Strangles Flashcards

1
Q

what are clinical signs of strangles?

A
  • pyrexia
  • pharyngitis
  • abscess formation in lymph nodes: usually submandibular and retropharyngeal
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2
Q

what lymph nodes are most commonly affected by strangles?

A

submandibular and retropharyngeal

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3
Q

when do horses get pyrexia with strangles?

A

3-24 days after exposure

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3
Q

what is the severity of strangles?

A
  • varies: some die and some barely affected
  • correlated with the dose and frequency of infectious challenge
  • varies with immune status
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4
Q

what age of horse is more at risk for severe disease with strangles?

A

older horses: complications from strangles more common

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5
Q

how long does immunity of strangles last?

A

10 years: not uncommon to get 18 year old horses that had it when they were younger and now get re infected and sick

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6
Q

what does pharyngitis from strangles cause?

A
  • difficulty eating and drinking/dysphagia
  • abnormal head positions
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7
Q

what is the major severe consequence of strangles?

A

upper respiratory tract obstruction: lymphadenopathy causes. can lead to choke, ARDS, death

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8
Q

nasal shedding of s. equi begins when? how long does it last?

A

begins 2-3 days after onset of fever and persists for 2-3 weeks in most animals

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9
Q

where do lymph nodes rupture?

A
  • thru skin to the outside
  • into the resp tract: nasopharynx and GUTTURAL POUCH
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10
Q

what is the only way to detect subclinical infections of strangles (chondroids in guttural pouch and spread it to others)

A

endoscopy

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11
Q

does strangles have good or bad immunity?

A

good immunity: 75% not treated will have long term immunity
- 20-25% susceptible within several months: they fail to produce or maintain antibodies

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12
Q

how does strangles persist with chronic shedders?

A

10% of horses experience failure of the GP drainage mechanism, which leads to empyema and then chondroids. so these horses can shed for months to years and be subclinical

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13
Q

what is atypical strangles?

A
  • catarrhal strangles: mild form seen in animals with limited susceptibility
  • older horses with residual immunity
  • foals with waning maternal ab production
  • vaccinated animals
  • THESE ANIMALS SHED VIRULENT S EQUI
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14
Q

T/F: atypical strangles animals are non infectious and we don’t need to worry about them

A

false- they shed virulent S. equi!!

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15
Q

what are common fomites for transmitting Strangles?

A

veterinarians and farriers!

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16
Q

direct transmission of Strangles

A

horse to horse: HAS TO BE DIRECT CONTACT with material. is nOT aerosolized. or contact with lymph node abscessation material

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17
Q

indirect transmission of Strangles

A

drinking, bedding, tools, vets, farriers, etc

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18
Q

T/F: Strangles is commonly transmitted via aerosols

A

false- it is not aerosolized.

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19
Q

convalescent strangles horses

A

outwardly healthy horses that continue to harbor the organism after full clinical recovery. consider all recovered horses potentially infectious for at least 6 weeks after their purulent dc have dried up

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20
Q

with a recovered horse from strangles, they should be considered infectious for at least _________ after their purulent dc has dried up

21
Q

when culturing potential strangles cases, what are we looking for

A
  • beta hemolytic streptococci
  • unsuccessful during incubation, early clinical phases, when bacterial count is low during convalescence
22
Q

when is strangles culture unsuccessful?

A

incubation, early clinical phases, when bacterial count is low during convalescence

23
Q

PCR is more sensitive than culture, but what is the downside of it?

A

it doesn’t tell you if the organism is active or viable, just that there are segments there

24
what is the most definitive diagnosis of Strangles?
PCR testing of endoscopically guided GP lavage for detection in subclinical infected carrier animals
25
you get a negative S. equi result on strangles on a horse with clinical signs. what are your thoughts?
visual detection if inflammation of the GP resp epithelium, presence of empyema, chondroids, or enlarged retropharyngeal lymph nodes on the floor of the GP may suggest Strangles even when test is negative
26
vaccination of strangles horses?
- no current consensus - extract vaccine disappointing - intranasal attenuated live vaccine: animals should have titers <3,200!i
27
if you want to give a horse a strangles vaccine, what should their titer be?
< 3,200
28
why is isolating horses so important?
shedding does not usually begin until 2 days after the onset of pyrexia: possible to isolate new cases before they can transmit infection!!
29
how long does nasal shedding with strangles persist?
2-3 weeks in most animals but horses may be infectious for at least 6 weeks after their purulent dc has dried up
30
how do you prevent strangles?
STOP ALL HORSES MOVEMENT ON AND OFF PREMISES
31
biosecurity of strangles cases
- quarantine and screening of new arrivals - appropriate disinfection and cleaning - education of caretakers
32
what can you treat strangles horses with/
- majority don't need treatment - supportive: rest, comfort stall, soft, moist, palatable food - acute febrile cases in stalls benefit from fan assisted ventilation - in many cases antibiotics are unnecessary!
33
T/F: you should use antibiotics with most strangles cases
false: don't use. if you do, you are going to slow the whole process down. slow immune development and slow the development of abscesses, breaking out, etc preference is to nOT USE
34
what are concerns with abx use in strangles cases?
- delay in maturation of abscesses or recurrence when abx are discontinued - diminish development of protective immunity
35
when are abx indicated in strangles horses?
- acute infx w high fever and malaise before abscess formation - profound lymphadenopathy and resp distress: at risk of strangling! - metastatic abscessation - PENICILLIN!! rare case where you can use just 1 abx to treat this
36
what is the drug of choice when abx are needed for strangles?
*penicillin* at double its dose!!! 22,000-44,000 iu/kg bwt IM q12h or IV q6hr - horses don't like IM! + risk of anaphylactic shock abx should NOT be used as a preventative in animals that may have been exposed!!
37
treatment of empyema/chondroids
- lavage - transendoscopic grabbing instruments - surgery
38
what are complications of strangles?
- spread of infx - immune mediated dz - rare extensions of dz
39
metastatic spread of strangles
- bastard strangles - hematogenous, lymphatic, close association
40
what are common sites of strangles to metastasize to/
GIT, mesentery, lungs, liver, spleen, kidneys, brain
41
how can you diagnose bastard strangles?
- hx of exposure to S. equi - intermittent low grade fevers - very high titers!! v useful - lab consistent with chronic infx: anemia, hyperfibrinogenemia, leukocytosis, neutrophilia, hyperglobulinemia
42
what are immune mediated complications of strangles?
- purpura hemorrhagica - myositis: infarctions, rhabdomyolysis - myocarditis: triggered by sstrep antigens
43
what is purpura hemorrhagica?
aseptic necrotizing vasculitis: deposition of immune complexes in blood vessel walls
44
what signs are seen with purpura hemorrhagica?
- edema: esp around limbs "stocked up", petechial or ecchymotic hemorrhage: look in vulva, see hemorrhages on lungs in necropsy - often have fever - mild transient but often severe and fatal leukocytoclastic vasculitis on histologic exam of skin biopsy is diagnostic
45
what is the treatment for purpura hemorrhagica?
adding in dexamethasone: 0.1-0.2mg/kg for 2-4 weeks
46
muscle infarctions from strangles?
- severe manifestation of purpura hemorrhagica - prognosis is guarded even with aggressive therapy
47
rhabdomyolysis with acute myonecrosis
- in horses with clinically evident Strangles - stiff and recumbent; elevations in CK and AST
48
how do you treat myositis with strangles?
- corticosteroids - in cases with atrophy, mm mass may return to normal - if concurrent infx, abx are indicated
49
where is immune mediated myositis most commonly seen?
topline: wastes away incredibly fast: within a week. not really leg muscles as much