Diagnosis of Equine Protozoal Myeloencephalitis Using Indirect Fluorescent Antibody Testing and Enzyme-Linked Immunosorbent Assay Titer Ratios for Sarcocystis neurona and Neospora hughesi

The aim of this study was to compare two serologic tests used to support a diagnosis of equine protozoal myeloencephalitis (EPM). Serum and cerebrospinal fluid (CSF) samples were analyzed for antibodies to Sarcocystis neurona and Neospora hughesi by indirect fluorescent antibody testing (IFAT) and surface antigens of S. neurona and N. hughesi by enzyme-linked immunosorbent assay (ELISA). The samples originated from neurologic horses with confirmed and suspected EPM (nine S. neurona, three N. hughesi), from neurologic horses with confirmed neurologic diseases other than EPM (16 horses) and from healthy horses (10). The IFAT on CSF and ELISA titer ratios showed equal sensitivity in diagnosing EPM caused by S. neurona. The ELISA titer ratios showed slightly greater specificity in diagnosing EPM than the IFAT on CSF. Overall agreement between the IFAT on CSF and ELISA titer ratio was 90.9%. The IFAT on CSF and ELISA serum/CSF ratio are indicated to help support a laboratory diagnosis of EPM.     

Equine Protozoal Myeloencephalitis: An Updated Consensus Statement with a Focus on Parasite Biology,Diagnosis, Treatment,and Prevention

Equine protozoal myeloencephalitis (EPM) remains an important neurologic disease of horses. There are no pathognomonic clinical signs for the disease. Affected horses can have focal or multifocal central nervous system (CNS) disease. EPM can be difficult to diagnose antemortem. It is caused by either of 2 parasites, Sarcocystis neurona and Neospora hughesi, with much less known about N. hughesi. Although risk factors such as transport stress and breed and age correlations have been identified, biologic factors such as genetic predispositions of individual animals, and parasite‐specific factors such as strain differences in virulence, remain largely undetermined. This consensus statement update presents current published knowledge of the parasite biology, host immune response, disease pathogenesis, epidemiology, and risk factors. Importantly, the statement provides recommendations for EPM diagnosis, treatment, and prevention.     

Intracranial medulloblastoma as the cause of progressive ataxia in a 6-month-old draft horse cross gelding

We describe the unique clinical presentation of a central nervous system neoplasm in a 6-month-old draft horse cross gelding. Based on the neurologic examination at admission, neurolocalization was most consistent with a mildly asymmetric cervical, multifocal, or diffuse myelopathy. Mild vestibular involvement also was considered, but no cranial nerve deficits were observed. The gelding was negative for Sarcocystis neurona or Neospora hughesi based on paired serum and cerebrospinal fluid (CSF) samples analyzed, with no evidence of cervical compression based on contrast myelography. The horse was euthanized because of progression of clinical signs. At necropsy, a mass was identified associated with the cerebellum, and histopathology was consistent with medulloblastoma, which has not been reported previously in the horse.     

Encephalitozoon cuniculi–Associated Equine Encephalitis: A Case Report

A case of encephalitis of unknown origin in the horse was investigated. Postmortem examination findings revealed a nonsuppurative granulomatous meningoencephalitis in the right hemisphere of the cerebral cortex. Testing for West Nile virus, equine herpes virus, equine infectious anemia, Toxoplasma gondii, Neospora caninum, and Sarcocystis neurona were negative. The horse had a titer for Encephalitozoon cuniculi, and sections from the affected area of the brain tested positive for the organism using both polymerase chain reaction (PCR) and immunohistochemistry. Amplicons generated using PCR were sequenced, and E. cuniculi genotype II was identified. This is the first case of E. cuniculi genotype II associated with encephalitis in the horse.     

Serological and molecular detection of Theileria equi in sport horses of northeastern Brazil

Theileriosis is a worldwide protozoal tick-borne disease caused by Theileria equi, which may produce a variety of clinical signs and turn infected horses into lifetime carriers. This study has aimed to perform a serological and molecular detection of T. equi and associated factors in sports horses from six areas of northeastern Brazil. In overall, 59.6% horses were positive by indirect immunofluorescence assay and 50.4% by polymerase chain reaction. No significant association was found when presence of ticks, age, gender, anemia or total plasma proteins was analyzed with seropositivity and molecular techniques. Although a significant association of infection was found in two cities. Thus, local risk factors other than presence of ticks, horse age, gender, anemia and total plasmatic proteins may dictate prevalence of T. equi infection in sports horses, even in highly endemic areas with no control of infection prior to horse competitions.     

