Rhodococcus equi

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I have a friend who about 6 years ago or so had foals diagnosed with Rhodococcus. She was basically told by the vet that once you have it on your place it is near to impossible to get rid of it. To protect her foals they would have to be infused. I don't remember the name of the fluid. So to this day, every foal that is born on her place gets infused by the time they are 2 weeks old to prevent them from getting infected by the Rhodococcus bacterium. She doesn't take any chances. Talk about an added cost to raise babies. Since she has been infusing the foals she has not had another incident.

If I remember correctly it happened during a year when it was very, very unsually dry and dusty here. The bacteria lies dormant and when the conditions are just right, that is when it rears it's ugly head. It is definitately nothing to fool around with!
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Well, for me anyway, this has been a great learning experience, and I appreciate it very much. If nothing else, the loss of those colts has raised everyone's awareness of this disease.
 
I just talked to one of our vets about this and the answer I got was yes it can effect older horses however in a different way. While not as serious or deadly it can cause things like chronic coughing not really with a runny nose ect but more a dry hacking cough. More of a after effect of those who may have been exposed to some extent as babies was how I understood it.

While it does exisit in many places proper management is necessary on a farm where large amounts of foals are born (and or died from it) medical precautions should be taken and treatment should occur for the entire foal crop and they said to go with caution more then likely for the next few foal crops as well. THe odds of just a couple of foals transported to new homes getting it are slim meaning within the foal crop more then likely foals died on the orginal farm and babies transported would not really add or take away from any chances of them meeting the same fate.

Not taking it as gospal just sharing what I was told
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of course like anything you can ask 10 vets and get 10 different answers

Either way it is scary and shows how much you really need to know your sellers
 
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Although I am not a big breeder when I became aware of this illness, I felt really

'dumb' that it had escaped my attention. It's not new nor is it isolated to mini

horse farms. I've found older articles addressing the issue and had the V-8 moment

of thinking how did I miss this? I thought I'd read everything about foal health I could

get my hands on.

It's my personal opinion, that I feel Forums such as this one, have a duty to it's members

that when something of this magnitude is known that it should be brought forward for

discussion. To be informed allows us to make better decisions.

This disease has far reaching implications financially for horse farms of any variety and

that doesn't touch the emotional end of loosing a foal because you didn't know what to

look for.

Some months ago when I learned about this I wrote the Vet in Canada that authored

the link mentioned in the first post. I misplaced his response. However, later I did pay for

another professional opinion, which while giving more in depth information was consistent

with to other articles I've now read. I will also be discussing this with my personal vet

at her next visit.

I am posting that response below. It's an additional opinion that you can add to your

arsenal of information on how best to care for your 'kids'.

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This is the question I posed and their responses:

I am interested in knowing more about Rhodococcus Equi Pneumonia in Foals, it's early treatment in the foal, are plasma transfers an effective treatment? How to protect your environment to minimize it's effects. Do foals continue to shed the bacteria after cure?

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Answer

February 4 2009 at 4:08 PM (2 hours and 1 minute and 7 seconds later)

This is a pretty broad question, I will give as much information as I can.

Rhodococcus (R. equi) is an intracellular bacteria that can often cause pneumonia in foals. R. equi can multiply in the enviroment (paddock dirt) especially during warm weather and with manure added to the dirt. The most common way for foals to become infected is thru inhaling the the bacteria in dusty paddock situations. Foals usually develop symptoms of infection between 3 weeks and 6 months old. Some symptoms are: increased respiratory rate, flared nostrils, cough and nasal discharge.

Antibiotics typically used to treat R. equi pneumonia are: Erythromycin, Azithromycin, or Clarithromycin combined with Rifampin. In other words, any one of the 'mycin antibiotics is usually combined with Rifampin.

Plasma transfers have shown more promise as a preventative for R. Equi than as a treatment. There have been studies that indicated that plasma transfer was an effective way to prevent R. Equi pneumonia and other studies that showed no significant improvement. One reason why there have been varying results is that the best time (or age)to administer the plasma has not been determined.

Since most foals are infected through their enviroment, prevention is mostly by keeping the paddock and stalls free of manure which can contain large numbers of the bacteria. This manure should not be spread on the pasture as a fertilizer. Also reducing the dust in the enviroment is belived to help. There has been some indication that foals born on pasture (grass) rather than in a stall or paddock are less likely to develop disease. This may be due to the reduced amount of bacteria they are exposed to in dust and dried manure.

When foals shed R. equi bacteria it is usually because of the bacteria they have coughed up and then swallowed. These swallowed bacteria are then able to multiply in the gut. This causes there to be large numbers of R. equi bacteria in the manure of infected foals. These foals should be isolated and their manure removed for composting away from other horses. Once a foal has completed antibiotic treatment for R. equi pneumonia and recovered (this will take a minimum of 3 weeks) there should not be any R. equi bacteria being shed. It's important to remember though that this bacteria can survive very well in the enviroment (soil).

