Ep. 60 – Strangles in Horses Explained Podcast

Welcome back to The Equine Vet Connect Podcast here at Countryside Equine Hospital.

 

Dan Carter, I’ve got Dr. Caroline Brown with me today.

 

Hello.

 

So we’re going to talk about the big S.

 

The big S.

 

Depending on where you’re at is if this strikes fear in your heart or not.

 

We’re going to talk about strangles.

 

Everybody’s least favorite thing, probably one of the scarier things that we talk about.

 

I think it’s like every boarding barn’s worst fear.

 

It’s every traveling owner’s worst fear.

 

It really is.

 

And depending on where you live, this can be a real pain in the butt.

 

Yes.

 

I mean, here in Georgia, this is a reportable disease.

 

So if it cultures and PCR is positive, we’ve got to notify the state and then the government gets involved.

 

Yes.

 

And in the words of Ronald Reagan, the most feared language, the most feared words in the English language are, I’m from the government and I’m here to help.

 

No one likes it, especially here in Georgia.

 

No.

 

So let’s dive into this little strep equi.

 

Strep equi subspecies equi.

 

Yeah.

 

There’s a big difference.

 

So there’s another streptococcus that we think about.

 

Streptococcus equi subspecies zooepidemicus.

 

Yes.

 

They’re two very different things.

 

Completely different pathogens.

 

Completely different pathogens.

 

The ones terrifying, ones not.

 

Ones okay.

 

Interestingly enough, they kind of cause the same sort of symptoms.

 

Yes, they do.

 

But for whatever reason, subspecies equi was like, oh, this is bad.

 

Yes.

 

So this is a bacterium.

 

It is a very contagious bacterium.

 

There’s a lot of, I guess, debate on how hardy this bacteria is in the environment.

 

Some people say that it can live for a very long time.

 

Some people say it’s only a couple of days.

 

But we know that this thing is very, very good at getting into your horse and causing a problem.

 

There was one paper I read that said that within two hours of inoculating it into a horse’s nostril, it’s already found in the lymph nodes.

 

I can believe that.

 

Which is absolutely insane how fast that moves for a little teeny tiny microscopic bacterium.

 

And I feel like this thing’s reputation has gotten a lot bigger.

 

You know, it’s almost like people think this thing’s got some kind of highly specialized ninja skills, where it’s able to sprout wings, fly to another barn.

 

I mean, it is, you know, Strangles has gotten to like mythical abilities.

 

At the end of the day, it’s a bacteria.

 

It has no super power.

 

It cannot fly.

 

Its one goal in life is to survive long enough to reproduce.

 

Yes.

 

That’s all it wants to do.

 

It’s just a bacteria.

 

It’s just a bacteria.

 

No superpowers.

 

Just a bacteria.

 

So let’s talk about that.

 

So basically, what this bacteria does is it enters through either the mouth or the nose, and it travels up and it finds the lymphatic tissue that lives in the horse’s larynx.

 

And once it gets into this lymph tissue, this is going to attract a ton of neutrophils into this area.

 

You know, I think one thing to always remember with most equine diseases, it’s not the disease, it’s the horse overacting to the disease is the problem.

 

That is like, if we can say one thing about horses is that their immune system is like too efficient.

 

Yeah.

 

And I’d say probably half of the problems that we see in horses it’s just because their immune system is freaking out over this.

 

You know, it’s kind of like the immune system looks like it’s, looks like it’s host.

 

Yes.

 

You think about it, a cow’s immune system freaks out about nothing.

 

We’ll need to do cows.

 

A horse, gum wrappers lose their mind.

 

One little bacteria, immune system loses its mind.

 

Proud flesh, they’re like, oh, that little wound, let me just.

 

It’s like dogs looking like they’re owners.

 

Yeah, it is.

 

So yeah, the immune system kind of follows what the animal’s like.

 

Same thing, dogs freak out about nothing.

 

Cats lose it.

 

Lose it.

 

Same type of immune system.

 

Dogs, meh.

 

Meh.

 

Cats, hyperactive.

 

So we get all these neutrophils in here, into these lymph nodes, and this is what causes this abscess formation.

 

Right.

 

And so that’s kind of the characteristic thing of strangles, is you get these enormous abscesses in their lymph nodes, kind of our two main spots, or our submandibular, which is the ones kind of under their chin, and then the retropharyngeal.

 

These are the ones that are kind of on the back of their neck.

 

And these can get so large that they can actually obstruct their airway.

 

Hence is why it’s called strangles, because it can essentially strangle them.

 

It is quite massive.

