Tidewater Equine Clinic

All fixed!! :-)

Our phones are down in the office. If you have an emergency, please call our answering service at 757-220-4416 and they will contact the vet on call. We are hoping this doesn't last long! We cannot currently access our voicemail either, so please don't leave a message if you have an emergency. All other messages will be returned tomorrow. Thank you!

We are getting a slew of phone calls lately regarding Equine Strangles. In the hopes of calming our horse owner's fears, here is an excellent article on this bacterial disease. We hope it answers some questions and alleviates a lot of fears about the issue.

A single case of Strangles can be managed with isolation, antibiotics, and proper biosecurity measures. Please read below.

Equine Strangles
Strangles: Dispelling the Myths
From The Horse: http://www.thehorse.com/articles/34919/strangles-dispelling-the-myths

By Christy Corp-Minamiji, DVM
Nov 24, 2014
Strangles. Even the common name for this bacterial disease—caused by the sinisterStreptococcus equi—sounds like something of legend, a cautionary tale inscribed by medieval monks.

The abscesses and pus-laden nasal discharge common to the condition can seem like something from a mythical plague. However, strangles is very much an actuality in today’s horse world, a real respiratory disease with a real, mundane bacterial cause.

Though the disease has been recognized in horses since it was first reported in 1251, myth and misunderstanding persist even today. But before launching into the realm of myth, let’s take a quick look at the basic facts of the disease.

The intranasal strangles vaccine can limit a horse’s clinical signs, if not prevent the disease altogether.

Photo: Erica Larson, News Editor

Cause Streptococcus equi spp equi (frequently referred to as S. equi) inhabits the respiratory tract of sick horses and carriers—those horses that might not be obviously sick.

Clinical signs Ashley Boyle, DVM, Dipl. ACVIM, assistant professor at the University of Pennsylvania School of Veterinary Medicine, says the first sign of strangles is often (though not always) a sudden fever spike. In a 2011 article in Compendium: Continuing Education for Veterinarians, Boyle lists other signs of the disease, including “lethargy, depression, bilateral mucopurulent nasal discharge, lymphadenopathy, and abscessation of the retropharyngeal and mandibular lymph nodes.” Translation: If your horse has strangles, he might seem very tired and have thick snot made up of mucus and pus streaming from both nostrils, swollen lymph nodes, and abscesses under the jaw and at the throatlatch.

Disease spread Sick horses shed S. equi via these nasal secretions and when the abscesses drain pus. Chronic carrier horses that appear healthy can shed bacteria trapped in their guttural pouches through their pharynx (more on this phenomenon in a moment). Horses can become infected through direct contact with diseased horses; contact with people, equipment, or surfaces that have recently touched diseased horses or their secretions/pus; or common water sources shared by sick or carrier horses.

While some bacteria might travel short distances through the air when a horse coughs or sneezes, Benjamin Buchanan, DVM, Dipl. ACVIM, AVECC, of Brazos Valley Equine Hospital in Navasota, Texas, says he is “not a big believer in aerosolized spread.” Rather, he stresses the role of water and stable management: “Water is a critical and often overlooked area of how (strangles) is spread. I’ve had farms where it spread stall to stall. It turned out they were submerging the water (faucet mouth in each bucket).”

“Water is a critical and often overlooked area of how (strangles) is spread.”

BENJAMIN BUCHANAN
Treatment Protocols vary depending on each horse’s disease stage and severity when detected and the treating veterinarian’s experiences. Practitioners frequently treat uncomplicated cases (those involving lymph nodes that have begun to abscess) symptomatically, with anti-inflammatory drugs to control pain and aid appetite and hot compresses or drawing agents to bring the abscesses to a head more quickly. Letting the disease run its course in this fashion offers the advantage of conferring more complete immunity against future disease.

However, draining abscesses can increase the risk of contamination and disease spread on a farm, so some veterinarians use antibiotics to treat horses with early disease to prevent abscesses from maturing, says Boyle. The downside is that horses treated with antibiotics won’t develop as good an immune response against future strangles threats.

Scott Weese, DVM, DVSc, Dipl. ACVIM, a professor in the Department of Pathobiology at the University of Guelph’s Ontario Veterinary College, says antibiotics “aren’t very effective once abscesses develop and are probably only justifiable early in disease and when good infection control measures are being used to prevent subsequent exposure. If you treat with antibiotics but are in a facility where S. equi is still being passed around, the horse may just get it again, and treatment might delay the inevitable.”
Possible complications As if strangles cases weren’t troublesome enough, roughly 20% of affected horses can develop complications—even lethal ones—according to the 2005 American College of Veterinary Internal Medicine (ACVIM) consensus statement regarding S. equi.

