Diseases Articles

EQUINE INFECTIOUS ANEMIA: The Only Protection is Prevention

Causes & Symtoms o! "esicular Stomatitis
E#uine En$ocrinolo%y: Cushin%&s 'isease an$ Meta(olic Syn$rome
)lister )eetle Poisonin%
P*OTECT +OU* ,O*SE F*OM EIA
E,"-. Out(rea/s
0hat&s The ,ye Over ,+PP1
"esicular Stomatitis In ,orses
"esicular stomatitis
2yme 'isease in ,orses
Anthra3 A!!ects Everyone

EQUINE INFECTIOUS ANEMIA: The Only Protection is
Prevention
E#uine In!ectious Anemia 4EIA5 is a $isease that threatens the 6orl$7s horse8 $on/ey an$
mule oulations9 'esite testin% an$ measures to era$icate the e#uine in!ectious anemia virus
4EIA"58 more than :;; ne6 cases are i$enti!ie$ each year in the U9S9
There is no cure !or EIA9 Althou%h most in!ecte$ horses sho6 no symtoms8 they remain
conta%ious !or li!e8 en$an%erin% the health o! other horses9 For this reason8 the Unite$ States
'eartment o! A%riculture 4US'A8 6669us$a9%ov 5 an$ state animal health re%ulatory a%encies
re#uire euthanasia or strict li!elon% #uarantine !or horses testin% ositive !or EIA"9
EIA E<P2AINE'
E#uine in!ectious anemia is a otentially !atal viral $isease9 EIA" rero$uces in 6hite (loo$ cells
that circulate throu%hout the (o$y9 The immune system8 via anti(o$ies8 may attac/ an$ $estroy
re$ (loo$ cells8 lea$in% to anemia9 In!lammation associate$ 6ith the viral in!ection may $ama%e
vital or%ans8 such as (one marro68 liver8 heart an$ /i$ney9 Secon$ary in!ections 4e9%9 neumonia5
may occur $ue to su(se#uent immunosuression9 EIA"-in!ecte$ horses may $ie !rom the $irect
e!!ects o! the virus or !rom secon$ary in!ections9
EIA %enerally has three !orms:
.5 Acute: Seen 6ithin .-= 6ee/s a!ter the horse&s !irst e3osure to the virus8 this hase is the
most $etrimental9 It may (e $i!!icult to accurately $ia%nose acutely in!ecte$ horses8 as anti(o$ies
are not imme$iately ro$uce$ an$ anemia is not resent at this sta%e9 ,o6ever8 the virus is
active8 multilyin% an$ $ama%in% the immune system an$ other or%an systems9
>5 Chronic: I! the horse survives the acute hase8 a su(acute or chronic hase may occur9 The
classic si%ns o! EIA8 such as !ever8 $eression8 6ei%ht loss8 anemia an$ etechial 4inoint si?e$5
hemorrha%es on the mucous mem(ranes8 are most li/ely seen in this hase9 *eeate$ !lare-us
o! clinical si%ns o!ten occur9 Such eiso$es are seen 6ith recru$escence o! the virus an$ viremia
4virus resent in the (loo$stream5 $urin% erio$s o! stress or the a$ministration o! corticosterio$s9
@5 Inaarent: Over time8 the erio$ic eiso$es $ecrease in severity an$ !re#uency9 0ithin a one-
year erio$ many horses (e%in to control the in!ection an$ sho6 no clinical si%ns9 These
inaarent carriers are in!ecte$ !or li!e an$ may (e a source o! in!ection !or other horses
T*ANSMISSION
EIA" is transmitte$ (y (loo$ or (y in-utero assa%e !rom mare to !oal9 )loo$ transmission can
occur via (loo$-suc/in% insects8 such as horse !lies8 $eer !lies an$ mos#uitoes9 The virus is
carrie$ in the resi$ual (loo$ on the insect7s moutharts as it travels !rom one horse to the ne3t9
Transmission may also occur via (loo$ trans!usion or (loo$-contaminate$ nee$les an$
instruments9 The virus may also (e !oun$ in semen an$ mil/9
EIA is also /no6n as As6am !everA (ecause the $isease has (een associate$ 6ith 6arm8 6et
re%ions8 (ut the $isease is not limite$ (y %eo%rahy9
States reortin% the hi%hest inci$ence o! EIA 4>;;. $ata5 inclu$e: Te3as8 O/lahoma8 Ar/ansas8
2ouisiana8 South 'a/ota8 Mississii8 Minnesota8 Michi%an8 Ala(ama an$ Flori$a9
S+MPTOMS
EIA may (e $i!!icult to $ia%nose (ecause the symtoms are not seci!ic an$ may vary !rom horse
to horse9 A$$itionally8 in$ivi$uals may $emonstrate no o(vious si%ns 4inaarent carriers59 Si%ns
may inclu$e one or more o! the !ollo6in%:
B Fever 4temerature may even e3cee$ .;: $e%rees F5
B 'eression
B Mucosal etechial hemorrha%es
B 'ecrease$ latelet num(ers 4throm(ocytoenia5
B 'ecrease$ re$ (loo$ cell num(ers 4anemia5
B S6ellin% o! le%s8 lo6er chest8 an$ a($omen 4e$ema5
B 'ecrease$ aetite 4anore3ia5
B Fati%ue8 re$uce$ stamina or 6ea/ness
B *ai$ (reathin%
B S6eatin%
B *ai$ 6ei%ht loss
B Nasal (lee$in% 4eista3is5
B Pale or yello6ish 4icteric5 mucous mem(ranes
B Irre%ular heart(eat an$Cor 6ea/ ulse
B Colic
B A(ortion
T,E CODDINS 4ADI'5 an$ C-E2ISA TESTS
The only 6ay to accurately $etermine 6hether a horse is in!ecte$ 6ith the EIA virus is (y
i$enti!yin% anti(o$ies in the (loo$ via a%ar %el immuno$i!!usion 4ADI'5 or cometitive en?yme
lin/e$ immunoa$sor(ent assay 4C-E2ISA5 tests9 The ADI' metho$ is consi$ere$ the E%ol$
stan$ar$F an$ is commonly /no6n as the Co%%ins test9 This test 6as $eveloe$ >: years a%o (y
veterinary researcher 'r9 2eroy Co%%ins9 A ne%ative Co%%ins test means there are no $etecta(le
anti(o$ies at the time o! testin%9 A ositive test in$icates the horse is in!ecte$ an$ a carrier o! the
virus9 C-E2ISA tests o!!er the a$vanta%e o! rai$ results9 ,o6ever8 !alse-ositive results are more
common 6ith the C-E2ISA tests an$ ositive results shoul$ (e veri!ie$ (y a stan$ar$ Co%%ins
4ADI'5 test9 Foals may (e !alse ositive $ue to maternal anti(o$ies asse$ via colostrum !or as
lon% as si3 months 6ith either test9
FE'E*A2 & STATE *EDU2ATIONS
The US'A re#uires that horses (ein% imorte$ !rom !orei%n countries have a ne%ative ADI' EIA"
test9 0ithin the U9S98 each state $ra!ts its o6n seci!ic re#uirements re%ar$in% EIA" an$ the
movement o! horses interstate8 intrastate an$ in chan%e o! o6nershi9 2earn 6hat is re#uire$ in
your state an$ states you 6ill (e visitin%9 )e a6are that la(oratory results ta/e time an$ lan to
have your horse teste$ in time to %et results (e!ore you must transort your horse9 )y la68 EIA is
a reorta(le $isease9 All ositive cases must (e !ile$ 6ith the state veterinarians an$ the !e$eral
Animal an$ Plant ,ealth Insection Service 4AP,IS86669ahis9us$a9%ov59
*ISG FACTO*S
There are mana%ement an$ %eo%rahic !actors that ut horses at %reater ris/ !or contractin% EIA9
These inclu$e:
B Close ro3imity to re%ions 6here EIA out(rea/s have (een i$enti!ie$9
B Sta(lin% or asture environments that have a stea$y in!lu3 o! ne6 horses8 esecially i! ne%ative
Co%%ins certi!icates are not re#uire$9
B E3osure to horses at sho6s8 sales or events8 esecially 6here strin%ent health care re%ulations
are not en!orce$ an$ veri!ication o! a current ne%ative Co%%ins test is not re#uire$9
B Pasturin% horses in s6amy areas an$ in areas 6here all horses have not (een re%ularly teste$
!or EIA9
T,E ON2+ P*OTECTION IS P*E"ENTION
There is no e!!ective treatment !or EIA9 There is no vaccine to revent it9 There is no cure9
,o6ever8 %oo$ mana%ement can re$uce the otential o! in!ection9 The !ollo6in% %ui$elines 6ill
hel:
B Use $isosa(le nee$les an$ syrin%es 4one er horse5 6hen a$ministerin% vaccines an$
me$ications9
B Sterili?e $ental tools an$ other instruments (e!ore usin% them on another horse9
B Test all horses !or EIA at least annually9
B Test horses at the time o! urchase e3amination9
B Sta(le o6ners8 horse sho6 an$ event mana%ers shoul$ re#uire an$ veri!y current ne%ative
Co%%ins certi!icates !or all horses enterin% the remises9
B Ne6 horses shoul$ (e #uarantine$ !or =: $ays an$ o(serve$ !or any si%ns o! illness8 inclu$in%
elevate$ temeratures8 (e!ore intro$ucin% them to the her$9 They shoul$ (e reteste$ i! e3osure
to EIA is susecte$ at a =:-$ay interval9
B All sta(le areas shoul$ (e /et clean8 $ry an$ 6aste-!ree9 Doo$ asture mana%ement
techni#ues shoul$ also (e ractice$9 *emove manure an$ rovi$e a$e#uate $raina%e to
$iscoura%e (ree$in% sites !or ests9
B ,orses that are at %reater ris/ 4such as animals 6ho are in !re#uent contact 6ith outsi$e horses
or 6ho live or travel in %eo%rahic re%ions /no6n !or EIA out(rea/s5 shoul$ (e teste$ more
!re#uently8 i$eally every =-H months9
'IFFICU2T C,OICES
I! your horse tests ositive !or EIA"8 your otions are e3tremely limite$9 Fe$eral an$ state health
a%encies8 as 6ell as the American Association o! E#uine Practitioners8 suort euthanasia as the
most ru$ent8 al(eit emotionally $i!!icult8 otion9 2i!elon% #uarantine in a screene$ stall is another8
less acceta(le alternative9 EIA"-ositive horses 6ill al6ays ose an unnecessary health ris/ to
other horses8 6hether or not they sho6 si%ns o! illness9 Even in the (est mana%ement situations8
(loo$-suc/in% insects cannot (e totally controlle$ or eliminate$9 The only 6ay to era$icate the
$isease is to eliminate the carriers9
,orses testin% ositive !or EIA" are re#uire$ (y la6 to (e ermanently i$enti!ie$ via (ran$in% or
tattooin% an$ (e #uarantine$9 Transortation an$ housin% are severely restricte$9 +ou shoul$
contact your state animal health a%ency !or seci!ic re#uirements9
O6ners 6ho choose #uarantine must ost si%ns clearly statin%: AQuarantine$: E#uine In!ectious
AnemiaA or AS6am Fever9A ,orses shoul$ (e #uarantine$ at least >;; yar$s a6ay !rom all other
animals9
CONTINUE' "IDI2ANCE NEE'E'
Stoin% the srea$ o! EIA" is everyone7s resonsi(ility9 I! you susect a horse has EIA8 call your
veterinarian or state animal health a%ency imme$iately9 They can assess the animal an$ initiate
the re#uire$ tests9
O6ner comliance 6ith EIA" testin% an$ the $estruction o! most /no6n reactors has ai$e$ in a
mar/e$ $ecline in EIA cases in the last >; years9 To$ay less than .I o! the . million horses
teste$ annually are !oun$ to (e carriers9 )ut 6ith an estimate$ H9H million horses in the U9S98
more 6i$esrea$ screenin% is nee$e$9 Even (ac/yar$ horses that never leave the roerty 6ill
(ene!it9 )y havin% your horse teste$8 you 6ill (e $oin% yoursel! an$ the entire e#uine in$ustry a
!avor9 The cost is minimal an$ the rice 6ell 6orth the eace o! min$9
For more in!ormation8 contact your veterinarian9
/ey6or$s: EIA8 E#uine In!ectious Anemia9
oste$: JC.JC>;;H9 2ast u$ate$: JC.JC>;;H
Causes & Sy!tos o" #esicular Stoatitis
$y Dana N% &iel' D#M' Di!loate AC#IM' A(#P )E*uine
Practice+
In >;;:8 "esicular Stomatitis 4"S5 6as $etecte$ in many 6estern states inclu$in% Ne6
Me3ico8 Ari?ona8 Utah8 Colora$o8 0yomin%8 I$aho an$ Montana in >;;:9 Many states have
lace$ increase$ restriction on any livestoc/ 4inclu$in% horses5 to control the srea$ o! the
$isease9 For e3amle8 some states 6ill re#uire all hoo!e$ animals8 inclu$in% horses !rom
"esicular Stomatitis-a!!ecte$ states to (e accomanie$ (y an O!!icial Certi!icate o! "eterinary
Insection 4OC"I5 6hich states the !ollo6in%: EAll animals susceti(le to "esicular Stomatitis 4"S5
i$enti!ie$ an$ inclu$e$ in this OC"I !or shiment have (een e3amine$ an$ !oun$ to (e !ree !rom
clinical si%ns an$ vectors o! "S8 have not (een e3ose$ to the "S virus an$ have not (een 6ithin
.; miles o! a "S-in!ecte$ remises 6ithin the last @; $ays9F In a$$ition animals ori%inatin% !rom a
"S-a!!ecte$ state enterin% the state 6ill re#uire rior ermission9
In >;;=8 the "esicular Stomatitis out(rea/ a!!ecte$ =;: horses in Colora$o8 Ne6 Me3ico an$
Te3as9 Prior to >;;=8 the last out(rea/ 6as in .KKL9 "S is a viral $isease that occurs in the
South6est commonly a!!ectin% horses8 cattle an$ i%s (ut can a!!ect shee8 %oats an$ 6il$
animals9 The maMor concern 6ith this $isease is that it mimics Foot an$ Mouth 'isease 4FM'58
6hich has (een era$icate$ in the Unite$ States since .K>K9 Intro$uction o! FM' into the U9S9
6oul$ have tremen$ous economic conse#uences so the U9S9 'eartment o! A%riculture&s Animal
an$ Plant ,ealth Insection Service 4US'A-AP,IS5 monitors any $isease that can loo/ similar to
