- it clears mucus, inhaled particles, and other debris from the airways

• physical—e.g. dust particles, excess mucus, inhaled fluids, constriction of the small airways (bronchospasm), compression (external or internal), increased airflow (e.g. exercise)?
• chemical—irritant gases (e.g. ammonia)
• thermal—cold air
• inflammatory—airway inflammation (tracheitis, bronchitis, bronchiolitis)

There are many specific conditions that can cause coughing in horses.  Below are the more common ones. Some are infectious, but most are noninfectious conditions; some don't primarily involve the respiratory tract.

• viral—influenza, rhinopneumonitis (equine herpes virus [EHV] types 1 and 4), equine viral arteritis (EVA)
• bacterial—strangles, Rhodococcus equi (foals), bacterial pneumonia or pleuropneumonia
• parasitic—lungworm, roundworm (foals)

• environmental—dust, other airway irritants (e.g. exhaust fumes, smoke), cold air
• disease—recurrent airway obstruction (also called chronic obstructive pulmonary disease [COPD] and "heaves"), inflammatory airway disease, silicosis (in CA)
• other—exercise-induced pulmonary hemorrhage (EIPH), tie-back for laryngeal hemiplegia ("roarer"), exercise, "nuisance cough"

• choke (esophageal obstruction)
• pharyngitis (inflammation at the back of the throat)
• congestive heart failure
• guttural pouch problems
• neurologic problems that affect the swallowing reflex

Determining the cause of coughing is somewhat like a detective story - one assembles clues that help narrow down the list of suspects.  Pertinent information includes the following:

• onset and duration—is the cough chronic and low-grade or sudden in onset?
• health of horse—is the horse sick or otherwise healthy? (consider the horse's appetite, attitude, temperature, respiratory rate and pattern, presence/absence of nasal discharge, exercise tolerance, body condition)
• nature of cough—is the cough "dry" or "wet"; harsh or soft?
• age—in foals consider roundworm and R. equi pneumonia; in young horses in training
  consider viral respiratory diseases
• housing, bedding (if stalled), feed—how is the horse managed?
• occupation—in show/competition horses consider flu, rhino, and other infectious conditions;
  in young racehorses consider inflammatory airway diseae, exercise-induced pulmonary hemorrhage, and pharyngitis
• recent travel—has the horse travelled recently?  If so, consider flu, rhino, strangles,
  and pleuropneumonia
• how many horses affected?
• is cough associated with particular activities? (e.g. eating, entering barn, exercise)
• vaccination status—is the horse currently vaccinated against respiratory diseases?

• physical examination (including thorough auscultation of the chest with a stethoscope)
• routine blood tests (looking for evidence of infection)
• endoscopy of the upper airway
• sample the lower airways—tracheal wash and/or BAL (bronchoalveolar lavage)
• radiography—head, throat, chest
• ultrasonography—chest cavity, lung surface, heart

Below are the principles of managing a coughing horse:

• specific treatment—depends on cause
• environmental management—important in all cases, as poor air quality can aggravate any respiratory problem
• preventive strategies—e.g. vaccination, quarantine, deworming

Cough suppressants and expectorants are of little use, unless the cause has been addressed

Re-printed courtesy of: Dr. Christine King

http://www.paper-horse.com/

D: degenerative, developmental

A: allergic, autoimmune

M: metabolic, mechanical

N: neoplastic (tumors), nutritional

I: infectious, inflammatory, immune-mediated, ischemic (low blood flow), iatrogenic ("man-made"),
   idiopathic (unknown)

T: traumatic, toxic

* degenerative—e.g. degenerative joint disease (DJD, or osteoarthritis)

* developmental—e.g. osteochondrosis (OCD), physitis ("epiphysitis")

* metabolic—e.g. laminitis ("founder"), exertional rhabdomyolysis ("tying up")

* mechanical—overload of a structure

- either sudden, massive overload or repeated, marginal overload ("wear & tear")

* infectious—e.g. foot abscess, infected wound, cellulitis, joint infection

* inflammatory—most of the specific causes of lameness have an inflammatory component

* traumatic—i.e. injury (external trauma)

* abnormal stance—e.g. pointing the toe, resting one leg more than another, dropped fetlock

* abnormal movement—head nod (forelimb lameness), hip hike (hindlimb lameness)

* reduced arc of foot flight—often seen as stiffness or reluctance to flex the limb normally

* shortened stride length—shortened "swing" phase of the stride

* abnormal foot placement—e.g. landing toe-first to spare the heel

* on a level, even surface

* at the walk and the trot

* on a straight line and on a circle (led, longed, or in a round pen)

- make sure the horse is on a loose lead or longe line

- watch the horse in both directions on the circle (i.e. to the left and to the right)

* from the side, in front, and the rear

* on different surfaces (e.g. hard and soft)

Bear in mind that there may be a problem in more than one leg.

