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I've got strangles and the blues. This stuff sucks! And the horse that started it all came with a huffy owner and a very expensive vet who called me several names, mostly amounting to incompetent, as he misdiagnosed the problem and did multiple expensive and unnecessary procedures to the lady's horse. Man is this going to be a bad two weeks. I've spent the morning on the phone to all of my customers. So far, they've all been really cool about it, except, of course, for the lady who brought this shit to my barn in the first place...  | ||
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Don't envy you. It's an ugly and dangerous disease and lot's of work to deal with in a boarding, training or breeding barn. "The liberty enjoyed by the people of these states of worshiping Almighty God agreeably to their conscience, is not only among the choicest of their blessings, but also of their rights." ~George Washington - 1789 | |||
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Unfortunately vets that are good at doctoring horses and diagnosing them correctly are few and far between. It is a 2 1/2 hour drive for me to get to a good horse vet. There are plenty of general purpose vets close by but through experience I know they are not good on horses _____________________________________________________ A 9mm may expand to a larger diameter, but a 45 ain't going to shrink Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing had happened. - Winston Churchill | |||
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This vet is a young guy (late twenties) who is working at a very well known equine only vet clinic here that mainly caters to the race track. I don't use them because they have a history, in my opinion, of doing unnecessary and potentially harmful stuff to pad the bill. It just pisses me off is all that they have the gall to make me out to be the one who doesn't know what he's talking about, when I know for a fact that they botched the diagnosis and every procedure and antibiotic and dollar spent was a complete and total waste. | |||
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What all did they do? Generally, maybe a culture or draining an abscess and then a decision as to whether or not to use antibiotics. Some do and some don't. A severe case with respiratory distress might call for a tracheostomy, but I have not seen one that bad for many years. A chronic or "bastard" strangles could be a different story, though. MFH | |||
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That stuff is a mess. I have had the same thing happen a time or 2. I vaccinate every thing exposed to it with "Pinnacle" It's an inter nasel vaccine. Works too!! Hang on TITE !! | |||
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Pinnacle seems to work well without the reactions common to the injectable. Be careful, though, as it is a live bacterial product and will cause an abscess if there is any contamination of an injection site. I avoid even mixing it until all other injections are complete. It will even grow well in the lab on a plate. FWIW MFH | |||
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This is a 15 year old Arabian gelding who does endurance racing in question. He would run away for the first five miles or so of the races, hence, why I had him. Anyway, the owner takes him to this vet at a very well known and generally well thought of equine vet clinic around here, at least by some. I've heard several stories of ridiculous treatments and had two personal experiences with them that left a bad taste so I do not use them unless specifically told to by a customer. They mostly do racehorses. The vet does not culture the horse, which would have been an inexpensive, quick, and definitive answer. The vet temp'd the horse, and he had a one degree fever. I have lost count of the times that I've heard him referred to as a "Very sick little horse," With a 1 degree fever? He doesn't do the basic and simple tests, but does run a scope down his gullet and comes up with a Gutteral Pouch infection as his diagnosis. In my opinion and experience, this is frequently used as a diagnosis when the vet can't figure out what is really going on. Yes, the gutteral pounches can and do collect and culture crap, and yes, I'll bet that he saw some puss in that area when he scoped, but don't you reckon that with a bad snotty nose and roaring case of strangles that there was puss everywhere in the back of his throat and nasal passages? There was no blood whatsoever to lead you to believe a fungal Gutteral Pouch infection was to blame. At the point that he left me, which was after a few days of having a runny nose, he was feeling a bit down, but his mood changed so he'd be feeling better for a while, then a bit down, then a bit better. He was still eating all of his feed and not yet swollen anywhere lymph node wise. He did visibly look like he'd lost weight. This is why I called her. On a scale of 1-10, 1 being perfectly fine and 10 being on death's doorstep, I'd have called him a 3. He had gotten worse, and it was now time to do something about it, but he was not THAT BAD AT ALL. I'll also note here, that rather than defend my "wait and see" approach and telling her that it's gonna