FM'9 The only 6ay to $istin%uish "S !rom FM' in livestoc/ is throu%h la(oratory tests9 ,orses
are not a!!ecte$ (y FM'9
Clinical Si%ns
The clinical si%ns o! "S in horses inclu$e !ever an$ (listers on the ton%ue8 lis an$ coronary
(an$s9 The (listers are so ain!ul that the horse may re!use to eat8 $evelo e3cessive salivation
or (ecome lame i! the coronary (an$ is a!!ecte$9 The incu(ation erio$ ran%es !rom > to >. $ays9
Transmission
,o6 "S srea$s is not !ully un$erstoo$ (ut it is (elieve$ to (e transmitte$ (y arthroo$s such as
!lies8 mos#uitoes an$ mi$%es9 ,orses can srea$ the virus i! the saliva !rom the ruture$ (listers
contaminates common areas such as 6ater an$ !ee$ (uc/ets9
The mor(i$ity rate 4the ris/ that an animal 6ill (ecome sic/ !rom a $isease5 is varia(le an$ can (e
as hi%h as K;I in a her$9 The mortality rate 4the ris/ that an animal 6ill $ie !rom a $isease5 !or
"S is lo6 !or horses9 A!!ecte$ horses may ta/e J-.= $ays to recover an$ can su!!er 6ei%ht loss
!rom the ina(ility to eat 6ell9 ,umans can contract the virus i! they come into contact 6ith horses
that are a!!ecte$9 The clinical symtoms in humans are similar to in!luen?aN !ever8 muscle aches8
hea$aches an$ malaise9 Peole shoul$ !ollo6 roer (iosa!ety metho$s 6hen han$lin% in!ecte$
horses9
Controllin% an Out(rea/
There is not a seci!ic cure !or the $isease9 I! a horse has symtoms consistent 6ith the $isease
the veterinarian must contact the State "eterinarian or the US'A:AP,IS imme$iately9 At that
time8 a (loo$ samle an$ an oral s6a( are collecte$ !rom each susect animal an$ the remises
are #uarantine$ en$in% la(oratory con!irmation o! the $isease9 Farms that have con!irme$ cases
o! "S are #uarantine$ !or @; $ays a!ter all clinical si%ns have resolve$9 All sic/ horses shoul$ (e
isolate$ !rom the healthy horses9 0hen 6or/in% on in!ecte$ horses8 rotective late3 %loves shoul$
(e use$9 Ma/e sure to imlement %oo$ vector control on the !arm9
'i!!erential $ia%nosis !or oral (listers in the horse
B )lister (eetle to3icosis
B Chemical stomatitis
B Perio$ontal %in%ivitis
B Phenyl(uta?one to3icity
B Plant a6n stomatitis or !orei%n (o$y
B Uremia
B +ello6 (ristle %rass ulcers
Imact on the E#uine In$ustry
Out(rea/s o! "S in .KK: involve$ @H: ranches in Ne6 Me3ico8 Colora$o8 Ari?ona8 Utah an$
Te3as9 In .KKJ8 a similar out(rea/ o! "S 6as $etecte$ on @L; ranches in Ari?ona8 Colora$o8 Ne6
Me3ico an$ Utah9 These out(rea/s have cause$ si%ni!icant economic har$shis !or the horse
in$ustry $ue to the man$atory restrictions imose$ on livestoc/ travel at the local8 state8 national
an$ international levels9 The ina(ility to shi horses to an$ !rom these states can result in lost
revenue !or the (ree$in%8 sho6in%8 racin% an$ sales in$ustry9
For more in!ormation re%ar$in% "esicular Stomatitis8 here are some a$$itional resources:
State "eterinarians:
htt:CC6669ahis9us$a9%ovCvsCsre%sCo!!icial9html
Fe$eral "eterinary Services O!!ices & "eterinarians 4A"IC5
htt:CC6669ahis9us$a9%ovCvsCareaOo!!ices9htm
State *esources !or "esicular Stomatitis In!ormation
htt:CC6669ahis9us$a9%ovCvsCceahCncahsCnsuCsurveillanceCvsvCCvsvOstatein!o9htm
/ey6or$s: "S8 "esicular Stomatitis 9
oste$: @C>JC>;;H9 2ast u$ate$: @C>JC>;;H
E*uine En,ocrinolo-y: Cushin-.s Disease an,
Meta$olic Syn,roe
$y Christie Mala/,re0ich' D#M' Di!loate AC#IM1 University o"
Minnesota Colle-e o" #eterinary Me,icine
Intro$uction
0ith each assin% year8 horses are livin% lon%er lives an$ their o6ners are (ecomin% more
intereste$ in reservin% health8 athletic !unction an$ #uality o! li!e throu%hout mi$$le a%e an$ the
%eriatric years9 This article revie6s t6o relate$ en$ocrine $isor$ers o! mature an$ %eriatric
horses: e#uine Cushin%&s $isease an$ a recently reco%ni?e$ con$ition that is currently /no6n as
Emeta(olic syn$rome9F Althou%h the t6o $isor$ers !eature some stri/in% clinical similaritiesP most
nota(ly a re$isosition to $eveloment o! chronic laminitisP the un$erlyin% $isease (iolo%y is
#uite $i!!erent in each case an$ success!ul mana%ement re#uires that the e#uine veterinarian
$istin%uish (et6een them9 Our un$erstan$in% o! (oth con$itions8 esecially meta(olic syn$rome8
is incomlete an$ su(Mect to continuous evolution8 (ut su!!icient in!ormation is currently availa(le
to hi%hli%ht some imortant similarities an$ $i!!erences !or the intereste$ horse o6ner9
0hat is E#uine Cushin%&s 'isease1
E#uine Cushin%&s $isease is a $isor$er o! the ituitary %lan$ that results in hormonal im(alances8
causin% a variety o! clinical si%ns: a lon%8 6avy haircoat that !ails to she$ accor$in% to normal
seasonal atternsN e3cessive s6eatin%N lethar%y an$ oor athletic er!ormanceN chronic recurrent
laminitisN in!ertilityN 6ei%ht lossN muscle 6astin%8 esecially alon% the tolineN a(normal $istri(ution
o! !at8 6ith accumulations in the crest o! the nec/8 tail hea$8 sheath an$ a(ove the eyesN
consumtion o! lar%e volumes o! 6ater an$ assa%e o! lar%e amounts o! urineN $elaye$ 6oun$
healin%N an$ increase$ susceti(ility to in!ections9 The $isease ten$s to occur in mi$$le-a%e$ an$
%eriatric horses8 6ith an avera%e a%e o! aro3imately >; years at the time o! $ia%nosis9 0ithout
treatment8 symtoms ten$ to 6orsen over time an$ many horses are euthani?e$ as a
conse#uence o! laminitis8 recurrent !oot a(scesses or comlications relate$ to (acterial
in!ections9
0hat Causes E#uine Cushin%&s 'isease1
In $o%s an$ humans8 Cushin%&s $isease is cause$ (y a hormone-secretin% tumor o! the anterior
art 4ars $istalis5 o! the ituitary %lan$ at the (ase o! the (rain9 In horses8 (y contrast8 the
$isease involves the interme$iate art 4ars interme$ia5 o! the ituitary9 This ortion o! the %lan$
is comrise$ o! $i!!erent hormone-secretin% cells than are resent in the anterior ituitary8
accountin% !or a $i!!erent hormone ro!ile o(serve$ in e#uine Cushin%&s $isease as comare$ to
humans an$ $o%s9 In a!!ecte$ horses8 the ars interme$ia ro$uces e3cessive amounts o! ro-
oiomelanocortin 4POMC5 an$ several hormonally-active $erivatives8 inclu$in%
a$renocorticotroic hormone 4ACT,59
Function o! the ars interme$ia is normally /et in chec/ (y $oamine-secretin% nerve cells
arisin% !rom the hyothalamus8 a near(y art o! the (rain that re%ulates a variety o! (o$y
!unctions such as thirst8 hun%er8 (o$y temerature8 6ater (alance an$ (loo$ ressure9 In most
cases o! e#uine Cushin%&s $isease8 the ituitary %lan$ is not truly neolastic8 (ut rather enlar%e$
an$ overactive as a result o! !aulty re%ulation (y the hyothalamus9 In !act8 the most e!!ective
availa(le me$ication !or the $isease8 er%oli$e8 6or/s (y mimic/in% the inhi(itory e!!ect o!
hyothalamic nerve cells on the ituitary9
In $o%s an$ humans8 the maMor hormone ro$uce$ (y the a(normal ituitary %lan$ is ACT,8
6hich stimulates the a$renal %lan$s to ro$uce lar%e amounts o! cortisol8 a hormone usually
release$ transiently an$ at lo6 levels to hel the (o$y reson$ to short erio$s o! hysical8
emotional or environmental stress9 Sustaine$ secretion o! e3cessive cortisol is resonsi(le !or
many o! the clinical si%ns o! Cushin%&s $isease in those t6o secies9 In e#uine Cushin%&s $isease8
(y contrast8 levels o! cortisol are usually normal or even lo68 in$icatin% that POMC $erivatives
other than ACT, lay a more imortant role in $isease $eveloment9 In vie6 o! the si%ni!icant
(iolo%ical $i!!erences (et6een human an$ canine Cushin%&s $isease an$ the e#uine version8 the
name ituitary ars interme$ia $ys!unction 4PPI'5 is no6 !avore$ amon% many veterinary
scientists to $escri(e the $isease in horses9
'ia%nosis o! E#uine Cushin%&s 'isease
In a$vance$ cases characteri?e$ (y a lon%8 6avy haircoat an$ other classical si%ns o! Cushin%&s
$isease8 $ia%nosis is relatively strai%ht!or6ar$ an$ may not re#uire any seciali?e$ testin%9
'ia%nosis o! early cases or those characteri?e$ (y !e6 o(vious clinical si%ns8 ho6ever8 is
consi$era(ly more $i!!icult9 A variety o! en$ocrinolo%ic tests have (een romote$ !or this urose8
(ut !e6 have (een scienti!ically vali$ate$ in horses !or 6hich the $ia%nosis has (een
su(se#uently con!irme$ (y necrosy e3amination9 In my oinion8 the t6o most ractical an$
accurate tests currently availa(le are 4.5 the $e3amethasone suression test8 an$ 4>5
measurement o! lasma ACT, concentration9
The $e3amethasone suression test is an overni%ht rotocol in 6hich a retreatment (loo$
samle is collecte$ in the late a!ternoon8 a!ter 6hich a lo6 $ose o! $e3amethasone is
a$ministere$ (y intramuscular inMection9 A secon$ samle o! (loo$ is collecte$ the !ollo6in% $ay
at aroun$ noon an$ (oth samles are su(mitte$ !or measurement o! lasma cortisol9 In normal
horses8 a$ministration o! $e3amethasone stimulates a ne%ative-!ee$(ac/ resonse that
suresses secretion o! cortisol !rom the a$renal %lan$s8 yiel$in% a much lo6er concentration in
the secon$ (loo$ samle9 In horses su!!erin% !rom Cushin%&s $isease8 ho6ever8 the ne%ative-
!ee$(ac/ resonse is (lunte$ an$ a lesser $e%ree o! suression8 i! any8 is o(serve$9
Althou%h it is 6i$ely consi$ere$ the most accurate test currently availa(le8 the $e3amethasone
suression test has t6o si%ni!icant $ra6(ac/s that limit its use in some cases: 4.5 it re#uires t6o
visits to the !arm (y the veterinarian8 6hich increases its cost to the o6ner8 an$ 4>5 many o6ners
an$ veterinarians !ear that a$ministration o! $e3amethasone mi%ht increase the ris/ o! laminitis in
a horse that is alrea$y re$isose$ to its $eveloment9 For these reasons8 many veterinarians
re!er an alternative test8 measurement o! lasma ACT,9 This test involves collection an$
analysis o! a sin%le (loo$ samleN the ituitary %lan$ in a!!ecte$ horses o!ten secretes e3cessive
amounts o! ACT, into the (loo$stream as comare$ to normal horses9 0hile use!ul8 this test is
%enerally consi$ere$ to (e some6hat less accurate than the $e3amethasone suression test8
an$ (loo$ samles must (e han$le$ very care!ully to avoi$ $e%ra$ation o! ACT, an$ !alsely lo6
measure$ values9 Stress an$ ain $ue to other con$itions may also result in !alsely elevate$
values9
Sulemental tests that may (e use!ul in susect cases inclu$e measurements o! (loo$ %lucose
an$ insulin9 Many a!!ecte$ horses are insulin resistant an$ some are si%ni!icantly hyer%lycemicN
early reco%nition an$ trac/in% o! these a(normalities 6ill ai$ in rational nutritional mana%ement o!
the $isease an$ rovi$e a$$itional criteria (y 6hich to evaluate the horse&s resonse to
treatment9
Treatment o! E#uine Cushin%&s 'isease
Otimal mana%ement o! Cushin%&s $isease involves a com(ination o! (oth seci!ic me$ication to
normali?e the !unction o! the ituitary %lan$ an$ suortive care to a$$ress an$ revent
comlications associate$ 6ith the $isease9 In (oth cases8 mana%ement 6ill (e li!e-lon% as there is
no 6ay to reverse the $isease rocess9 In the early sta%es8 seci!ic me$ication may not (e
re#uire$ an$ conservative measures such as (o$y cliin% to remove the lon% hair coat8 strict
attention to $iet8 an$ scruulous attention to teeth8 hooves an$ reventive care may (e su!!icient
to rovi$e %oo$ #uality o! li!e9 Since a!!ecte$ horses are o!ten insulin resistant8 s6eet !ee$ an$
other !ee$stu!!s hi%h in solu(le car(ohy$rates shoul$ (e avoi$e$ in !avor o! $iets emhasi?in%
!i(er an$ !at9 Pellete$ or e3tru$e$ !ee$s $esi%ne$ seci!ically !or ol$er horses are stron%ly
recommen$e$8 (ut those 6ith hi%h levels o! su%ar or molasses shoul$ (e avoi$e$ unless nee$e$
to encoura%e the horse to eat9 In (oth mil$ly an$ severely a!!ecte$ horses8 the imortance o!