The three skills required are Observation, Palpation, and Manipulation

* look for symmetry between left and right legs, and between the inside and outside of a normally
  symmetrical structure

* when asymmetry is found, is it caused by enlargement (e.g. swelling) or reduction in tissue mass?

* feel for heat, swelling, pain, and changes in tone or texture of a tissue

* characterize any swellings as hard, firm, soft, fluid-filled

* move the structure or tissue through its normal range of motion

* check for pain, altered range of motion (increase or decrease), and crepitus (a grating, grinding,
  or crackling sensation)

* pain * heat * swelling * redness * loss of function

Observation—symmetry of the hoof wall; integrity of the hoof wall (cracks, bulges, etc.)
and sole (defects, foreign objects, etc.); discharge, discoloration, or odor; shoe and nails

Palpation—coronary band (pain, swellings, depressions); heel bulbs; sole (thumb pressure);
digital pulses (at fetlock or pastern)

Manipulation—move the heels independently; tap the hoof wall; use hoof testers (if you have them)

The foot is the most common site of lameness.

Observation—swelling, position (angulation)

Palpation—nature of the swelling, heat, pain

Manipulation—flex (bend) and extend (straighten) the joint, checking for pain and altered range
of motion

Observation—swelling

Palpation—nature of the swelling, heat, pain

Manipulation—pain, instability, crepitus

Observation—swelling

Palpation—swelling (subtle swelling may not be obvious to the eye), location of the swelling
(within or around the structure?), heat, pain, change in tension and texture

- if possible, also palpate the sites where the structure attaches to bone

Manipulation—pain, instability of the associated joint

Observation—swellings or atrophy (loss of muscle mass)

Palpation—pain, change in tone and texture, crepitus, heat or coolness

Manipulation—pain, reduced range of motion in the associated joint(s)

The neck and back consist of a complex series of bones, joints, tendons, ligaments, and muscles:

Observation—symmetry, posture, contour

Palpation—nature of any swellings, pain, change in muscle tone and texture

Manipulation—pain, reluctance to flex or extend, reduced range of motion

Also consider these other possible sources of lameness:

* the skin

* the nervous system (brain, spinal cord, nerves)

* the tack (especially the saddle)

* the rider ("bridle lameness" or "rein lameness")

- when you return to the suspect area you should get the same (or greater) response
  to palpation or manipulation each time

- the pain response may be subtle (e.g. tensing up, turning the head to look at you,
  moving away from your hand), but if it is repeatable, it is probably significant

2. Assuming the opposite leg is normal, use it for comparison if unsure that your findings
   are significant.

4. A specific diagnosis often is not possible without veterinary examination and diagnostic imaging.

* physical examination (observation, palpation, manipulation)

* diagnostic anesthesia—regional nerve blocks and joint blocks

* diagnostic imaging—the method chosen depends on the veterinarian's suspicions

- radiography (x-rays)—bones and joints

- ultrasonography—soft-tissue problems, such as tendon and ligament injuries,
  and joint surfaces

- thermography—body surface temperature imaging, looking for areas of inflammation
  (increased temp.) or reduced blood flow (decreased temp.)

- nuclear scintigraphy ("bone scan")—soft-tissue phase for soft-tissue inflammation;
  bone phase for bone or joint problems

- computerized tomography (CT)—any tissue, but mostly used for bone problems

- magnetic resonance imaging (MRI)—mostly soft tissues and joint surfaces

• therapeutic trial—presumptive diagnosis based on response to treatment

Please visit for further articles - http://www.paper-horse.com/l

Synopsis: Orthodox philosophy and treatment of Laminitis or Founder in the horse is presented with Holistic approach and theory of cause, with case study presented.

