Strangles

Okay - we do rescue and we pulled a horse from an auction - out bid the meat buyer on her - and although she was isolated, that was not enough, to prevent spreading it.

She started to cough a few days after bringing her here, and then a few days later another horse was cough - though he has had no contact with her. . .
As it stands now, I'm sure we are dealing with strangles - she has not been here a week, and three horses are coughing, they all have the snots. . .the rescue and one other are fairly lethargic, fever. . .
My vet would choose this week to be out of town until next Tuesday, and there is only one other vet in the area, and he has prove incompetent in the past. . .

My vet said to start 30cc Pen G x a day for 7 days on the horses from 900-1000lbs and dosed on down for those smaller. . .
He suggested added (sp?) Gentacin (sp?), but the cost was so high and so much I've read and been told seems to state that Pen G should do the trick if caught early, I am trying that for now.

I have a few questions. . .I'd like overall insight on strangles from first hand experience. I've not dealt with it in the past.

Is treating everyone as a precaution the best choice? My vet said likely it was. . .even those without symptoms. . .

Is 7 days, in your experience, enough to treat it? We are going on the assumption it is strangles for now until the vet is back Tuesday.

This article from Alpha Horse may help you. I'm sorry your horses are sick.

By Jeffrey Rolo

Strangles is a word that strikes fear into the hearts of many horse owners. Okay… maybe fear is too strong a word, but equine strangles is certainly an occurrence we all dread. While perhaps its reputation is deserved for the mess alone it can create, the good news is strangles is not as ominous as legend would have us believe.
What causes horse strangles?
Strangles is caused by exposure to the Streptococcus equi bacterium, and in fact Streptococcus is what also causes strep throat in humans. This bacterium is introduced through a horse's nasal passage where it proceeds to attach to the lymph nodes around the pharynx and submandibular regions (the back of the throat and under the jaw areas). The lymph nodes attempt to fight off the invading and reproducing bacteria, eventually causing a possible abscess to form.
How is strangles transmitted?
Streptococcus equi is passed on through direct exposure to the nasal discharge of afflicted horses as well as the pus that is released from abscesses. It is a highly contagious bacterium, especially among younger horses, but since direct exposure is required for it to be transmitted preventing it from spreading further is actually fairly easy. Once you have confirmed a horse is afflicted with strangles it's vital that you isolate him from all other horses – any box stall will do.
Contaminated watering buckets, ponds, bedding, hay and even fence railings can spread the disease to healthy horses, so make sure to sanitize any areas the sick horse had contact with if possible, particularly if other horses are also present in those areas. The bacteria can survive for a few weeks given the right atmosphere.
What are the signs?
If your horse comes down with equine strangles he may lose his appetite and develop a fever. In addition the lymph nodes around the throat will swell up due to the accumulation of purulent fluid (pus) caused by the nodes fighting off the invading bacteria. As the nodes expand your horse may keep his neck outstretched to relieve the pressure in his throat area.
As the disease progresses your horse will develop a very thick, cloudy mucous discharge that is enough to make almost anyone grimace. Depending on the severity of the disease as well as whether it has received any treatment, eventually the pus may collect enough to cause an abscess by which the pus can be drained.
A horse will begin developing signs of the disease about 2-6 days after exposure. Usually it will take about a week and a half to two weeks for the disease to run its course, abscesses to rupture and the pus to be drained.
How severe is the disease?
Normally equine strangles isn't too dangerous; it's just awfully miserable, messy and inconvenient for both you and your horse. That being said, once you realize your horse has developed strangles you should contact your veterinarian and have him diagnose your equine since the severity can vary and complications can arise.
Generally unless the lymph nodes swell to levels that affect the horse's ability to breathe, the disease can be allowed to run through its course. Statistics have been shown to suggest fatality rates among completely untreated strangles cases can range in 1% to 3% while another set suggested the rate was as high as 10% to 20%! I believe the latter to be significantly inflated, but in either case such statistics aren't relevant for domesticated horses since the majority of us call a veterinarian and provide care.
How should horse strangles be treated?
Much will depend on the severity and stage of your horse's case. Penicillin has been shown to be effective against Streptococcus equi, but application of it should be done during the initial stages of strangles or after any abscesses have ruptured.
Once the disease has caused abscesses to form, penicillin can actually delay the abscesses from opening and draining the pus. As such, it's usually best to let the abscess work its course (or have the vet cut it open), then apply penicillin after the draining has begun to wipe up the remaining bacteria.
There is some debate as to whether applying penicillin can actually inhibit a horse's ability to form a natural immunity against strangles, or worse provoke bastard strangles. Unfortunately there really isn't enough scientific proof to connect antibiotics to the increased chance of developing bastard strangles, but I can understand why many veterinarians would rather play it safe for light cases that can be healed naturally. When a couple of my young horses developed strangles my veterinarian recommended allowing the disease to run its course naturally since the cases were not severe. A couple times a day I would clean the horses' nose, ensure they could breath easily, make sure they had plenty of clean water and food, and finally watch for potential worsening or complications. Within about a week the strangles worked its way through and the horses were fine.