early $ia%nosis an$ a%%ressive treatment o! (acterial in!ections cannot (e overstate$9
Me$ications use$ to treat this con$ition !ocus on 4.5 re$ucin% the amount o! ACT, an$ other
POMC $erivatives secrete$ (y the ituitary 4e9%9 cyroheta$ine8 er%oli$e58 an$Cor 4>5
suression o! cortisol synthesis an$ release (y the a$renal %lan$s 4e9%9 trilostane59 The $ru% o!
choice is currently er%oli$e mesylate 4Perma3Q58 6hich is a$ministere$ $aily (y the oral route9
An initial $ose o! ;9;;> m%C/% 4aro3imately . m% !or a .;;;-l( horse5 once $aily is
recommen$e$N this $ose may (e %ra$ually increase$ i! clinical imrovement !ails to occur a!ter
one to t6o months o! theray9 A !avora(le clinical resonse to theray 6ill (e associate$ 6ith
imrovement or normali?ation o! results in the $e3amethasone suression an$ lasma ACT,
tests9 Early cases or those characteri?e$ (y seasonal e3acer(ation o! clinical si%ns may (ene!it
!rom intermittent courses o! theray8 6hile more a$vance$ cases %enerally re#uire continuous
treatment !or the li!e o! the horse9 Occasional severe cases (ene!it !rom treatment 6ith a
com(ination o! (oth er%oli$e an$ cyroheta$ine 4PeriactinQ59 Trilostane8 an inhi(itor o! a$renal
cortisol synthesis8 has sho6n some romise in clinical trials con$ucte$ in the Unite$ Gin%$om8 (ut
this $ru% is not currently availa(le in the Unite$ States9
In a$$ition to these me$ications8 a variety o! nutritional sulements an$ alternative theraies
have (een a$vocate$ !or the mana%ement o! e#uine Cushin%&s $isease9 A comrehensive revie6
o! these strate%ies is (eyon$ the scoe o! this article8 (ut t6o that may (e hel!ul an$ are unli/ely
to ose si%ni!icant ris/s inclu$e $ietary sulementation o! ma%nesium 4to achieve a tar%et
calcium:ma%nesium ratio o! >:.5 an$ chromium icolinate9 These nutrients are hel!ul in the
mana%ement o! tye > $ia(etes an$ insulin resistance in humans8 an$ may (e (ene!icial in
e#uine cases comlicate$ (y insulin resistance an$ hyer%lycemia9 An her(al ro$uct reare$
!rom chaste(erry e3tract 4"itus a%nus castus5 has also (een recommen$e$ !or the mana%ement
o! e#uine Cushin%&s $isease8 (ut a recent scienti!ic stu$y er!orme$ at the University o!
Pennsylvania&s Ne6 )olton Center !oun$ it ine!!ective9
0hat is E#uine Meta(olic Syn$rome1
E#uine veterinarians have lon% reco%ni?e$ a relate$ syn$rome o! o(esity8 insulin resistance an$
chronic laminitis a!!ectin% a some6hat youn%er %rou o! a$ult horses9 Althou%h these horses
6ere initially susecte$ to comrise a su(set o! e#uine Cushin%&s $isease cases8 a lon% haircoat
is not a !eature o! the con$ition an$ tests o! ituitary !unction 4e9%9 the $e3amethasone
suression test an$ lasma ACT, concentrations5 usually yiel$ normal results9 Furthermore8
a!!ecte$ horses $o not reson$ to me$ications such as cyroheta$ine an$ er%oli$e8 6hich are
!re#uently o! (ene!it in Cushin%&s $isease9
In the ast !e6 years8 veterinary scientists have (e%un to e3amine this con$ition more closely an$
researchers at the University o! Missouri have a$vance$ a ne6 name8 Emeta(olic syn$rome9F
Selection o! this name 6as (ase$ on several aarent similarities (et6een a!!ecte$ horses an$
the human con$ition /no6n as meta(olic syn$rome8 6hich is characteri?e$ (y 4.5 o(esity8
esecially involvin% accumulation o! !at 6ithin the a($omenN 4>5 elevate$ (loo$ lii$s an$ re$uce$
concentrations o! hi%h-$ensity liorotein 4so-calle$ E%oo$F5 cholesterolN 4@5 insulin resistance an$
hyer%lycemiaN an$ 4=5 hi%h (loo$ ressure9 Since a!!ecte$ horses are !re#uently o(ese8 insulin
resistant an$ hyer%lycemic8 there are clearly some le%itimate oints o! comarison 6ith the
human $isease9
Si%ni!icant $i!!erences are also evi$ent8 ho6ever8 as a!!ecte$ horses usually e3hi(it normal (loo$
ressure an$ $o not consistently e3hi(it elevate$ levels o! (loo$ lii$s9 The e3tent to 6hich the
e#uine an$ human syn$romes are (iolo%ically analo%ous remains to (e seen an$ 6ill only (e
$etermine$ throu%h years o! care!ul research9 Until !urther in!ormation is availa(le to %ui$e the
rational selection o! mana%ement strate%ies8 it 6ill (e imortant to /ee an oen min$ an$ !ocus
on theraeutic measures that are truly e!!ective in the horse an$ not simly assume$ to (e
e!!ective (ase$ on e3traolation !rom the human meta(olic syn$rome9
0hat Causes E#uine Meta(olic Syn$rome1
O(esity aears to (e the central ro(lem in (oth humans an$ horses su!!erin% !rom meta(olic
syn$rome9 Althou%h (o$y !at is commonly vie6e$ as an inert su(stance that !unctions solely as a
stora%e !orm !or ener%y8 nothin% coul$ (e !arther !rom the truth9 )o$y !at 4esecially that store$
6ithin the a($omen8 liver an$ s/eletal muscle5 contains cells that are very active meta(olically
an$ hormonally8 an$ 6hen resent in e3cessive amounts their e!!ects can tri%%er a casca$e o!
meta(olic $istur(ances lea$in% to insulin resistance an$ ersistent hyer%lycemia9 These
a(normalities8 in turn8 e3ert a variety o! $eleterious e!!ects on the car$iovascular system8 cartila%e
an$ (one9 One o! these e!!ects is increase$ synthesis an$ release o! cortisol 6ithin the eriheral
tissues o! the (o$y8 6hich may account !or the re$isosition to laminitis in a!!ecte$ horses9
'ia%nosis o! Meta(olic Syn$rome
Meta(olic syn$rome is usually !irst reco%ni?e$ 6hen chronic recurrent laminitis (ecomes evi$ent
in !at horses lac/in% other !oun$er tri%%ers9 A!!ecte$ horses are o!ten %rossly o(ese8 6ith
e3cessive accumulations o! !at in the crest o! the nec/8 over the rum an$ aroun$ the tail hea$
an$ in the sheath o! male horses9 There is no sin%le test that can o!!er a $e!initive $ia%nosis o!
meta(olic syn$rome at resent8 (ut $ia%nostic tests that are hel!ul in arrivin% at a clinical
$ia%nosis inclu$e measurements o! insulin an$ %lucose in the (loo$ !ollo6in% a erio$ o! !astin%8
the intravenous %lucose tolerance test an$ tests !or e#uine Cushin%&s $isease 4e9%9 the
$e3amethasone suression test an$ lasma ACT, concentration59 It is articularly imortant to
$istin%uish cases o! meta(olic syn$rome !rom early cases o! Cushin%&s $isease8 (ecause the
latter horses can (e e3ecte$ to reson$ to theray 6ith er%oli$e 6hile the !ormer %rou
ro(a(ly 6ill not9
In o(ese horses 6ith a$vance$ meta(olic syn$rome8 !astin% concentrations o! insulin are almost
al6ays elevate$8 an$ (loo$ %lucose concentrations are !re#uently elevate$9 In less severely
a!!ecte$ cases8 the intravenous %lucose tolerance test may (e nee$e$ to $emonstrate insulin
resistance9 This test involves serial measurement o! (loo$ %lucose an$ insulin !ollo6in%
intravenous a$ministration o! a stan$ar$ $ose o! %lucose9 In normal horses8 concentrations o!
(oth insulin an$ %lucose rise initially8 (ut return to normal 6ithin one to t6o hours9 Insulin resistant
horses8 (y contrast8 sho6 %reater elevations in (oth insulin an$ %lucose8 an$ these hi%her levels
are sustaine$ !or a lon%er erio$ o! time (e!ore returnin% to (aseline values9
Treatment o! Meta(olic Syn$rome
At resent8 treatment strate%ies !or e#uine meta(olic syn$rome !ocus almost e3clusively on
reversal o! o(esity an$ insulin resistance throu%h strict $ietary mo$i!ication an$ imlementation o!
an e3ercise ro%ram8 i! ossi(le9 O! course8 horses su!!erin% active (outs o! laminitis cannot (e
e3ercise$ until !oun$er has (een (rou%ht un$er satis!actory control9
The most imortant rincile o! !ee$in% a!!ecte$ horses is strict limitation o! solu(le car(ohy$rate
in the $iet9 Nutritional re#uirements shoul$ (e met 6ith e3clusively !i(er-(ase$ !ee$stu!!s such as
%oo$ #uality %rass hayN .9; R .9:I o! (o$y6ei%ht er $ay is a use!ul %ui$eline !or the amount to
!ee$8 (ut articularly thri!ty horses may re#uire !urther restriction (e!ore si%ni!icant 6ei%ht loss is
achieve$9 Sources o! solu(le car(ohy$rate such %rain8 s6eet !ee$8 carrots8 ales an$ !resh
asture must (e eliminate$ comletely8 as even very small amounts are li/ely to sustain insulin
resistance9 I! horses must (e turne$ out onto asture8 they shoul$ (e !itte$ 6ith %ra?in% mu??les
that have (een artially or comletely tae$ to revent %rass inta/e9 I! %reater $ietary ener%y is
re#uire$ once o(esity has (een (rou%ht un$er control an$ an e3ercise ro%ram has (een
initiate$8 %rass hay shoul$ (e sulemente$ 6ith soa/e$ (eet ul an$Cor !at 4ve%eta(le oil or
rice (ran5 rather than %rain9 It is li/ely that a variety o! commercial comlete !ee$s tar%etin%
meta(olic syn$rome 6ill (ecome availa(le in the near !uture8 6hich 6ill %reatly simli!y nutritional
mana%ement o! a!!ecte$ horses an$ eliminate the nee$ !or !ee$ analysis9
I! horses !ail to reson$ to $ietary mana%ement $esite 6hat aears to (e an aroriate $iet8
analysis o! the !ora%e (y a nutritional la(oratory such as 'airyOne 4htt:CC6669$airyone9com5 is
stron%ly recommen$e$8 as the nutritional comosition an$ solu(le car(ohy$rate content o! %rass
hay varies si%ni!icantly8 $een$in% on secies8 %eo%rahy an$ environmental con$itions $urin%
%ro6th8 $ryin% an$ stora%e9 Fora%e analysis also ermits #uanti!ication o! minerals such as
calcium an$ ma%nesium8 6hich can (e use$ to %ui$e their rational sulementation9
A variety o! sulements have (een a$vocate$ in the mana%ement o! e#uine meta(olic
syn$rome8 (ut there is currently little scienti!ic evi$ence to suort or re!ute their e!!ectiveness9 As
6ith Cushin%&s $isease8 sulementation 6ith chromium icolinate an$ ma%nesium to achieve a
$ietary calcium:ma%nesium ratio o! >:. is 6i$ely recommen$e$8 an$ e#uine nutritionists also
recommen$ that $ietary levels o! calcium8 ma%nesium8 hoshorus8 coer8 ?inc8 man%anese
an$ selenium shoul$ (e at least .:;I o! the levels recommen$e$ (y the National *esearch
Council9 Analysis o! the !ora%e is re#uire$ to (alance minerals accurately in this manner9
Cinnamon has recently (een a$vocate$ as an a$Munctive therayN it e3erts some (ene!icial
e!!ects humans 6ith tye > $ia(etes an$ is unli/ely to (e harm!ul in any 6ay9 One nutritionist has
recommen$e$ a$ministration at a rate o! = ts er .;;;-l( horse er $ay9
O6ners o! a!!ecte$ horses are o!ten temte$ to $eliver sulements such as minerals8 cinnamon8
an$ other me$ications in a small amount o! %rain8 (ut this ractice is stron%ly $iscoura%e$ as it
may (e su!!icient to revent resolution o! insulin resistance9 Small amounts o! soa/e$ (eet ul
that have not (een treate$ 6ith molasses are a much (etter choice9 In humans8 e3ercise an$
$ietary control are !re#uently sulemente$ 6ith me$ications that inter!ere 6ith cortisol synthesis
an$ increase insulin sensitivity8 (ut these have not yet (een evaluate$ in e#uine $isease9
Nevertheless8 such me$ications reresent a$$itional otions !or valua(le horses that !ail to
reson$ to conservative mana%ement9
A$$itional In!ormation
Pituitary ars interme$ia $ys!unction: e#uine Cushin%&s $isease9 ,arol$ C9 Schott9 "eterinary
Clinics o! North America 4E#uine58 >;;>N volume .L: 9 >@J R>J;9
The e#uine meta(olic syn$rome: eriheral Cushin%&s syn$rome9 Phili S9 Sohnson9 "eterinary
Clinics o! North America 4E#uine58 >;;>N volume .L: 9 >J. R >K@9
Treatment o! e#uine meta(olic syn$rome9 Phili S9 Sohnson8 Eleanor Gellon9 Comen$ium on
Continuin% E$ucation !or the Practicin% "eterinarian8 >;;=N Fe(ruary >;;=: 9 .>> R .@;9
/ey6or$s: Cushin%7s 'isease8 Meta(olic syn$rome8 Cushin%7s8 meta(olic8 ituitary ro(lems9
oste$: .C:C>;;:9 2ast u$ate$: .C:C>;;:
(lister (eetle Poisonin-
$y (en2ain Es!y' D#M
Many horse o6ners !ee$ al!al!a hay to sulement their horse an$ is a very e!!icient
source o! rotein an$ calcium9
Al!al!a hay re#uires very seci!ic %ro6in% con$itions an$ is rimarily harveste$ in the 6estern
Unite$ States9 Even i! you are usin% al!al!a that has (een harveste$ months or years reviously8
your horse is still at ris/ !or (lister (eetle to3icity9
The (lister (eetle 4Eicauta5 is hi%hly to3ic to shee an$ cattle8 (ut rimarily to horses9 As little as