 

I mean, it’s quite impressive just how big these lymph nodes can get.

 

Yes.

 

And this is painful.

 

These abscesses are very painful, and they will develop an intense fever.

 

Like, I’ve seen like 105 pushing 106.

 

But what’s interesting about this, and kind of when we get into a little bit later about biosecurity, is that these fevers develop two days before these horses start shedding this bacteria out.

 

And that’s kind of one of the, I think one of the big things that we have with this disease, that when we are going into monitoring them, when we’re dealing with an outbreak, and we have these horses that start showing fevers, we have some time to relocate them and kind of slow down that spread of this disease during an outbreak.

 

You know, and it’s interesting, because it’s one of the few diseases that does that.

 

Yes, it is.

 

Usually it’s the exact opposite.

 

By the time we see a fever, they’ve been shedding pathogens for up to 48 hours before that.

 

This is one of the few ones that gives us a heads up and says, hey, you start seeing this fever.

 

You start seeing this fever, you know that something’s going on.

 

And that’s usually some of the first signs that we get is that these horses, they feel like crap, they’re not eating, they’re super dumpy, and then they’re getting these big swollen lymph nodes.

 

So that’s usually the call that we’re getting that, hey, something’s going on.

 

And then eventually these lymph nodes are getting so large that they run out of space and they rupture.

 

Yes.

 

And there’s kind of two spots that they’ll go.

 

So the sub mandibular, the ones on the bottom of the jaw, they’ll usually rupture outwards, and they’ll be draining outside.

 

But these retropharyngeal ones, they’ll rupture on the inside of the horse.

 

My favorite structure.

 

The guttural pouch, the most useless structure in a horse.

 

It is.

 

It’s absolutely useless, but it’s so much fun.

 

It’s so much fun, and it’s just this big empty space inside of a horse’s, I guess it’s part of their larynx.

 

I don’t really know exactly.

 

They think it’s like a part of their inner ear.

 

Yeah.

 

We don’t really know what it does other than help veterinarians.

 

Get stuff stuck into it and cause a problem.

 

So, yes.

 

And what’s kind of nice about when these abscesses rupture is, for a lot of horses, this is the end.

 

This is, you know, they feel a lot better once this happens.

 

Usually, that fever has gone away, their pain goes away, they’re starting to feel better.

 

Now, they’re just draining pus all over the place.

 

Spreading disease.

 

Spreading the disease.

 

So, and this shedding can go on for two to three weeks.

 

Right.

 

After this.

 

So, this is where, you know, yes, the horse is usually feeling better at this point, but we’re not out of the woods yet as far as, you know, dealing with this outbreak.

 

We still have to be very careful about this.

 

We’ll kind of dive deeper into, you know, if we’re going through an outbreak, kind of our system of how to deal with this and how to monitor everything.

 

But, you know, what’s nice about, you know, this kind of treating these guys is that a lot of this is supportive care.

 

True.

 

Well, I want to back up just for a minute and talk a little bit more about the spread of it, because again, this disease has become, people think it’s got mythical powers, and it’s able to like translocate, and, but it really, it takes direct contact with the bacterium.

 

Yes.

 

And it’s contact on the nose or mouth.

 

Yes.

 

It cannot enter through the skin.

 

If they step and strangles, it doesn’t mythically burrow through the foot and get into the lymph nodes.

 

It does take direct contact through the mouth or the nose.

 

Yes.

 

So this is important.

 

Yes.

 

Especially as we go through and talk about control methods.

 

It’s very important.

 

Remember, that’s the only way it can spread is that direct contact with the mouth or the nose.

 

That thing that I always remember whenever we go to a horse show is you always bring your own hose.

 

Good point.

 

Yes.

 

You always have your own hose that you attach to the water well, and once you’re done with it, you take it and you do not let anybody else use it.

 

Right.

 

Don’t share water buckets.

 

Don’t share water buckets.

 

We’ll get into that.

 

Sorry about that segue, but I just thought it was important just to, I’m going to keep reiterating that throughout because I do feel like it’s gotten to have these mythical powers that don’t exactly exist.

 

Because again, I mean, it’s such a widespread thing.

 

And you know, usually when you see these outbreaks, that’s what you hear about is just these horses just popping up with it everywhere.

 

And I think that’s where, you know, the meds come in.

 

It’s like, oh, it’s just, it’s flying through the air.

 

It’s new in this.

 

And it’s like, it’s really not.

 

It’s just direct contact.

 

It’s direct contact.

 

And that’s, it’s just a, it’s just really good at moving.

