, horses with URT obstruction and EIPH were more likely to be hypoxic during exercise (P = .037). It was concluded that horses with dynamic URT abnormalities are likely to have exercising hypoxemia. Although IAD and EIPH were commonly indentified in poor performers, they were not significantly associated with abnormal exercising blood gas analysis.     

Dysphagia caused by focal guttural pouch mycosis: mononeuropathy of the pharyngeal ramus of the vagal nerve in a 20-year-old pony mare

A 20-year-old pony mare was presented to the equine hospital with a ten-day history of dysphagia, regurgitation and coughing. An obstruction of the oesophagus was excluded via endoscopy, but the proximal oesophagus appeared to be distended and circular contractions were missing. A guttural pouch endoscopy revealed a single, black-mottled plaque on the pharyngeal ramus of the vagus nerve in the left guttural pouch, causing a local swelling of this nerve. The pharyngeal ramus seemed to be atrophic distal to the lesion. A biopsy was taken from the lesion and histopathological findings proved the reasonable suspicion of a guttural pouch mycosis with a high degree of purulent-necrotic inflammation and invasion of fungal hyphae. There were no signs of neoplasia, such as melanoma. Daily guttural pouch irrigations with a clotrimazole emulsion (20 g Canesten^® Gyn⁴ solved in 500 ml water), led to a good recovery of the mucosa above the nerve. Periodic endoscopic examination of the left guttural pouch showed that local thickening and distal atrophy of this pharyngeal ramus did not improve, neither did the clinical symptoms. Due to progressive weight loss, acute respiratory distress and aspiration pneumonia, the 20-year-old pony mare unfortunately had to be euthanized three weeks after discharge. This case report emphasizes the enormous importance of a single nerve for the realization of the swallowing process. The one-sided loss of function of the pharyngeal branch of the vagal nerve cannot be compensated neither by the remaining ipsilateral nerves nor by the contralateral normal functioning glossopharyngeal and vagal nerves and thus inevitably leads to severe dysphagia.     

Multicentric Hemangiosarcoma in the Horse: A Case Report

The present article reports a case of multicentric hemangiosarcoma in a 22-year-old Warmblood mare presented for recurrent fever and weight loss. Thoracic ultrasonography showed multiple small areas of pulmonary consolidation. Ultrasonography in the region of the right liver lobe showed the presence of a rounded mass, approximately 24 × 19 cm² in size, extending from the 9th to 14th rib of the right side, characterized by multiple fluid-filled cavities and hypo- and hyperechoic rounded areas. On the left side, several hyperechoic rounded areas were detected in the spleen. Because of sudden onset of hemoperitoneum and worsening of the clinical conditions, the mare was humanely destroyed. Necroscopy confirmed the presence of hepatic, splenic, and pulmonary lesions, and showed further nodules on the stomach wall. The microscopic appearance of the lesions was consistent with hemangiosarcoma with multiple visceral metastases. Because the reported prevalence of equine hemangiosarcoma is as low as 0% to 0.7%, this case report may provide further information and describe one of the possible ultrasonographic patterns of multicentric hemangiosarcoma in horses.     

A surgical approach to the lateral compartment of the equine guttural pouch in the standing horse: modification of the forgotten "Garm technique"

The objective of this study was to evaluate the feasibility, efficacy and complications following lavage and drainage of the lateral compartment (LC) of the equine guttural pouch (GP) using a modified Garm's technique (MGT). In an ex vivo study (study 1), six cadaver heads were examined to assess the anatomical limits of the surgical approach and whether vital structures might be damaged. This was followed by an in vivo study (study 2) in which a lavage/drainage tube was placed for 3 days into each LC of four standing horses using the MGT. In both studies, the procedure offered direct access into the LC and indirect access into the medial compartments of the GP. In study 1, the MGT provided a rostroventral point of access allowing drainage of the LC, with no obvious iatrogenic damage. In study 2, the MGT permitted lavage of the entire GP in three healthy horses and one horse with mild GP empyema. The only major complication was development of emphysema of the lateral wall of one LC, with secondary collapse of the mucous membrane. The time for secondary wound healing was 12-14 days. The MGT can be performed safely in standing horses and may be of value in providing access for lavage and drainage in horses with mild GP empyema.     

Maintenance of arytenoid abduction following carbon dioxide laser debridement of the articular cartilage and joint capsule of the cricoarytenoid joint combined with prosthetic laryngoplasty in horses: An in vivo and in vitro study

The objective was to evaluate CO₂ laser debridement of the cricoarytenoid joint (CAJ) combined with prosthetic laryngoplasty to prevent post-operative loss of arytenoid abduction in seven horses. Horses were assigned to either laser debridement of the left CAJ and laryngoplasty (laser treated, n = 5) or control laryngoplasty (sham, n = 2), and were evaluated with endoscopic examinations and measurement of right to left angle quotients (RLQ) to assess maintenance of arytenoid abduction. The animals were euthanased at intervals after surgery and larynges were harvested for post-mortem testing, including determination of translaryngeal flow, pressure, impedance and RLQ. Measurements were obtained under increasing vacuum-generated negative pressure with laryngoplasty sutures intact and with the knot/crimp of the laryngoplasty sutures removed. Following post-mortem testing the cricoarytenoid joints were examined histologically.Post-operative endoscopic examinations revealed no significant differences between RLQ measurements calculated for day 1 following surgery to the termination date of the study for the seven horses. Post-mortem RLQ at airflows of 10 and 60 L/s was significantly higher in sham than in laser treated horses both before and after knot/crimp removal. Translaryngeal impedance at 10 and 60 L/s was not statistically different between groups. Histopathology revealed necrosis and loss of articular cartilage in the laser treated horses. The lymphoid cell infiltration subsided but joint capsule and periarticular fibrosis increased over the course of the study. Post-operative loss of arytenoid abduction after laryngoplasty can be minimized with CO₂ laser debridement of the CAJ joint.     