Veterinary School Text book definition: " Founder or laminitis is primarily a non-infectious inflammation of the sensitive laminae of the hoof, most frequently affecting the forefeet, sometimes all 4 feet and less frequently, one foot. Inflammation in one foot usually occurs when its opposite is unable to sustain weight. Rarely are the hind feet alone involved. The disease is associated with digestive disturbances with impaction of the cecum and great colon a contributing cause. Overloading of the digestive tract with great quantitities of grains (wheat barley and oats) in an animal unaccustomed to this diet almost always results in founder. Drinking large quantities of cold water when overheated contributes to the disease. Symptoms are extreme pain in affected feet. "

Founder occurs as an acute onset, or chronic condition.
.
Acute founder occurs suddenly, is an extremely painful condition of the affected feet, the swollen, engorged vascular laminae with rich nerve endings expand against a rigid hard horn of a hoof, you can imagine the pain these poor animals feel! The horse resists moving, tends to bear all possible weight on the unaffected hind feet. The hoof shows increased temperature and the digital pulse is prominent. Many times these animals go down, refuse to eat or drink. The prognosis is guarded.

1. Removal of shoes and keeping the horse's feet in cold water or ice boots
2. Blood transfusions from a normal animal (250 cc. 3 a day for 2-3 days)
3. Antihistamines (because many researchers feel histamine is released as part of the syndrome of the disturbed digestive system. Histamine produces widespread inflammation, heat and swelling in targeted tissues).
4. Corticosteroids are administered to reduce the inflammatory process.
5. Elimination of most grains from diet and substitution of wheat bran and laxatives
6. Grooving the hoof walls with ¼ inch wide vertical grooves, 1-½ inches apart to relieve pain. The hoof should be bandaged for 1-2 weeks following grooving.
7. Rest and no exercise.
8. The therapeutic effect of treating acute laminitis with I.V. Saline-Citrate solution to counteract the histamine production, has been reported sporadically in the literature for over 40 years (in English Vet Record: 72 (38): 787, 1960). A solution of one oz. of salt, (sodium chloride) and ½ oz. of sodium citrate in one pint of water administered intravenously gives surprisingly good effects in the impaction of the ileum, or poor condition resulting from intestinal dysfunction. One injection is frequently sufficient to trigger a response.
9. Aftercare of hoof with corrective light steel bar shoe to prevent hoof contraction with rolled toes can be helpful. Painting of outer surface of hoof with solution of ½ pine tar and ½ fish oil to stimulate healthy growth of new hoof. Frequent trimming- at least once a month.

Chronic founder often follows repeated mild attacks or a single acute attack. The structures of the foot degenerate, causing the animal to walk on its heels. The toes grow very long and the sole is sometimes wrinkled. The prognosis is poor.

"Clover founder" is classified as a chronic laminitis. This laminitis is associated with obesity, sluggishness, mental changes, rough hair coat that sheds poorly, infertility, cardiac hypertrophy and grazing on ladino clover pastures. Some researchers incriminate hypothyroidism.

Please note orthodox explanation of cause of laminitis being digestive origin: cecum, small intestine and colon are the organs involved. I feel the disturbance is both physical and electromagnetic.

• I believe laminitis results from accumulated toxic chemicals, drugs, past vaccines, dewormers, and heavy metals, especially chronic aluminum toxicity. Aluminum and other heavy metals are a real health hazard. These originate from contaminated waters and feed. There are certain plants that concentrate aluminum from the soil 100 xs more than any other foodstuff. These foods are cereal grains: oats, wheat, corn and barley; and legumes: clovers and alfalfa's. A horses diet! Exactly the foods incriminated by orthodox veterinary literature! How do these foods become contaminated by aluminum? By Acid rain falling on clay soils.
  
  Clay is bound aluminum. Burning fossil fuels for energy from industry and auto emissions produce chemicals when combined with water (rain) produce acids. Acid rain falling on clay chemically releases the aluminum to be a free agent thus being taken up by the roots of the plants growing there and getting into the underground water reserves. When a horse loads up on grains, alfalfa or clover, he/she is concentrating the aluminum that goes to the digestive system, releases histamine which circulates through the blood stream setting up the extensive tissue inflammation in the hooves of the fore legs especially.
  