be okay, the vet milked her and told her what a good thing it was that she'd brought this "very sick little horse" to him. He then proceeds to flush the gutteral pouches, which I'm sure were again full of puss before the horse was loaded back in the trailer. He then prescribed SMZ tabs, which is about the weakest antibiotic you can get for respiratory infections. Wait, didn't this guy say this was a "Very sick little horse"? Why then are we using the weakest antibiotic? He's done this now twice, so far. On my particular place, I regularly have horses get a snotty nose from the arena dust. 9 times out of 10, I lay them off for a couple of days and give the arenas a good soaking. I get this snotty nose as well. In 2-3 days we're all fine. This is why I do not rush off to call the vet. I'm not saying that vets are useless or unwarranted at all, but neither do I call them for every single little thing. I also do not rush my kids off to the ER with a 1 degree fever. I am from the school of not using antibiotics for everything, and especially Strangles and Pigeon Fever. There are two schools of thought on this, and I am not going to give advice to customers on health issues. Vets do that. If they want to use Antibiotics, have at it. I'll never say a word. But let's know what we are treating before we start the antibiotics. Is that too much to ask? Anyway, my approach, and the one that the other 3 vets I consulted with on this case concurred on, is to let them swell and burst and you are good, and done with it. Quarantine the sick from the well and pull the newly sick as soon as they show signs. 20 years of experience has taught me that treating them vastly increases the likelihood of re-occurrence. You basically prolong the problem. I can also say that this has been the quickest onset of strangles and mildest overall case of it that I've ever seen. We are over the hump in less than a week. Most horses are swelling and bursting in 3-4 days. Several have not even snotted up. If you do a quick search on true Gutteral Pouch infections you will quickly see that it usually presents as a MILD respiratory infection that reoccurs MULTIPLE TIMES, and it wouldn't be unusual for it to go a month before they scope and diagnose. This vet immediately went to that, but didn't think about one of the most common things that presents this way. Why? I think because he can charge a bunch more for a scoping and flushing than a shot of penicillin. And he's just about guaranteed a return customer 10 days later. I've consulted several other vets, a good friend, my current horse vet, and my former horse vet, now retired. Retired vet said that it took a special scope to even be able to definitively diagnose gutteral pouch infection and that she'd always sent horses to LSU vet school for that to be done, since they do have the best equipment for that specialized stuff. In short, she didn't think that this vet had a scope capable of even properly diagnosing what he claimed to diagnose. I'd like to mention that when I had two others present with symptoms, I took one to my good ole country equine vet. I told him what I was seeing and thought, he took a look at the horse on the trailer. Saw the swollen lymph nodes at a glance, diagnosed Strangles and no treatment correctly right away, and didn't charge me a dime. So, the lady has now had two courses of incorrect treatment and a "very hefty vet bill" and I'm sure she's in for at least one more treatment and now her horse may very well get Bastard strangles or become a carrier. Meanwhile, the other two dozen sick horses on my place are merely running the course, and the grand total for all of them is $0.00. And, they will likely never get strangles again, while the little Arab is now primed for a case of Bastard STrangles and the owner may indeed get to see what a "Very sick little horse" looks like. Yet, I am the bad guy in this scenario. As if I did something to cause her horse to get sick and then neglected him. Sometimes, the proper, educated, and experienced thing to do is NOTHING. Now she's shouting loud and proud what an idiot I am. I'll also note that the 15 year old came from a very well known and internationally famous endurance rider. This lady does not believe in bits, because they are obviously cruel. She instead opts for a noseband of some kind, not a bosal, and not a mechanical hackamore, but some other type of a bitless bride. All of her horses, including this one have a nice knot of scar tissue on their noses from that noseband rig of hers. None of mine have scar tissue. I got this little Arab to loping and trotting for miles around the SugarCane and rice and bean fields out here, under control on a loose rein with no new scars, and yet the famous lady is her "good friend" and I'm apparently not capable of offering adequate care for her horses. I will add this to the mix. I've not had a sick horse on the place in quite a while, well beyond any incubation period. It's been a couple of years since any strangles. I had gotten in two horses about two weeks before this gelding snotted up. One, was an Arabian mare, owned by the same lady as the gelding, and the other was a pony cross gelding. Both came from the same boarding facility, and were both referred to me by the wife of the vet in question. After