Cholangiocarcinoma and Squamous Cell Carcinoma of the Stratified Epithelial Portion of the Stomach in a Horse: A Case Report

Both cholangiocarcinoma and squamous cell carcinoma of the stomach stratified squamous epithelial portion are rarely found in equine medicine despite being more common in human beings, dogs, and cats. The objective of the present article was to report the simultaneous occurrences of these two types of neoplasias in an 11-year-old mare. Numerous firm, whitish nodules were distributed throughout the liver parenchyma and those protruding over its surface were umbilicated in their appearance. It was verified that the nodules adhered to the peritoneum and omentum, diaphragm, spleen, and stomach serosa compressed the adjacent structures. The stomach stratified squamous epithelial portion, particularly originating in the margo plicatus toward the cardia, was covered by numerous smooth, whitish spherules. Microscopic examination allowed the liver, tumor, and the abdominal implants to be identified as a cholangiocarcinoma, and the stomach neoplasia as a carcinoma of its stratified squamous epithelial portion. Considering this as an uncommon finding, although when considered individually, the presence of a cholangiocarcinoma and a squamous cell carcinoma of the stratified squamous epithelial portion of the equine stomach in the same specimen is worthy of reporting.     

Pathogenic potential of equine alphaherpesviruses: The importance of the mononuclear cell compartment in disease outcome

Equid herpesviruses types 1 and 4 (EHV-1 and EHV-4) are closely related pathogens of horses. While both viruses can infect the upper respiratory tract, EHV-1 regularly causes systemic infection, which is only rarely observed in the case of EHV-4. Little is known about the molecular basis for this striking difference in pathogenic potential. Recently, we have started a systematic analysis of differences in the amino acid sequences of proteins involved in virus replication, more specifically entry and egress, as well as proteins involved in immune evasion. Here, we summarize our findings relevant to glycoproteins D and G (gD and gG), which share a high degree of similarity between the viruses, yet exhibit important differences. We found that both these glycoproteins appear to be involved in the conquest of the mononuclear cell compartment. While gD is involved in infection of peripheral blood mononuclear cells through an RSD motif present in EHV-1 but not EHV-4, gG is implicated in thwarting innate responses by sequestration of chemokines. Again, the activity is only present in EHV-1, more specifically in a short stretch of variable amino acids in the extracellular domain of gG. The differences in the two glycoproteins of EHV-1 and EHV-4 are discussed, as is their role in pathogenesis. In addition, hypotheses are proposed related to the other equid respiratory alphaherpesviruses, EHV-8 and EHV-9, based on the amino acid sequences of gD and gG.     

Comparison of the Head and Neck Positions in Ridden Horses Advertised in an Australian Horse Sales Magazine: 2005 Versus 2018

The impact of head and neck position (HNP) on horse welfare has received much attention in the scientific literature within the last two decades. Studies have identified physiological and behavioral signs of distress in horses ridden for prolonged time in an HNP with their noseline behind the vertical (BTV), which may compromise their welfare. The objective of this study was to compare potential differences of HNPs shown in horse sales photographs advertised in an Australian horse sales magazine (Horse Deals) from the years 2005 and 2018. In addition, factors potentially impacting HNPs, such as type of tack presented in (e.g., noseband type), riding discipline, and competition experience of the horse, were investigated. The sample population (n = 570) comprised horses ridden with headgear and bit in walk, trot, or canter/gallop, advertised in an Australian horse sales magazine. Issues from April 2005 and October/November 2018 were selected. Head and neck position was categorized as BTV, on the vertical (OV), slightly in front of the vertical (IFV), or extremely in front of the vertical (EIFV; any HNP >30° IFV). Data were analyzed using the chi-squared test and post hoc testing via a multiple regression approach through SPSS and test of proportions via the Z-score calculator for two independent population proportions. Analysis of combined data from years 2005 and 2018 showed 47.0% (n = 570) of the horse sample population were advertised with HNPs BTV. Behind-the-vertical HNP was observed as the predominant HNP (57.8%; n = 268) in the warmblood/eventers/show/performance (WESP) category (P < .0005). In 2005, 53.4% (n = 303) of the sample population were ridden BTV compared with 39.7% (n = 267) in 2018 (P < .001), 12.9% (n = 303) were OV in 2005 compared with 15.0% (n = 267) in 2018 (P > .05), and 10.9% (n = 303) were IFV in 2005 compared with 27.3% (n = 267) in 2018 (P < .0004). These results suggest a positive development with fewer vendors/riders selecting images where the horse’s nose was BTV. However, this may be explained by the larger proportion of horses advertised in the WESP category in 2005 (63.0%; n = 303) versus 2018 (28.5%; n = 267), and the WESP category predominantly comprised of dressage, jumper, and eventing horses. In addition, the reduction of HNPs BTV from 53.4% (n = 303) in 2005 to 39.7% (n = 267) in 2018 could be attributed to the observation that in 2018, a larger proportion of horses were listed in categories that do not require the horses to be worked with a flexed HNP referred to as “on-the-bit” (e.g., western, endurance, Australian sStock horses). The HNP BTV remains preferential by a substantial proportion of the horse-owning public when advertising horses for sale, particularly in disciplines where the horse is worked in a flexed HNP or “on-the-bit.”