 

Once you get that direct contact, it’s…

 

It’s highly contagious.

 

Highly contagious.

 

And there was something I was reading about it too, that this bacteria is really good at avoiding neutrophilic destruction too.

 

Yes.

 

Like, it’s just one of those things that, you know, if they pick it up, the neutrophils just can’t get rid of it.

 

Like, it’s just that powerful of a bacteria.

 

I know, it actually fights the neutrophils, which usually they win everything, but…

 

Right.

 

Not in this case.

 

But yeah, just want to remind people that, like it is highly, it’s highly virulent.

 

Really, it should be, it’s highly virulent, not so much highly contagious, it’s just highly virulent, meaning you does have to have very specific requirements to transmit.

 

However, it only takes like one to set up this massive infection.

 

Correct.

 

Correct.

 

So…

 

Yeah.

 

So we’ve talked about the kind of like main part of strangles.

 

And they say that, you know, 75% of horses are going to recover just fine once these lymph nodes rupture.

 

But let’s get into everybody else.

 

Oh, yeah.

 

So there’s, there’s a couple kind of sequelae that we look at with, with horses that have gone through strangles.

 

Probably the most common one that you hear about is the, the bastard strangles.

 

Yes.

 

So this is basically where this bacterium has now decided to leave the lymph nodes, and it’s going to start spreading to other parts of the body.

 

And it can do that through the lymphatic system, it can do that through the blood, it can do that across tissue planes as well.

 

And so basically, you’re going to get these abscesses all throughout the body.

 

Yeah, these guys are pretty adventurous.

 

They’ll catch your eye some way.

 

Yes, yes.

 

And so that is where the, I think a lot of the magical things about strangles comes in, is where I think people kind of get the idea that, oh, it’s, it is, you know, doing all this.

 

And it’s like, no, it’s just, it’s exploring its habitat.

 

You know, it’s, and it’s kind of most common places are the liver, the mesentery, which is all the kind of tissues around the gut.

 

It likes the lungs, the spleen, the kidneys, and the brain.

 

So, interesting.

 

I did not know about the brain.

 

Yeah, it can go to the brain.

 

Fun fact.

 

So, dang you, blood brain barrier.

 

I know.

 

Need you to work better.

 

But thankfully, this is not a common occurrence.

 

No, it’s not.

 

It is not.

 

But it is-

 

Have you seen one?

 

I have not.

 

Not a confirmed one.

 

I haven’t either.

 

It’s on my bingo card.

 

Knock on some wood there.

 

It’s on the bingo card, but I hope I don’t see it.

 

Yeah.

 

It’s rare, but it does happen.

 

And then your other kind of big scary is your Purpura hemorrhagica.

 

This one’s pretty legit.

 

I’ve seen a lot of this.

 

I’ve seen some as well.

 

This says it’s only in about one to two percent of horses.

 

I don’t know about that.

 

Both of these are kind of happening in those kind of two to four weeks after the infection, but they get this acute necrotizing vasculitis is the official term.

 

But basically, you just get this subcutaneous edema all over the place.

 

It’s kind of cool.

 

Like I’m an immunology nerd and it forms these antigen antibody complexes.

 

Yes.

 

And it literally turns, they turn into ninja stars.

 

So I guess there is some ninja, two strangles, but what it is the the strep in protein actually binds with part of the immune system.

 

And it literally tumbles around with these sharp points, for lack of a better way to think of it, and it starts poking holes in everything.

 

Yes.

 

And they just start leaking.

 

And they just get this massive edema because I mean, these antigen antibody complexes, they just they wreck the world.

 

Oh, and they are painful.

 

These guys are miserable.

 

They are miserable.

 

And the other fun thing is they get these little, they’re called petechia.

 

And it’s just little teeny tiny bleeders all throughout their mucous membrane.

 

So it looks like little red polka dots all over.

 

Yep.

 

So, or eczemosis if it’s on an organ.

 

So if you ever wonder why when your horse has a cellulitis, we flip their lip up and look at their mucosa, we’re checking for petechiae.

 

Because we want to know is this cellulitis or are we dealing with purpura?

 

Right.

 

And so one of the things that if we’re starting to see one of these things in your horses is we’re going to ask, hey, were they exposed to strangles at all?

 

Or even the strangles vaccine, which we will also get into a little bit later.

 

In fun fact, there is a group that thinks it’s not just the strep equi that can cause the purpura type reactions.

 

A lot of the strep species can cause purpura.

 

Yes.

 

So it’s not just strep equi.

 

So strep purpura.

 

Yes.

 

There’s also some reports of a just big myositis reaction in some of these.