all of this crap, I learn that both of these horses were "sick" a couple of months ago, not with strangles though,  but our hero vet treated them, again, with very weak antibiotics, and they were fine now. I'll bet you dollars to pesos that at least one of these horses is now a strangles carrier due to this vet's incorrect diagnosis and treatment. They still don't think that their horses have, or have had strangles. I'll leave it to ya'll to do the math. The arab gelding was my patient 0. I've no doubt.In addition, because I am a standup guy, I've voluntarily quarantined my place for good while. I'll lose about a month's worth of revenue over this BS. No Horses In or Out. Which means that I'm feeding a bunch of horses that I can't train, for free. And I'm not allowing anyone to bring a horse over, even for a lesson. Meanwhile the carrier and sick gelding that started all of this for me were unceremoniously dumped back in their paddocks at a highly populated boarding facility and will spread this mess like wildfire. It still isn't being called strangles, and I'll bet you any amount of money that you want that the owner and other customers of the boarding facility have no idea what is going on. Meanwhile, I'm a leper of the horse community. Sorry for the long post. It was cathartic. Thanks for letting me bitch.  This too shall pass. | |||
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Personally, I don't vaccinate for Strangles at all, or, at least not in a dozen years or so. The shot vaccine is a Russian Roulet for a major muscle abscess and the nasal is a guaranteed week of sickness induced by me, on purpose. I just don't get the attraction. Neither is that effective either, in my experience. It's like the flu shot, which strain are you vaccinating for, versus which strain will show up? Just my opinion, and hopefully they've gotten better. West Nile is similar. When I was training in Texas, West Nile was just getting to be commonly known about and the vaccine was brand new. The legendary cutting stallion, Gray's Starlight, died of West nile just a couple of months after being vaccinated for it. Again, I do vaccinate for most things, but some of the newer vaccines are not as effective as they'd have us believe. I don't vaccinate for strangles, because the vaccine can be worse than the disease, and most horses in training will be exposed to it, get over it, and likely be immune to it for life soon enough anyway. | |||
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My daughter had a horse a few years ago that contracted “Strangles” at a horse show. Wow, talk about a wakeup call from an owner’s perspective. Her horse at the time was a 6 year old Zangersheide that she competed in English Hunter competitions. The Cliff notes version is that the horse spent 3 weeks at the local Vet’s place before I had the horse transported to Texas A&M where it was quarantined for another 5 weeks. In the end the horse fully recovered and was no worse for the wear. What we did was THE RIGHT THING to do. The barn where this mess came from never said a word to anyone and effectively put their entire stable of high dollar hunter/jumpers at risk. Although the local Vet diagnosed the problem correctly, I do not feel they were capable of treating the horse adequately based on their facilities. Preaching to the choir but… Strangles is not a joke and if not misdiagnosed, Vets may not have the right facilities required to properly handle the case, and the most shocking aspect I found was that barn owners are hesitant to report and openly communicate the issue! Safari James USMC DRSS | |||
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Pigeon Fever also known as Colorado Strangles is incideous desease, it takes so long to come to a head in some cases, and its very easy to misdiagnos as regular strangles or distemper as its called in some places...Most cases come to a head under the jaw or between the front legs and pop and drain in both cases..If your lucky with that, they will start a slow recovery and be immune for life...when they drain on the ground or in the water then whole damn area is very infectious and I have seen it infect a whole herd..I understand both Pigeon Fever and regular strangles is a staff infection, it seldom kills the animal but the horse can shut down internally in his kidneys, heart, lungs and develop other problems that very well may kill him. Founder is also a side effect and I suppose that is the result of fever? I wish you the best and sorry for any loss you suffer with this stuff..I know it can be devistating. Ray Atkinson Atkinson Hunting Adventures 10 Ward Lane, Filer, Idaho, 83328 208-731-4120 rayatkinsonhunting@gmail.com | |||
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We are actually fairing quite well. I've had a few swell and burst with no snotty nose, and a few snot up, but not swell up. Overall, I'd have to say that this case has been the fastest I've seen yet, both in it's onset, and leaving. It has also been the mildest in terms of how poorly the horses have felt and all of that. This is also the only late summer case I can remember, so maybe that has something to do with how it ran it's course. Just about everything is on the downhill slide, and a few are about completely healed up and ready to go back to work. I had about 8 head that never showed any signs at all. We'll just assume that those had already been exposed. We also had at least one horse that I know has already had strangles and he got it again, and was one of the sickest of the lot. They said his last case was pretty bad as well. | |||
