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Bastard strangles

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  • Bastard strangles

    I have a wonderful 8 year old Rocky Mountain who is very, very sick. He first got sick in October and we went through test after test trying to find out what was wrong. It was apparent that he had an internal abscess but could not find through the sonogram where it was located. All pigeon fever tests came back negative as well as ever other test under the sun. He recovered after three months and 11 courses of Excede. He was OK for a few months but three weeks ago the symptoms came back - in spades. We consulted with CSU and tested for strep and strangles which tested positive.

    They say that it most likely is bastard strangles. That is so strange since I raised him as a yearling and to my knowledge he has never been exposed (and none of my other horses have had strangles).

    At this point it looks like he is going into peritonitis. This morning his back end was trembling. But get this... he has never stopped eating - regardless of the fever. We are treating him with the Excede and have added Rifampin. Has ANYONE else experienced something like this?

  • #2
    I had a horse with what presented as Internal (Bastard?) Pigeon Fever. His pigeon fever titer was high but belly taps never showed the bacteria. He had liver abnormalities in the sonogram. He wasn't responding to the normal course of TMS and Rifampin. We never tried Excede. UC Davis and my vet put him on Minocycline (23 capsules twice a day) and Rifampin and he recovered.

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    • #3
      I had one with either bastard strangles or internal pigeon fever--we never poked it to find out which it was. We treated with Excede and rifampin right off the bat with success. I hope it works for you too. I wonder if another class of antibiotic might be warranted with the rifampin at this point, since you've had so much excede exposure--perhaps something to ask your vet about?

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      • #4
        Yes, try something else right away. We went through Tucoprim, Oral Baytril and Naxel. IV Baytril brought the fever down but giving an injection every day for a month or more wasn't something we wanted to do. UC Davis had tried Minocycline successfully on only a few horses at that time so we gave it a go. We were 6 weeks into it by then, most days with a fever, and after 4 days his fever was gone. He stayed on it for another 6 weeks. He was on Rifampin the whole time as well. This was the winter of '16-'17 and he's fine now except his GGT creeps up so we have him on Platinum Liver Support probably for the rest of his life.

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        • #5
          While he may not have been exposed by an infected horse, it could have been through the vet or farrier if they were unknowingly in contact with a horse who was infected but not showing the signs and then came to your place?

          I hope he responds to something you give.

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          • #6
            A good client adopted a horse from the kill string once. Horse came to her emaciated with a host of problems. Colicked regularly. Founder. Abscessed wherever we tried to draw blood. Was Rx'd bastard strangles and did several courses of abx. This went on for over a year. We thought she was just a problem child and faced the certain future of having to have her PTS because we could not stop her abscessed feet from occurring despite the best farrier work and very knowledgeable team of vets from several practices.

            She was tested for Cushing's disease several times and always came back within normal limits, though admittedly high normal. In exasperation vet Rx'd 1/4 tablet of prascend/ pergolide. Horse was 1400lbs if an ounce. After starting on the prascend, she never had an off day again. Abscessed. Colic stopped happening. Horse became robust and happy. Best part we could give seasonal vaccines and she wouldn't suffer, and we could draw blood for noggins or what have you -- and she stopped abscessing.

            Test for cushings if you want, or just put hoss on a super low dose of pergolide and see what happens. Many many test negative yet benefit from a low dose of the cushion's medication..

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            • #7
              I'm sorry to hear about your horse. It sounds like you have good help from the folks at CSU. Treating internal abscesses is always very difficult. This post is long, and shouldn't be considered veterinary advice, but I hope there is some information here that might be of assistance to you.

              Has anyone done rectal palpation on your horse to try to localize the abscess that way? Does blood work offer any clues about where the abscess might be? I'm guessing that the testing was serology for Strep equi antibodies? Did you also check to see if your horse is a gutteral pouch carrier (could have implications for other herdmates)? Looking for underlying immunosuppression (like the Cushing's idea) seems reasonable too.

              In terms of transmission, clinically normal horses can carry Strep equi (strangles), and your horse could have also been silently infected. So transmission can happen at horse shows, trail rides, etc. even where there is not an active strangles outbreak going on. Or via fomite as previously mentioned.

              The addition of rifampin can be helpful to penetrate abscesses. It is very hard to get good penetration into abscesses because the body walls off the pockets of infection and there is limited blood flow. Rifampin typically needs to be combined with another antibiotic.

              While there are a lot of similarities between internal pigeon fever and bastard strangles and the treatments are similar, they are not always exactly the same. For example, enrofloxacin (Baytril) can be helpful with internal pigeon fever, but some strains of Strep equi/strangles have enrofloxacin resistance, so if you cannot test your particular strain, that might not be a great drug choice. Strep equi is reliably susceptible to beta lactam class drugs (which includes ceftiofur/Excede as well as penicillin); with some bacteria you definitely have to worry about acquired resistance to some drug classes but it has not been found in Strep equi against the beta lactams to date.

              However, just because the bacteria will be killed when exposed the drug in a laboratory doesn't mean that you can necessarily get the drug to the site of infection very well in a live horse. This is part of why the disease is so difficult to treat. If a horse is hospitalized, some vets give IV penicillin because you can give high doses frequently to keep the drug concentration in the body up over time (in contrast to the slow release formulation of Excede). Penicillin can also be combined with rifampin treatment.

              There are veterinary clinical microbiologists at CSU who can help your vet or you talk through antimicrobial treatment and understanding the susceptibility of Strep equi to various drugs.

              If you are interested in learning more, these are some scientific articles that you might find helpful, including case series that discuss the details of some horses with the same condition as your horse:
              https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867011/
              https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552593/
              https://www.researchgate.net/profile...962d8e2cbe.pdf

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