“Bastard strangles” refers to abscess development in the internal lymph nodes—usually in the mesentery (ligamentous attachment of the intestines to the body wall), kidneys, spleen, lungs, or brain. These horses might not show outward signs of the disease, but they can develop fever, weight loss, and life-threatening illness. Boyle says researchers theorize that in these horses the bacteria has spread via the lymphatics and settled somewhere besides the typical upper respiratory system and lymph nodes of the head and neck. But no one knows why some horses are susceptible to this form of the disease and others aren’t.

Another twist in the strangles plot is an immune-mediated disease called purpura hemorrhagica—the result of the immune system going overboard in its fight againstS. equi. Horses with very high blood antibody titers to S. equi (either from vaccination or prior infection) can develop an excessive immune response when exposed to the antigen (by revaccination or contact with S. equi in the environment). Purpura results in vasculitis, or severe inflammation of the blood vessels. The most common signs are edema (swelling) of the legs, head, and/or lower belly, serum oozing from the skin in these areas, and red spots or blotching of the mucous membranes (in the lips, gums, and inside of the v***a or re**um). Horses with purpura might also develop severe muscle soreness, difficulty breathing, or signs of colic.

Now that you’re familiar with the disease in question, here are some myths worth dispelling:

MYTH 1: Strangles is a disease of young horses.

“The biggest misconception is that it’s a young horse problem,” says Buchanan. He describes a recent run of strangles cases at Brazos Valley Equine Hospital, where for three years, at any given time, a horse was housed in their isolation barn due to strangles. “And not just 2-year-olds,” he says, “but also 10-year-olds and older.”

Perhaps the severity of strangles signs in younger horses is to blame for this myth. The ACVIM consensus statement authors report that older horses might have milder signs, develop smaller abscesses, and recover from the disease faster than young horses.

MYTH 2: S. equi bacteria persist in the environment for weeks to years.

Conventional wisdom has long held that S. equi can persist in the stable environment for extended time periods. Studies in which researchers examined the organism under laboratory conditions seemed to bear this out. However, Weese and colleagues debunked this notion in a 2009 Canadian Veterinary Journal study. They realized that in prior studies researchers had evaluated the bacterium’s longevity only under “ideal” conditions, rather than those of an actual stable, where temperature and moisture fluctuations, wind, and sunlight impact surfaces.

“Stressors in the environment that will take care of (e.g., kill) bacteria will be UV light, desiccation (drying out), and temperature and humidity changes,” Weese says. In other words, bacteria prefer a consistent environment, and the real world can do a lot to shorten the out-of-horse life span of bacteria such as S. equi.

Weese and his colleagues found that as few as 24 hours of sunlight could kill S. equiunder their experiment’s conditions. While he acknowledges that variations in environmental conditions can make a difference, such as protective layers of mucus or dirt, surface texture, and actual sunlight exposure, Weese calls the previously recommended environmental quarantine period of three months extreme. “If you can wipe off the surfaces and get a day of sunlight, it’s going to be a pretty quick death (for the bacteria),” he says.

MYTH 3: If you wait two weeks after the last sick horse recovers, the barn is disease-free.

Buchanan says the myth of an arbitrary post-disease “safe zone” is a dangerous one to believe. “Once a horse has been infected, there is no (set) time period after which he’s not contagious,” he explains. “Unless you test, you can’t know he’s not contagious.” In his practice, Buchanan says veterinarians perform many polymerase chain reaction (PCR) tests to check for S. equi DNA and whether a horse is still shedding strangles bacteria.

Boyle also advocates testing all recovering horses from an outbreak to verify that the disease is truly gone. Currently, she is trying to determine what sampling method is best for detecting carrier horses. But for the moment she believes scoping the guttural pouches, where the bacteria can hide for years in dried out or “inspissated” pus, offers the fastest and most accurate results.

“In endemic barns with a chronic shedder, generally the horse that doesn’t get sick and never gets tested is the one doing the shedding,” Buchanan adds. “If you don’t test you’ll have a seasonal endemic problem every year.”

These “silent shedders” have had lymph nodes rupture into their guttural pouches during past active infection, leaving pus that has dried out into chondroids. “When the horse swallows (water), it sheds the bacteria,” he explains. “One day, the herd immunity is (weak) enough, the horse is drinking water, it sheds into the water, and there’s an outbreak.”