 

So I’m a neuromuscular nerd too.

 

Yes.

 

It used to be called immune-mediated myositis.

 

Correct.

 

And now it’s heavy chain myopathy.

 

It’s a quarter horse condition, it is genetic.

 

And for whatever reason, strangles will set this off.

 

Yes.

 

And when I say these horses drop muscle tone, you’ve got a great looking two or three year old who easily find it in the younger horses.

 

And I think it has to do with they’re the ones that typically get strangles.

 

But they will have just beautiful top line, a really nice hip to them.

 

And that’s on Monday and you come out of the barn on Tuesday and you’re trying to figure out which horse is in the stall because that’s not the one that you left Monday night.

 

They have literally lost muscle tone that quickly overnight to where you don’t recognize the horse.

 

And it is a genetic condition and it is part of the five panel test.

 

But yes, it seems to be, it’s a genetic condition the horses have and it is triggered by strangles.

 

Yes.

 

So.

 

Very interesting.

 

And they can be subclinical and never actually show signs of having strangles because not every horse gets infected with the bacteria will have the big lymph nodes.

 

Those are the small subset.

 

But, yeah, their muscle just falls off.

 

Yeah.

 

That one, when I was kind of researching this, that was the one that I was like, Whoa, that’s, you don’t hear about that one as much.

 

Like you hear about the bastard strangles, you hear about the purpura, but you don’t, you don’t hear about that one.

 

But that one’s just as scary.

 

If you’re in, in, in heavier quarter horse country, like I used to see this in my reiners and my cutters, and then also some of the barrel horses, but it’s usually the bigger, heavier, stockier type quarter horses.

 

So reiners and cutters, I tend to be, that’s where I typically see it.

 

Yeah.

 

Don’t see a ton of it, but I definitely do.

 

I had a set of embryos, I had two, two-year or two, three-year-olds.

 

They were from embryo flush, the same genetics, they both had IMM or heavy chain myopathy.

 

It’s difficult when they change the name of a disease.

 

They do, yeah.

 

When they change it, it’s tough.

 

But one had it, one didn’t.

 

And it was remarkable to see the difference.

 

How quickly they…

 

Yeah.

 

Wow.

 

Interesting.

 

Yeah.

 

Strangles.

 

Very interesting.

 

So, yep.

 

Oh, so gotten into all the scarries.

 

Let’s talk about how do we test for strangles?

 

How do we confirm this?

 

Let’s start from the beginning.

 

Like what makes you want to test?

 

So we’re going to get into some clinical science here.

 

We’ll test on a little bit, but let’s kind of roll through a progression of things you might see.

 

Yes.

 

So we talked about that fever that starts, and that’s kind of your, your big first hint that something’s going on.

 

And these horses, like we said, they’ll get up to 105, 106, very intense fever.

 

And this usually is starting about two to three days before you start seeing the nasal shedding start.

 

And they will get this very intense, disgusting mucus that is coming out of their nose.

 

It is white, it is thick, and it is just copious.

 

It is just coming out of them.

 

Yep.

 

And they’ll start to get these…

 

This is where you’ll start to see some of the, like, lymph nodes starting to get big.

 

And again, these can get so large that it’s actually, you know, cutting off their airway.

 

And it is painful.

 

If you kind of touch this area, even if they’re not that enlarged yet, they will react.

 

They are hot, they are painful.

 

And kind of, I think, the typical picture that is on all of the, you know, PowerPoint slides that I found of this is, you know, the young kind of yearling sitting there with their neck all, like, stretched out, and their lymph nodes are all huge, and they’re just like, ah, like.

 

When we say huge, it looks like you took two water balloons and shoved it right behind the jaw.

 

Yes, yes.

 

I mean, it’s, they can get huge.

 

Very big.

 

And, you know, these lymph nodes, they’re supposed to rupture usually within a week of kind of starting this fever, but what I actually end up seeing is, they’ll start leaking before they actually ruptures.

 

You’ll start to see, like, the skin over this area get very thin, and you’ll start to just see, like, some kind, it’s almost like it’s weeping out of there before it finally just bursts.

 

And again, once that lymph node is burst, usually that fever goes away.

 

Yes.

 

And once that goes away, they feel fine.

 

They’re like, I’ve never been better.

 

Yes, I know.

 

That’s good.

 

Yes, but they’re still, again, they’re shedding pus and strangles all over the place.

 

Yes.

 

And usually, you know, once we’re open, once we’re draining, you know, give it another kind of couple weeks and we’re usually good.