Equine protozoal myeloencephalitis in the Netherlands? An overview

Equine protozoal myeloencephalitis (EPM) was diagnosed in a Dutch Warmblood gelding a few months after its export to the United States. The horse came back and was treated here. Additionally, an overview of the disease complex 'EPM' is given. Mode of infection, diagnosis of disease and its differential diagnoses, and general therapeutic options are presented. Although EPM due to infection with Sarcocystis neurona in Europe seems restricted to those horses that return or are imported from North America, the possibility of future cases of EPM caused by an infection with Neospora spp. is briefly discussed.     

Neospora hughesi: experimental infections in mice, gerbils, and dogs

Neospora hughesi is a recently described cause of equine protozoal myeloencephalitis (EPM). A rodent model for pathogenicity would facilitate development of therapies to be used in horses. In the present study, we examined the susceptibility of BALB/c gamma-interferon gene knockout (gamma-INFKO), BALB/c, CD-1, and C57BL/6 strains of mice and gerbils to infection with tachyzoites of the Nh-A1 strain of N. hughesi isolated from a horse from AL, USA. Only the gamma-IFNKO mice developed severe clinical disease following infection with N. hughesi and died 19-25 days after infection and exhibited severe cardiac lesions. In contrast, experimental infection of gamma-INFKO mice with tachyzoites of the NC-1 or NC-Liverpool strains of Neospora caninum resulted in deaths 8-10 days after infection. The most severe lesions were in the livers, spleens, and lungs of these mice. Gerbils inoculated with N. hughesi did not develop clinical disease, had few microscopic lesions, but did seroconvert. Two dogs fed the brains of mice, shown to contain N. hughesi tissue stages by cell culture and gamma-IFNKO mouse bioassay, did not shed N. caninum-like oocysts over a 23 days observation period. The marked difference in pathogenicity between the two species of Neospora in gamma-IFNKO mice, and lack of oocyst excretion by dogs fed N. hughesi infected mice provide additional evidence that the species distinction between N. caninum and N. hughesi is valid.     

Neospora abortion in New Zealand cattle

Protozoal abortion in cattle was retrospectively studied by examining material submitted to the Batchelar Animal Health Laboratory in the years 1987-90. Only cases in which foetal brain had been submitted were examined. Histologically, protozoal lesions were seen in the brains of 28% of 320 aborted foetuses. Lesions were also seen in 10% of the hearts and 34% of the placentas examined, but these were not as characteristic as those in the brains. Protozoa, confirmed immunohistochemically as being Neospora caninum-like in two brains, were seen in 5% of aborted foetuses with lesions. No protozoa or associated lesions were seen in 57 late term foetuses or neonatal controls. A farm survey supported the hypothesis that Neospora is an important cause of multiple abortions in cattle. Laboratory and farm data suggested that protozoal abortion was more common in early gestation. No predisposing causes of abortion were found and there was no evidence of point infection of affected herds.     

Detection of Neospora caninum tachyzoites in cerebrospinal fluid of a dog following prednisone and cyclosporine therapy

Abstract: A 9‐year‐old female spayed Shetland Sheepdog was presented to the Kansas State University Veterinary Medical Teaching Hospital for evaluation following a 3‐week history of left rear limb lameness that had progressed to generalized ataxia. Multifocal or diffuse brain lesions were suspected based on physical examination findings. Cerebrospinal fluid (CSF) contained 52 nucleated cells/μL composed of mixed inflammatory cells. Treatment with prednisone and cyclosporine was initiated based on a presumptive diagnosis of granulomatous meningoencephalitis. Thirteen days later the dog was nonambulatory and mentally obtunded. Repeat CSF analysis revealed 298 nucleated cells/μL with 61% eosinophils. Rare protozoal tachyzoites consistent with Neospora caninum, Toxoplasma gondii, or Sarcocystis spp. were found extracellularly and within macrophages and an eosinophil. Despite cessation of prednisone and cyclosporine therapy and provision of supportive care, the dog died 6 days later. Examination of brain tissue sections revealed multifocally extensive, necrotizing, histiocytic, and lymphoplasmacytic meningoencephalitis with numerous protozoal zoites and cysts. Immunohistochemical analysis of brain tissue using a monoclonal antibody specific for N. caninum confirmed the diagnosis of neosporosis. Similar but less severe lesions were noted in the spinal cord, although organisms were not found. This case emphasizes the value of repeated CSF analysis when therapy is ineffective and the importance of excluding infectious causes of meningoencephalitis before commencement of immunosuppressive therapy.     

Seroprevalence of antibody to NcSAG1 antigen of Neospora caninum in cattle from Western Java,Indonesia

Neospora caninum can cause fetal abortion and neonatal mortality in cattle, and is a cause of economic concern worldwide. This study aimed to determine the prevalence of Neospora caninum-specific antibodies in cattle from Western Java, Indonesia. Serum samples from 991 cattle from 21 locations were tested for antibodies to N. caninum by using an enzyme-linked immunosorbent assay (ELISA) on the basis of recombinant NcSAG1. The overall seroprevalence was 16.6%, ranging from 0 to 87.5% in the sampled locations. The results of this study indicate latent infection rates of sampled animals were different in each location. Further studies are necessary to elucidate the relationship between N. caninum infection and abortion in cattle, and to identify risk factors for infection in high-prevalence environments.     

