Objective—To assess the serial use of serum immunoperoxidase monolayer assays (IPMAs) and fecal PCR assays, combined with other diagnostic methods, to identify subclinical Lawsonia intracellularis infections for targeted treatment of Thoroughbred foals and weanlings at farms in which the pathogen was endemic or nonendemic.
Animals—100 foals and weanlings (53 and 47 at farms in which L intracellularis was endemic and nonendemic, respectively).
Procedures—Serum was collected every 4 weeks and tested via IPMA, for antibodies against L intracellularis. Fecal samples were collected every 2 weeks and tested by use of an L intracellularis–specific PCR assay. When results for IPMAs or PCR assays were positive or clinical signs compatible with equine proliferative enteropathy (EPE) were detected, clinicopathologic testing was performed to determine treatment.
Results—No foals had positive results for the L intracellularis–specific IPMA until after weaning; 32 of 53 (60.4%) weanlings at the farm in which L intracellularis was endemic and 8 of 47 (170%) at the farm in which L intracellularis was nonendemic had positive IPMA results, whereas the number of weanlings that tested positive via fecal PCR assays at those farms was 6 and 0, respectively. Nineteen of 32 weanlings with positive IPMA results at the farm in which L intracellularis was endemic were treated for EPE; 5 of these had clinical signs of EPE. No weanlings at the nonendemic farm had clinical signs of or were treated for EPE.
Conclusions and Clinical Relevance—IPMA appeared to be a useful means of identifying weanlings exposed to L intracellularis.
Case Description—A 2-year-old Thoroughbred filly was evaluated because of hemorrhage from the vulva and suspected hematuria of 5 days' duration.
Clinical Findings—A primary coagulopathy was ruled out on the basis of results of hematologic testing. Vaginoscopy and cystoscopy revealed a large bleeding mass in the bladder that extended into the vagina, causing marked obliteration of normal urogenital structures and difficulty in urination. Histologic examination of endoscopic and surgical biopsy speci-mens revealed a poorly differentiated neoplasia likely of mesenchymal origin. Chronic suppurative cystitis caused by Streptococcus zooepidemicus was also diagnosed.
Treatment and Outcome—The tumor continued to grow despite treatment with doxorubicin and, within 45 days, was causing substantial discomfort and stranguria. Given the grave prognosis, the horse was euthanized. At necropsy, the tumor was found to have caused widespread destruction of the urinary bladder and to have invaded the broad ligament of the uterus. The mass was identified as a poorly differentiated leiomyosarcoma on the basis of results of histologic examination and immunohistochemical staining for α-actin.
Clinical Relevance—Findings suggested that leiomyosarcoma should be considered in the differential diagnosis when examining horses with urogenital bleeding.
Objective—To determine signalment, physical examination and clinicopathologic abnormalities, outcome, and subsequent fertility of mares with periparturient hemorrhage (PPH) and identify factors associated with outcome (ie, survival vs death).
Design—Retrospective case series.
Procedures—Medical records were reviewed for information on age, breed, initial complaint, physical examination and clinicopathologic abnormalities, treatment, outcome, and subsequent fertility.
Results—Median age was 14.0 years (range, 5 to 24 years), and median number of foals produced prior to the diagnosis of PPH was 8 (range, 1 to 16). Ten (14%) mares had prepartum hemorrhage and 63 (86%) had postpartum hemorrhage. Treatment was aimed at restoring cardiovascular volume, enhancing coagulation, controlling pain, and reducing the effects of endotoxemia. Sixty-one (84%) mares survived and 12 (16%) died or were euthanized. Common complications included fever, leukopenia, retained fetal membranes, increased digital pulses, thrombophlebitis, and cardiac arrhythmias. Of the 53 surviving mares for which subsequent breeding information was available, 26 (49%) produced 1 or more foals after recovering from PPH.
Conclusions and Clinical Relevance—Results suggested that PPH can develop in mares of any age and parity. Treatment was associated with a good prognosis for survival and a reasonable prognosis for future fertility.
Objective—To identify factors significantly associated
with an epidemic of fibrinous pericarditis during
spring 2001 among horses in central Kentucky.
Animals—38 horses with fibrinous pericarditis and
30 control horses examined for other reasons.