!our 4=5 to si3 4H5 %rams o! (lister (eetles can (e $ea$ly to an ..;; l(9 horse9 )lister (eetles
s6arm in al!al!a !iel$s an$ are $ra6n into (ales (y acci$ent9 Even small arts o! these (eetles are
to3ic to a horse9 0hole insects nee$ not (e resent to (e $an%erous9
Canthari$in is the chemical !oun$ in (lister (eetles that causes the $ama%e notice$ (y the o6ner
an$ veterinarian9 It is a contact irritant an$ a vesicant 4causes (lister !ormation59 The tissues most
o!ten a!!ecte$ (y canthari$in are %astrointestinal mucosa 4inclu$in% the mouth58 renal or (la$$er
an$ the heart muscle9 Althou%h this may seem simle enou%h8 most o! the symtoms in the early
sta%es o! oisonin% are non-seci!ic an$ $eath may occur rai$ly9 Some o! the clinical si%ns that
may occur are as !ollo6s:
En$oto3ic shoc/ an$ various $e%rees o! colic - Usually results !rom mucosal $ama%e an$ !rom
the mi%ration o! normal intestinal (acteria9
Salivation an$ anore3ia - *esults !rom vesicle 4(lister5 !ormation an$ erosions in mouth an$
ton%ue9
ETo3ic 2ineF R In$icates a urle-(lue line that !orms on the %ums aroun$ the (ase o! the incisor
teeth9 This usually in$icates some $e%ree o! en$oto3emia9
0atery !eces or (loo$y stool - From a(ra$e$ an$ $eterioratin% %astrointestinal mucosa9
Car$iac arrhythmias - Occur most o!ten !rom electrolyte a(normalities 4or hyocalcemia5 or
$ama%e to the heart muscle itsel! 4myocar$ium59
,ematuria 4(loo$y urine5 - Evi$ence o! renal $ama%e or may (e !rom ureter8 (la$$er or urethral
mucosa $ama%e9
EThumsF - This is a curious syn$rome uni#ue in the horse9 It is also calle$ synchronous
$iahra%matic !lutter9 It is seen as rhythmic contractions o! the a($ominal musculature9 It occurs
(ecause o! hyocalcemia an$ your horse may aear to have various $e%rees o! the Ehiccus9F
)loo$6or/ your veterinarian 6ill run may reveal lo6 levels o! ma%nesium 4hyoma%nesemia5 an$
calcium 4hyocalcemia59 Increase$ ac/e$ cell volume 4PC"5 an$ rotein levels in the (loo$ 6ill
in$icate $ehy$ration9 Increase$ (loo$ urea nitro%en an$ creatinine in$icate renal $ama%e an$
$ehy$ration9 'een$in% on 6hat sta%e o! the syn$rome your horse is in8 you may o(serve a
transient8 or short-live$8 hyer%lycemia9
There is no anti$ote !or canthari$in9 The only treatment your veterinarian can rovi$e is
suortive9 Intravenous !lui$s 6ith or 6ithout calcium are in$icate$ to com(at $ehy$ration9
Activate$ charcoal an$ mineral oil may (e a$ministere$ throu%h a naso%astric tu(e (y your
veterinarian to hel evacuate to3ins !rom the %astrointestinal tract an$ $elay otential a(sortion9
Dastric rotectants may $ecrease %astrointestinal $iscom!ort an$ colic9 Anti(iotics are mainly
rohylactic 4reventive59 Please as/ your veterinarian a(out this e3tremely $ea$ly $isease8
esecially i! you !ee$ al!al!a hay !rom a ne6 or un/no6n harvestin% source9 Since there are many
reresentatives o! the secies Eicauta8 your county a%ricultural a%ent may (e a(le to rovi$e
you 6ith ictures or amhlets o! oisonous (eetles in your area or !rom the %eo%rahical are
6here you urchase your al!al!a hay9
/ey6or$s: (lister (eetles8 (lister (eetle oisonin% 9
oste$: @C.:C>;;=9 2ast u$ate$: @C.:C>;;=
P3OTECT 4OU3 5O3SE F3OM EIA
$y 6ritten $y the AAEP
E#uine In!ectious Anemia 4EIA5 is a otentially !atal $isease that threatens the 6orl$&s
horse8 $on/ey an$ mule oulations9 The virus that causes EIA rero$uces in the 6hite (loo$
cells that circulate throu%hout the (o$y9 The immune system8 via anti(o$ies8 may attac/ an$
$estroy re$ (loo$ cells8 lea$in% to anemia9 In!ecte$ horses may $ie !rom the $irect e!!ects o! the
virus or !rom secon$ary in!ections9 'esite testin% an$ measures to era$icate the e#uine
in!ectious anemia virus8 EIA"8 more than :;; ne6 cases are i$enti!ie$ each year in the U9S9
There is no cure !or EIA9 Althou%h most horses sho6 no symtoms8 they remain conta%ious !or
li!e8 en$an%erin% the health o! other horses9 For this reason8 the Unite$ States 'eartment o!
A%riculture an$ state animal health re%ulatory a%encies re#uire euthanasia or strict li!elon%
#uarantine !or horses testin% ositive !or EIA9
+our horse&s only rotection a%ainst EIA is revention9 Doo$ mana%ement ractices can re$uce
the otential o! in!ection9 The !ollo6in% %ui$elines !rom the American Association o! E#uine
Practitioners 4AAEP5 6ill hel:
B Use $isosa(le nee$les an$ syrin%es8 one er horse8 6hen a$ministerin% vaccines an$
me$ications9
B Sterili?e $ental tools an$ other instruments (e!ore usin% them on another horse9
B Test all horses !or EIA at least annually9
B Test horses at the time o! urchase e3amination9
B Sta(le o6ners8 horse sho6 an$ event mana%ers shoul$ re#uire an$ veri!y current ne%ative
Co%%ins certi!icates !or all horses enterin% the remises9
B Ne6 horses shoul$ (e #uarantine$ !or =: $ays an$ o(serve$ !or any si%ns o! illness8 inclu$in%
elevate$ temeratures8 (e!ore intro$ucin% them to the her$9 They shoul$ (e reteste$ i! e3osure
to EIA is susecte$ at a =:-$ay interval9
B All sta(le areas shoul$ (e /et clean8 $ry an$ 6aste-!ree9 Doo$ asture mana%ement
techni#ues shoul$ also (e ractice$9 *emove manure an$ rovi$e a$e#uate $raina%e to
$iscoura%e (ree$in% sites !or ests9
B ,orses at %reater ris/8 such as those in !re#uent contact 6ith outsi$e horses or 6ho live or travel
in %eo%rahic re%ions /no6n !or EIA out(rea/s8 shoul$ (e teste$ more !re#uently8 every = R H
months9
For more in!ormation a(out EIA8 as/ your e#uine veterinarian !or EE#uine In!ectious Anemia: The
Only Protection is Prevention8F a (rochure rovi$e$ (y the AAEP in conMunction 6ith E$ucational
Partner )ayer Animal ,ealth9 A$$itional in!ormation can (e !oun$ on the AAEP&s horse health
0e( site8 6669my,orseMatters9com9
The American Association o! E#uine Practitioners8 hea$#uartere$ in 2e3in%ton8 Gy98 6as !oun$e$
in .K:= as a non-ro!it or%ani?ation $e$icate$ to the health an$ 6el!are o! the horse9 Currently8
AAEP reaches more than : million horse o6ners throu%h its over J8:;; mem(ers 6orl$6i$e an$
is actively involve$ in ethics issues8 ractice mana%ement8 research an$ continuin% e$ucation in
the e#uine veterinary ro!ession an$ horse in$ustry9
/ey6or$s: EIA8 E#uine In!ectious Anemia 9
oste$: .>C.KC>;;@9 2ast u$ate$: JC.JC>;;H
E5#78 Out$rea9s
$y Thoas 3% :en/' D#M' MS )source: Pu$lishe, courtesy o" The
Aerican Quater 5orse ;ournal & the Aercian Quarter
5orse 3acin- ;ournal +
Most horse o6ners /no6 that e#uine heresvirus tye . 4*hino5 causes uer resiratory
in!ection in youn% horses an$ a(ortion in re%nant mares8 (ut many ro(a(ly $on7t reali?e that it
can also cause a severe neurolo%ical $isease that a!!ects the horse7s (rain an$ sinal cor$ an$
may result in aralysis an$ $eath9 *ecently8 out(rea/s o! the neurolo%ical !orm o! E,"-. have
occurre$ at sta(les in Ohio8 Pennsylvania an$ "ir%inia as 6ell as in En%lan$9 In Ohio alone8 the
$isease a!!ecte$ 6ell over .:; horses8 resultin% in the $eath o! at least .:9
E,"-. routinely causes uer resiratory in!ection in youn% horses 46eanin%8 yearlin%s8 an$ >
year ol$s5 resultin% in $eression8 a snotty nose8 loss o! aetite8 an$ a ersistent cou%h9 I! a
num(er o! youn% horses are house$ or asture$ to%ether8 most 6ill (ecome sic/ an$ then
recover unevent!ully9 Pre%nant mares that (ecome in!ecte$ o!ten a(ort their !oals late in
%estation8 $eliver still(orn !oals or 6ea/ !oals that $ie 6ithin $ays o! (irth9 In rare instances8 a$ult
horses e3erience the resiratory !orm o! E,"-. an$ then $evelo the neurolo%ical !orm o! the
$isease9 Neurolo%ical symtoms inclu$e incoor$ination that can ro%ress to the ina(ility to stan$8
lo6er le% s6ellin%8 the ina(ility to urinate or ass manure8 urine $ri((lin%8 an$ re$uce$ tail tone9
Some o! these symtoms also occur in other neurolo%ical $iseases such as ra(ies8 EPM8 an$
0est Nile "irus in!ections8 so it is imortant that the animals (e e3amine$ (y a veterinarian as
soon as ossi(le9 )ecause E,"-. is a virus8 it $oes not reson$ to anti(iotics9 There!ore8
suortive treatment is the only otion an$ is tailore$ to the in$ivi$ual atient an$ %ui$e$ (y the
severity an$ ran%e o! clinical si%ns9 It usually inclu$es anti-in!lammatory $ru%s8 !lui$s to maintain
hy$ration8 an$ slin%in% o! horses that are una(le to stan$9 In most cases8 horses that remain
stan$in% have a %oo$ ro%nosis8 althou%h recovery may ta/e 6ee/s or months9 ,orses that %o
$o6n an$ are una(le to stan$ have a oor ro%nosis9
E,"-. is srea$ rimarily throu%h cou%hin% or snee?in%8 (ut can also (e carrie$ in !etal tissues8
the lacenta an$ uterine !lui$s !rom mares that have a(orte$9 Stu$ies have sho6n that the virus
$oesn7t live lon% in the environment8 (ut transmission via cou%hin% or snee?in% can occur over a
$istance o! u to @: !eet9 'irect contact 6ith in!ecte$ horses as 6ell as contaminate$ !ee$8
e#uiment8 clothin%8 an$ tac/ can also srea$ the $isease9 The %oo$ ne6s is that the virus is
easily /ille$ (y $isin!ectants9 0hen treatin% an area 6here the $isease has occurre$8 remove all
or%anic material such as manure an$ $irt9 Then $isin!ect all sur!aces an$ e#uiment 6ith a
solution o! . art (leach 4so$ium hyochlorite5 an$ .; arts 6ater9 Ma/e sure you 6ear ru((er
%loves 6hen han$lin% the $isin!ectant9 'on7t !or%et to 6ash an$ $isin!ect any trailer that has (een
use$ to transort sic/ animals9
0ithout a $ou(t8 the (i%%est ro(lem 6ith E,"-. is that once horses have (een in!ecte$ they can
(ecome latent carriers o! the virus !or the rest o! their li!e9 Althou%h latently in!ecte$ horses are no
lon%er sic/ or she$$in% the virus8 they carry the virus an$ can sontaneously (e%in she$$in% it
$urin% erio$s o! stress9 The intermittent she$$in% (y carrier horses is thou%ht to (e the source o!
sora$ic out(rea/s o! the $isease8 inclu$in% close$ her$s 6here no ne6 horses have (een
intro$uce$9
Elimination o! E,"-. !rom a her$ is virtually imossi(le (ecause o! the resence o! latently
in!ecte$ animals9 ,o6ever8 a %oo$ strate%y to re$uce the inci$ence o! E,"-. is the com(ination
o! a %oo$ vaccination ro%ram in conMunction 6ith the imlementation o! an e!!ective reventive
her$-mana%ement ro%ram9 "accination sche$ules vary (ase$ on the re%ion o! the country8 the
a%e o! the animals8 an$ the tye o! 6or/ they $o !or a livin%8 so visit 6ith your local e#uine
veterinarian to %et their recommen$ations !or your seci!ic horses9 In a$$ition to an a%%ressive
vaccination ro%ram8 ne6 arrivals8 sic/ horses8 an$ horses returnin% !rom sho6s or other horses
!acilitates shoul$ (e isolate$ !or at lease J $ays9 I! horses at the sho6 6ere sic/ or there 6as a
con!irme$ E,"-. out(rea/8 isolate the horses !or >. $ays9 'isin!ect all areas o! the (arn in 6hich
a susect or sic/ horse has (een house$ or 6or/e$9 I! an out(rea/ o! the $isease occurs in your
area8 encoura%e (arn ersonnel an$ ri$ers to 6ear leather or ru((er (oots that can (e $isin!ecte$
in a $isin!ectant tu( at the entrance o! the (arn9 Se%re%ate horses into the smallest ossi(le
%rous9 2ar%e %rous o! horses sharin% a common airsace can all (e in!lecte$ (y one horse
she$$in% the virus9 An$ !inally8 i! you susect that your horses have (een e3ose$ to E,"-. or
e#uine in!luen?a virus8 ta/e rectal temeratures $aily 4normal a$ult (o$y temerature is .;;9:TF59
I! any horse7s temerature is elevate$8 consult your veterinarian imme$iately9
/ey6or$s: E,"-.8 neurolo%ical8 $iseases8 heres virus8 heres8 resiratory $isease 9
oste$: HC.JC>;;@9 2ast u$ate$: JC.;C>;;@
6hat.s The 5y!e Over 54PP<
$y Dr% Sharon S!ier an, The Aerican Association o" E*uine
Practitioners
E,+PPF has (een the (u??6or$ aroun$ certain sho6 circuit circles since .KK>9 It has ma$e
some horsemen turn 6hite8 some others turn re$ an$ still others shru% their shoul$ers9 0hat is
the (i% $eal a(out this $isease1
The American Association o! E#uine Practitioners an$ 'r9 Sharon Sier !rom the University o!