  Why the forefeet? Because here is the trajectory of the acupuncture energy meridians of the colon, cecum and small intestine. Aluminum also goes to the brain and the nervous system and thus touches every organ in the body. Most affected always is the Liver and endocrine system (thyroid, adrenals, pituitary, ovary, testicle, etc.) It also has an imbalancing of the nutritional minerals that produce illness.

• Electromagnetic disturbances in the acupuncture energy meridian flows, chi or Life force of all organ systems.
  In Chinese medicine, Hoof (nail) is related to the Liver. Liver is the primary organ of detoxification. Aluminum is a very serious toxin. When Liver has excess heat, it passes it on the heart and small intestine. Also hoof will receive excess heat.
  
  The Liver and Digestive organs have related energy links to the thyroid, adrenal glands, reproductive and immune system organs. That is why founder is associated with laminitis, digestive problems, and can be associated with " obesity (hypothyroidism), poor hair coat that sheds poorly, infertility (endocrine) and heart problems".
  Please refer to a case study, "Kahuna" a Gelding 24 years old with severe intractable founder for several months despite all orthodox treatment.
  
  A hair analysis reveals the culprit: Toxic metals of aluminum, lead, mercury, cadmium, nickel, selenium, and arsenic with imbalances in nutritional minerals.

Normal values of minerals presented for the horse. There are no tolerable levels of toxic metals for humans, horses, dogs and cats.

Comparison of Kahuna's minerals to the normal values in the chart show he has lower than normal calcium, iron, copper, and chromium with sodium and potassium loss from the body. Elevated above normal are: magnesium, manganese, zinc and phosphorous. His Aluminum levels are 1000% above tolerable levels, as well as presence of toxic metals lead, mercury, cadmium, nickel, selenium and arsenic. To that add pesticides, herbicides, and fungicides found contaminating the feed fed horses, as well as drug dewormers given as a preventative several times yearly, and you have a toxic soup exiting the gastrointestinal tract to the blood circulation poisoning all organ systems and targeting the dermis of the hooves. No wonder horses suffer Acute Founder and other illnesses!

In addition to orthodox treatment, I recommend:

• Acupuncture Therapy: Dr. Marvin Cain, whom I respect greatly as a top equine acupuncturist, treats laminitis with releasing "excess heat" in the Small Intestine and Large Intestine (Colon and Cecum) acupuncture energy meridians at their distal points on the outside lateral and inside medial, respectively of the coronet band of the two front feet. He inserts an 18 or 20 gauge hypodermic needle (depending on size of horse) at these two points into the digital veins of the fetlock joint, lets it bleed as much as a liter.
  
  In so doing, pressure is relieved in the foot structures and "cleansing from within" is accomplished with fresh oxygenated blood being permitted to flow through the area. He also acupunctures and balances Liver points. He recommends lipotrophic supplements for the liver: choline, Biotin, Inosatol, Cysteine, etc.)
• Supportive Homeopathy -Please see my remedy for Founder Formula 5M which contains pain reliever and anti-swelling remedies, circulation, lymph and histamine nosode and organ remedies Liver, Gall Bladder, Small Int. Heart, Colon and Lung.: give 4 tabs every hour first day, then 4 x daily or more often as needed thereafter. Homeopathy Total Organ Support for the Male 60C or Female, Endocrine Balance for the Male or Female 30C.
• Yellow Color therapy to help heal the Liver and Digestive System.
• Removal of heavy metals with Dr. Dodd's Homeopathic 3 bottle set Detox Formula with detailed instructions. For specific drugs, pesticides and dewormers I am available for consultation and can make custom homeopathic nosodes for specific cleansing of these chemicals. 

The only way I have found to chelate out the heavy metals is with my homeopathic nosode set of 3 bottles Detox 15x, 30C and 60C. The set comes with detailed instructions.

http://www.holisticvetpetcare.com Copyright Dr. Gloria Dodd DVM

Horses get sick and painful for as many reasons as people and all animals do.

How to tell if your horse is lame.

In my experience of observing the many animals I have attended since opening my practice in l960 and my education in both orthodox and holistic philosophies, I have come to the following conclusion: WE GET SICK FROM ANY AND ALL THINGS THAT WEAKEN THE BODY’S PROTECTIVE ELECTROMAGNETIC FORCE FIELD OR LIFE FORCE.