Dr. Jean

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DrMike agrees with this Expert (February 4 2009 at 4:16 PM)

Dr. Jean (Offline) -- Horse Veterinarian -- 13 years of experience in equine practice

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Your Reply

February 4 2009 at 5:04 PM (55 minutes and 57 seconds later)

Thank you for your prompt response. It is consistent with other research I have done.

I want to connect as many dots as possible about this foal disease since I recently became aware of it. I feel I may not be asking all the right questions to become fully informed.

One other question I had was regarding the spreading of this disease from farm to farm, thru the sale of foals. Is it possible to contaminate a 'clean' farm by bringing a youngster that is carrying the disease onto the farm?

I guess my concern is that, is it something one needs to ask if it is present on a farm before purchasing?

If it does live well, in the soil, is it common or just an occassional occurance, given the right circumstances?

I do not want to over react to this - But with foaling season upon us and people thinking of adding to their herds with likely prospects, this seems it could have far reaching implications to the health of your herd, financially and emotionally as well, should your farm become infected. Thanks for any further information you could share that might be helpful............

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Answer

February 4 2009 at 6:51 PM (1 hour and 46 minutes and 11 seconds later)

Rhodococcus can spread from farm to farm through infected horses. One way this could happen is with a youngster that wasn't showing many symptoms but then after the stress of moving is very sick and shedding large numbers of the bacteria. It would be possible to contaminate a previously 'clean' farm this way.

Asking any farm you might buy a brood mare or foal from whether they have had Rhodococcus is a good idea.

Rhodococcus seems to be more of a problem on some farms, though it isn't exactly understood why. Some researchers believe the soil on these affected farms contains just the right ingredients so that the bacteria is better able to survive. Rhodococcus is more prevalent in warmer and drier parts of the U.S. where paddocks become dusty in the summer. On some farms nearly every foal can be affected, while other similar farms can just have one or two cases a year.

Having your farm become infected with Rhodococcus can have a significant impact on both the horse's health and the finances. The best way to prevent any horse bringing it in is to keep new arrivals isolated for 3 weeks after they arrive. I've included a link to a government article giving details on biosecurity practices for horse farms. This is an overview of how to prevent new horses from spreading any disease they might carry. http://www.omafra.gov.on.ca/english/livest...acts/00-091.htm

http://www.omafra.gov.on.ca/english/livest...acts/00-091.htm

Dr. Jean
 
I had a foal 2 years ago that was a dwarf. She got rodococcus coming 3 mo. old her first symptom was heave breathing. She never got a runny nose or caugh. She also got a very high fever, 105 at times. we treated her for 3 months and $3,000. dollars later she is as healthy as a dwarf can be. I have had her story listed on Yahoos dwarf forum if anyone would like to read it. I learned a very good lesson, but my vets are saying that they are starting to find that the transfusions are not working. Yes the bacteria can be in the ground and yes horse can be carriers. And you can do alot of sanitizeing but more than likely it will still be there. I HAVE NEVER HAD TROUBLE BEFORE OR AFTER! It is very possible that I will but so far I have not. By the way this foal tested ok for her IGG. And I want to thank the people that have posted sites to read, because I do read all I can on this. There was also another one that I read that says they are finding that farms that are very religious about shots proper care are more suseptible. I may have read this on The Horse. By the way If this foal would have been normal size my vet would not have been able to xray her lungs. She has also been to Va. Tech to the internal Med. Vet. Lorie
 
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Some points that stood out for me.

1. Foals usually develop symptoms of infection between 3 weeks and 6 months old.

2. Plasma transfers have shown more promise as a preventative for R. Equi than as a treatment. There have been studies that indicated that plasma transfer was an effective way to prevent R. Equi pneumonia and other studies that showed no significant improvement.

3. It's important to remember though that this bacteria can survive very well in the enviroment (soil).

So now we have to ask sellers, have you ever had "Rhodococcus Equi Pneumonia in Foals".

Buyer beware, this is terrible
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I'm confused.... IF we all have it, how come SOME places are diagnosed with is and have to have transfusions? Why don't all farms have transfusions done?

Also, If you buys a stallion from a known carrier farm, can that stallion "bring it" to your farm??

I'm
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... LOL
 
I'm confused.... IF we all have it, how come SOME places are diagnosed with is and have to have transfusions? Why don't all farms have transfusions done?Also, If you buys a stallion from a known carrier farm, can that stallion "bring it" to your farm??

I'm
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... LOL

I do not believe we all have it, conditions have to be just right.

It sounds like you might not get all your answers, you will have to decide, do you want to take a chance?
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Learn something new everyday, that is what this forum is about.

