Recovering from strangles

[Jemayni]

Right, Im hoping to pick peoples brains on recovery from strangles as Im starting to loose the will to live!

Basically my pony has been suffering from it for a month & is currently on his 6th cycle of anitbiotics (hes had varying amounts of trimeds, penicillin & cephaguard,) whenever he is on a course of drugs the infection is contained but as soon as the antibiotic gets out of his system his temperature sky rockets again (it got to 105.2 last week!)

He has been scoped so we know there is no infection remaining in his gutteral pouches. So, basically I was wondering if anybody had any words of wisdom - is it common for this to go on for a month?

PM if prefer!

 

[PapaFrita]

We've had strangles at our yard but none of the horses were as poorly as your lad. I think one horse had a couple of weeks off work, so I think a month is probably quite normal.
I have to say that I consider my YO's handling of the whole strangles thing at our yard incredibly irresponsible and they all went off to a show this weekend!

 

[glenruby]

My first pony had strangles a few years back.
Im presuming you are working with your vet on this one. But, I have always been told that until the abcess bursts (if there has been any development) then treatment with penicillin is pointless. It just halts the progress of the disease then the strep continues its action once the Pen has worn off.
Could you try lettin it run its coure ( with horse in isolation of course) without antibiotic tx and usig a small amount of steroid to control his temperature shold it escalate? Admin of a steroid does carry a risk of laminitis, but its likely this is what your vet is using to reduce his temperaure at the oment anyway. Its the standard tx on the ridiculously expensive racehorses iv seen with raised temperatures ( due to viruses) this winter.
For the record, my pony only started his Penicillin treatemtnthe day his abcess burst (after it had burst). the previous day he was given Finadyne and dex to reduce fever and make him more comfortable.

 

[KatB]

Agree re. the peniciilln, unfortunately it may have delayed the recovery. HOWEVER, the fact he has no infection remaining is good. Get him on red cell or an immune boosting supplement, just to help his body, but other than that, not alot you can do, just a bit of a waiting game.

 

[Jemayni]

Thanks PF, Im in the same situation with my YO, if she wasnt so apathetic, I wouldnt be in this mess in the first place! thanks for the feedback on horses on your yard!

 

[Jemayni]

Yup my vet bill is already in 4 figures (thank god for petplan) -The vet is well & truly involved!

That's really interesting what you suggest about penicillin; the first 3 lots of antibiotics were penicillin based, the latter 3 have been cephaguard (sp.) It helps me to understand why it kept returning initially & why he was changed onto sephaguard (the vet was a bit elusive when I tried to discuss this!)

Sorry if Im being completely dumb but what is "tx." My pony has not developed abcesses and is no longer dropping large amounts of mucus, so Id be worried that letting it run its course may take us backwards? Nonetheless I will have a chat with my vet about it, if only to see why we havent tried this yet!

 

[Jemayni]

Right I will go & buy some red cell, have been considering putting him on a NAF immune supplement anyway; I completely forgot about Equine America products - I have a lot of faith in them!

Thanks for the reply KB, its all so very confusing!

ETS: Im thinking of propell plus not red cell!

I think Red cell is cheaper anyway!

 

[joan]

Hi: I don't have an in depth knowledge about this but about 2 months ago my instructor's yard was hit by strangles and interestingly, the horses that were treated with antibiotics were the ones that took the longest to recover. Only one horse had an abscess. I think about 6 or 7 horses were involved.

 

[Tia]

Some of mine caught strep a few years ago due to a silent carrier. Only a handful actually caught it. None were given penicillin as I have major issues with this being used where strangles is concerned. All were well and truly over and done with it within a month. They were down in the dumps for a couple of weeks beforehand, but once the abscesses burst, they all felt much better. I kept our place confined for 60 days after the last horse cleared up and it went no further. All horses recovered perfectly.

Apart from the cost of going through a lot of Povidone, the financial cost of recovery was minimal. I did ask my vet to come and lance one abscess which I was having trouble encouraging to burst, but that only cost about $40.

 

[Tia]

Cephaguard is an interesting drug to use as it was designed for cows. I'd imagine it works just as well on horses, though have never heard of it being used for them.

 

[Jemayni]

Thanks Joanie, there seems to be a common thread appearing in these replies re antibiotics!

 

[Jemayni]

Thanks Tia, apparently Cephaguard is a "new fourth grade antibiotic used for this type of respiratory infection" according to my vet. I'd never heard of it either, it has also been used in humans I believe. It does seem to be effective stuff & has worked wonders with the others on the yard - just seems to be mine that it hasn't been so great with!

Thanks for your input re: treatment; it seems a common alternative not to use penicillin & one that I had been previously unaware of!