We have to stop thinking of ourselves, and animals as physical beings alone. All things exist in physical and energy forms. I have proven this to myself by photographing the electromagnetic field (EMF) of dogs, cats, and people. Other European researchers have photographed the EMF of horses, sheep and cattle. This special photography is called Kirlian, and requires a special technique of exposing the film with electricity in a light free environment taken by a Kirlian camera.

I have also measured the magnitude of the EMF of horses, dogs, cats, and people by using a sophisticated, electronic machine first made in Germany. By both methods I have compared the EMF of "healthy" individuals to those having known organ illnesses. In the Kirlian photograph, the sick animal and person show "holes" in the EMF and the amplitude (the width or thickness of the EMF halo around the hooves, fingers and toes) is very weak compared to the continuous, strong EMF of a healthy body. (Please refer to section on Kirlian Photography)

1. Inheritance of a genetic code that is flawed and produces a weakened constitution that may lead to impaired organ function, poor immune response or coping with stress.
2. Yes, horses suffer illnesses due to stress as we do, probably more so because they are creatures of speed and reaction. Reacting quickly to danger has been survival for the horse in its evolution but now we restrict his movements to small stalls, corrals and or pastures and demand he conform to our standards of his living.
3. Environmental toxins- chemicals in the food, water and air that is foreign to the metabolism of the body. To this I add the toxic affects of drugs, wormers, and vaccines.
4. Trauma to any part of the body but especially the head, which deranges the natural flow of Chi or Life Force. This touches every cell in the body depriving it of the needed energy for health.
5. Noxious energy fields where we work and live. These are EMF’s of the earth known as "geopathic" forces and man-made noxious EMF’s. Geopathic forces are produced where two underground streams of water intersect, giving up a ray of energy. Any horse confined over this point for a period of time will develop painful arthritis, malfunction of the internal organs and impairment of the immune system. Man-made noxious energies are becoming more important because of its omnipresence on this planet: electrification of every building, corral and fenced pasture. Telecommunication of every nature from telephones, computers, radios, television (how about those TV monitors in every stall?), military and commercial satellites in the stratosphere, which circle the globe, and are becoming increasingly more in number everyday. Progress at a price. When man-made noxious energy fields are superimposed over geopathics, the destructive affect on one’s health is malignatized 1000 % I have seen horses develop incessant, unexplained nervous pacing up and down, have increased susceptibility to colic, allergies, bacterial, viral and fungal infections, a mare and stallion’s ability to produce offspring diminish, and increased numbers of stillbirths and weak newborn. I have seen tumors and cancer develop in these areas.
6. The increasing pervasion of heavy metals in our water and food. These are aluminum, mercury, lead, cadmium, selenium, zinc, iron copper and arsenic. Every sick dog, cat, and horse I have examined has had heavy metals in their hair analysis with the concurrent derangement of the essential vitamin, mineral and electrolyte balance in the body. The most prevalent has been aluminum, which goes to the brain and nervous system and touches every cell in the body with a destructive energy. These patients did not get well until along with the detoxification of drugs, and vaccines, the heavy metals had to be eliminated from the body too. Our ground waters and food plants are contaminated by pollution in two ways, directly from improper disposal by households and commerce, and by polluted air emissions from burning fossil fuels forming acid rain that falls on clay soils, releasing the bound aluminum as a free agent to enter the underground aquifers and plants growing in the area. Aluminum is particularly concentrated by cereal grains and alfalfa, (a horse’s diet!) There is much research evidence proving aluminum’s role in neurological dysfunction, premature aging, infertility, and depression of the immune system with increased allergy, tumor and cancer developing. To learn more of these dangers and reference reading refer to the section on Noxious Energy Fields in my web page, and my newsletter # 1 Heavy Metal Contamination of Food and Water.