Cali!ornia at 'avis have colla(orate$ to reson$ to many unans6ere$ #uestions a(out ,+PP9
Thou%h still many #uestions 6ill remain unans6ere$ simly (ecause o! the $isease&s youth8
e$ucation a(out ,+PP can re$uce its srea$ an$ severity9
0hat is the cause1
,yer/alemic erio$ic aralysis 4,+PP5 is an inherite$ $isease o! the muscle8 6hich is cause$ (y
a %enetic $e!ect9 In the muscle o! a!!ecte$ horses8 a oint mutation e3ists in the so$ium channel
%ene an$ is asse$ on to o!!srin%9
So$ium channels are EoresF in the muscle cell mem(rane 6hich control contraction o! the
muscle !i(ers9 0hen the $e!ective so$ium channel %ene is resent8 the channel (ecomes Elea/yF
an$ ma/es the muscle overly e3cita(le an$ contract involuntarily9 The channel (ecome Elea/yF
6hen otassium levels !luctuate in the (loo$9 This may occur 6ith !astin% !ollo6e$ (y
consumtion o! a hi%h otassium !ee$ such as al!al!a9 ,yer/alemia8 6hich is an e3cessive
amount o! otassium in the (loo$8 causes the muscles in the horse to contract more rea$ily than
normal9 This ma/es the horse susceti(le to sora$ic eiso$es o! muscle tremors or aralysis9
This %enetic $e!ect has (een i$enti!ie$ in o!!srin% o! the American Quarter ,orse sire8
Imressive9 To $ate8 con!irme$ cases o! ,+PP have (een restricte$ to $escen$ants o! this horse9
,o6 is it srea$1
,+PP is an autosomal $ominant %enetic trait8 6hich means only one coy o! the %ene is re#uire$
to ro$uce the $isease8 an$ that the $isease can e#ually occur in (oth se3es 4mare8 %el$in% an$
stallion59
To eluci$ate8 suose a mare has teste$ E,+PP ,CN9F This means she is hetero?y%ous8 or carries
one coy o! the ,+PP %ene9 )ree$in% her to a normal sire8 or ,+PP NCN8 6ill result in a :;
ercent chance the o!!srin% 6ill carry the ,+PP %ene 4,+PP ,CN5 an$ a :; ercent chance o!
the !oal (ein% normal9 )ree$in% her to a hetero?y%ous sire8 or ,+PP ,CN8 6ill cause only a >:
ercent chance o! the o!!srin% (ein% normal 4,+PP NCN58 a :; ercent chance o! the o!!srin% to
carry the %ene 4,+PP ,CN5 an$ >: ercent chance o! the o!!srin% to (e homo?y%ous 4,+PP
,C,8 or carry (oth coies o! the ,+PP %ene59
A carrier o! the $e!ect 4,+PP ,CN5 is a!!ecte$ 6ith ,+PP9 These horses can sho6 clinical si%ns o!
the $isease an$ can ass the %ene on to their o!!srin%9 Thou%h horses8 6hich are homo?y%ous8
sho6 more clinical symtoms8 hetero?y%otes also o(tain the $isease (ecause it is a $ominant
trait9
Are there any si%ns1
'ia%nosis o! ,+PP can (e very $i!!icult (ase$ on o(servance o! the horse9 There are many
$i!!erent symtoms8 6hich can mimic other $iseases such as Etyin%-uF or colic9 Classic si%ns
inclu$e erio$ic attac/s o! muscle sasms8 tremors8 6ea/ness8 s6eatin% an$ recum(ency9
'urin% any attac/8 the horse may have rai$8 la(ore$ or $i!!icult (reathin%9 ,omo?y%otes 6ill
have noisy (reathin% $ue to aralysis o! the muscles in the throat9
Furthermore8 severity o! clinical si%ns an$ !re#uency o! eiso$es vary amon% horses even thou%h
they ossess the same %enetic $e!ect9 The $uration o! clinical si%ns also varies 6ith eiso$es o!
muscle tremors or aralysis lastin% only minutes to three hours or more9
EThe classi!ication o! severity o! clinical si%ns an$ !re#uency o! eiso$es is $i!!icult8F 'r9 Sharon
Siers states8 E(ecause horses may e3erience sasms that are not 6itnesse$9F
In !act8 some ,+PP-a!!ecte$ horses may sho6 no si%ns at all9 Most horses aear clinically
normal the maMority o! the time9 This ma/es the $isease even more $i!!icult to $etect9
So ho6 can you tell i! your horse has ,+PP1
EIn or$er to veri!y that a horse has ,+PP8F 'r Sier states8 Ea 'NA test on hair roots must (e
er!orme$ (y a license$ la(oratory such as the "eterinary Denetics 2a(oratory at the University
o! Cali!ornia8 'avis9F
,o6 common is ,+PP1
Another stu$y (y 'r9 Sier $etermine$ the !re#uency o! ,+PP in the horse oulation9 The stu$y
!oun$ that the %ene is not (ein% $ilute$ in su(se#uent %enerations9 Instea$8 it is asse$ on 6ith
hi%h !re#uency9
In still another stu$y to $etermine the %ene !re#uency8 .8;;; horses 6ere chosen at ran$om (y
the University o! Cali!ornia at 'avis to test !or ,+PP9 The $ata conclu$e$ that the ,+PP %ene is
in!re#uent amon% American Quarter ,orses8 yet is su(stantially lin/e$ to e$i%rees tracin% (ac/
to a common sire9
EIt is hoe!ul that ,+PP 6ill $ecrease amon% (ree$in% stoc/ $urin% the ne3t $eca$e8F 'r9 Sier
states8 Eas lon% as (ree$ers continue to select stoc/ !ree !rom the %ene9F
0hat a(out testin%1
All o!!srin% o! Imressive shoul$ (e teste$ !or ,+PP9 ,orses 6ith susicious symtoms o! the
$isease shoul$ also (e teste$9
Testin% can (e er!orme$ (y contactin% a veterinarian9 Can mana%ement in$uce or re$uce an
,+PP attac/1
Environmental !actors can actually cause an attac/ o! muscle 6ea/ness9 O6ners o! ,+PP-
ositive horses shoul$ (e a6are that e3ternal stimulus an$ events coul$ increase the chance o!
aralysis onset9 These !actors inclu$e $ietary chan%es8 !astin%8 %eneral anesthesia8 an$
concurrent illness an$ e3ercise restriction9
EMana%ement !actors remain an imortant cause o! symtoms8F 'r9 Sier states9 EO6ners o!
a!!ecte$ horses shoul$ (e a6are o! the ossi(le reciitatin% !actors an$ (e a(le to treat or
mana%e the symtoms9
'ietary mana%ement is e3tremely imortant in the mana%ement o! a!!ecte$ horses9 'ietary
a$Mustments inclu$e 4.5 avoi$in% hi%h otassium !ee$s such as al!al!a hay8 (rome hay8 canola oil8
soy(ean meal or oil8 an$ su%ar molasses an$ (eet molasses8 an$ relacin% them 6ith timothy or
)ermu$a %rass hay8 %rains such as oats8 corn8 6heat an$ (arley8 an$ (eet ulN 4>5 !ee$in%
several times a $ayN an$ 4@5 e3ercisin% re%ularly an$Cor (ein% allo6e$ !re#uent access to a lar%e
a$$oc/ or yar$9 Geein% the horse on asture 6or/s 6ell (ecause $ue to the hi%h 6ater content
o! asture %rass8 the horse is unli/ely to consume lar%e amounts o! otassium in a short erio$ o!
time9 I! the horse is e3eriencin% ro(lems on its resent $iet8 it is recommen$e$ to !ee$ a $iet
containin% (et6een ;9HI an$ .9:I total otassium concentration9 As there is a 6i$e variation in
otassium concentration o! !ora%es $een$in% on maturity an$ soils8 it is a$visa(le to have !ee$s
analy?e$ !or otassium concentrations an$ other nutrient re#uirements9 Comlete !ee$s lo6 in
Potassium are commercially availa(le9 Alternatively8 $iets can (e !ormulate$ such as the
!ollo6in%8 6hich 6ill result in total GU content o! aro3imately .I:
=9:= /% o! late (loom timothy or similar lo6 GU %rass hay
>9>J /% o! shre$$e$8 soa/e$ (eet ul 46ithout molasses5
>9>J /% oats8 $ivi$e$ into small !re#uent !ee$in%s9
Several $ru%s have (een use$ !or revention o! clinical eiso$es o! aralysis9 ,orses have (een
treate$ 6ith either aceta?olami$e 4>-= m%C/% orally8 every L to .> hours5 or hy$rochlorthia?i$e
4;9:-. m%C/% orally8 every .> hours5 6ith aarent success9 These a%ents e3ert their e!!ects
throu%h $i!!erent mechanismsN ho6ever8 (oth cause increase$ renal otassium ATPase activity9
Aceta?olami$e has (een sho6n to sta(ili?e (loo$ %lucose an$ otassium (y stimulatin% insulin
secretion9 )ree$ re%istries have restrictions on the use o! these $ru%s $urin% cometitions 4some
re#uire a veterinary certi!icate59
Maintain a re%ular !ee$in% an$ e3ercise sche$ule an$ avoi$ !astin% or 6ater $erivation9 These
horses $o (etter i! allo6e$ access to a a$$oc/ or asture rather than strict stall con!inement9
'aily or ni%htly turnout is also hel!ul9 Avoi$ rai$ chan%es in the $iet9
Fee$s that contain (eet ul 46ithout molasses5 have lo6er otassium than !ora%es9 For horses
e3eriencin% ro(lems8 an analysis o! the !ee$in% ration shoul$ (e er!orme$ (y your
veterinarian !or a selecte$ $iet lo6er in otassium 4V.9:I59 The $ietary re#uirement !or horses !or
otassium is ;9HI9 Many %rains are very lo6 in otassium 4;9:I58 (ut molasses is very hi%h in
otassium 4W@I5 an$ shoul$ (e avoi$e$9 Access to a salt or mineral (loc/ is also imortant9
In!orm your veterinarian o! the ,+PP con$ition rior to any %eneral anesthesia8 as this may
reciitate an eiso$e o! aralysis9 I! your horse is receivin% me$ication8 maintain him or her on
theray (e!ore an$ a!ter sur%ery or anesthesia9 Use common sense 6hile haulin% an$ (e sure to
sto an$ 6ater horses !re#uently 4every t6o hours59
EMany horses 6ith this trait are asymtomatic an$ have very success!ul careers8F 'r9 Sier
comments9 EMost horses can (e easily mana%e$ 6ith %oo$ care an$ can still (rin% %reat leasure
to their o6ners9 Put this con$ition into ersective 6ith re%ar$ to many other con$itions horses
can have9F
Shoul$ an ,+PP-ositive horse (e ri$$en1
Accor$in% to 'r9 Sier&s stu$ies8 the chance o! a aralysis eiso$e occurrin% 6hile the horse is
(ein% ri$$en is unli/ely9 ,o6ever8 muscle sasms are unre$icta(le an$ can occur 6ith only
sli%ht symtoms9 There!ore8 it is recommen$e$ that only e3erience$ horsemen 4those a6are o!
symtoms an$ !amiliar 6ith the horse&s (ehavior5 han$le an$ ri$e a!!ecte$ horses9 A!!ecte$
horses are not suita(le !or youn% ri$ers9 Contact a veterinarian imme$iately i! any a(normal
clinical si%ns are o(serve$9
0hat i! my horse %oes into a mil$ ,+PP eiso$e1
'r Sier recommen$s the !ollo6in% roce$ure !or mil$ eiso$es o! an ,+PP attac/ 4muscle
tremors8 (ut the horse is not $o6n5
B Contact your veterinarian imme$iately9
B E3ercise the horse 46al/in% or lon%ein%59 Use caution as the horse coul$ stum(le an$
!all9
B E3ercise stimulates a$renaline8 6hich hels re$uce otassium insi$e cells9
B Fee$ $ry %rain 4oats8 or corn-oats-(arley8 or you may use li%ht Garo syru !or a %lucose
sulement59 Fee$in% car(ohy$rates sulies %lucose8 6hich stimulates the release o!
insulin8 6hich romotes otassium uta/e in cells9
In SE"E*E cases8 a veterinarian may a$minister intravenous calcium %luconate 4;9> to ;9= mlC/%
o! a >@I solution $ilute$ in . liter o! :I $e3trose58 6hich usually rovi$es imme$iate
imrovement9 An increase in e3tra cellular calcium concentration raises the muscle mem(rane
threshol$ otential8 6hich $ecreases mem(rane hyere3cita(ility9 To re$uce the serum
otassium8 intravenous $e3trose 4H mlC/% o! a :I solution5 alone or com(ine$ 6ith so$ium
(icar(onate 4. to > mE#C/%5 can (e use$ to enhance intracellular movement o! otassium9 0ith
severe resiratory o(struction8 a tracheotomy may (e necessary9 For severe cases 6ith
rolon%e$ recum(ency 4WL hours58 6hich can lea$ to ischemic rha($omyolysis8 the use o! slin%s
has resulte$ in success!ul recovery9
0hat is the ro%nosis !or ,+PP-ositive horses1
The ro%nosis !or li!e !or hetero?y%ous a!!ecte$ horses 4NC,5 is %oo$8 althou%h recurrent (outs o!
the $isor$er may occur9 The !ee$in% o! $iets lo6 in otassium an$ maintenance theray 6ith
$iuretics may ai$ in ma/in% lon%-term maintenance more severely a!!ecte$ horses9 ,omo?y%ous
a!!ecte$ horses 4,C,5 have a oorer ro%nosis !or normal li!e an$ can (e $i!!icult to mana%e9
Consi$erin% the autosomal-$ominant transmission o! this $isor$er8 o6ners o! a!!ecte$ horses
shoul$ (e stron%ly $iscoura%e$ !rom (ree$in% these animals !or the lon%-term health o! the
Quarter ,orse an$ other relate$ (ree$s9 O6ners o! a!!ecte$ horses shoul$ use caution 6hen
han$lin% or ri$in% a!!ecte$ horses an$ (e a6are o! the clinical symtoms o! this $isease9
)io%rahical in!ormation: 'r9 Sharon Sier is an associate ro!essor in the 'eartment o!