Procedure—A questionnaire was developed to solicit
information regarding a wide range of management
practices and environmental exposures from farm
owners or managers.
Results—The following factors were found in bivariate
analyses to be significantly associated with an
increased risk of pericarditis: being from a farm with
mares and foals affected by mare reproductive loss
syndrome, exposure to Eastern tent caterpillars in or
around horse pastures, younger age, shorter duration
of residence in Kentucky and at the farm of current
residence, being fed hay grown outside Kentucky, a
lack of access to pond water, access to orchard grass
for grazing, and a lack of direct contact with cattle. In
multivariate logistic regression analyses, only variables
related to caterpillar exposure and age were significantly
associated with fibrinous pericarditis.
Conclusions and Clinical Relevance—Results suggest
that fibrinous pericarditis in horses may be associated
with mare reproductive loss syndrome. Exposure
to Eastern tent caterpillars was the greatest risk factor
for development of fibrinous pericarditis. The distribution
of times of diagnosis of fibrinous pericarditis was
consistent with a point-source epidemic. (J Am Vet Med
To compare soil concentrations of macrolide- and rifampicin-resistant Rhodococcus equi strains (MRRE) on horse-breeding farms that used thoracic ultrasonographic screening (TUS) to identify foals with subclinical pneumonia combined with subsequent administration of macrolides and rifampin to affected foals (TUS farms) versus soil concentrations on farms that did not (non-TUS farms), determine whether the combined use of TUS and antimicrobial treatment of subclinically affected foals was associated with soil concentration of MRRE, and assess whether there were temporal effects on soil concentrations of MRRE during the foaling season.
720 soil samples and 20 completed questionnaires from 20 horse-breeding farms (10 TUS farms and 10 non-TUS farms) in central Kentucky.
A questionnaire was used to gather information from participating farms about their 2019 foaling season. Soil samples were collected during January, March, May, and July 2019 for bacterial culture and antimicrobial susceptibility testing to identify any isolates of MRRE. Results were compared for TUS farms versus non-TUS farms. Linear mixed-effects modeling was used to evaluate for potential associations between the soil concentration of MRRE and the use of TUS.
Overall, the sum of the mean soil concentrations of MRRE was significantly higher for TUS farms (8.85 log10-transformed CFUs/g) versus non-TUS farms (7.37 log10-transformed CFUs/g).
CONCLUSIONS AND CLINICAL RELEVANCE
Our findings indicated that farms that use TUS to identify foals with subclinical pneumonia for antimicrobial treatment select for antimicrobial-resistant R equi strains. Because prognosis is worse for foals infected with resistant versus nonresistant strains of R equi, prudent use of antimicrobials to treat foals with subclinical pulmonary lesions attributed to R equi is recommended.
Objective—To determine whether mares are a clinically important source of Rhodococcus equi for their foals.
Sample Population—171 mares and 171 foals from a farm in Kentucky (evaluated during 2004 and 2005).
Procedures—At 4 time points (2 before and 2 after parturition), the total concentration of R equi and concentration of virulent R equi were determined in fecal specimens from mares by use of quantitative bacteriologic culture and a colony immunoblot technique, respectively. These concentrations for mares of foals that developed R equi–associated pneumonia and for mares with unaffected foals were compared. Data for each year were analyzed separately.
Results—R equi–associated pneumonia developed in 53 of 171 (31%) foals. Fecal shedding of virulent R equi was detected in at least 1 time point for every mare; bacteriologic culture results were positive for 62 of 171 (36%) mares at all time points. However, compared with dams of unaffected foals, fecal concentrations of total or virulent R equi in dams of foals with R equi–associated pneumonia were not significantly different.
Conclusions and Clinical Relevance—Results indicate that dams of foals with R equi–associated pneumonia did not shed more R equi in feces than dams of unaffected foals; therefore, R equi infection in foals was not associated with comparatively greater fecal shedding by their dams. However, detection of virulent R equi in the feces of all mares during at least 1 time point suggests that mares can be an important source of R equi for the surrounding environment.
Objective—To determine whether airborne concentrations of virulent Rhodococcus equi at 2 horse breeding farms varied on the basis of location, time of day, and month.
