Term
| Describe the management of a Strangles outbreak. |
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Definition
-stop movement of all horses on/off farm
-isolation: clean, contaminated, exposed
-tx decisions on clinical cases
-monitor carriers/recovered horses |
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Term
| How do we monitor Strangles carriers/recovered horses? |
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Definition
-nasopharyngeal swabs culture/PCR weekly x3
-guttural pouch endoscopy
-eliminate carrier infection |
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Term
| What are our sample options for Strangles PCR dx? Which is best? |
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Definition
0polypropylene tubing, gutteral pouch lavage, nasopharyngeal lavage
-gutteral pouch best |
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Term
| How do we diagnose Strangles in the lab? |
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Definition
| -primers specific for S. equi M protein |
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Term
| Describe Strangles quarantine. |
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Definition
-no fence contact
-no shared feed/water sources
-separate equipment
-manage this area last if limited personell
-decontaminate boots |
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Term
| How do we treat Strangles? |
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Definition
-gutteral pouch catheterization & tx" 60 ml flush
-Na Penicillin in pouches |
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Term
| You finally have the herd free of Strangles. How does this change how you handle new herd additions? |
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Definition
-separate from infected quarantine
-nasopharyngeal lavage & PCR
-segregate/treat based on results |
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Term
| What are the common complications seen w/ Strangles? |
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Definition
-metastatic abscessation: Bastard Strangles
-abdominal mesenteric LN
-lungs, liver, spleen, kidney, brain
-pneumonia/pleuropneumonia
-immmune-mediated myositis |
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Term
| When would we refer a Strangles case? |
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Definition
-if they have any severe complication of Strangles
-ex: hemorrhage, colic, laminitis, rapid death, immune-mediated myositis |
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Term
| What are the major complications that warrant a referral w/ Strangles cases? |
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Definition
-purpura hemorrhagica: peracute death
-pleuropneumonia: in babies
-rhabdomyolysis: recumbent
-Bastard Strangles: chronic wt loss |
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Term
| What would you see on CBC w/ chronic wt loss? |
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Definition
-inc fibrinogen
-mature neutrophilia
-anemia of chronic dz
-hypergammaglobulinemia
+/- fever & colic |
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Term
| What do we see on cytology of peritoneal fluid w/ abdominal abscess due to Strangles? |
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Definition
-non-degen neutrophils
-inc protein |
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Term
| How do we treat abdominal abscessation due to Strangles? Prognosis? |
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Definition
-sx & long-term abx
-guarded prognosis |
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Term
| What is the most common cause of death due to Strangles complications? |
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Definition
-pleuropneumonia
-occurs in weanling foals |
|
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Term
| What are the clinical signs of pneuropneumonia secondary to Strangles? |
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Definition
-thoracic pain
-reluctance to move, breath deep, cough, lie down
-abducted elbows
-pain on intercostal palpation
-ventral thoraco-abdominal edema |
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Term
| How do we diagnose pleuropnuemonia? |
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Definition
-TTW
-U/S: comet tails, consolidation, fibrin, pleural effusion
-CBC w/ fibrinogen & inflammation |
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Term
| How do we treat pleuropneumonia? |
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Definition
-abx initially +/- thoracocentesis
-later: sx thoracotomy |
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Term
| When would we perform a rib resection w/ a thoracotomy for treating pleuropneumonia? |
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Definition
-absceses
-no resection if not caseous |
|
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Term
| Which antimicrobials do we use to treat pleuropneumonia? |
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Definition
-K penicillin
-ceftiofur
+/- gentamicin
+/- metronidazole
-followed by oral TMS, CAP, DOX to kill of secondary stuff later in dz |
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Term
| What is the typical signalment of purpura hemorrhagice due to Strangles? Why do they get it? |
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Definition
-older 8-9y, esp QH/Paints
-due to Strangles vx when their titers are too high causing Ag-Ab deposition |
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Term
| What do we see on histopath w/ purpura hemorrhagica due to Strangles? |
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Definition
|
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Term
| When do we see CS of Purpura hemorrhagica due to Strangles? |
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Definition
|
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Term
| What are the CS of purpura hemorrhagica due to strangles? |
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Definition
-fever
-tachycardia, tachypnea
-petechiation to ecchymoses
=ventral edema: warm, painful, multifocal
-serum leakage or skin sloughing
-organ dysfunction: lungs, kidney, GI, laminitis
-reluctance to move
-wt loss |
|
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Term
| What are the major differentials for equine vasculitis? |
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Definition
-EHV1
-EIV
-EIA
-EVA
-Anaplasma phagocytophilum
-IMTP
-photodermaitits
-secondary to C. pseudotuberculosis infection |
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Term
| What do we see on clin path due to purpura hemorrhagica due to Strangles? |
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Definition
-anemia
-neutrophilia
-hyperproteinemia
-hyperglobulinemia
-hyperfibrinogenemia
-inc muscle enzymes: QH & paints |
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Term
| What kind of titers can you run for purpura hemorrhagica due to strangles? |
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Definition
| -Strep titers for M-proteins (ELISA) |
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Term
| Which values of SeM Strep Titers suggests purpura hemorhagica due to strangles? |
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Definition
|
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Term
| What are our objectives for treating purpura hemorrhagica due to strangles? |