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Glad to hear you are doing well...I'm surprised at one horse having it twice as the vets tell me they can't do that! My guess is there are several strains of it, so it can happen.. Ray Atkinson Atkinson Hunting Adventures 10 Ward Lane, Filer, Idaho, 83328 208-731-4120 rayatkinsonhunting@gmail.com | |||
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Lane in red above. www.pea-texoma.com ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ J. Lane Easter, DVM A born Texan has instilled in his system a mind-set of no retreat or no surrender. I wish everyone the world over had the dominating spirit that motivates Texans.– Billy Clayton, Speaker of the Texas House No state commands such fierce pride and loyalty. Lesser mortals are pitied for their misfortune in not being born in Texas.— Queen Elizabeth II on her visit to Texas in May, 1991. | |||
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Dr. Lane, First of all, let me say that I was hoping that you'd chime in on this, so thanks for sharing your greater knowledge and experience. My problems with this vet are as follows. He never did culture the horse, and the owner of the horse STILL does not know/acknowledge that what he treated was Strangles. So I ask you, did he treat the wrong disease right, or the right disease wrong? Isn't identifying the problem step 1? He did nothing to help calm her down. Whatever I may say about him, this was certainly not his first case of strangles to treat, or whatever in the hell he thought he was treating. Don't you want to portray to your customers that "You got this, and it's going to be okay"? He was fine leaving her hysterical, a state in which I am sure she happily allowed him to do "Whatever it takes to Save My Baby!" His wife, who I know from a volunteer group that I help, took it upon herself to call me and let me know how badly I'd screwed up. Surely that is less than professional? I know that there aren't Medical Privacy laws and such regarding horses, but come on. I took it and did not tell her just what I think of her husband, which is very little. This is NOT my first dealing with him, and certainly NOT with this particular Practice. He also sent both of these horses back to the boarding facility immediately. If your horse was at that facility and a strangles horse was brought back and tossed in a paddock next to yours, or a very valuable Pepto colored horse, wouldn't you be pissed off? As to the SMZ, what you've stated is news to me as to its effectiveness. Maybe we've been using it wrong, but I can say that of the horses that I've treated with SMZ, about half have relapsed, and I am not referring specifically to strangles cases, but more generally. If given a choice between using SMZ of anything else, I have always gone with anything else, simply because it has had such a poor track record, in my experience. It certainly is cheap, and doesn't have the potential drawbacks of Penicillin, so I WILL look into this, and thanks. Both of the horses treated by this guy relapsed. None of mine have. As I understand it, and according to all of the research that I did with all of the free time I've had lately since I'm not riding or giving lessons, relapsing horses are the very ones most likely to develop bastard strangles. Please tell me where I am wrong here. As to the scoping, I don't know beans about how to do that, or what is required, so I'll take your word for it. It does seem to me that treating the beginning of strangles with a GP flush is about like blowing your nose to treat the flu though, of course, this is an embellishment and not an exact correlation. In the case of an ongoing infection, isn't that GP going to be re-infected? If he treated them so successfully, why did they both relapse? I certainly agree with flushing the GP once things have run their course to prevent a carrier being allowed. I can say that I have worked in multiple places where money was no problem and they would do whatever the vet said. I have also been around some world class vets like yourself. You would certainly know their names. I can not ever recall a horse being scoped or GPs messed with in the past. Maybe that form of treatment is newer. I don't know, it just seemed mighty suspect to me that in 20 years I've never needed to have that done, and this guy apparently does it to every thing that comes in. I'll also say that one of the other cases that I have first hand knowledge of is this clinic giving hock injections, (steroidal, not HA) to another trainer's horses, the entire barn, sore or not, every six weeks starting at the end of their two year old year throughout the three year old year. Are you telling me that THAT is Kosher? They made a pile of cash on that one, and didn't do those horses or owners any favors. I'm still friends with that guy, and since he moved away he says it's amazing how he injects so seldom now. This and other stories make me tend to not trust these