 

[sqippa]

My boy had a bad bout a few years ago (too old to be covered by insurance unfortunately). He was ill from early July to September! He never had abscesses but the infection went into his gutteral pouches, causing lymphadanopathy and partial paralysis of his soft pallet and vocal cords. He used to dribble water out of his nose when he drank poor lad and boy did he make a lot of noise breathing. Any how we treated with Baytril and he was on some Potassium iodide (I think) solution and also on a drug called Interferon to boost his immune system. None of this worked until we went for plain old injected penicillin which finally did the job. Yes there is the case for not using antibiotics until the abscesses burst but modern day strangles is not like the old version and many cases are what they call atypical and do not show the old gorey symptoms but are more discrete. These will often clear up if left alone but may not as with my boy. I would hope that your vet knows what they are doing and you may simply have to play around with the drugs until one works. May be worth getting him swabbed to do a sensitivity test on the culture so you know you are using the correct antibiotics though.

Good luck, but you may have to accept that there is going to be a long road to recovery.

Sqip

 

[Jemayni]

Thanks Squippa, & thanks very much for your honesty. I have been down the Potassium Iodide route already, but all it achieved was conjunctivitus and consequently I didnt even feel it that worthy of mentioning! It sounds like the 2 cases are similar in how resistant they have proven to drugs; I have little faith remaining in cephaguard & penicillin TBH, however he has had 2 swabs thus far, but neither have returned from the lab yet - I am hoping with a definite diagnosis we may be able to try something different again!

 

[Quarrybank]

Your boy sound like he had it simular to Spider.
He also had it bad (see my other posts) & didn't get the typical external absesses bursting. They were inside, in his gutteral pouches. He also went on Baytril, however in the end he had to be hospitalised & had antibiotics flushed into his gutteral pouches through catheters. He got it at the beginning of May last year & we had the all clear at the end of July.
However he too was left with paralysis of the larynx. I had a tie back done in October, but that failed (I think because there were probably other complications from the strangles), He had water coming down his nose along with partially digested food, coughed badly

It was reversed 2 weeks ago, & he's now stopped all the horrid side effects, but will prob make a noise & have exercise intollerence when I bring him back into work.
Jemayni - Good luck with you horse & keep in contact with your vet. I agree with sqippa, it might be worth getting a culture done to see which antibiotic is best. They did this for Spider to see which antibiotics to use when they flushed him out. It took a while, but did the trick in the end. You don't want internal absesses to take hold as that's what does the long term damage.

Lot's of healing vibes to you.

 

[Jemayni]

I remember reading various posts about Spider, glad he seems to be back on track & best of luck bringing him back into work.

Thankyou for your input, fortunatly my vet is lovely & Im now in contact with her directly, opposed to through the centre! He has had cultures done & Im awaiting results, hopefully this will provide us with some direction! Thanks for the vibes - they are well recieved in my current environment!

 

[GreedyGuts]

Antibiotics are not indicated in the management of typical strangles. The disease has not changed in any way that make this approach necessary or advisable. In most cases the disease will run its course without intervention.

The bacteria that causes strangles is very sensitive to penicillin, so the fact that your horse is having these ongoing problems suggests that there is something more complex going on. I would be suspicious that he has foci of infection elsewhere - bastard strangles.

Antibiotics don't get into abcesses regardless of whether the causative bacteria is sensitive to them, but may help to keep them in check (the rationale for not treating strangles with antibiotics is that you don't want to keep the abcesses in check, you want them to burst and delaying this prolongs the disease process). This could be why your horses symptoms are recurring once treatment is stopped.

I would be inclined to ask your vet to speak to a specialist about your horse and consider referral, as this may be the best way of getting to the bottom of what is going on with your horse.

 

[Tia]

I agree with Greedyguts; sounds like the horse's condition is far more complex than just regular strangles. I think I would also be asking to speak to a specialist now. I can imagine how concerned you are about your horse Jemayni. It's never a nice infection at the best of times.

 

[sqippa]

Contrary to what some other posters have suggested, not all cases of strangles result in closed conventianal abscesses and I speak from experience here having seen the pus simply oozing out of Barley's gutteral pouches (Quarrybank I bet you can empathise here if you were lucky enough to see your guy's scope on a TV screen as I was.) Strangles has evolved as all disease causing organisms do and this Atypical type can mean that some lucky horses simply get a fever and a bity of a runny nose before feeling fine only a few days later. When my boy had it this was the case for the 4 other horses who got it. They needed no intervention at all but my boy who was the horse whose symptoms prompted testing and diagnosis of the outbreak was very ill. His temperature went through the roof, he has big time bogeys, leaving floaters in his water bucket (nice!) his submandibular glands were inflammed but did not abscess and externally he really didn't seem too bad. This was because his infection was focused in the gutteral pouches. It is probably the same with your guy as was suggested earlier and not being able to find where it is hiding can make treatment tricky.