MYTH 4: Vaccination is dangerous and does no good.

Though some horses might have local reactions to the intramuscular vaccine and, rarely, horses might develop purpura hemorrhagica, Buchanan remains a strong proponent of intranasal vaccination against strangles. “In my (region’s horse) population, we consider it a core vaccine,” he says. “It’s about 70-80% effective. If it doesn’t prevent the disease, it will limit the clinical signs.” He says his practice sees far more problems from infection than from vaccination, so he and his colleagues consider the vaccine a low risk when used properly.

Other practitioners such as Weese don’t consider strangles to be a core vaccine. “It needs to be a risk-based vaccine,” he says. “In many areas and in many horse populations, the risk is relatively low, and it’s harder to justify, especially with a marginally protective vaccine.”

In Buchanan’s experience, the benefit of protection outweighs the low risk of vaccine reactions. “Treating a sick horse is expensive,” he says. “You can lose a month of showing or training time. We had a farm (in the area) go bankrupt, and a lot of that was due to a bad strangles outbreak that crippled them financially.”

Boyle is currently conducting a study examining how long high S. equi titers persist after a disease outbreak. Because of the purpura risk, she recommends either testing titers in horses that have been exposed to the disease or waiting at least two years before vaccinating them against the disease. “Certain horses seem to be hyperresponders,” she says. For that reason, she and other practitioners recommend against vaccinating in the face of an outbreak.

“In endemic barns with a chronic shedder, generally the horse that doesn’t get sick and never gets tested is the one doing the shedding.”

BENJAMIN BUCHANAN
MYTH 5: Antibiotics cause bastard strangles.

Historically, some owners and veterinarians have feared that treating strangles with antibiotics could drive the bacteria deeper into the body, increasing the horse’s risk of developing bastard strangles. But Boyle says there is no literature confirming this. For her own part, she says, “I’ve gotten much more aggressive in using antibiotics” in treating strangles caught in the early stages. “The trick,” she says, “is using the appropriate antibiotics long enough.”

She recommends scoping the guttural pouches and monitoring blood fibrinogen levels on these horses to know when it is safe to discontinue administering the drugs. “If you’re treating with antibiotics, you probably want to continue at least until the fibrinogen is down into the normal range,” and any evidence of infection in the guttural pouches is gone, she says.

Buchanan agrees, saying the concern with discontinuing antibiotics too soon is not having killed all the bacteria.

Take-Home Message
Horse industry participants must fight fear and fiction surrounding strangles with facts. Using smart biosecurity practices, consulting with your veterinarian regarding vaccination, and testing all exposed horses in an outbreak to confirm the disease is gone can go a long way toward taming the strangles beast. h

ABOUT THE AUTHOR

Christy Corp-Minamiji, DVM
Christy Corp-Minamiji, DVM, practices large animal medicine in Northern California, with particular interests in equine wound management and geriatric equine care. She and her husband have three children, and she writes fiction and creative nonfiction in her spare time.

Site: http://www.thehorse.com/articles/34919/strangles-dispelling-the-myths

Strangles: Dispelling the Myths The infection caused by the bacteria Streptococcus equi,, commonly known as strangles, has been described in horses for almost 800 years. The name strangles describes the condition in which an affected horse is suffocated as lymph nodes i

We are excited to introduce a new option for your horse's preventative care -- our new Wellness Program! After numerous client requests, we are offering the following optional plans that, at a discount, cover the preventative care that your horse generally needs for the year (physical exams, core vaccines, dentals, and fecals). There are also a few add-on options such as bloodwork, sheath cleaning, etc. that will be offered at a discount when you purchase one of the plans. These plans offer regular visits (spring and fall) that give us the opportunity to catch changes in your horse's health early on. Please look over the plans below and feel free to call us with any questions or to purchase a plan.

Now is the time to booster or start Botulism vaccines. Call us with any questions or to schedule an appointment!

Did you know that llamas and alpacas need teeth care, much like horses? Dr. Dreher attended to this loveable llama today!

https://www.facebook.com/100064771924047/posts/662468235922235/?sfnsn=mo&mibextid=DcJ9fc

Our patient Otis has got his beach body going! He's handling the heat and looking fine out there 😆

Hope you and your animals are staying cool and safe!

On average horses drink 7-10 gallons of water a day and this remains as important in cold weather as it is in the summer because reduced water intake can lead to gastrointestinal problems such as the dreaded impaction colic.