Equine Piroplasmosis

Equine piroplasmosis (EP) is a tick-borne protozoal disease of horses, mules, donkeys, and zebras that is characterized by acute hemolytic anemia. The etiologic agents are two hemoprotozoan parasites, Theileria equi (Laveran, 1901) and Babesia caballi (Nutall and Strickland, 1910) that are transmitted primarily by ixodid ticks. Equine piroplasmosis is found globally where tick vectors are present and is endemic in tropical, subtropical, and some temperate regions. Horses infected with B. equi remain seropositive for life; horses infected with B. caballi are seropositive for several years to life. Economic losses associated with EP are significant and include the cost of treatment, especially in acutely infected horses; abortions; loss of performance; death; and restrictions in meeting international requirements related to exportation or participation in equestrian sporting events. Equine babesiosis–free countries limit the entrance of Babesia-seropositive horses into their countries. In the United States a few sporadic outbreaks have occurred in recent years but have been limited due to implementation of stringent control methods. The cELISA for both T. equi and B. caballi is currently the recommended test for international horse transport. Different therapies for control and sterilization of the parasites are discussed.     

Prevalence of Neospora hughesi and Sarcocystis neurona antibodies in horses from various geographical locations

Parasite-specific antibody responses to Neospora antigens were detected using the immunofluorescent antibody test (IFAT) and immunoblot analysis in select equine populations. For comparison, a naturally infected Neospora hughesi horse and an experimentally inoculated Neospora caninum horse were used. In addition, all samples were tested for antibodies to Sarcocystis neurona by immunoblot analysis. A total of 208 samples was evaluated. The equine populations were derived from five distinct geographic regions. Locations were selected based on distribution of Didelphis virginiana, the native North American opossum which serves as the definitive host for S. neurona. Only 11% of the samples that had positive titers of 1:100 using the IFAT were also positive for antibodies by immunoblot analysis in this study. Overall, there was a 2% seroprevalence for Neospora antibodies in all horses tested based on immunoblot analysis described. The seroprevalence for S. neurona antibodies varied from 0% (New Zealand and Montana) to 54% (Missouri). We concluded that, in testing for antibodies against Neospora antigens using either IFAT or immunoblot analysis, as described, positive results should not be attributed to the presence of antibodies to S. neurona.     

Neospora-like protozoal infections associated with bovine abortions

Eighty bovine fetuses with presumed protozoal infections from a previous 2-year retrospective study were examined by immunohistochemistry using antisera against Neospora caninum. In 66 (83%) of the fetuses, protozoa were found that reacted positively with anti-N. caninum sera. In three (4%) additional fetuses, protozoa identified as Sarcocystis species did not react, and in two fetuses (3%) single protozoal clusters were found only in hematoxylin and eosin-stained slides. A group of 20 fetuses were chosen for further evaluation. They included 14 fetuses from the first group of 80 fetuses plus six additional fetuses that had large numbers of protozoa in the fetal brain. The 20 fetuses were examined immunohistochemically with antisera to N. caninum, Hammondia hammondi, and Toxoplasma gondii. Protozoa from 3/20 fetuses, identified as Sarcocystis species, failed to react with any antisera. In 16/20 fetuses protozoa reacted positively to antisera against N. caninum, and in most cases reacted to H. hammondi, and weakly to one or more of the antisera against T. gondii. Thick-walled protozoal tissue cysts were found in the brain of four of these 16 fetuses by transmission electron microscopy. The cyst wall morphology was comparable to N. caninum. The results suggested that a single protozoal parasite of unknown identity was responsible for most of the bovine abortions. By immunohistochemistry, the unknown protozoon reacted most strongly and consistently to N. caninum antisera, but was antigenically distinct from N. caninum. Ultrastructurally, tissue cysts found in four fetuses most closely resembled Neospora caninum.     

Acute pulmonary Sarcocystis falcatula-like infection in three Victoria crowned pigeons (Goura victoria) housed indoors.

Three free-roaming Victoria crowned pigeons (Goura victoria) housed in a completely enclosed tropical exhibit were found dead without antemortem signs of illness. The birds died within 9 days of each other. Gross necropsy revealed moderate pulmonary edema in all three birds. Histopathologic examination revealed pulmonary edema and pulmonary protozoal merozoites compatible with Sarcocystis spp., Toxoplasma gondii, or Neospora spp. infection. Immunohistochemical staining for T. gondii and Neospora spp. were negative. Immunohistochemical staining identified a Sarcocystis falcatula-like parasite in all three birds. It is suspected that new exhibit soil contaminated with feces from the Virginia opossum (Didelphis virginiana) was the source of the infective sporocysts.     