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Definition
-remove antigenic stim: abx, drainage
-suppress immune response: steroids
-dec inflammation of vessel walls
-supportive care |
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Term
| What is the tx protocol for purpura hemorrhagica secondary to strangles? |
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Definition
-Dex
-Pred
-Furosemide sometimes
-NSAIDs
-Fluids, hydrotherapy, leg wraps, nutritional support |
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Term
| What are the two types of myopathies due to Strangles? |
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Definition
-infarctive (IgA): acute rhabdomyolysis
-IgG mediated: progressive muscle atrophy |
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Term
| Why are QH & paints predisposed to Strangles myopathy? |
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Definition
| -M protein in strep cell wall has AA sequences similar to myosin |
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Term
| What is the result of Strangles myopathy? |
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Definition
| -either acute death or long-term recover of wasted mm |
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Term
| Describe infarctive myopathy secondary to strangles. |
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Definition
-aka IgA myopathy
-rhabdomyolysis scondary to vascular infarction and immune mediated vasculitis
-acute over 24h
-dx via muscle biopsy & hx |
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Term
| What are the cliical signs of infarctive myopathy secondary to Strangles? |
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Definition
-severe depression
-muscle pain
-stiff gait
-thrombosis
-hemorrhage
-colic |
|
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Term
| What do we see on clin path w/ severe acute rhabdomyolysis due to strangles? |
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Definition
-inc WBC, fibrinogen, CPK, AST
-electrolyte derangements
-muscle histopath: severe acute myonecrosis w/ macrophages |
|
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Term
| What are the sequelae of IgG myopathy secondary to Strangles? |
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Definition
-bright, alert, normal appetitie
-muscle stiffness, lameness
-rapids onset of muscle wasting & atrophy
-inc CPK & AST |
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Term
| What do we see on muscle biopsy of IgG myopathy secondary to Strangles? |
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Definition
| -atrophy of fast twitch fibers w/ lymphocytic vasculitis |
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Term
| How do we treat immune-mediated myopathy secondary to Strangles? |
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Definition
-corticosteroids
-abx
-supportive care
-muscle mass may return to normal long term |
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Term
| What causes equine Strangles? |
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Definition
|
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Term
| Who is most affected by Strangles? |
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Definition
-weanlings to 5y
-3w course |
|
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Term
| Why is Strangles such an issue? |
|
Definition
-farm outbreak resolution takes months and months
-subclinical carriers have it for months and months
-thus really never leaves a farm |
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Term
| How long can a horse carry Strangles subclinically? |
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Definition
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Term
| Describe the pathogenesis of Strangles. |
|
Definition
-many shared proteins w/ Strep equi zooepidemicus
-incubation: 3-14d
-purulent lymphadenitis & can spread to any LN
-direct transmission |
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Term
| What characteristics of Strangles helps it adhere to upper resp epi? |
|
Definition
-adhesins
-fibronectin binding proteins
-hyaluroic acid capsule |
|
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Term
| What characteristics of Strangles helps it invade lymphatics & blood vessels? |
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Definition
-hyaluronidase
-streptolysin-S like hemolysin
-lymphatic & hematogenous dissemination |
|
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Term
| How long can post-infection carriers keep Strangles? |
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Definition
|
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Term
| Describe a long term carrier of Strangles. |
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Definition
-asymptomatic
-guttural pouch empyema or chondroids |
|
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Term
| When do we frequently see Strangles? |
|
Definition
-transient populations, usually younger
-traveling: breeder, competition, sale |
|
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Term
| What are the clinical signs of Strangles? |
|
Definition
-fever, depression, anorexia
-nasal discharge mucopurulent
-cough
-lymphadenopathy: leads to lameness & difficulty breathing
-dysphagia
-dyspnea |
|
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Term
| How do we diagnose Strangles? |
|
Definition
-CS
-PCR of guttural pouch
-Culture: nasal swab, abscess |
|
|
Term
| How do we diagnose Strangles? |
|
Definition
-rads
-endoscopy of guttural pouches
-U/S |
|
|
Term
| How do we treat Strangles? |
|
Definition
-drainage
-lavage
-abx sometimes |
|
|
Term
| How do we ID Strangles carriers? |
|
Definition
| -guttural pouch lavage weekly x3 |
|
|
Term
| How do we treat Strangles carriers? |
|
Definition
0lavage + chondroid removal
-saline + K penicillin
-cattle IM cephalosporins |
|
|
Term
| How do we treat Strangles? |
|
Definition
-isolation
-abx prior to abscessation & w/ exposure
-after SMLN abscessation: isolation & drainage ONLY
-debilitated: penicillin & supportive rx |
|
|
Term
| How does tx change w/ dysphagia due to Strangles? |
|
Definition
-anti-inflammatories
-nutritional management |
|
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Term
| How long does immunity to Strangles last after natural infection? |
|
Definition
|
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Term
| What are our concerns w/ Strangles vaccination? |
|
Definition
-risk of exposure
-istorical vx rxn: if titers too high cause purpua |
|
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Term
| How do we admin Strangles vaccination? |
|
Definition
| -ML IN & IM AWAY FROM EACH OTHER |
|
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Term
| What vaccination complications occur w/ MLV IN Strangles vaccination? |
|
Definition
-occasional rxn
-nasal dischage, submandibular abscesses, cases of purpur hemorhagica |
|
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Term
| What vaccination complications occur w/ IM killed products Strangles vaccination? |
|
Definition
| -soreness, purpura hemorrhagica |
|
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Term
| What issues do we see w/ IM Strangles vaccination? |
|
Definition
-soreness & abscesses at injection sites
-occasional cases of purpura hemorrhagica
-ONLY GIVE TO NORMAL HEALTHY HORSES W/ NO RECENT EXPOSURE TO BACTERIA |
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