We take what we like and leave the rest. I never heard of this until today.
 
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Report: Hyperimmune Plasma Not Effective for R. equi

by: Stacey Oke, DVM, MSc

March 19 2009, Article # 13809

Print Email NEW! Add to Favorites RSS ShareThis

The administration of hyperimmune plasma to foals is costly, time-consuming, potentially risky, and does not appear to decrease the occurrence of Rhodococcus equi pneumonia, reported Siobhan McAuliffe, MVB, Dipl. ACVIM, head veterinarian of the Stables of King Abdullah & Sons located in Saudi Arabia and colleagues at the 10th International Congress of World Equine Veterinary Association (WEVA).

There was no difference in terms of severity of disease or number of treatment days between the two groups.Hyperimmune plasma is administered to foals to prevent or control R. equi pneumonia, but evidence supporting the efficacy of this practice is lacking. To further explore this issue, McAuliffe divided foals into one of two groups during the 2005 foaling season. One group of foals was administered hyperimmune plasma on two separate occasions, whereas foals in the second group served as untreated controls.

Forty seven of the 80 foals were positive for R. equi. Twenty-four had been treated with hyperimmune plasma while the remaining 23 were not. Further, there was no difference in terms of severity of disease or number of treatment days between the two groups.

As recommended by the authors in their abstract, alternate management strategies are advisable.

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Funny that I just received the Horse Health report today and they had this article>
 
It is nothing that i would want here, that is for sure and i do not plan on bringing any of it here either

Knowing only a little bit about the disease, i'm just sorry to any of those who have had to deal with it on their farms (including the original person - i cannot imagine what that is like every foaling season, with nothing you could do about it)
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I have read so many different reports on this since it came up. None seem to agree weather giving the transfusions is effective or not. Some say yes and some say no. I do applaud those farms for going the extra mile and giving this. I also read one that said no vaccination yet and another that said there is and that they are finding it effective in trials. ughhh.
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Hard to know with such conflicting info
 
The bacteria itself is present in soil always but under the right conditions, such as dry dusty soil contaminated heavily with manure, it can multiply to the extent that it is dangerous to foals or immune deficient animals including humans. Of course once it is IN the animal or person it multiplies rapidly overcoming the animal. As that animal coughs and swallows mucous that is heavily laden with the bacteria it goes into their stomach and again multiplies rapidly and is evacuated in their manure which of course helps to contaminate the soil even more. If it isn't "fed" with dirt and manure the sun, wind and rain "disinfects" your land so that it doesn't become dangerous.

What I think it comes down to is sanitary management of our farms and land. Manure should not be spread on grazing pasture till it is decomposed. Manure should be harrowed, picked or vacuumed regularly in your grazing pastures. Rotate your pastures. Foals should not be kept in dry, dusty, manure laden pens. If it is possible to foal out your mares out of doors on a grassy field take advantage of that. Keep your foaling stalls as clean as possible. Disinfect the walls and floors if you can between mares foaling.
 
I have been reading this with interest...learning something new.

I wonder how you could tell if a horse were carrying it, or can you tell??...didn`t see anything in the articles I have read to indicate how one would know, other than necropsy. Did I just miss it??
 
I'm confused.... IF we all have it, how come SOME places are diagnosed with is and have to have transfusions? Why don't all farms have transfusions done?
This is a natural bacteria, as I understand it, in a horse's digestive tract (note NOT the respiratory tract), but it is there in small amounts. If you have a farm w/ a lot of horses and especially if you don't keep things clean (clean up the poop), then this bacteria builds because the horses are putting it out and it's allowed to stay and grow in the manure and dirt. Eventually, it can reach the level where it can make young foals sick.

So, while it is not an uncommon bacteria, it IS uncommon to have it in sufficient amounts to cause a foal to get Rhodo Pneumonia. If you get sick foals from a farm where they were infected, then they carry potentially large amounts of that bacteria to your property, and putting your new foals from then on at risk if you do not transfuse them with plasma with high immunity against the bacteria.

I've talked at length with my vets and rehash it as we transfuse our foals. Taking the steps we are taking means our foals are staying healthy and we're not allowing the bacteria to spread. It's also a God send that we were cleaning the paddock the sick colts were in very often, and that the weather was cool and damp the entire time they were alive here. This bacteria really thrives in hot, dry dusty places.

The system of an older foal and adult horses will not allow this bacteria to grow and "thrive" within them enough to make them sick, or to make them a danger of contaminating other property with high levels of the bacteria. I think all our horses (yours, mine, everyone's) has this within their digestive tract but again, in small and non-dangerous amounts).
 