guys. I never said that a horse that has had strangles COULD NOT get it again, merely that they are far less likely to. I have said that at least one horse that got it this time, I know to have had it before. I believe that some or all of those who did not get the full blown dose of symptoms were probably ones that have had it before, or were exposed. I also know that several of the ones who were in the main herd, with most of the cases, and did not get sick have had it before, including two mares that I own. Again, I have no doubt that they CAN get it twice, but surely you'd agree that they are far LESS LIKELY to have another full blown case. Incubation period is two weeks or less, exactly the time frame between her mare showing up, and horses beginning to get sick. Again, a universal theme among all of the sources, both human and binary. No doubt that it can live in a GP, water trough, etc. longer. It would seem logical that since I only had two horses come in, in a time period that is anywhere near the incubation period, that one of them was the change that caused the change. I'm open to being educated on this if you have another theory. Is another cause of the outbreak possible? Certainly. It does seem suspicious that a horse that I suspect of having had Strangles two months ago, again not correctly diagnosed by this vet, shows up, and horses begin getting sick right at the maturation of the incubation period. Where am I wrong? Again, she did relapse at least once. This seems to indicate, to my ignorant mind, that she may not have been sufficiently treated. Please, tell me where I am wrong. I will end this retort by asking you a simple question Dr. Lane. Is there any way in hell that a customer of yours would leave your clinic, with their horse, and go turn it out with 100 other horses? They turn this horse out, with one of the most contagious equine diseases that exists thinking that their horse had a GP infection, and is "very sick" yet have at no time heard you use the words Strep Equi or Strangles? I think that you are far too competent for that to happen. I know that this is exactly what this vet did, all the while insinuating that I am the one who isn't taking the situation seriously... No disrespect at all intended. Thanks for your insight. | |||
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Daniel, We treat or consult on 100's of cases of Strangles per year...much to my chagrin. I hate the disease and hope I never see another case again. The facts I stated in the first paragraph are just that...the facts. Due the numbers we see and the economic devastation it causes...we stay on the cutting edge of the science of that disease. The incubation period of that disease is highly variable...the reason I asked you that question. It can range from a week to up to a year in some cases...making exposure almost impossible to pin-point. It is the most mis-treated disease that I know of in the horse. That is evident from the fact that it has been around from at least Egyptian Pharaoh times and has not mutated since. It cannot live outside of the horse and only survives with asymptomatic carriers. If all cases were scoped, PCRed, and treated until negative...we could eradicate the disease...at least in the states. The dose of trimethoprim/sulfamethoxazole in the horse is 30 mg/kg dosed twice daily. For a 1000 lb horse...this is 15 - 960 mg tabs twice a day. Besides penicillin it may be the best drug for many deep-seated Streptococcal infections...not many choices here for the horse. The guttural pouches should be sampled on all horses with Strangles to see if they are carriers. Many (without guttural pouch lavage) shed Strangles Strep for months after they appear normal. In the regards to the rest of the practice statements...I would rather stay out of that and just concentrate on the facts which I have tried to set straight. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ J. Lane Easter, DVM A born Texan has instilled in his system a mind-set of no retreat or no surrender. I wish everyone the world over had the dominating spirit that motivates Texans.– Billy Clayton, Speaker of the Texas House No state commands such fierce pride and loyalty. Lesser mortals are pitied for their misfortune in not being born in Texas.— Queen Elizabeth II on her visit to Texas in May, 1991. | |||
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P.S. - yes, you are correct...all Strep equi equi positve horses should be isolated until the mucous in their GPs and nasal passage ways is found to be be PCR negative for the bug. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ J. Lane Easter, DVM A born Texan has instilled in his system a mind-set of no retreat or no surrender. I wish everyone the world over had the dominating spirit that motivates Texans.– Billy Clayton, Speaker of the Texas House No state commands such fierce pride and loyalty. Lesser mortals are pitied for their misfortune in not being born in Texas.— Queen Elizabeth II on her visit to Texas in May, 1991. | |||