Colorado State University, Wells, LeRoy and Ralston have made a study of the heavy metal content in the hair of 391 horses. These horses varied by breed, age, coat color, and sex. The study analyzed correlations of copper, lead, chromium, mercury, aluminum and nickel with these horses’ mineral content, (both in feed and hair), age differences, sex, color hair coat and eleven different breeds. Pathologies, electrolyte imbalances and toxicities were noted.

http://www.holisticvetpetcare.com/newsletters.htm - Please visit Dr. Dodds site for further and more detailed information

GRASS SICKNESS – A GUIDE FOR HORSE OWNERS

This page is intended only as a guide. It is not designed to replace your Veterinary Surgeon's expertise.

Grass Sickness is a very unpleasant disease of horses, ponies and donkeys in which there is damage to the parts of the nervous system which control the function of the horse's digestive system. The exact cause is still unknown but the nature of the damage to the nervous system suggests that some kind of toxin is involved. The mortality rate exceeds 90%.

The disease was first described in 1909 when an outbreak occurred near Dundee, but it is now seen in most parts of the UK and Europe. However, the east side of Scotland still has the highest incidence and in some areas up to 1% of the horse population will contract the disease.

Cases occur in every month of the year but most are seen between April and July with a peak in May. As its name would suggest, nearly all animals become affected while they are out at grass but there have been a few instances where stabled horses have contracted the disease. Certain fields seem to be associated with Grass Sickness, whereas others will never produce a case - the reason for this is unknown, but the type of pasture (new, permanent, hill etc) does not seem to matter and nor does application of fertiliser.

Despite the fact that certain fields are "bad" for Grass Sickness, there is no evidence that it is a contagious disease. Stallions, geldings and mares are equally prone. Grass Sickness has been seen in animals from 4 months to over 20 years of age, but the greatest number of cases occur in 2 to 7 year olds with a peak at 3-4 years. Stress may be a factor in precipitating the increase and many cases have a history of stresses such as being recently purchased, mixed with strange horses or travelling a long distance.

Grass Sickness occurs in three forms: acute, subacute and chronic; but there is considerable overlap in the symptoms seen in the three forms and not all the symptoms are present in every case.

Acute Cases - Less than 48 hours of illness

Major Signs You Can See
Depression
Restless with severe abdominal pain (colic) and abdominal distension
Inability to swallow (may drool saliva or play with water)
Possibly reflux of stomach contents down the nose
Trembling
Sweating

Signs your Vet may find
Reduced or absent gut noises
Pulse faster than 60 beats per minute
Reddening of the skin inside the mouth
Rectal faeces hard, dry mucus coated or possibly absent
Dehydration

Helpful tests your Vet can use
Heparinised plasma to test: Cortisol, Packed cell volume, Urea
Peritoneal fluid analysis: in Grass Sickness, fluid is deep yellow in colour with raised cell counts and protein. These features help to distinguish Grass Sickness from other types of colic.

Subacute Cases - Duration 2-7 days

Major Signs You Can See
Depression
Less severe abdominal discomfort than acute cases
Difficulty in swallowing or inability to swallow
Trembling
Sweating
Lying down a lot
Losing weight
Behavioural abnormalities (eg pawing ground, playing with water, standing with hindquarters in a corner)

Signs your Vet may find
Reduced or absent gut noises
Pulse sometimes faster than 60 beats per minute
Rectal faeces hard/dry
Dehydration

Helpful tests your Vet can use
Peritoneal fluid analysis

Chronic Cases - Duration at least 8 days

Major Signs You Can See
Severe weight loss
Difficulty in swalowing, especially dry food
Chew very slowly
Snuffling (often thick mucoid material appears at the nostrils)
Some trembling
Some patchy or generalised sweating
Behavioural abnormalities

Signs your Vet may find
Reduced gut noises
Dehydration

Helpful tests your Vet can use
None, but tests may be necessary to eliminate other causes of weight loss eg liver disease or other gastrointestinal tract diseases. Your Vet will be able to choose the best ones.