Me$icine an$ Ei$emiolo%y at the University o! Cali!ornia at 'avis9 She is the Chie! o! Service in
the E#uine Fiel$ Service9 ,er clinical interests are in %eneral ractice8 internal me$icine $isor$ers
inclu$in% $iseases o! muscle an$ %astrointestinal $isor$ers9 'r9 Sier is the reciient o! the A"MA
Council on *esearch A6ar$ in .KK= !or e3cellence in e#uine research9 She has (een involve$
6ith research on hyer/alemic erio$ic aralysis in horses since .KL:9
/ey6or$s: ,+PP8 hyer/alemic erio$ic aralysis9
oste$: @C.@C>;;@9 2ast u$ate$: @C.@C>;;@
#esicular Stoatitis In 5orses
"esicular Stomatitis 4"S5 is a conta%ious $isease that a!!licts horses8 livestoc/8 6il$li!e an$
even humans9 The $isease is cause$ (y a virus 6hich althou%h rarely li!e threatenin%8 can have
si%ni!icant !inancial imact on the horse in$ustry9 "esicular Stomatitis is a reorta(le $iseaseN in a
susect case8 state an$ !e$eral animal health authorities 6ill (e contacte$ (y your veterinarian9
0hen a case o! vesicular stomatitis is con!irme$8 your state veterinarian&s o!!ice 6ill #uarantine
the a!!ecte$ !arm or ranch9 In an e!!ort to minimi?e ris/ o! srea$ o! the $isease8 horses 6ill (e
con!ine$ to that location !or a seci!ie$ erio$8 usually !or @; $ays !ollo6in% resolution o! the last
case on that roerty9 E#uestrian event or%ani?ers may also choose to cancel horse sho6s8
ro$eos8 an$ other e#uestrian activities in the surroun$in% area9 Imorts an$ e3orts o! horses
may also (e restricte$9
Clinical Si%ns & 'ia%nosis
0hen vesicular stomatitis occurs in horses8 (lister-li/e lesions $evelo on the ton%ue8 mouth
linin%8 nose an$ lis9 In some cases8 lesions also $evelo on the coronary (an$s8 or on the u$$er
or sheath9 0hen "S is susecte$8 an e3act $ia%nosis shoul$ (e o(taine$ (y testin% the (loo$ !or
virus-seci!ic anti(o$ies9 Testin% is necessary to rule out the ossi(ility that the lesions are
cause$ (y hotosensitivity 4sun(urn58 irritatin% !ee$s or 6ee$s8 or to3icity !rom non-steroi$al anti-
in!lammatory me$ications li/e henyl(uta?one9 "S shoul$ not (e con!use$ 6ith !oot an$ mouth
$isease 6hich $oes not a!!ect horses8 an$ 6hich 6as era$icate$ !rom the U9S9A9 in .K>K9
The incu(ation erio$ !or vesicular stomatitis R meanin% the time !rom e3osure until the !irst
si%ns aear R ran%es !rom t6o to ei%ht $ays9
A !ever may $evelo initially as (listers !orm on the ton%ue8 %ums8 or coronary (an$s9 One o! the
most o(vious clinical si%ns is $roolin% or !rothin% at the mouth9 This occurs !ollo6in% ruture o!
the (listers that create ain!ul ulcers in the mouth9 The sur!ace o! the ton%ue may slou%h9
E3cessive salivation is o!ten mista/en as a result o! a $ental ro(lem Must as a horse that is not
eatin% 6ell may (e susecte$ as havin% colic9 0ei%ht loss may (e a secon$ary e!!ect8 as a horse
6ith mouth ulcers !in$s it too ain!ul to eat9
I! lesions !orm aroun$ the coronary (an$8 in!lammation 6ithin the !oot may result in lameness or
laminitis9 In severe 4(ut rare5 cases8 the lesions on the coronary (an$ may cause the hoo! to
slou%h9
The $isease %enerally runs its course 6ithin t6o 6ee/s8 althou%h it may ta/e as lon% as t6o
months !or the sores to entirely heal9 Until the ulcers are comletely heale$8 the horse remains
in!ective an$ the otential remains !or $isease to srea$9
Treatment
0hile a horse is su!!erin% !rom vesicular stomatitis8 !ee$in% so!t !ee$s may re$uce mouth
$iscom!ort9 Anti-in!lammatory me$ications as suortive care hel to minimi?e s6ellin% an$ ain
so a horse 6ill continue to eat an$ $rin/9 Secon$ary (acterial in!ection o! ulcerate$ areas is
another concern9 I! !ever8 s6ellin%8 in!lammation or us $evelos aroun$ the sores8 treatment 6ith
anti(iotics may (e re#uire$9 ,o6ever8 there is little an o6ner or veterinarian can $o (ut 6ait !or
healin% to occur an$ ta/e aroriate recautions to minimi?e the ris/ o! srea$ o! the $isease to
other horses an$ livestoc/9
'isease Transmission
There are still many #uestions re%ar$in% ho6 vesicular stomatitis is transmitte$9 The $isease is
$istri(ute$ only in North an$ South America8 6ith a %reater inci$ence in 6armer re%ions9
'ue to the seasonal occurrence o! "S $urin% summer throu%h early !all8 it is (elieve$ that insects
such as (itin% !lies an$ %nats transmit the virus9 Sta(le an$ house!lies are other ossi(le (ut
unli/ely vectors9 "S also seems to (e asse$ !rom horse to horse (y contact 6ith saliva or !lui$
!rom ruture$ (listers9 Physical contact (et6een animals8 or contact 6ith (uc/ets8 e#uiment8
housin%8 trailers8 !ee$8 (e$$in% or other items use$ (y an in!ecte$ horse can rovi$e a rea$y
means o! srea$9
Prevention
)y o(servin% the !ollo6in% %ui$elines you can hel revent the occurrence o! "S:
B ,ealthy horses are more $isease resistant so rovi$e %oo$ nutrition8 re%ular e3ercise8
$e6ormin% an$ routine vaccinations9
B Isolate ne6 horses !or at least >. $ays (e!ore intro$ucin% them into the her$ or sta(le9
B O(serve your horse closely9 Imme$iately isolate any horse that sho6s si%ns o! in!ection9
B Imlement an e!!ective insect control ro%ram9 Gee sta(lin% areas clean an$ $ry9 *emove
6aste an$ eliminate otential (ree$in% %roun$s 4stan$in% 6ater8 mu$$y areas5 !or insect vectors9
B Use in$ivi$ual rather than communal !ee$ers an$ e#uiment9
B Clean an$ $isin!ect !ee$ (un/s8 6aterers8 horse trailers an$ other e#uiment re%ularly9
B )e sure that your !arrier an$ other e#uine ro!essionals 6ho come into $irect contact 6ith your
animals e3ercise $ue care so as not to srea$ the $isease !rom one horse or !acility to the ne3t9
B On !arms 6here "S has (een con!irme$8 han$le healthy animals !irst8 ill animals last9 ,an$lers
shoul$ then sho6er8 chan%e clothin% an$ $isin!ect e#uiment to revent e3osin% others9
B Anyone han$lin% in!ecte$ horses shoul$ imlement roer (iosa!ety metho$s8 inclu$in% 6earin%
late3 %loves9
B I! you are sonsorin% an event $urin% an out(rea/8 re#uire a current health certi!icate on every
horse enterin% the venue9
"esicular Stomatitis In ,umans
,umans can contract vesicular stomatitis !rom in!ecte$ horses9 There!ore8 it is imortant to !ollo6
roer (iosa!ety measures9 Precautions shoul$ inclu$e 6earin% late3 %loves an$ avoi$in% $irect
contact 6ith the horse&s saliva or (lister !lui$s9 Secial care shoul$ (e ta/en to /ee mouth8 eyes
an$ any oen 6oun$s !rom (ein% e3ose$ to in!ection9
"esicular stomatitis in humans ten$s to cause severe !lu-li/e symtoms such as hea$ache8 !ever8
muscle aches8 an$ e3treme !ati%ue9 Peole rarely $evelo (listers in their mouths9 ,o6ever8 i!
you e3erience in!luen?a-li/e symtoms a!ter 6or/in% 6ith a "S in!ecte$ horse8 contact your
hysician imme$iately9
"accines An$ 'isin!ectants
"accines have (een $eveloe$ to hel com(at vesicular stomatitis9 ,o6ever8 there is
consi$era(le $e(ate over their e!!icacy in reventin% or re$ucin% the severity o! an out(rea/9 The
erio$ o! rotection is thou%ht to (e !airly limite$ an$ once vaccinate$8 a horse 6ill test ositive
there(y incurrin% travel restrictions9 "S may recur once the anti(o$ies 6ithin the horse&s system
6ane9 Contact your state veterinarian !or in!ormation on the availa(ility o! vaccines an$ any
ermits that may (e re#uire$9
Sunli%ht an$ heat are /no6n to #uic/ly $estroy the virus that causes vesicular stomatitis9
Commercial $isin!ectants such as chlorine (leach 4;9H=:I58 0esco$yne 4= I58 *occal 4.:>;;58
Setisol 4.::;58 an$ cresylic aci$s 4. I5 are also e!!ective9
0or/in% 0ith +our "eterinarian
)y 6or/in% closely 6ith your e#uine veterinarian8 you can $evelo strate%ies to re$uce the
li/elihoo$ o! a vesicular stomatitis out(rea/8 or to minimi?e the e!!ects shoul$ one occur9
"eterinarians an$ o6ners 6ho susect that an animal has vesicular stomatitis shoul$ imme$iately
contact state or !e$eral animal health authorities9
For more in!ormation8 contact: US'A8 AP,IS8 "eterinary Services8 Emer%ency Pro%rams8 =J;;
*iver *oa$8 Unit =.8 *iver$ale8 M' >;J@J-.>@.8 4@;.5 J@=-L;J@9
This in!ormation is rovi$e$ courtesy o! the American Association o! E#uine Practitioners8 =;J:
Iron 0or/s Par/6ay8 2e3in%ton8 G+ =;:..8 4L:K5 >@@-;.=J9
oste$: JC>=C>;;>9 2ast u$ate$: JC>=C>;;>
#esicular stoatitis
$y Eli/a$eth Mu"or,' D#M an, ;osie Trau$7Dar-at/' D#M' MS
'een$in% on 6hat re%ion o! the Unite$ States you live in8 vesicular stomatitis 4"S5 may or
may not (e in your voca(ulary o! e#uine me$ical terms9 I! you live east o! the Mississii8 you
may never have hear$ o! the $isease unless you have recently shie$ a horse to or !rom the
6estern states9 I! you live in areas o! the 6estern USA8 ho6ever8 you have li/ely (ecome !amiliar
6ith "S as a result o! the out(rea/s that occurre$ in .KK:8 .KKJ8 an$ .KKL9
"esicular stomatitis is an in!ectious viral $isease that causes sora$ic out(rea/s in horses an$
cattle in the USA8 esecially in the South6est an$ *oc/y Mountains9 It occurs every year in
livestoc/ in areas o! Me3ico8 Central America8 an$ South America9 The $isease has also (een
reorte$ in s6ine8 an$ one llama 6as $etermine$ to (e "S-ositive in the .KK: out(rea/9 There
are at least t6o "S virus serotyes8 In$iana an$ Ne6 Sersey8 that cause out(rea/s o! $isease in
livestoc/ in the 6estern USA9
Clinical course o! the $isease
In horses8 in!ection 6ith "S viruses commonly causes vesicles 4(listers5 or ulcers in the mouth or
nose8 6hich may (e seen as $roolin%8 s6ellin% an$Cor crustin% o! the mu??le8 an$ un6illin%ness
to $rin/ or eat9 Si%ns o! the $isease last !or J to .; $ays9 "esicles or ulcers may also (e seen on
the coronary (an$4s58 mammary %lan$s8 reuce8 or vulva9 ,orses 6ith "S 6ill o!ten lose (o$y
6ei%ht8 (ut re%ain the 6ei%ht rea$ily a!ter the oral lesions heal9 Clinical si%ns have (een reorte$
to occur @ to .= $ays a!ter e3osure to an a!!ecte$ animal9 Any livestoc/ 6ith vesicles or other
si%ns o! "S shoul$ (e romtly e3amine$ (y a veterinarian9
Some o6ners reort that in!ecte$ horses are simly $eresse$ or Ao!!A not su(Mectin% horses to
un$ue stress all contri(ute to maintainin% horses in %oo$ %eneral health9 +our veterinarian can
hel you $evelo a health maintenance lan to /ee your horses healthy9
Chan%in% or $isin!ectin% clothes an$ (oots an$ 6ashin% your han$s a!ter 6or/in% 6ith in!ecte$
animals9
'isin!ectin% areas an$ e#uiment 4inclu$in% !ee$ers an$ 6aterers5 use$ (y a!!ecte$ animals
(e!ore intro$ucin% non-in!ecte$ animals9
Some reorts su%%est that insects may lay a role in transmittin% "S viruses amon% horses9
Althou%h insect transmission has not (een roven in the !iel$8 minimi?in% insect contact 6ith
livestoc/ may hel revent the srea$ o! "S viruses9 Mana%ement ractices aime$ at re$ucin%
insect contact 6ith horses inclu$e sta(lin% horses $urin% erio$s o! increase$ insect activity8
usin% insect reellents on horses8 controllin% insects in areas 6here horses are house$ 4usin%