 

They say that the whole kind of course of the disease from, you know, that inoculation to the fever and everything, and we’re now finally stopped draining and shedding, that can go anywhere from about three to four weeks, which kind of gets into some of our biosecurity when we’re talking about it for monitoring this in an outbreak and how we deal with, you know, looking ahead with things.

 

Well, one of the things we didn’t touch on was age does play a role in this as well.

 

Yes, yes.

 

This is typically younger horses, like, I think, what are the stats, like, less than four?

 

Typically.

 

That’s kind of your poster child for it is these kind of, it’s usually about one-year-olds because this actually, you know, this is one of these things that the nursing mare will pass this immunity to her foal.

 

So you don’t typically see this in a lot of nursing foals and even weanlings, they’re not typically getting it right away.

 

It’s usually not until they’re about a year old that you’ll start to see this go through.

 

Yeah, I’ve actually never seen clinical disease in horse above the age of four.

 

Really?

 

I haven’t.

 

You have not?

 

No, I have not.

 

It doesn’t mean it can’t happen.

 

Oh, I’ve seen it.

 

I just haven’t personally seen it.

 

I think it’s again, because you hear about these massive outbreaks and then you look at it and you’re like, oh, it’s usually just a bunch.

 

It’s a baby farm.

 

It’s all the right.

 

Yeah.

 

I guess that’s where I’ve dealt with it.

 

Most are on like the training tracks and, you know, it’s almost like you get into a lot of the breeding farms.

 

We’ve done a much better job of controlling it.

 

But when I first started in practice, it was almost like the chickenpox of the veterinary world.

 

I mean, it was just something that there’s going to be some yearling farm every year breaks, almost like a rite of passage for a whole to be involved in an outbreak in these really dense young horse population.

 

And I guess that’s why I haven’t seen it as much, is my practice centers mostly around older horses.

 

But younger horses, so be paying attention to that.

 

Yes.

 

Especially if you’re bringing in younger horses, if your horses are around younger horses, be careful.

 

Be careful.

 

So we’ve got these clinical signs sitting out there.

 

It’s starting to look like strangles, we’re following all these paths.

 

What’s one of the things that, like, when we get there, we’re gonna do this, it’s gonna pop in our head, and then we’re gonna say, all right, we’re gonna do some testing.

 

We’re gonna do some testing.

 

And there’s a couple of different tests out there.

 

Yes.

 

So let’s get into those.

 

So our gold standard for these guys is our PCR testing.

 

That is going to be our, you know, our best way to identify this.

 

For a long time, it was all about the culture.

 

Correct.

 

You try to culture these bacteria.

 

But these guys are tricky.

 

They, they can, you can have negative cultures, but still have this bacteria present.

 

And I think that has to do with survival, somewhat with survival rate.

 

Yes.

 

And that’s been questioned.

 

But then also, if you have dead bacteria, if your swab grabs all dead bacteria, they’re not going to grow.

 

They’re not going to grow, but doesn’t mean that it’s not there.

 

Correct.

 

So once, so this kind of development of the PCR test has really become fantastic.

 

And it’s, I mean, we’ve gotten into a point now where we can have our turnarounds on these tests.

 

It’s incredible.

 

It’s amazing.

 

I mean, so if you’re, if you’re in the middle of one of these outbreaks, or if you have a suspect horse, and you’re trying to move fast, we can have these results within the same day.

 

It’s amazing.

 

The only thing that slows us down is getting into a lab that can run the test.

 

Right.

 

And what PCR looks for, we’ll do a podcast maybe on different laboratory testing techniques.

 

But PCR is basically looking for genetic material.

 

Yes.

 

It’s looking for a specific sequence of DNA that is very unique to strep equi.

 

And that’s what it’s looking for.

 

So whether the bacteria is live or dead, it makes no differentiation.

 

It just says, this DNA strand exists inside this horse.

 

Correct.

 

So there’s a couple of different places that you can collect from.

 

They say the best place to really get it is the guttural pouch.

 

Right.

 

Especially when you start looking into some of these long-term carriers, which we haven’t even really gotten into those.

 

That’s a whole episode.

 

To that whole population of the shutters, the silent shutters.

 

But you can sample it from a nasal swab if they’ve got copious mucus coming out.

 

I’ve sampled some from the ruptured lymph nodes.

 

There’s a lot of different places you can get it from.

 

I do a lot of pharyngeal swabs.

 

Pharyngeal swabs, yeah.

 

I really love the AI culture rods.

 

You can get all the way up the nose and you can grab that.

 

You can get up there to the pharynx.

 

Great place to get a sample.