Anyone requiring more information about Grass Sickness or wishing to contribute to Grass Sickness Research should contact:

Equine Grass Sickness Fund
Moredun Foundation
Pentlands Science Park
Bush Loan
Penecuik
Midlothian
EH26 0PZ
Tel: 0131- 445 5111

http://www.cee.hw.ac.uk/~rose/equine/gs-lflt.htm

For more information

by: Michael Ball, DVM

Caused by the bacterium Streptococcus equi, this highly contagious disease is most common and severe in young horses

One beautiful spring morning, you are milling around  in the barn after the morning feeding trying to decide how to spend the rest of the day. Then you notice that one of your horses just isn't quite right today. The mare is not typically an aggressive eater, but today she really is not interested in her morning grain ration at all. On closer inspection, you notice that she feels warm. A quick check with a thermometer reveals a temperature of 103.5 degrees Fahrenheit--significantly above her normal 100.4 degrees Fahrenheit. You also note that there is a cloudy nasal discharge from both nostrils, and as you are stroking her head, you notice several small "lumps" in front of the throat latch area that she resents you touching.

After a visit and consultation with your veterinarian, your fears about "strangles" are confirmed, and within several days, two more horses in the barn are showing similar signs.This scenario is a typical textbook description of a strangles outbreak, a problem with which many horse owners are all too familiar."Strangles" is a disease caused by the bacterium Streptococcus equi, a Gram positive (stains purple with the special Gram stain) organism that is considered to be an "obligate" parasite of the equine species.

The nature of a species of bacteria that is considered to be an obligate parasite is that it does not survive well outside the horse's body. But, as we will discuss later in this article, it survives well enough and long enough to be transmitted from horse to horse via nasal secretions and pus from draining abscesses.

Strangles is ostensibly a disease of the upper respiratory tract, and it generally involves the lymph nodes of the head region. The inner lymph nodes occasionally can become so large that the horse has great difficulty breathing and can actually asphyxiate, hence the name strangles. More technically, the disease is a purulent (associated with pus) pharyngitis (inflammation of the throat) and lymphadenitis (inflammation of the lymph nodes).

The bacterium Streptococcus equi has been the known causative agent of the disease for the past century, but the observation of a strangulating disease condition associated with abscessing lymph nodes in horses dates back to the 13th Century. In Bongert's Handbook of Pathogenic Microorganisms, it is noted that the first description of the disease was by Jordanus Ruffus in 1251. It was observed in the 1800s that transmission of this disease was associated with pus and contaminated drinking buckets, and by 1888 the bacterium Streptococcus equi was determined to be the causative agent.

The organism has been the focus of a great deal of scientific research due to the morbidity (ability to cause disease) and several unique characteristics of the organism itself; the organism has some special characteristics that make it extremely adept at evading the immune system. A great deal of this research has been performed by John F. Timoney, MVB, PhD, Dsc, MRCVS, formerly from Cornell University's College of Veterinary Medicine and currently with the Department of Veterinary Science, Gluck Equine Research Center, University of Kentucky. Timoney has published numerous scientific papers on Streptococcus equi, and a comprehensive review of the disease in an edition of the Veterinary Clinics of North America: Equine Practice, much of which will be referred to here. Timoney is considered by his colleagues to be the world's leading authority on Streptococcus equi.

Streptococcus equi is considered to be highly "host-adapted" to the equine species, meaning that it has evolved as a micro-organism that is very good at causing disease in horses, donkeys, and mules. The organism does not typically cause disease in other species of animals. As previously mentioned, in addition to being host-adapted, Streptococcus equi also is considered to be an "obligate parasite,"and therefore requires its "host" (the horse) for survival. The pus and nasal secretions appear to have some protective effect such that the organism has been reported to survive for weeks to months outside the horse's body in a contaminated environment.

The disease is highly contagious and can be transmitted by direct contact with nasal secretions or pus from a draining abscess. In addition to direct "nose-to-nose" contact, the organism can be transmitted by people (your dirty hands), flies, or "fomites." A fomite, by definition, is an inanimate object (i.e., a water bucket) that transmits a disease to a healthy animal via its contamination from a sick animal. Both of these methods of disease transmission are very significant and will be discussed later in this article.

Members of the equine species of all ages can be affected, but the disease is most common and most severe in young horses. Many foals have some degree of immunity to the disease that they acquire from their dams' colostrum. Of course, the level of immunity that is transferred is dependent upon both the quantity and quality of the colostrum (first milk) that the foal received at birth. If the mare has had the disease and developed immunity and/or has been vaccinated, then there will be high levels of protective blood proteins (antibodies) that can be transferred in the Some horses can become more "systemically" ill and potentially spread the streptococcus organism throughout their bodies. Those horses might have a very high and persistent fever and severe depression. The term "bastard strangles," as mentioned before, is used to describe the condition when other lymph nodes within the body are affected. This condition can be difficult to accurately diagnose and treat and generally carries a poor prognosis.