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I have been reading this with interest...learning something new. I wonder how you could tell if a horse were carrying it, or can you tell??...didn`t see anything in the articles I have read to indicate how one would know, other than necropsy. Did I just miss it??
By the time an owner notices symptoms, the disease is pretty far along. It's just a mild cough really until it then spirals quickly downward, and that mild cough already means there are absesses in the lungs from it. It is stunning to see how "normal" a horse can appear and w/o a temperature, but be so seriously ill when it comes to this.

Yes, there is a way to tell though if a horse has it in their respiratory tract. You can have a nasal swab done to find out. I surely never knew that before, but do now
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Jill thanks for sharing that information somehow you made it much more clear then my vet did
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Again I am very sorry for your loss and glad you are able to keep your new babies healthy
 
I have been reading this with interest...learning something new. I wonder how you could tell if a horse were carrying it, or can you tell??...didn`t see anything in the articles I have read to indicate how one would know, other than necropsy. Did I just miss it??
By the time an owner notices symptoms, the disease is pretty far along. It's just a mild cough really until it then spirals quickly downward, and that mild cough already means there are absesses in the lungs from it. It is stunning to see how "normal" a horse can appear and w/o a temperature, but be so seriously ill when it comes to this.

Yes, there is a way to tell though if a horse has it in their respiratory tract. You can have a nasal swab done to find out. I surely never knew that before, but do now
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When I talked to a fellow from Guelph University about several diseases one of which was Rhodococcus he suggested that the nasal swabs are not always consistant at pointing out if the disease is present or not - there have been false positives and negatives with the nasal swab and a lab culture. Symtoms can be varied as well - constipation, cough, fever, depression and panting breath similiar to heavey breathing can be seen or not. Apparently quite often you have what appears to be a healthy foal just drop dead.
 
My friends had it at their farm and gave me this to post about their experience:

"We had rhodoccocus one year. We had a foal that got sick and the vet treated him with typical antibiotics for a couple of weeks and the vet thought our foal was fine and cleared him as healthy. But the vet basically misdiagnosed the illness and was not aware at the time the foal had rhodoccocus. The foal was no longer showing symptoms but he really still had the disease which we found out a couple of months later when the foal started showing symptoms again.

Rhodococcus requires a much longer treatment time frame especially if it is advanced enough that you are seeing symptoms. In our case the foal showed no more symptoms for a couple of months. By the time he showed signs of being sick again (raspy coughing, and heavy breathing) he was too far gone to save even though we tried. He also infected our other foals. When a foal gets rhodoccocus the bacteria flourish in their intestines and multiply by the millions and come out in their feces. Other foals inhale the bacteria and become infected. Rhodoccocus thrives in dusty hot sandlot types of environments where the sand is constantly being kicked up when the horses walk. The disease is similar to tuberculosis in humans. It causes bacteria pockets in the lungs that are cyst type nodules that build up and spread with time. That's why eventually you get pnuemonia type symptoms because the lungs are compromised so badly but it takes it a long time to spread inside the lungs and by the time the sympoms show in a foal the lungs are usually pretty will covered with these cysts. The cysts are "pockets of bacteria" and each nodule or cyst is loaded with deadly bacteria and the way it's encapsulated in these nodules sort of protects the bacteria pockets which is another reason it takes so long to treat. If treatment is stopped too early the bacteria protected in the cysts will flourish again and take over again.

When we had the problem we had all of our foals chests xrayed and the ones that were ill had cysts in their lungs. On the xrays it looked like they had "cotton balls" in their lungs, the cotton balls were the pockets (or cysts) of bacteria. The reason this disease is so deadly is it's ability to multiply in a foals intestines by the millions and be passed in their feces and therefore spread to other foals so easily. Also the silent nature with which it creeps up on you. By the time the foals show symptoms they are very very ill and require several months of medication. The other thing is that regular antibiotics (penicillen, naxcel, etc) will not kill the rhodoccocus but may improve the foal's symptoms temporarily which makes you think the problem is solved but you later find out it's not. The best results are from a combination of Clorithromycin and Rifampin. Erythromicin and Rifampin used to be used but studies showed that Clorithromycin and Rifampin are more effective (and expensive as heck).

We were told by the vets that once we had it we would have it every year. The following 2 years we tested the blood of our foals every 3 weeks to check for a rise in white blood count along with a rise in fibrinogen levels because these are the earliest indicators of the disease and will show up within 2-3 weeks of a foal getting the disease which is much earlier detection than swabbing or xrays. We did not however have any foals get the disease the following 2 years and after that we discontinued the testing as we had gone two full years without any foals infected with rhodoccocus."
 
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so interesting. I know one of the studies I read said they cant figure out why some farms get it so bad every year and others get it once and its gone. This was a newer study that said they dont think it lives in the soil as long as previously thought. Like I said its very confusing to get information on this. They did say the only thing farms that get it year after year had in common was over crowding of mares and foals.
 

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