 

So that’s kind of become our main thing.

 

Flushes as well.

 

Flushes, passing tube and you’re basically doing a nasal wash.

 

You’re actually squirting saline up the nose and then catching it in a tube.

 

Yes.

 

Another great way to sample that.

 

All the good things.

 

And then the other kind of thing that comes up is the titers, the protein titers.

 

SEM titers.

 

SEM titers.

 

So from what we understand, this was kind of what they did for a while with looking for these guys.

 

But again, you have to be careful with this because in kind of our traditional strangles, we’re just really only focusing on the lymphoid tissue in the mouth and the nose.

 

We’re not seeing it in the blood.

 

And so this kind of comes into play when you’re looking for these horses that are going to be our bastard strangles guys.

 

This is where this can be helpful.

 

And then kind of looking into when we get into vaccine history, looking at their titers because sometimes this can show you, have these horses been exposed to strangles?

 

Were they recently vaccinated?

 

Does this horse kind of have a lot of immunity to this already?

 

But it’s not really something that we’re going to be looking for when we’re just looking at a horse for kind of our traditional strangles.

 

Well, I think that’s important to, when we’re talking about the SEM titer, is titers, they will show exposure.

 

Yes.

 

They’re not exactly indicative of clinical disease because you can have a lot of things.

 

You know, how long does a horse hold a titer?

 

Has it been vaccinated?

 

It is important when we’re looking at risk for purpura.

 

That’s a very important test if you’re looking at risk for purpura.

 

So we won’t get into that today.

 

I feel like we’re going to have like three episodes on this.

 

I told you, I started writing this and I was like, this is going to be more than an episode.

 

This is, there’s a lot, there’s a lot here.

 

So, so I guess to kind of summarize when you have the clinical signs, we talked about these high fevers, nasal discharge, right population of horrors.

 

We’re going to reach for that PCR.

 

Yes.

 

Yes.

 

So PCR is our friend.

 

It is our, that is our friend.

 

It is a great, great test.

 

Yes.

 

So, but.

 

All right.

 

So now we’re in the middle of strangles.

 

We’ve got to, you know, I like to say we focus on two things in the middle of an outbreak.

 

One, stopping the outbreak.

 

Yes.

 

So quarantine.

 

Yes.

 

The other one’s treatment.

 

Yes.

 

So, so let’s, I kind of want to get into the biosecurity of it because I think that’s kind of the, the best, like, I think that’s kind of the most important thing because.

 

I would agree.

 

Yeah.

 

So there was a veterinarian and I forgot to write down their name, but they came up with the traffic light system for the, for the outbreaks.

 

I know who that was.

 

You know who it is?

 

This was done on a horse farm up in Ohio.

 

Really?

 

Yes.

 

I might have been involved.

 

You might have been involved in that?

 

I might have been involved in that.

 

All right.

 

We actually pulled this off with, because we had a big yearling sale coming and we had to shut this thing down quick, because it’s our big money maker.

 

And so the plan, and I mean, this happened, this is like 15, 16 years ago.

 

We actually went to Walmart and bought stacks of T-shirts.

 

And when you came in every day, you were given your color.

 

They’re the red, yellow, green.

 

Yeah, we had three different barns.

 

And you were actually given a T-shirt to wear for that day.

 

And that was how, and like once you got your T-shirt, like we had whole stages on how you could go.

 

And like where you got to eat lunch, who you couldn’t talk to.

 

I mean, it was a whole.

 

But it worked.

 

It worked.

 

We actually, it worked.

 

We shut this outbreak down in less than two weeks.

 

That’s yeah, a little humble brag there.

 

So it was, it was pretty cool.

 

That’s awesome.

 

So yeah, did not know that.

 

So another, another fun Dan Carter fact of another random job he’s worked.

 

Start teaching other vets about the traffic light.

 

The traffic light.

 

So this is where if you’ve got an outbreak going on, you start sorting all of your horses on your property with red, yellow, green.

 

So red is our horses that have either confirmed strangles or we’re waiting on test results.

 

But, you know, all signs, high probability.

 

Yeah, all signs are pointing to this horse has strangles.

 

Our yellow horses are going to be, they’ve had direct contact with our red horses, but they’re not yet showing any clinical signs.

 

We don’t have a fever or don’t have any nasal shedding.

 

You know, we’re acting okay, but we know that this horse maybe lives in the stall next door to them.

 

They’ve been sharing a pasture, they’ve been nose to nose.

 

So these are our horses, I think that are, this is probably the most important group, in my opinion, is, you know, because these are our horses that are going to be at risk.