Studies demonstrate that horses will drink more if provided access to heated water and that most water consumption happens within three hours of feeding. How can you use this information to your advantage? Refill buckets at feed time with warm water to maximize your horse’s water intake—especially in the winter when water is more likely to be freezing or close to freezing.

As always, if you have any questions or would like to learn more about preventing colic in your horse, your equine veterinarian remains your best source of information!
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Brought to you by the AAEP Horse Owner Education Committee.

We want to let our clients know that there have been recent reports of cases of Equine Rhino (EHV) as well as Equine Influenza (EIV) in the south eastern area of Virginia. We encourage anyone who takes their horses to events in which they may have contact with other horses (trail rides, shows, etc) to booster their horses' Rhino/Flu vaccines. Please call with any questions.

Equine Viral Respiratory Disease:

Equine Herpesvirus 1&4 (Rhinopneumonitis):

Equine rhinopneumonitis virus, or equine herpesvirus 1(EHV-1) and 4 (EHV-4), causes respiratory disease in horses. In areas of high horse concentration, outbreaks are very common, especially among young horses. In one study 100% of horses had been exposed to EHV at some time in their lives. EHV-4 primarily causes respiratory disease, while EHV-1 can cause respiratory disease, abortion, or paralysis.

EHV can spread rapidly in a barn, especially if the horses are in crowded conditions. Some horses will contract EHV and have no symptoms (latent infections). These latent infected horses can reactivate without clinical signs but still be contagious. Under stressful conditions such as transport, competition, or sale latent horses can break with symptoms.

Clinical signs include fever (102 degrees to 106 degrees F), congestion, loss of appetite, serous nasal and ocular discharge, depression, swollen limbs, and swollen lymph nodes. Symptoms can last for a few days up to a month. A cough can develop in the later stages of the disease. Secondary bacterial infections can occur, further complicating the disease progression and recovery. Some horses develop performance limiting inflammatory airway disease. Because immunity after natural infection or vaccination is brief (less than 60 days), horses that have had EHV can become reinfected.

Treatment includes; fever control, immunostimulants, antiviral medication, discontinue work, increase ventilation, and decrease dust. In addition antibiotics may be used to prevent or treat secondary bacterial infection.

Because treatment options are limited, prevention is the best approach. Vaccinations should include all horses on the premises. Booster vaccines are important before horses gather in new places such as shows, sales, clinics, or reproductive facilities. Horses in high risk groups may need vaccinated as frequently as every 60 days.

Infected horses should be isolated from healthy horses. Keep stalls well ventilated and dust free. Do not share feed or water facilities. Wash all surfaces that come in contact with infected horses thoroughly. Feed or treat infected horses last, after all the healthy horses in the barn have been attended too. New horses introduced into a herd or coming home from a "high risk" event should be isolated for up to six weeks.



Equine Influenza Virus (EIV):

EHV Equine Influenza (EIV) is a highly contagious respiratory disease in horses. EIV can spread throughout a barn, horse show, or sale because a horse can be infected and not yet show clinical signs but are very contagious to other horses. Unlike EHV, EIV is not capable of prolonged survival in individual animals or in the environment. Transmission of the virus among horses generally occurs via direct contact with nasal secretions, by the aerosol route, or through contact with recently contaminated surfaces.

Clinical signs tend to be similar to those of EHV; however horses with EIV tend to have more intense symptoms. They can develop a high fever, harsh cough, heavy nasal discharge, enlarged lymph nodes, swollen limbs, and difficult breathing. Secondary bacterial infection is more common in horses that contract EIV and can start in as little as 48 hours. Some horses with EIV can take months to fully recover. The most severely infected horses can develop secondary pneumonia, and even die.

Treatment is also similar to EHV affected horses. Rest and supportive care is important. Fever control, immunostimulants, and antiviral medications are also recommended. In addition antibiotics to prevent or treat secondary bacterial infection are indicated.

vaccination.single.jpgLike EHV infection prevention is better than treatment. The same hygiene and isolation protocols as discussed above should be implemented. Vaccination against EIV should be given to every horse that will encounter other horses at least twice per year. Horses in high risk groups should be vaccinated more frequently. Discuss with your veterinarian an appropriate vaccination protocol to protect your horses from EHV and EIV infections.