insectici$es8 screens8 (u%-?aers8 insect tras8 etc958 an$ movin% animals !rom astures
containin% 6ater6ays $urin% the summer months9
Peole 6ho 6or/ closely 6ith in!ecte$ animals have (een reorte$ to $evelo si%ns o! "S
inclu$in% aches8 ains8 an$ !ever9 In rare cases8 eole in!ecte$ 6ith "S viruses may $evelo oral
vesicles9 I! any o! these si%ns $evelo8 contact your hysician romtly !or $ia%nosis an$
treatment9 0earin% $isosa(le %loves an$ 6ashin% han$s thorou%hly 6ith soa an$ 6arm 6ater
a!ter han$lin% animals 6ith si%ns o! "S can re$uce the ris/ o! (ecomin% in!ecte$9
A sa!e8 e!!ective vaccine a%ainst "S is not currently availa(le in the USA9 A vaccine 6as
$eveloe$ an$ use$ $urin% the "S out(rea/ in .KK:8 (ut its e!!ectiveness at reventin% clinical
"S 6as not roven in the !iel$9 Several research %rous are currently 6or/in% on $eveloin% ne6
vaccines !or %eneral use9
*e%ulation o! the $isease
Out(rea/s o! "S have cause$ si%ni!icant economic har$shis !or horse o6ners $ue to the
man$atory restrictions imose$ on livestoc/ travel at the local8 state8 national8 an$ international
levels9 The re%ulations an$ restrictions result8 in art8 !rom the relative lac/ o! research-(ase$
in!ormation a(out the $isease9
The $isease is hi%hly re%ulate$ rimarily (ecause the clinical si%ns o! "S are in$istin%uisha(le
!rom the clinical si%ns o! !oot an$ mouth $isease 4FM'59 Foot an$ mouth $isease a!!ects cattle
an$ s6ine8 an$ has (een comletely era$icate$ !rom the USA an$ !rom many other countries
aroun$ the 6orl$9 )ecause FM' is a $evastatin% $isease that is strictly re%ulate$ 6orl$6i$e8
most countries $o not 6ant to ris/ the economic conse#uences o! intro$ucin% any $isease that
clinically resem(les it9
There!ore8 in or$er to maintain %oo$ tra$e relations 6ith the Euroean Union8 *ussia8 Eastern
Euroe8 China8 Saan8 Cana$a8 an$ others8 the USA intensely monitors an$ attemts to control
"S nationally9 Consi$erin% the active lea$ershi role o! the USA in the North American Free Tra$e
A%reement 4NAFTA5 an$ 0orl$ Tra$e Or%ani?ation 40TO58 any restrictions in tra$e 6ithin North
America or 6orl$6i$e resultin% !rom a !ailure to a$e#uately re%ulate "S 6oul$ have $evastatin%
e!!ects on the e#uine an$ cattle in$ustries9
0ithin the USA8 many una!!ecte$ states imose livestoc/ entry restrictions $urin% "S out(rea/s9
The ina(ility to shi horses into these states 4or the cost o! testin% each horse to con!irm that it is
!ree o! "S (e!ore shiment5 can cause horse o6ners 6ho re%ularly sen$ animals to these states
!or (ree$in%8 sho6in%8 racin%8 or sale to lose su(stantial revenue9
"esicular stomatitis is currently classi!ie$ (y the O!!ice Internationale $es Ei?ooties 4OIEN the
international authority !or monitorin% $iseases o! $omestic animals5 as a A2ist AA $isease8 alon%
6ith $iseases such as FM' an$ (ovine son%i!orm encehaloathy 4ma$ co6 $isease59
Accor$in% to the rules o! the OIE8 the Unite$ States 'eartment o! A%riculture: Animal an$ Plant
,ealth Insection Services 4US'A:AP,IS5 must reort all con!irme$ cases o! "S 6ithin >= hours9
In$ivi$ual veterinarians i$enti!yin% horses 6ith clinical si%ns o! "S are re#uire$ to noti!y their
State "eterinarian or US'A:AP,IS:"eterinary Services imme$iately9 Susect horses are then
insecte$ (y a veterinarian !rom US'A:AP,IS:"eterinary Services9 At this time8 a (loo$ samle
an$ an oral s6a( are collecte$ !rom each susect animal8 an$ the remises is imme$iately
#uarantine$ en$in% la(oratory con!irmation o! the $isease 4%enerally =L hours59 Premises that
have con!irme$ "S-ositive horses then remain #uarantine$ !or @; $ays a!ter clinical si%ns have
(een cleare$ !rom all livestoc/ on the remises9
In .KK:8 remises in =. states 6ere investi%ate$ !or susect "S in livestoc/9 ,orses an$Cor cattle
on @HJ remises in Ne6 Me3ico8 Colora$o8 Utah8 Ari?ona8 0yomin%8 an$ Te3as 6ere $etermine$
to (e "S-ositive9 No animals 6ere $etermine$ to (e "S-ositive in .KKH8 (ut in .KKJ another
out(rea/ o! "S occurre$8 resultin% in remises investi%ations in =; states9 'urin% .KKJ8 horses
an$ cattle on @L; remises in Ari?ona8 Colora$o8 Ne6 Me3ico8 an$ Utah 6ere $etermine$ to (e
"S-ositive9 As o! Au%ust >.8 .KKL8 horses an$ cattle on :J remises in Ari?ona8 Colora$o8 Ne6
Me3ico8 an$ Te3as 6ere $etermine$ to (e "S-ositive9
Current stu$ies
Currently8 researchers !rom Colora$o State University Colle%e o! "eterinary Me$icine an$
)iome$ical Sciences 4CSU-C"M)S5 in conMunction 6ith the Colora$o 'eartment o! A%riculture8
the US'A:AP,IS:"eterinary Services8 the US'A:A%riculture *esearch Services 4A*S58 an$
many other u(lic an$ rivate a%encies throu%hout North an$ Central America are con$uctin%
stu$ies on "S9 Some o! these stu$ies are e3aminin% "S viruses in the la(oratory8 an$ others are
stu$yin% the $isease on remises in areas 6here out(rea/s have occurre$9 The cooeration o!
in$ivi$ual livestoc/ o6ners throu%hout these re%ions has (een invalua(le to the success o! these
stu$ies9 Questions (ein% investi%ate$ inclu$e: 0hich insects can har(or an$Cor transmit "S
viruses1 0here $o "S viruses come !rom at the onset o! an out(rea/1 0hy $oes "S sometimes
occur in animals in the same locations out(rea/ a!ter out(rea/8 an$ sometimes srea$ into ne6
locations1 0hy $o some animals %et sic/ an$ some $o not1 Is in!ection 6ith "S viruses occurrin%
outsi$e the areas 6here it is tyically seen8 (ut in a $i!!erent !orm1
Fun$in% !or "S research is (ein% rovi$e$ (y the CSU-C"M)S Colle%e *esearch Council !rom
Colora$o *acin% Fun$s8 the US'A:AP,IS:"eterinary Services8 the US'A:AP,IS:National
"eterinary Services 2a(oratory8 the US'A:Forei%n A%riculture Services8 an$ the US'A:A*S9
For !urther in!ormation a(out vesicular stomatitis8 lease contact the US'A:AP,IS:Emer%ency
Pro%rams Sta!! at =J;; *iver *$8 Unit =.8 *iver$ale8 M' >;J@J-.>@. or hone @;.-J@=-L;J@9
U$ates on current "S status nationally an$ !or in$ivi$ual states are availa(le throu%h the
US'A:AP,IS 6e( site htt:CC6669ahis9us$a9%ovCvsCe or !rom the US'A:AP,IS:Centers !or
Ei$emiolo%y an$ Animal ,ealth >=-hour "oice *esonse Service at .-L;;-:=:-LJ@>9
Coyri%ht X .KKH->;;> American Association o! E#uine Practitioners9 All ri%hts reserve$9
American Association o! E#uine Practitioners
=;J: Iron 0or/s Par/6ay Y 2e3in%ton8 G+ =;:..
Phone: L:K->@@-;.=J Y Fa3: L:K->@@-.KHL
e-mail: aaeo!!iceZaae9or%
NOTICE: The American Association o! E#uine Practitioners 4AAEP5 is the coyri%ht o6ner o! all
in!ormation containe$ herein9 Althou%h the AAEP rovi$es this in!ormation to anyone8 the AAEP
retains the coyri%ht !or all te3t an$ %rahic ima%es9 This means that you CANNOT $istri(ute the
te3t or %rahics to others 6ithout the e3ress 6ritten ermission o! the AAEPN EmirrorF or
other6ise inclu$e the te3t or %rahics on your o6n server or $ocuments 6ithout our ermissionN
or other6ise mo$i!y an$Cor re-use the te3t or %rahics on this system9 +ou MA+ rint coies o! the
in!ormation !or your o6n ersonal use8 store the !iles on your ersonal comuter !or your ersonal
use only8 an$ re!erence hyerte3t $ocuments on this server in your o6n $ocuments9
The material resente$ herein is rovi$e$ (y the American Association o! E#uine Practitioners !or
e$ucational an$ in!ormational uroses only9 'ecisions re%ar$in% the health an$ 6el!are o! your
horse shoul$ (e ma$e only a!ter consultation 6ith a veterinarian 6ith 6hom a vali$ client-atient-
veterinarian relationshi has (een esta(lishe$9
oste$: JC.;C>;;>9 2ast u$ate$: JC.;C>;;>
:ye Disease in 5orses
$y San,ra :% (ushich' MS' D#M
0hat is 2yme $isease1 2yme $isease is a (acterial illness cause$ (y the sirochetal
4cor/scre6 shae$5 (acterium )orrelia (ur%$or!eri9 It is most commonly transmitte$ (y the (ite o!
in!ecte$ I3o$es s tic/s8 commonly re!erre$ to as A$eer tic/sA or A(lac/ le%%e$ tic/sA9 Not all
I3o$es s tic/s are in!ecte$ 6ith )orrelia (ur%$or!eri9 In areas hi%hly en$emic !or 2yme $isease8
such as the northeastern an$ mi$-Atlantic USA8 Minnesota8 0isconsin8 an$ northern Cali!ornia8 a
%reater roortion o! tic/s 6ill li/ely (e in!ecte$ than in areas 6here 2yme $isease is less
common9
,o6 $o tic/s transmit the 2yme $isease (acteria1 Immature 4larval5 $eer tic/s hatch !rom e%%s
an$ can (ecome in!ecte$ 6ith )orrelia (ur%$or!eri 4the (acterium that causes 2yme $isease5 i!
they ta/e a (loo$ meal on a ro$ent 6hich is alrea$y in!ecte$ 6ith )orrelia (ur%$or!eri9 The tic/
may then transmit the in!ection to ne6 hosts 6hen it ta/es its su(se#uent (loo$ meals9 These
tic/s have @ $evelomental sta%es 4larvae8 nymh an$ a$ult5 an$ must have a (loo$ meal (e!ore
they can molt 4chan%e5 into the ne3t sta%e9 They live !or > years8 over6interin% even in col$
climates9 The tic/s must attach to the ne6 animal host an$ !ee$ !or .>->= hours (e!ore they can
transmit the (acteria to in!ect the ne6 host9 *o$ents8 esecially the 6hite-!oote$ mouse8 serve as
the natural 6il$li!e hosts o! the tiny larval I3o$es s tic/s9 Mi$$le sta%e tic/s 4nymhs5 !ee$ on a
variety o! 6il$ an$ $omestic secies8 inclu$in% humans8 ro$ents8 $o%s8 cats8 (ir$s8 etc9 'eer are
the re$ominant 6il$li!e host !or a$ult tic/s8 (ut $omestic animals8 such as horses8 cattle8 $o%s
an$ even cats may serve as su(stitute hosts9
0hat e!!ect $oes )orrelia (ur%$or!eri in!ection have on $omestic animals1 The $isease cause$
(y )orrelia (ur%$or!eri 42yme $isease5 a!!ects humans an$ many $omestic animal secies9 It is a
multisystemic $isease8 a!!ectin% rimarily the Moints8 the musculos/eletal system an$ the
neurolo%ical system9 It is imortant to /no6 that in many $omestic animals8 inclu$in% $o%s8 cats8
cattle an$ horses8 su(clinical in!ection 4e9%9 in!ection 6ithout the $eveloment o! clinical $isease5
is common9 Thus8 a $omestic animal livin% out$oors in a re%ion 6here 2yme $isease is common
may (e (itten (y )orrelia (ur%$or!eri in!ecte$ tic/s an$ (ecome in!ecte$ 6ith )orrelia (ur%$or!eri9
This animal may %o on to $evelo symtoms o! 2yme $isease 46hich haens less than .;I o!
the time5 or may remain clinically healthy9 Su(clinical in!ection ma/es $ia%nosis $i!!icult8 as the
common (loo$ tests !or )orrelia (ur%$or!eri in!ection measure anti(o$ies 4art o! the (o$y7s
resonse to in!ection8 an$ 6oul$ (e ositive in an animal 6hich ha$ (een e3ose$ to )orrelia
(ur%$or!eri re%ar$less o! 6hether the animal (ecame clinically ill !rom the in!ection or not9
,o6 $o horses (ecome in!ecte$ 6ith )orrelia (ur%$or!eri1 ,orses livin% in 2yme $isease
en$emic re%ions may (ecome in!ecte$ 6ith )orrelia (ur%$or!eri via the (ite o! in!ecte$ I3o$es
secies tic/s9 The a$ult tic/s8 6hich are resent in the !all an$ early srin%8 are the sta%e most
li/ely to !ee$ on horses9 This sta%e o! tic/ is usually lar%e enou%h to (e $etecte$ $urin% %roomin%N
the tic/s are o!ten !oun$ aroun$ the hea$8 throatlatch area8 (elly8 an$ un$er the tail9 *emoval o!