Animal Health Trust were really helpful with me so you might want to get in touch with them but here are some links to useful sites

http://www.aht.org.uk/pdf/strangle_leaflet.pdf
http://www.equine-strangles.co.uk/
http://www.edp24.co.uk/Content/Sport/Equestrian/2006/asp/Strangles.asp

Well I'm sure there's more out there but it is helpful to know that you are not alone and that this does sometimes happen but you can get there in the end.

Hey I still have to have sugar in my tea 4 years on, the stress of sorting my old boy out mad me sugar hungry! Goodluck and keep positive.

sqip

 

[Quarrybank]

Ditto all that sqippa has said (including the big bogeys

although they arrived after the initial diagnosis)
Spider went in because I was worried about how he was swallowing & thought he had something stuck in his throat! He had a v v high temperature & wasn't really eating. The v high temperature was an ongoing problem in the first few weeks. Strangles hadn't even come into our thoughts (although with hindsight he had most of the symptoms apart from the obvious - large glands) As soon as the scope went in, I looked at the vet & we both went ...... STRANGLES. I have never seen so much pus & mucus it was disgusting. The pouches were so full you couldn't see the site of the absesses themselves.
I wouldn't wish what I (& sqippa) went through with our horse but I agree that if you're lucky strangles is an inconvenience, but it can be a lot more complicated than people think & in those case antibiotics & further treatment is sadly necessary.
Jamayni - has your horse been scoped? If not that would be my next step, so you can see what's going on inside.

 

[sqippa]

Funny, we were thinking that he had a tumor or something like that and he went in for head X-rays. We were half expecting to find some growth but got a load of pus instead and similar to you went 'sh*t-strangles!'. This was like you some significant time after first symptoms. I think it was about a month before he was actually diagnosed, we did do swabs initially as blood tests were suspiscious and suggested bacterial infection and inflammatory responses in line with strangles but they came back negative and due to extrenal sypmtoms being very light we didn't persue further. Scope results were a real shocker! Doubt the vets would have invited us to the clinic if they had thought that was what we were dealing with, boy did they have some disinfecting to do afterwards.


Keep us posted Jemayni and PM me if you like.

Squip

 

[brighteyes]

My experience with strep equi/zooepidemicus is similar - one conventional submandibular abscess preceeded by very high temperature (for which I gave Danilon) and one (massive) unilateral gp infection in our most elderly pony. One 'no show' and one mildly affected horse out of my home stabled herd.

Vets never did use the 's' word

but the chap at Leahurst where we took the old lady to be scoped and flushed said that the infection was definitely a sequel to a strangles infection.

The prognosis for her recovery from the chondroids seen on x-ray was guarded to poor and I left for Leahurst with a heavy heart. However, somehow, she had shifted the impacted gp herself and, well (touchwood) she is still alive and very much kicking as I write.

And that's how I come to be here on HHO - after asking for any positive outcomes (ie survivors) of gp infections

FWIW I would suspect that either the ab's have prolonged the infection - ab's tend to be contra-indicated in strangles - or worst case scenario 'bastard strangles'. I sincerely hope this is not the case.

Jemayni I hope your pony improves soon and is on the mend in no time. x

 

[Jemayni]

Thanks GG, apologies that it has taken me so long to reply. My horse has not developed abcesses, I am not sure whether this is because he was heavily treated with antibiotics at the onset of symptoms or because of the nature of this strain. He has also not demonstrated any clear sign of lymph node enlargement, and his gutteral pouches scoped clear - this has led the vet away from the idea that the infection has spread elsewhere. Having said that there is no reason why the infection should keep returning the way it is doing, if it is that straight forward!

After reading all these replies, Im getting to the point where Im thinking that I need to speak to a specialist!

 

[Jemayni]

Thanks Tia; as I mentioned in my reply to greedy guts, he has had all the various tests for bastard strangles & they have all returned negative. But this isnt explaining why the infection keeps returning. My vet is coming out again on Thursday - so I will pick her brains about referring him!

 

[Jemayni]

Thanks Sqippa, the two cases do sound relatively similar on some levels, the 2 horses that infected mine were atypical; & whilst my pony has extreme snot & a very high temperature, he has not had the abcesses. He has had his gutteral pouches scoped & they were completely clear, so we are still at a loss unto where the infection is. I will have a good look through those websites this evening, thankyou for them.

NB: My weight watchers diet has gone completely out of the window in the last fortnight!

 

[Jemayni]

Thanks QB, my pony has been scoped & they were perfectly clear, this is why I cant understand why the infection is going on & on! Suppose I will keep ploughing on in the hope of finding the light at the end of the tunnel!

 

[Jemayni]

Thanks bright eyes, it is very difficult to get the strangles word out of a vet, they seem to be so concerned with confidentiality, they just dont use it! Thanks for your post, nice to see the light at the end of the tunnell post!