Clostridium – Botulism and tetanus and gangrene, oh my!!

 

After last week’s discussion on Rabies, I decided it was important to discuss another readily-controlled, animal-killing pathogen – Clostridium.  This genus, or group of bacteria has more species members than any other genus of bacteria.  A book could be, and probably has been, written about all of the Clostridial diseases that exist.  Clostridium bacteria produce neurotoxins or tissue toxins when seeded into wounds or ingested.  They generally favor environments that are anaerobic (without oxygen).  A few of the more notable diseases featured in this group include tetanus, botulism (limber-neck in poultry), gas gangrene, and overeating disease.  Others less commonly known include blackleg, red water, Tyzzer’s and black disease.  Many people (and foals, lambs, etc.) have been infected with, and killed by C. difficile diarrhea.  Any diarrhea, abscess (foot or otherwise), or hot, painful deep tissue infection in a vertebrate could well have a Clostridial source.

Many species in this genus live in the environment all around us, like Clostridium tetani, the organism that causes tetanus (not just on rusty nails!).  Some areas of the country (notably Kentucky and Texas), have high levels of botulism in the soil and are avoided.  Only a few years ago, C. botulinum bacteria growing in a batch of haylage produced a neurotoxin that, on ingestion, killed over 100 horses in the Ocala area.  Botulism is an important disease of foals in the Kentucky area, and vaccination is recommended for broodmares and foals in that area of the country.  As it causes flaccid (limp) paralysis, intensive care is required to support almost every bodily function during the weeks of recovery – eating, drinking, and breathing.

Tetanus, like botulism, can kill just about anything.  While botulism is usually ingested or inhaled, tetanus is usually associated with a wound, often a puncture wound that is allowed to heal over, creating the perfect warm, airless environment for it to multiple and produce toxins.  Its neurotoxin has the exact opposite effect than botulism: the uncontrolled paralysis is “tonic-clonic,” meaning the muscles undergo spasmodic continuous contraction.  Stiffness will first be noticed in the limb or area near the wound, and will become generalized in a matter of days.  The powerful clamping of the chewing muscles, often resulting in the subsequent starvation, dehydration and death of an animal affected by tetanus, is what gives rise to the term “lockjaw.” The body takes a rigid, arched position as the back muscles contract, overwhelming the abdominal muscles and pulling the head back.  There are no blood tests to diagnose tetanus, but often the characteristic symptoms readily point to this historic culprit.

Control of tetanus is easily achieved through annual vaccination.  A tetanus toxoid vaccine, given annually, is usually used for small ruminants, but can be given off-label to other species such as al pacas and llamas. Most horses receive their tetanus toxoid vaccine in the “EWT” (Eastern Encephalitis, Western Encephalitis, and Tetanus) combination product twice a year.  Ruminants (cattle, sheep, and goats) are usually are given a “seven way” vaccine as youngsters, then annually and pre-breeding that includes overeating disease (C. perfringens).  Generally vaccination is recommended starting at 4-6 months of age. The vaccines are inactive bacterial products, so unlike some vaccines, there is no risk of infection from vaccination. It is not uncommon for animals (and people) to be stiff for a day or two after vaccination.

If your animal receives a deep wound, call us immediately!  Antitoxin must be given to animals that are not vaccinated if they receive a deep puncture wound that will predispose to infection.  This antitoxin has been associated with reactions resulting in liver disease in horses, so regular vaccination is strongly recommended.  Like for Rabies, vaccination is cheap, easy and effective! Don’t overlook this important and easily preventable disease when taking care of your horses and livestock.

In the meantime, my spoon splint is finally off!!! …although I still have an annoying bandage on my foot (which I continue to shake at people), I feel like my stall-turned-paddock (when I get to go out in the barn aisle-way) rest is close to over! May your food bowl always be full, and your litter box be ever-clean!

 

Rabies!!!

 

I would like to talk about a very serious subject in this week’s blog:  Rabies.  Dr. Lacher and Dr. King recently heard about a case of Rabies in a pony in North Carolina and asked me to share some information about Rabies and its management in horses.  I was all ears since I too have to be vaccinated for this deadly disease.

Rabies is a virus of mammals which affects the nervous system.  The virus is transmitted from an infected animal to other animals through bite wounds, typically from a fox, skunk, raccoon or bat.  Once the virus enters the animal it seeks out a nerve to bind to and follow to the brain.  The virus is on a search and destroy mission until it reaches the brain, only then does it branch out to other tissues like salivary glands.

We were all taught not to approach the dog foaming at the mouth, it might have Rabies.  If a raccoon or fox is seen during the day and is acting aggressive most of us would worry about Rabies.  What if your horse was mildy colicky, had a slight lameness or was having difficulty urinating?  These are all symptoms of Rabies in horses.  And there is the biggest problem with equine Rabies cases.  Many of us do not recognize it is Rabies until it is too late.  The pony in North Carolina had a wound it was itching and wouldn’t leave alone.  In this case, as in many other equine cases, lots of people were exposed to this horse before anyone realized it might have Rabies.  This means all these people had to go through post exposure vaccination!  That would not make for happy neighbors.