The treatment of uncomplicated strangles cases typically involves careful monitoring of the horse's vital signs, temperature, heart rate, and respiratory rate. Significant increases in these can indicate a more advanced disease or respiratory distress from airway compression and warrant further veterinary evaluation. It has been reported that up to 20% of horses suffering from strangles can suffer from complications, making the careful monitoring of the affected horse important. In addition to monitoring, any external abscesses are encouraged to "mature" and drain by applying hot compresses and lancing them, if your veterinarian determines this is appropriate. Affected lymph nodes generally rupture and drain within seven to 14 days from the onset of clinical signs. And remember, the pus from draining lymph nodes can be a great source for spreading the Streptococcus equi organism and must be handled carefully to avoid the spread of disease to healthy horses. In addition, it is often the pus from abscesses or from the nasal passage that is cultured in order to confirm the disease.

The use of antibiotics in the treatment of strangles is somewhat controversial in the veterinary literature. For many cases, by the time the disease is noticed, it often is too late to arrest the progression. In fact, it is the opinion of many that the use of antibiotics at that time can prolong the progression of the disease and decrease the immunity that can develop post-infection. In the case of complicated strangles and more severe disease progression, antibiotics might be necessary, but this decision should be left to your veterinarian.It has been reported that approximately 75% of horses develop a solid and long-lasting immunity following recovery from the disease; after a second attack of the disease, there is usually a development of solid immunity. As previously mentioned, the foal is solely dependent on the passage  of immunity from the dam via colostrum. The importance of adequate colostrum intake in newborn foals is crucial to their health and can never be over-emphasized.

There are three commercially produced vaccines available, but none that afford complete protection. Because of Streptococcus equi's unique ability to evade the immune system, it is difficult to develop a vaccine that creates 100% immunity. It has been shown that vaccination can reduce the "attack rate" (the percentage of horses which will be "attacked" by the organism during an outbreak) by 50%. There have been adverse reactions associated with vaccination, which typically consisted of local abscess formation in the muscle at the injection site and muscle soreness.

In some horses, an immune-mediated disease called purpura hemorrhagica can occur following vaccination or natural infection. Purpura consists of an inflammation of the blood vessels, causing them to become "leaky" and subsequently allowing edema or swelling of the legs and underbelly. Should limb swelling occur following vaccination or natural infection, your veterinarian should be consulted.

The best method of dealing with strangles probably is reducing the chance of having to deal with it at all. Instituting and actually following/enforcing strict on-farm "quarantine" for new animals for 14-21 days before exposing them to the general population of horses can prevent an outbreak. The quarantined horses should be monitored daily for the presence of nasal discharge or fever. Anyone working with the "new" horses should practice adequate hygiene procedures to prevent human or fomite transmission of strangles or other diseases. When traveling with your horse, new stabling should be disinfected prior to use, and all feed/water buckets should be appropriately cleansed.

If a horse on the farm shows signs of strangles, it should immediately be isolated in a "quarantine" situation, and all horses having had contact with the affected horses should be monitored carefully for the development of fever. Strangles is a highly contagious disease and the isolation of affected horses is extremely important in limiting the spread throughout a herd.

The simple act of hand washing with a disinfectant soap cannot be over-emphasized; hand washing can significantly reduce the risk spreading contagious diseases. Rubber boots and coveralls should be worn when working with affected horses, then appropriately washed.

Stalls and equipment should be washed thoroughly with a detergent cleanser, rinsed thoroughly with water, then disinfected with an appropriate dilution of either chlorhexidine gluconate of povidone iodine. It is extremely important to both wash down the "crude" debris with detergent and rinse off the detergent as both the presence of "organic debris" and detergent will make the disinfection less effective.

There are concerns about the ability of flies to transmit the disease, so sprays and other measures should be taken to reduce the local fly population. It also has been suggested that bedding removed from the stalls of affected horses be isolated and covered by a plastic tarp to prevent access by flies to contaminated bedding. Paddocks grazed by affected horses should be considered contaminated and not be used for at least one month.

Copyright 1997 Michael Ball, DVM