Sample Population—2 farms in central Kentucky with recurrent R equi-induced pneumonia in foals.
Procedures—From February through July 2008, air samples were collected hourly for a 24-hour period each month from stalls and paddocks used to house mares and their foals. Concentrations of airborne virulent R equi were determined via a modified colony immunoblot technique. Differences were compared by use of zero-inflated negative binomial methods to determine effects of location, time, and month.
Results—Whether mares and foals were housed predominantly in stalls or paddocks significantly affected results for location of sample collection (stall vs paddock) by increasing airborne concentrations of virulent R equi at the site where horses were predominantly housed. Airborne concentrations of virulent R equi were significantly higher from 6:00 pm through 11:59 pm than for the period from midnight through 5:59 am. Airborne concentrations of virulent R equi did not differ significantly between farms or among months.
Conclusions and Clinical Relevance—Airborne concentrations of virulent R equi were significantly increased when horses were predominantly housed at the site for collection of air samples (ie, higher in stalls when horses were predominantly housed in stalls and higher in paddocks when horses were predominantly housed in paddocks). Concentrations of virulent R equi among air samples collected between the hours of 6:00 am and midnight appeared similar.
Objective—To determine the prevalence of antimicrobial resistance to macrolide antimicrobials or rifampin in Rhodococcus equi isolates and to describe treatment outcome in foals infected with antimicrobial-resistant isolates of R equi.
Sample Population—38 isolates classified as resistant to macrolide antimicrobials or rifampin received from 9 veterinary diagnostic laboratories between January 1997 and December 2008.
Procedures—For each isolate, the minimum inhibitory concentration of macrolide antimicrobials (ie, azithromycin, erythromycin, and clarithromycin) and rifampin was determined by use of a concentration-gradient test. Prevalence of R equi isolates from Florida and Texas resistant to macrolide antimicrobials or rifampin was determined. Outcome of antimicrobial treatment in foals infected with antimicrobial-resistant isolates of R equi was determined.
Results—Only 24 of 38 (63.2%) isolates were resistant to > 1 antimicrobial. Two isolates were resistant only to rifampin, whereas 22 isolates were resistant to azithromycin, erythromycin, clarithromycin, and rifampin. The overall prevalence of antimicrobial-resistant isolates in submissions received from Florida and Texas was 3.7% (12/328). The survival proportion of foals infected with resistant R equi isolates (2/8 [25.0%]) was significantly less, compared with the survival proportion in foals that received the same antimicrobial treatment from which antimicrobial-susceptible isolates were cultured (55/79 [69.6%]). Odds of nonsurvival for foals infected with resistant R equi isolates were 6.9 (95% confidence interval, 1.3 to 37) times the odds for foals infected with susceptible isolates.
Conclusions and Clinical Relevance—Interpretation of the results emphasized the importance of microbiological culture and antimicrobial susceptibility testing in foals with pneumonia caused by R equi.
Objective—To determine whether the concentration of airborne virulent Rhodococcus equi varied by location (stall vs paddock) and month on horse farms.
Sample—Air samples from stalls and paddocks used to house mares and foals on 30 horse breeding farms in central Kentucky.
Procedures—Air samples from 1 stall and 1 paddock were obtained monthly from each farm from January through June 2009. Concentrations of airborne virulent R equi were determined via a modified colony immunoblot assay. Random-effects logistic regression was used to determine the association of the presence of airborne virulent R equi with location from which air samples were obtained and month during which samples were collected.
Results—Of 180 air samples, virulent R equi was identified in 49 (27%) and 13 (7%) obtained from stalls and paddocks, respectively. The OR of detecting virulent R equi in air samples from stalls versus paddocks was 5.2 (95% confidence interval, 2.1 to 13.1). Of 60 air samples, virulent R equi was identified in 25 (42%), 18 (30%), and 6 (10%) obtained from stalls during January and February, March and April, and May and June, respectively. The OR of detecting virulent R equi from stall air samples collected during May and June versus January and February was 0.22 (95% confidence interval, 0.08 to 0.63).
Conclusions and Clinical Relevance—Foals were more likely to be exposed to airborne virulent R equi when housed in stalls versus paddocks and earlier (January and February) versus later (May and June) during the foaling season.