 

So we need to be watching all these horses, but especially these yellow horses.

 

We’re going to be taking temps on them twice a day for the next couple weeks and watching to see if they get a fever.

 

Because again, once these horses start showing a fever, you still have two days before they start showing.

 

So if you have these horses that start popping a fever, that’s where you can move them over into this red group and prevent any of the spread from going on.

 

It’s very important to use in the system.

 

You remember, there’s no second chances.

 

If any of the clinical signs show nasal discharge, fever, anything, they move immediately.

 

Yes.

 

There is no pass, no pass go, no collect $200.

 

I mean, it is, we’re moving quickly.

 

Yes.

 

And then our green horses are horses that are on the property, but they have not had any contact with the red or the yellow group.

 

These guys are also still important.

 

We’re still going to be monitoring their temps a couple times a day.

 

We’re still going to be watching them because, again, the strangles bacterium is, we don’t really know exactly how hardy it is, and it can spread nose-to-nose contact, but we know it can also spread through fomites.

 

So if they shared a bucket at some point, or the dreaded water hose.

 

So these guys, you know, they’re going to be on their own, but we have to watch all of these guys, and we’re going to be moving them from group to group as we start to see changes.

 

And the initial sort is really important on this.

 

Yes.

 

Because what we say is you’re guilty by association.

 

So if we have a horse that’s confirmed, that horse goes directly to the red barn.

 

If they’re in stalls, the horse on either side goes to the yellow.

 

And that’s the way we do the initial sort.

 

Because that’s very important.

 

You don’t want all horses considered green.

 

No.

 

You got to move your red ones.

 

And then anybody that’s been associated with those horses goes to the yellow.

 

Yes.

 

And they’re going to hang out there.

 

Green, you have to be 100 percent sure.

 

Yeah.

 

Because that’s your cleanest barn.

 

And if you have any doubt at all, they do not go in green.

 

Correct.

 

Yep.

 

And if there’s any question, whatever the highs, if you’re trying to decide between red or yellow, they go to red.

 

If you’re trying to decide between green and yellow, they go to yellow.

 

Because you cannot move down.

 

No.

 

You can only move up.

 

You can only move up.

 

You cannot move down.

 

Nope.

 

And like I said, you have to, if you’re on the fence, always choose the one above.

 

Correct.

 

And that’s the only way you’re going to stop this.

 

Correct.

 

Correct.

 

So.

 

So that’s kind of our our traffic light system, but apparently it works pretty well.

 

It does work great.

 

Like I said, because it can spread.

 

That’s one of the things we didn’t really mention.

 

It can spread between people and tools.

 

Yes.

 

And so these barns are stopped.

 

And like I said, we would literally, we went and bought out all kinds of t-shirts from the Walmart.

 

And every day you came in and got to sign your pack of t-shirt and what you’re wearing that day.

 

So you could look at the distance.

 

The other guy’s red.

 

I can’t talk to him.

 

Like you don’t get to wave to each other.

 

We took it very serious.

 

What color were you?

 

I was managing from afar.

 

Okay, so I was like the head coach.

 

I was on the sidelines.

 

I wasn’t actually in fact, the only barn I would go in.

 

You’re the traffic cop out there.

 

Just like, yeah, the only barn that I would ever go in was the red barn.

 

I would only go in the red barn.

 

And I was providing medical care for the horses in the red.

 

I did not go to any other barn.

 

Correct.

 

So it was my job to go to the red barn at the end of the day.

 

And so, and when this is going on, I think it’s important to say, too, there are no horses in or out of that property when this is going on.

 

You are shut down.

 

In Georgia, it’s a mandatory quarantine.

 

South Carolina, it is not.

 

So it does vary state to state, but this has to be reported in the state of Georgia.

 

The state’s going to get involved.

 

I do my best to convince them to have this under control and let me manage it.

 

Because, like I said, nobody wants to hear I’m from the government.

 

Right.

 

Which is where this can become a big problem if you’ve got, you know, one of these show barns or a training barn, where you’ve got horses in and out almost every single day.

 

Like some of these racetracks where it seems they’re getting new horses multiple times a week.

 

It’s, that’s a huge deal.

 

That can be devastating.

 

And you’re usually going to be looking at a minimum of 30 to 35 day quarantine.

 

Oh yeah.

 

That’s the best you can hope for.

 

It’s about a 30 day quarantine.

 

Absolutely.

 

So this is, we take this extremely seriously when we have one of these.

 

Yes.

 

And so the biosecurity is critical.