Urinary incontinence and incoordination in three horses associated with equine protozoal myeloencephalitis

Urinary incontinence, weakness and ataxia associated with equine protozoal myeloencephalitis (EPM) was diagnosed in three horses. Rectal examination of all horses revealed distention of the urinary bladder. Urine was expressed when manual pressure was applied to the bladder of each horse during rectal examination. The anal reflex and tone of the anus and tail were normal in all horses. Two horses had bacterial cystitis associated with Enterococcus sp. All horses were treated with pyrimethamine and a sulfonamide for EPM, but there was a variable response to treatment.     

Neurotropic T-cell-rich B-cell lymphoma in a 14-year-old Morgan gelding

A 14-year-old Morgan gelding was presented for progressive weakness and muscle atrophy. The horse was initially diagnosed with equine protozoal myelitis based on history, physical examination, and laboratory diagnostics. Despite therapy, the horse declined clinically and was euthanized. Necropsy revealed a rare form of neurotropic lymphoma, described in this report.     

Prevalence of Antibodies to Neospora caninum and Toxoplasma gondii in Swedish Dogs

Neospora caninum is a newly described coccidian parasite which has been found in various species such as the dog, cattle, horse, sheep and goat. Morphologically it resembles Toxoplasma gondii with which it is related (Holmdahl et al. 1994), and with which it has earlier been confused. The life cycle of N caninum is only partially known. Tachyzoites and tissue cysts are the only known stages of the parasite, and transplacental transmission is the only known route of infection. Subclini-cally infected dams can transmit the parasite to their fetuses and successive offspring from the same mother might be born infected (Dubey et al. 1990b). Clinical neosporosis is mostly seen in pups or young dogs, and the majority or all pups in a litter are often affected. The disease is characterized by ascending paralysis of the legs, with the hind legs more severely affected than the front legs, paralysis of the jaw, difficulty in swallowing and muscle flaccidity and atrophy (Dubey 1992, Dubey & Lindsay 1993). Fatal infections with N caninum in dogs have been reported from many countries, e.g. Norway (Bjerkäs & Presthus 1988), USA (Dubey et al. 1988), Sweden (Uggla et al. 1989a,b) and the United Kingdom (Dubey et al. 1990a). Serological surveys for antibodies to N. caninum in dogs from Kansas, USA and England have shown a prevalence of 2 and 13%, respectively (Lindsay et al. 1990, Trees et al. 1993).     

Incidence and vertical transmission rate of Neospora caninum in sheep

The infection by Neospora caninum in sheep can lead to abortion and the birth of weak and debilitated lambs. The aim of this study was to assess the incidence of natural infection by Neospora caninum and the vertical transmission rate among sheep. A flock of 50 sheep was monitored for serum antibody titres against N. caninum and seroconversion over a period of six months using an indirect ELISA technique. The offspring of the herd was also investigated regarding anti-N. caninum antibodies to determine the vertical transmission rate through the indirect immunofluorescence technique. The initial and final prevalences of infection by N. caninum were 26.0% (13/50) and 72.0% (36/50), respectively, and the incidence of infection by N. caninum in the present study was 62.2% (23/37). The vertical transmission rate found was 15.4% (2/13). A high incidence of infection by N. caninum in sheep was observed, and this is the first report assessing the incidence of N. caninum among naturally infected sheep.     

Effects of dietary horse beans (Vicia faba) on colostrum and milk composition and milk yield in sows

In an experiment sows received 0, 17 and 34% horse beans in the diet. Horse beans replaced the protein mixture (soybean meal, fishmeal, and meat and bone meal) by one half or in full.The composition of colostrum was altered by the dietary horse beans. An increase in dietary horse beans significantly reduced dry matter contents (P ≤ 0.05) and protein contents (P ≤ 0.001). As to the various protein fractions, total whey protein and albumin showed the greatest decline (P ≤ 0.001), followed by immunoglobulin (P ≤ 0.01) and beta lactoglobulins (P ≤ 0.05). Casein and alpha lactalbumin contents were not altered significantly.The total fat content of colostrum was not influenced by dietary horse beans, but the percentages of C 18:1 increased (P ≤ 0.001) and C 18:2 decreased (P ≤ 0.001) with increasing amounts of horse beans in the diet.The effect of horse beans on the composition of sow milk was insignificant, although there was a tendency to higher dry matter and protein content in milk from sows fed diets without horse beans.Horse beans at both levels had a negative effect on milk yield (linear trend: P ≤ 0.05).