Rabies is definitely a case of the best defense is good offense:  vaccination.  The rabies vaccine is very effective.  It cannot be said with 100% certainty but no one Dr. Lacher or Dr. King could find knows of a single case of rabies in a vaccinated animal.  This makes it among the most effective vaccines we have, which is good since we also have no known treatment.  It is recommended that horses be vaccinated yearly for rabies.  Due to some unique features of the equine immune system it does not respond to the rabies vaccine for very long.  Studies have shown that most horses can fight off an exposure for 14-16 months following vaccination making yearly vaccination very important.  Humans, dogs and cats do a much better job responding to the vaccine and can remain immune for many years.  It is still recommended that dogs and cats be vaccinated at least every 3 years for public health reasons.

You come out to feed in the morning and find a raccoon acting strangely near your horses.   What should you do?  First, do not try to come near any wild creature acting oddly.  Call Animal Control.  Move your horses to a safe area as far away from the raccoon as possible.  Call Springhill Equine.   If your horses are up to date on their rabies vaccines we will administer a second vaccine as soon as possible.  If your horse has not been vaccinated a quarantine will be necessary for 6 months!  If you suspect your horse may have rabies, call us immediately and limit contact as much as possible.    The moral of this story is to vaccinate for rabies.  It’s cheap, easy and effective!

On a personal note, my broken foot continues to heal well.  Dr. Long at Newberry Animal Hospital says I might get my splint off this week.  I sure hope I do since I am so tired of being locked up in the Clinic.  I have a new appreciation for horses on stall rest.  It’s NO fun!!!!

Happy Holidays from Tony!!

We at Springhill Equine (by we I mean Tony, and of course the other staff and Doctors), want to take a moment to wish all of our wonderful clientele a very happy and peaceful holiday and joyous transition into the new year!

We are very excited to start seeing our Wellness patients (new and old!) for their first visits! In addition, the staff, in particularly Dr. King, is ecstatic to be coming into breeding season.  She is ready for sleepless nights, bouncing foals, and the reward of pregnancy (for the mare)!! The year of 2012 promises to bring many exciting events for Springhill, continuing our old traditions, refining our current favorites, and adding new features to our packages and services. We can’t wait to see what new faces and old come through our doors this year!

The year of 2011 was a great one for Springhill as well, despite a rocky ending. An overall successful breeding season ended with the addition of Dr. King and our technician Danielle. Our other technician, Amber, moved into our office manager position, and has done a great job as our clinic crusader – along with our staff handling everything from answering your calls, preparing medications, and keeping your reminder cards coming! Our current team was complete with the addition of Michelle, who has worked for a long standing Springhill client for many, many years!  The overall excitement of the Springhill team, however, was sadly dashed to the ground in November when a tragic attack left me crippled for the remainder of the year. Hopefully the morale of the group will peak up a bit after my cast is removed in 2012.

Thanks for being loyal readers of my blog in 2011, and please help me come up with ideas of what you want to read about in 2012!  Feel free to email blog ideas to the clinic, vets@springhillequine.com.  I’m feeling quite comatose from all these cookies that you have been bringing by the office (THANK YOU!!!!!) – so I think I am going to tuck in for a warm winter’s nap and hibernate until 2012!!  May your litter box be clean until then, and your food bowl be exceptionally, holiday full!  See you next year!

 

Cold Weather Colics

 

Brrr!!  The weather outside is frightful (well for Florida anyway) and your horse is far from delightful…because he’s colicking.  This time of year Dr. Lacher and Dr. King stay very busy treating colicking horses.  While I was making them scratch my right ear (I can’t with my broken foot) they explained why this time of year leads to colics.

Part of the problem in Florida is our wide variety of temperatures.  A few days ago it was tank tops and shorts and today its heavy jackets.  Our horses have a hard time adapting to these rapid changes of temperature!  I find staying inside the office with the heat on is the easiest way to deal with cold, rainy days.

The biggest culprit when it comes to winter time colics is WATER!  Our horses seem to decide that since it’s a little chilly they don’t need to drink.  We then throw out extra coastal hay to keep them from eating the pasture down to nothing.  And the combination of not drinking and extra hay equals an impaction and a visit from Dr. Lacher or Dr. King.  Dr. Lacher says way back when she was a kid (I think she’s going to limit my cat treats this week for that age comment) bran mashes were commonly feed once weekly.  The thought behind this was that the bran moved any sand out of the GI tract.  There are at least two problems with the bran mash scenario:  bran doesn’t move sand and you just gave your horse a totally different feed type without transitioning the diet.  So if bran is out what is in?  Just the water.  That’s right just water.  You can add water to your horse’s meal no matter what you feed.  Pelleted and Senior diets readily dissolve in water and soak up a ton of extra water which your horse then consumes because it comes with grain.  It’s a lot like getting your children to drink milk by adding Frosted Flakes.  Another way to get more water in to your horse’s diet is with soaked beet pulp.  This is a great option for our easy keeper patients.  Beet pulp shreds with no added molasses are low calorie and will soak up 2-3 times their dry weight in water.