the tic/ can (e accomlishe$ (y %rasin% the mouth arts o! tic/ a$Macent to the s/in 6ith
t6ee?ers an$ ullin% %ently (ac/9 Promt removal o! the tic/ minimi?es ris/ o! )orrelia (ur%$or!eri
transmission9
0hat are the clinical si%ns o! 2yme $isease in horses1 Clinical si%ns 4symtoms5 o! 2yme $isease
aear in less than .; I o! horses that are in!ecte$ 6ith )orrelia (ur%$or!eri9 The most common
symtoms are lameness an$ (ehavioral chan%es9 The lameness is usually associate$ 6ith lar%er
Moints 4not the !oot58 an$ !re#uently shi!ts !rom lim( to lim(9 The horse may aear to have a
%enerali?e$ sti!!ness9 Fever may or may not (e resent9 Occasionally8 laminitis 4an in!lammation
o! the tissues insi$e the hoo! 6all5 has (een associate$ 6ith 2yme $isease9 )ehavioral chan%es
associate$ 6ith 2yme $isease are $i!!icult to cate%ori?e9 As 6ell as an un6illin%ness to 6or/
46hich may (e associate$ 6ith musculos/eletal ain58 o6ners !re#uently o(serve increase$
irrita(ility an$ a chan%e$ attitu$e in these horses8 6hich #uic/ly return to normal !ollo6in%
treatment9
,o6 is 2yme $isease $ia%nose$ in horses1 'ia%nosis o! 2yme $isease in horses is articularly
$i!!icult !or t6o reasons: horses8 as athletes8 are su(Mect to many musculos/eletal inMuries an$
a(normalities 6hich may result in lameness similar to that seen 6ith 2yme $isease8 an$ the (loo$
tests commonly use$ !or 2yme $isease $ia%nosis $etect anti(o$ies to )orrelia (ur%$or!eriN since
su(clinical e3osure 4see a(ove5 is common8 a ositive anti(o$y test Must in$icates that the horse
has (een e3ose$ to )orrelia (ur%$or!eri8 not that his illness is relate$ to 2yme $isease9
The $ia%nosis o! e#uine 2yme $isease is %enerally (ase$ on the !ollo6in%: history o! tic/
e3osure8 or livin% in a 2yme $isease en$emic re%ion veterinary clinical e3amination su%%estive
o! 2yme $isease elimination o! other ossi(le $ia%noses (y e3amination an$ testin% 4lameness
e3ams8 3-rays8 (loo$ 6or/ !or other $iseases8 etc95 ositive (loo$ tests !or 2yme $isease to
suort the clinical $ia%nosis resonse to aroriate theray
,o6 is 2yme $isease treate$ in horses1 2yme $isease is treate$ 6ith anti(ioticsN the seci!ic $ru%
selecte$ (y your veterinarian 6ill $een$ on hisCher e3erience an$ re!erences !or the articular
case9 Treatment len%th is o!ten several 6ee/s9 +our veterinarian may choose oral8 intramuscular
or intravenous routes o! a$ministration !or anti(iotic theray9 *esonse to theray is usually seen
in the !irst >-: $ays !ollo6in% treatment9 In a$$ition to anti(iotics8 some veterinarians 6ill
a$minister anti-in!lammatory $ru%s an$Cor me$icines to hel relace the normal intestinal (acteria
/ille$ (y the anti(iotics9 A si$e e!!ect o! treatment in a small num(er o! animals 6ith 2yme $isease
is a reaction to to3ins release$ (y )orrelia (ur%$or!eri that are /ille$ $urin% the !irst !e6 $ays o!
treatment9 This can result in 6orsenin% symtoms !or a $ay or t6o8 an$ in the horse this reaction
may reciitate laminitis9 It is there!ore imortant to monitor the horse !or si%ns o! laminitis
4reluctance to move8 A6al/in% on e%%shellsA %ait8 increase$ 6armth in hooves5 $urin% the !irst
6ee/ o! treatment9 The veterinarian shoul$ (e contacte$ imme$iately i! laminitis is susecte$8 so
reventive treatment may (e initiate$9
0hat can (e $one to revent e#uine 2yme $isease1 There is no vaccine !or 2yme $isease
currently license$ !or horses9 There are several 2yme $isease vaccines availa(le !or $o%s8 an$ a
human vaccine shoul$ (e availa(le in the near !uture9 One 6oul$ e3ect an e#uine vaccine to
!ollo69 Until then8 revention o! 2yme $isease in horses is (ase$ rimarily on tic/ control9 'aily
%roomin% an$ removal o! tic/s is one o! the (est 6ays to revent )orrelia (ur%$or!eri in!ection9
4*emem(er8 the tic/s nee$ to attach an$ !ee$ !or .>->= hours (e!ore they can transmit the
(acteria59 Tic/ reellents may (e alie$ to the haircoat 4articularly hea$8 nec/8 le%s8 (elly8 an$
un$er the tail5 6hen horses are turne$ out9 Tic/ reellents containin% the chemical ermethrin are
esecially e!!ective8 an$ several ro$ucts containin% this chemical are arove$ !or use on
horses an$ other $omestic animals9 *emem(er to aly these ro$ucts in early srin% an$ !all8
6hen a$ult I3o$es s tic/s are active9 Geein% astures mo6n 6ill ma/e the environment less
hosita(le !or tic/s8 an$ removin% (rush8 6oo$ iles8 etc9 !rom asture areas 6ill $ecrease ro$ent
nestin% areas8 6hich also hels $ecrease tic/ oulations9
As al6ays8 i! you susect 2yme $isease or any illness in your horse8 consult your veterinarian !or
early $ia%nosis an$ treatment8 as 6ell as !or a$vice on $isease revention9
Coyri%ht X .KKH->;;> American Association o! E#uine Practitioners9 All ri%hts reserve$9
American Association o! E#uine Practitioners
=;J: Iron 0or/s Par/6ay Y 2e3in%ton8 G+ =;:..
Phone: L:K->@@-;.=J Y Fa3: L:K->@@-.KHL
e-mail: aaeo!!iceZaae9or%
NOTICE: The American Association o! E#uine Practitioners 4AAEP5 is the coyri%ht o6ner o! all
in!ormation containe$ herein9 Althou%h the AAEP rovi$es this in!ormation to anyone8 the AAEP
retains the coyri%ht !or all te3t an$ %rahic ima%es9 This means that you CANNOT $istri(ute the
te3t or %rahics to others 6ithout the e3ress 6ritten ermission o! the AAEPN EmirrorF or
other6ise inclu$e the te3t or %rahics on your o6n server or $ocuments 6ithout our ermissionN
or other6ise mo$i!y an$Cor re-use the te3t or %rahics on this system9 +ou MA+ rint coies o! the
in!ormation !or your o6n ersonal use8 store the !iles on your ersonal comuter !or your ersonal
use only8 an$ re!erence hyerte3t $ocuments on this server in your o6n $ocuments9
The material resente$ herein is rovi$e$ (y the American Association o! E#uine Practitioners !or
e$ucational an$ in!ormational uroses only9 'ecisions re%ar$in% the health an$ 6el!are o! your
horse shoul$ (e ma$e only a!ter consultation 6ith a veterinarian 6ith 6hom a vali$ client-atient-
veterinarian relationshi has (een esta(lishe$9
oste$: JC.;C>;;>9 2ast u$ate$: JC.;C>;;>
Anthra= A""ects Everyone
$y 3al!h C% >no0les D%#%M%
Author *alh C9 Gno6les '9"9M9
Anthra3 is a rai$ly $eveloin%8 acute or su( acute8 !ever ro$ucin%8 in!ectious $isease o! all
6arm-(loo$e$ secies inclu$in% humans9 Anthra3 is a serious8 $an%erous8 reorta(le $isease
that 6hen susecte$ shoul$ (e (rou%ht imme$iately to the attention o! your veterinarian9 Anthra3
out(rea/s are most commonly !oun$ in re%ions 6ith al/aline soil such as the Dreat Plains states
4North 'a/ota South to Te3as5 an$ the Intermountain )asin states 4Neva$a an$ Utah59 The
!re#uency o! !iel$ out(rea/s o! anthra3 in these areas is more revalent than in the other
%eo%rahical arts o! the Unite$ States9
Its in!ectious nature 6as !irst $emonstrate$ in .L@H9 The causative (acteria )acillus anthracis
6as !irst cultivate$ (y Goch in .LJH an$ Pasteur in .LJJ9 In !act the ioneerin% an$ classical 6or/
o! Pasteur sho6e$ that (y chan%in% the (acteria )acillus anthracis8 a vaccine coul$ (e ro$uce$
to rotect susceti(le animals8 a%ainst in!ectious $iseases9
Anthra3 in the horse is characteri?e$ (y a hi%h !ever 4(o$y temerature may reach .;J $e%rees5
an$ a rai$ly !atal course9 *i%or mortis is a(sent or incomlete in an anthra3 carcass9 ,orses are
mil$ly resistant8 there!ore cases mi%ht (e seen (e!ore they $ie9 In cattle an$ shee8 out(rea/s
$eclare themselves 6ith $ea$ animals9 ,orses !re#uently have ventral e$ema8 are !evere$8 an$
are o(viously Esic/F9 ,orse carcasses o!ten have $ar/ (loo$ oo?in% !rom the mouth8 nostrils an$
anus9 'ia%nosis can (e (ase$ on these clinical si%nsN ho6ever8 it is routine to o(tain a la(oratory
con!irmation (y $emonstratin% )acillus anthracis !rom a (loo$ samle an$C or a (loo$ culture9
Time is o! essence in $ia%nosin% a horse her$ 6ith anthra3Pthe E#uic/ /illerF9 Althou%h (loo$
cultures ta/e lon%er !or results8 they are the !inal $isease con!irmatory measure8 an$ can (e
imortant i! ossi(le human e3osure occurs or i! liti%ation shoul$ !ollo6 an anthra3 eiso$e9
,o6 it&s srea$
Transmission o! anthra3 usually occurs throu%h the interrute$ !ee$in% o! horse !lies 4ta(ani$ae5
or throu%h the horse&s natural %ra?in% activity9 A uni#ue !eature o! anthra3 is that the (acteria has
t6o rincile !orms: First8 the restin% !orm or Asore !ormA9 Sores have (een /no6n to survive !or
.;; years in (ison (ones9 'urin% times o! summer !loo$in%8 the sores can (e consume$ (y
horses or other animals that %ra?e on !loo$ lain astures9 0hen this haens8 the secon$ !orm
o! anthra3 (acterium $evelos calle$ the ve%etative !orm9 This !orm rai$ly multilies in the
animal7s (loo$ stream8 resultin% in su(se#uent (loo$ oisonin% 4seticemia59 Accomanie$ (y the
!ormation o! to3ins8 this se#uence can lea$ to $eath unless romtly treate$ to sto the
ro%ression o! the (loo$ oisonin%9 Since humans can contract anthra38 secial recautionary
measures nee$ to (e ta/en9 'o not han$le cases o! susecte$ anthra3 unless you 6ear
rotective ru((er %loves9 The less you move or transort a horse carcass the (etter9 *emem(er
the sores can live in the soil or (ison (ones at least .;; yearsP$on&t AscatterF otential sources
o! sores in the environment9
,an$lin% Anthra3
In $ealin% 6ith an out(rea/ o! anthra3 in a horse her$ the !ollo6in% nee$s to occur: .5 +our
veterinarian shoul$ romtly esta(lish a !iel$ $ia%nosis !ollo6e$ (y a la(oratory con!irmation9 I!
anthra3 is susecte$8 initiate treatment imme$iately9 Animals reson$ #uic/ly to lon%-actin%
anti(iotic treatment9 >5 )o$y temeratures shoul$ (e ta/en an$ recor$e$ on every horse her$
mem(er9 Any animal in the her$ that reveals a temerature in e3cess o! t6o $e%rees a(ove
normal 4KK9: F5 nee$s to (e treate$ systemically 6ith enicillin or a enicillin $erivative9
Anti(iotics a$ministere$ early in the $isease mi%ht save some animals9 @5 The incu(ation erio$
!or anthra3 is three to seven $ays9 Temeratures nee$ to (e ta/en an$ recor$e$ !or the ne3t ten
$ays to (e assure$ that anthra3 has (een success!ully overcome in the her$9 =5 "accination o!
the non-!e(rile her$ mem(ers 4those 6ithout !ever5 shoul$ (e comlete$9 There is no vaccine
license$ !or use in horses8 (ut the Sterne&s strain8 nonencasulate$ live sore vaccine that is
license$ !or use in cattle has (een use$ to vaccinate horses9 The initial $oses o! the vaccine
shoul$ (e a$ministere$ >-@ 6ee/s aart !ollo6e$ (y annual revaccination9 The horse mi%ht sho6
e$ema aroun$ the inMection site an$ in surroun$in% tissues9
Anthra3 is consi$ere$ a otential military %erm 6ar!are a%ent8 so recautions to rotect yoursel!
at all times 6hen anthra3 is $ia%nose$ or susecte$ in your horse her$9 I! you thin/ that you have
(een e3ose$ to anthra38 consult your hysician imme$iately9 Sores or car(uncles on the s/in
are the most common !orm o! anthra3 in humans8 (ut can (e e!!ectively treate$ 6ith anti(iotics9
A(out the Author:
'r9 Gno6les is a $istin%uishe$ li!e mem(er o! the American Association o! E#uine Practitioners9
,e is also an international consultant !or e#uine irolasmosis an$ electronic i$enti!ication o!
animals9
oste$: HC.HC>;;>9 2ast u$ate$: HC.HC>;;>