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Complications Associated with Metastatic Spread of Infection S equi may potentially infect any anatomic site. The term bastard strangles is often used to describe metastatic abscessation. Spread of the organism may occur through several routes, including hematogenous spread, lymphatic migration, or via close association with a septic focus, for example, when connecting structures, such as cranial nerves, allows transport of the organism or when there is direct aspiration of purulent material. Common sites of infection include the lung, mesentery, liver, spleen, kidneys, and brain (hence my post above about the stallion). Respiratory distress may occur due to tracheal compression resulting from enlargement of the cranial mediastinal lymph nodes (another reason it is not a bad idea to scope these horse on first exam and while you are there look into the GP CAUSE IT IS SO SIMPLE TO DO). Suppurative bronchopneumonia is one important sequela of strangles. Of 15 horses with complications associated with strangles, 5 had pneumonia or pleuropneumonia, and 3 of 5 deaths were attributed to pneumonia, making this the most common complication resulting in death.1,26 In a previous study, 22 of 35 cases with complications (62%) died of pneumonia secondary to strangles.25(another reason why antimicrobial therapy should be considered immediately in some cases) Another important complication of strangles is extension of infection to the sinuses or guttural pouches. In a general study of guttural pouch empyema, S equi was isolated in 14 of 44 horses; 5 of 74 horses with strangles had guttural pouch involvement.1,26 Infection of the guttural pouch is of particular importance because the guttural pouch is the most common site for prolonged carriage of the organism.7,22 Horses with infection in the sinuses may also become car- riers. Other reported conditions associated with S equi in- fection include myocarditis, endocarditis, panophthalmitis, periorbital abscesses, ulcerative keratitis, paravertebral abscesses, septic arthritis, and tenosynovitis. The diagnosis and treatment of S equi infections that have spread are potentially more difficult than in cases of uncomplicated strangles. The specific means of diagnosis vary depending on the site of infection and whether there are concurrent signs of classic strangles. For infections such as bronchopneumonia, guttural pouch empyema, or sinusitis, appropriate samples can be collected for culture. However, for some internal abscesses, a specific diagnosis may be difficult. A history of exposure to S equi and laboratory results consistent with chronic infection, such as elevated SeM-specific antibody titers, anemia, low-grade fever responsive to penicillin, hyperfibrinogenemia, and hyperglobulinemia, are supportive of the diagnosis of metastatic abscessation. Mesenteric abscesses may be accompanied by an immune ascites with elevated SeM-specific antibody in ascitic fluid. Treatment of S equi infection that has spread frequently involves long-term antimicrobial therapy, and appropriate local treatment or drainage of abscesses if possible. The prevalence of metastatic abscessation (which is the so-called "Bastard Strangles") is generally low. However, in a recent study in which outbreaks of strangles on 2 farms were investigated, 7 out of 25 (28%) developed metastatic abscessation.4 Of these, euthanasia was performed in 5 horses, 4 of which had neurologic signs and confirmed cerebral abscesses. The reason for the high incidence of complications, and particularly neurologic disease, on these farms is unclear, but possible theories include a high infectious dose, the virulence of the strains involved, differences in host susceptibility, or other unidentified factors. (not relapse or use of anti-microbials such as "SMZs") It has been suggested that antimicrobial treatment following the development of an abscess might contribute to metastasis (Bastard Strangles), based on the theory that protein synthesis by the organism is altered by antimicrobial treatment and reduced immunogen level results in suboptimal immune response. However, there are currently no experimental or clinical data that support the theory that antimicrobial treatment increases the prevalence of bastard strangles. In the study by Spoormakers et al,4 no antibiotics were used in any of the cases before complications were identified, yet the inci- dence of significant complications was high and it is known that metastatic infection has occurred in other outbreaks where antibiotics have not been used. Hence, relapse nor the use of antibiotics has NO causal relationship with "bastard strangles". And...if you have been around Strangles before or just been involved in a large scale horse operation and you have NEVER had a GP scoped...there is a problem...cause you should have had...the attending vet dropped the ball. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ J. Lane Easter, DVM A born Texan has instilled in his system a mind-set of no retreat or no surrender. I wish everyone the world over had the dominating spirit that motivates Texans.– Billy Clayton, Speaker of the Texas House No state commands such fierce pride and loyalty. Lesser mortals are pitied for their misfortune in not being born in Texas.— Queen Elizabeth II on her visit to Texas in May, 1991. | |||
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WOW....thanks for the lesson, gentlemen. Now for the pop-quiz! | |||
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