The most common type of impaction from coastal hay is called an ileal impaction.  This happens at the very end of the small intestine.  The last 12-18 inches of the small intestine are very muscular and narrow.  When a bolus of gooey chewed coastal hay with a low water content reaches this area, known as the ileum, the muscle contracts causing pain and stopping the rest of the intestinal contents from passing through.   Adding water will help reduce ileal impaction but the best way to make a big impact is to feed a half to one flake of alfalfa hay per day per horse.  Alfalfa is high in potassium so it stimulates thirst and it has a natural laxative effect on the GI tract.  A small amount of alfalfa really makes coastal a manageable roughage source without adding much in cost.

Let’s talk wardrobe.  Your horse doesn’t need an entire SmartPak catalog of blankets and sheets but consider having a waterproof, breathable sheet especially for the geriatrics.  If the weather is cold and wet a sheet prevents your horse from getting soaked and if you come home to find your horse shivering you can throw it on to warm him up.  If you don’t have a sheet or blanket available throw an extra flake or two of hay.  This gets the hind gut fermentation going which in turn produces heat.

What about warm water?  An interesting study was done a few years ago which revealed that horses don’t care about the temperature of their water.  They will drink more cold than warm water.  Just make sure your horse has access through any ice that may form.  We find that our Florida horses have no idea how to break that cold hard stuff on top of their water troughs and expect us to do it for them.

I hope you have picked up a few hints to help avoid unexpected visits from the Docs this Holiday season!

May your litter box be clean and your food bowl full! Tony

 

57th Annual AAEP Convention in San AnTONYo!!

Tony here – recovering slowly but surely.  The foot is feeling better, but the folks at the office think it’s a great idea to have me on a diet so I lose some weight – I couldn’t disagree more.  There has been a lot of talk about all the conferences the Doctors and staff have been going to.  Last week I shared what I’ve heard discussed about the Laminitis Symposium.  This week, I decided to focus on all of the exciting things Dr. King brought home from the AAEP Convention in San Antonio, Texas!

One of the hot topics of discussion in the office, in preparation for foaling/breeding season coming up quickly, is the new guidelines published by AAEP for Control of Venereal Diseases.  A new (to the United States) strain of CEM, or Contagious Equine Metritis, was found in a 4 year old stallion in Arizona this year.  CEM is caused by a bacteria called Taylorella equigenitalis that can be spread by normal-appearing stallions, and can cause infection and inflammation in the uterus.  Springhill Equine will be working to adhere to their recommendations during the coming breeding season.

Other exciting reproductive developments include the first equine embryo biopsy.  By sampling DNA from the embryo, the researchers were able to correctly determine the sex, as well as test the embryo for diseases such as HERDA and HYPP.  Springhill is excited to see these signs guiding our pathway to the future of equine medicine!  Another case described a mare, who had previously given birth to three healthy foals, experience early embryonic death, and was found to have developed a genetic abnormality.  Researchers at the Gluck Center in Lexington, KY quote that 35-40% of samples are positive for a DNA abnormality.  Tests run from $200 for a basic karyotype to $450 for an advanced DNA analysis – please contact us if you think your horse may have this type of problem!  In addition, Dr. King plans to start using what are called buffered chelator solutions, such as Tricide, to help break up biofilm and potentiate antibiotics in the uterus of ‘problem mares.’

Another important reproductive point that was made was regarding EVA vaccination.  EVA, or Equine Viral Arteritis, is a venereal disease that can cause abortion.  Vaccines are very tightly regulated by the U.S. Government, so that stallions that are vaccinated can be kept track of.  This way, if a horse ends up testing positive, they know if it is because they are truly infected or if they have just been vaccinated for the disease.  If your horse is vaccinated for EVA (you know who you are), it is recommended that semen be withheld for 14 days post-vaccination.  A study with 10 stallions vaccinated for EVA resulted in transient low levels of the virus in one stallion’s semen on day 2 and 4 post-vaccination.  The study also showed that none of the 10 horses transmitted the virus to horses in the next stalls, there were no adverse effects of the vaccine, and all successfully showed an acceptable immune response to the vaccine.

Other important points – colic recurrence is higher than previously thought (37% medical, 50% surgical), medical management of bladder rupture is possible in foals, and a BRIX Alcohol Refractometer is a quick and cost-effective way to decide if foal colostrum supplementation is necessary. The doctors would be happy to discuss this option with you if you are interested! Another important point I heard them say is DO NOT give foals cow milk replacers if there is any nursing issue, should they need plasma in the future the transfusion reaction can kill them! There was also the official launch of the new, FDA-approved pergolide.  Please contact the office if you want to switch to this new product and/or need to get a prescription.  Or even better, stop by the office and give me some pets on your way!!  Thanks for reading, may your litter box be clean and your food bowl full!