Also, one big issue we have is having HUGE doses like this 2 times a day - the horses are already so traumatized - they will not let us catch them and one filly starts to rear when my husband gets near her. . .ugh! Geez. What a mess.

We followed the no antibiotic until the abscess had burst proctocol. A pain to keep the horses in quarantine but the majority worked through with no need for injections.

Have you taken temps on the horses?

I had a similar situation years ago at my barn.

Strangles can last from 7 - 30 days for a horse to be symptom free. We tried different antibiotics with no help from any - for the most part they didn't make a difference at all. Even tried different decongestants (like tri-meth and stuff) again for nothing.

What helped the most was warm compresses 4-6x a day on any horses that abscessed, checking temps 4x a day and using bute and/or banamine as needed (paste version of both) and putting the horses on ulcer supps to prevent colic from stress or weight loss from loss of appetite. Even when horses were off their feed we found the ulcer supps in a warm bran mash with some beet pulp helped keep them hydrated and from getting too weak.

The ones that got the 4-6x a day care healed the fastest.

I also found that any horse on the property that had been vacc'd for strangles at least 2x yr for 3 or more years NEVER got symptomatic other than at most a minor fever lasting less than 24h and off their feed for 1 - 2 feedings max. To put that into perspective at the time where I was located there were approx 50 horses on the property - the ones that were regularly vacc'd were all in the barn where the worst of the outbreak was (we believe a horse that came in that was vacc'd was a carrier bc we later found out he came from a barn that had 3 outbreaks in 1.5 years... nice right?!?!? He was a pvt owned horse too ugh). So you can't even argue that the non symptomatic ones were the ones with the least exposure. My clyde-x duke I only had for 1 year at that point and he abscessed. He is stabled next to and can go nose to nose with my tb sky who i've had for a lot longer and had been vacced 2x a year as long as I owned him. Sky never went symptomatic despite duke oozing next to him (gross!).

We also found that if you are careful and take temps of even non symptomatic horses 2x a day at least, you can treat with bute/banamine (depending on your vet's reco and what the horse responds to better) at the first sign of a slight fever and potentially head off the rest of the symptoms.

At the end of the day, good nursing care is a MUST, and no horses in or out for 30 days MINIMUM past the last horse's last symptom and you can keep it contained. As far as spreading on the property - even the best QT can still spread it as strangles is airborne and resistant to antibacterial agents s can travel with you from one end of the property to the other even if you spray yourself down with lysol. Best thing to do is not handle horses on anyone else's property after handling any affected horses.

Feel free to ask any questions you may have. We had this issue years ago but it was most definitely a learning experience and im happy to help in any way that I can. Best of luck to you. Best part is that strangles is rarely fatal, and usually self-limiting without meds.

I think over the years, this to me, has proven to be the best approach.

We did not take temps except on the obviously symptomatic mare - started pen g and now they are getting to where they will not let us near them because of a fear of being injected -

I'm so afraid to watch and wait and not do an antibiotic -
I will do banamine though, and I've called the vet about whether there
Is a feed through antibiotic I can do to avoid injections.

I would think a feed through would be less effective. The injections are there to insure that the horse gets every last drop of what they need.

Strangles can get scary but try to keep in mind that it is just a nasty infection and it will clear up in time. I personally wouldn't be giving antibiotics to a nonsymptomatic horse. Seems like a waste of meds. Granted, Strangles is super contagious but if managed properly, has a low fatality rate. The contagious aspect of it is what gives Strangles its really bad rap. Once it is in your barn, you are best to just work around it and sterilize as soon as it is gone.

Thanks - three have symptoms, and I just assume it is a matter of time before all 9 do - My vet is out of town and it is cracking me up

ALSO: Do most cases results in the open abscesses like this:
or no?