We would like to congratulate Dr. Dreher on her precious little bundle! Welcome to the world, sweet little Maggie 💕💓💖💗

Today is the day, folks! Dr. Dreher's little bundle is due anytime now! And where is she? She's out making horse calls, of course. So if you see her on the road, honk and give her some encouragement!! 🥰

⚠️ Health Alert ⚠️

Woodside Equine Clinic has posted that Potomac Horse Fever cases are being reported in their area. While we have not had any cases in our practice, we think it wise to share their information and make our clients aware. Please call us if you have any questions!

Woodside writes:
Due to the Potomac Horse Fever cases we have been seeing, we are recommending giving the PHF boosters early this year. If it has been at least three months since your horse last received a PHF vaccine, they can receive a booster at any point now. Please call the clinic if you are interested in scheduling a booster appointment.

Remember, Potomac Horse Fever is not contagious from horse to horse contact but it is important to keep water and food sources cleaned regularly. It is recommended to try to minimize the exposure to infected insects by turning off stable lights at night in high risk areas. We also recommend that you familiarize yourself with the signs and symptoms and let us know if you have any concerns.

Last week the staff enjoyed a baby shower for Dr. Dreher…looking forward to Baby Girl's arrival soon 💗

Hello everyone! Please note, the office will be closing early tomorrow, Friday, July 8th at 2:00 pm. The vets will still be completing their appointments and Dr. Lee will be on call for any emergencies. Thank you!

Hello folks! We are currently working on our first time sending out statements from the new software. It seems the ones emailed out this morning may not be complete/correct. Please call if you have any questions and please be patient with us!

Never a dull moment at Tidewater Equine! 🥰

Please join us in welcoming ‘Vhagar’ an adorable male cria born yesterday. Ashley Sarkozi is certainly smitten!

So very proudly owned by Laura Hineman

Hello everyone -- we are excited to announce a new software program here in the office! (So please be patient with us, we are still learning... slowly... 😆) The nice thing is, we can now email your monthly statements instead of mailing them, so be sure to call in and let us know if you'd like us to start doing that (or email us at [email protected]). We will also soon have a client portal set up, where clients will be able to sign on and access their animals' medical records, vaccines, etc! So be sure to get us your email, if we don't already have it.

But most of all, once again, have patience and pity on us. Some of us don't learn as fast as we used to. 🤣

Congratulations to Colonial Williamsburg on their new filly and new c**t! Pictured is the filly. How nice is she!?
Dr. Lee will have to work on his camera skills so we can get a good photo of the c**t 😊

Here’s a bit of cuteness to kick off your weekend ❤️ Ashley giving snuggles to ‘Sally’ owned by Colonial Williamsburg.

Welcome to the world little miniature fella! This young man, just a couple weeks old now, needed a little help from Dr. Lee and seems to be quite happy with his new ‘digs.’

Precious and loving life… owned by Susan Wise Bauer

**We are up and running!**

Well, here we are again! Power and phones out due to an accident (car vs utility pole). Any emergencies can be called in to 757-220-4416. Please share. Will notify everyone when we are up and running.

Phones and power are back -- we are up and running!! Thank you Dominion Power

Our power & phones are both currently out. If you have an emergency please call our answering service at 757-220-4416.

The rhino vaccine is so important if your horse comes in contact with other horses.

Virginia horse test positive for Equine Herpesvirus-1 According to the Virginia Department of Agriculture and Consumer Services’ State Veterinarian’ Office, a horse has tested positive for Equine Herpesvirus-1 on Monday.

Although our office will be closed on both Thanksgiving Day and Friday, the vets will be on call for emergencies.

Turplus the turkey is grateful to Dr. Dreher today for coming and checking him out after he was attacked by a dog. He hopes everyone has something to be grateful for and has a wonderful Thanksgiving!

A recent addition to the Tidewater Equine Clinic veterinary staff, please welcome Dr. Emily Dreher (pronounced Dray-er).
Dr. Dreher was born in Detriot, MI and grew up in Williamsburg, VA. At 13 years of age, she acquired ‘Flag’, a Paint mare who followed her through her college years and whom she still owns today. Dr. Dreher earned her bachelor of science degrees in Animal Science and Biological Systems Engineering at Virginia Tech. She then received her Masters degree in Genetics at the University of Nebraska-Lincoln and recently attained her veterinary degree from the University of Pennsylvania. Dr. Dreher and her husband, Greg, enjoy spending time outdoors, including hiking with their dogs. She also enjoys baking, canning and pickling. Her ongoing passion for rural VA farm life and the desire to help animals will make her quite an asset to the clientele of Tidewater Equine Clinic.