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Foal pneumonia: Rhodococcus equi and more
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FEB 16, 2024
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Foals develop multiple forms of pneumonia. Differential diagnoses will vary based on clinical signs and age of the foal. As with adult horses, culture and cytology of the tracheal fluid is required to obtain a definitive diagnosis.
Clinical signs
Clinical signs of pneumonia may not be too prominent until disease is severe or may be masked by clinical signs of the primary condition (i.e. sepsis). Fever, lethargy, tachypnea, nostril flaring, increased abdominal respiratory effort, purulent bilateral nasal discharge and cough may be present. Sudden death is not uncommon with severe disease.
Young foals:
Pneumonia associated with sepsis
- The most common organisms isolated are Gram negative enteric bacteria (E. coli, Klebsiella spp, Actinobacillus equuli, etc.) or Streptococcus zooepidemicus.
- Predisposing factors: Placentitis, failure of passive transfer, prematurity, etc.
- Severe disease develops rapidly.
- Route of infection may be vertical (in utero), hematogenous (umbilical infection, ingestion, and absorption of bacteria) or respiratory.
- Treat the underlying disease. Systemic broad-spectrum antibiotics to treat sepsis. Adjust as soon as sensitivity is available.
EHIV-1 pneumonia
- EHV-1 infection of a mare around foaling time may lead to the birth of a weak.
- The time of foal infection remains unknown.
- Foals develop severe, progressive pneumonia that may be complicated by secondary bacterial infection.
- Foals typically die within 2 weeks in spite of critical care; thus prognosis is poor. There might be a history of respiratory clinical signs in the farm or abortions associated with the birth of these affected foals.
Pneumocystis carinii
- Affects immunosuppressed foals (co-infection with other organisms, malnutrition, etc.). Causes interstitial pneumonia.
- Cytology definitive: Macrophage with P. carinii organism inside. Radiographs may show a distinct military pattern.
- Treatment (based on humans) is trimethoprim sulfa (TMS). Correction of underlying cause of immunosuppression if possible.
Adenovirus
- Adenovirus can be present in horses and result in subclinical or mild upper respiratory tract disease that resolves uneventfully.
- It causes progressive, fatal bronchopneumonia in Arabian foals that have severe combined immunodeficiency disease (SCID).
- The clinical sings are of those of pneumonia accompanied by lymphopenia (if SCID) and neutropenia (immunosuppression). The virus replicates in the respiratory epithelium.
Diagnosis
- Auscultation can be misleading: May be normal even if disease is severe.
- If patient is stable: transtracheal wash and submit fluid for culture/sensitivity and cytology.
- Thoracic radiographs: Helps with assessment of disease severity.
- Ultrasound: Widely available, easy to do. Limited to the surface of the lung unless consolidation/ abscessation is present.
- Hematology: Non-specific inflammatory findings
Treatment
- Varies with the condition (see above) but in many cases, treatment is instituted using broad spectrum antibiotics until results from culture-sensitivity are available.
- Intranasal oxygen: For critical patients.
- Anti-inflammatories: Ensure patient is hydrated before using.
- Bronchodilators: Evaluate case by case as it may cause a ventilation-perfusion mismatch.
- Rest
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How to reference this publication (Harvard system)?
Sanz, M. (2024) “Foal pneumonia: Rhodococcus equi and more”, WEVA - International Congress - Chile, 2023. Available at: https://www.ivis.org/library/weva/weva-international-congress-chile-2023/foal-pneumonia-rhodococcus-equi-and-more (Accessed: 05 June 2024).
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