 

Getting these horses sorted, getting them separated, and it becomes very difficult.

 

Like it was easy for us because we had, we had three different barns.

 

So it was really easy to set this up.

 

We had three different barns.

 

But when you have one barn, it gets a lot more difficult because you’ve got to create space.

 

Yes.

 

And this is where you may have to, your horses, you may have to set up barns as the quarantine and nothing gets to come in there.

 

Right.

 

I mean, it’s, it can be tricky, but this is where working with your veterinarian and really understanding the facility you have and figuring out the best way to do this.

 

Because even if you create like a barrier in the middle of the barn, and you set up, this is, you pretend like there’s a wall there.

 

So you’ve got one side of the barn and another side, not across the aisle, and you can create space in the middle of it, let’s say three to four stalls.

 

You can have a sick and a not sick, and you’re able to, you’re able to create those barriers that way as well.

 

So if you don’t have multiple barns, all hope is not lost.

 

Work with your veterinarian, figure out how to set that biosecurity up.

 

Right, yeah, absolutely, absolutely.

 

And part of that too is cleaning.

 

Yes.

 

Like this becomes really important, how we clean and disinfect.

 

Yes, because they’re, again, this bacteria is questionably hardy in the environment.

 

And so there are certain compounds that work better for cleaning this than others.

 

So my phenolytic compounds is what that says.

 

Bleach does not work.

 

Nope.

 

No bleach.

 

Neither phenolic.

 

But I think that’s like our Lysols.

 

Most of your Lysols.

 

Most of the Lysols were better.

 

That was the one that kept kind of consistently coming up.

 

And the one thing you can do that will help you kill this, one, sunlight.

 

Sunlight kills this thing.

 

Yes.

 

Dead as a hammer.

 

Yes.

 

Two, dry.

 

Yes.

 

This bacteria desiccates.

 

Dry.

 

Whatever it takes to get things dry, get them dry.

 

And I think those are probably the two best disinfectants we have.

 

The next one is when we get into the phenolic compounds.

 

Yes.

 

Like I said, that’s Lysol.

 

There’s other commercially available phenolic compounds.

 

Right.

 

And again, when you’re, you know, you’re doing this, it’s not just the horses and the people that you’re moving.

 

It’s all their equipment too.

 

So, any buckets that they’ve touched, tack, you know, pitchforks, you know, grooming tools, anything, all of that gets separated and completely disinfected.

 

Because, you know horses, they’ll put their mouth on anything.

 

Is rocow still around?

 

Do you even know?

 

It was a phenolic compound we used to clean with.

 

I think it is.

 

I’ve heard of it.

 

I don’t know if it’s still around.

 

Yeah, I was a big fan of rocow.

 

I’m sure it’s probably gotten flagged for something.

 

It worked really well.

 

It won’t kill anything.

 

I’m sure they took it off the market because it worked really well.

 

It fries your skin off if it sits too long.

 

What’s that other compound?

 

Rescue?

 

Rescue.

 

Rescue, yeah.

 

Yeah, that’s a really, really good one.

 

Is that what they use on the parvo dogs too?

 

I think, because that one, again, kills earthing.

 

It does.

 

And it’s a peroxide-based type system.

 

It’s a reactive oxygen, and that stuff will kill about everything.

 

Yeah.

 

Oh, yeah.

 

And it’s probably a little safer than the old ROCAL.

 

So yeah, I think cleanliness.

 

And here’s the other thing to remember too, when you’re using any of these compounds.

 

If there is organic debris…

 

Poop.

 

Yeah, this is poop.

 

This is having anything on the walls of the stall.

 

If there’s any kind of organic material, no disinfectant will work.

 

Correct.

 

So you’re going to have to scrub.

 

You have to pre-clean before you…

 

So I think that’s a big thing, is that cleaning and disinfecting are two completely different things.

 

Great point.

 

Great point.

 

That…

 

And I don’t think that’s clear when it comes to things, but I’m like…

 

The best example I can think of is hand sanitizer.

 

If your hands are nasty and you put hand sanitizer on them, it doesn’t matter how much you dump onto your hands.

 

It’s still gross.

 

You’re still going to have crap all over your hands.

 

So you have to wash your hands first with soap and water, scrub all the dirt under your fingernails, all of that, and then you can put your hand sanitizer on.

 

And that’s going to kill everything else that’s still there.

 

So that’s the same thing when it comes to doing our cleaning and our disinfecting.

 

Well, it kind of goes back to what your mom taught you.

 

You got to sweep the floor before you mop the floor.

 

You’ve got to remove that organic material.

 

This is poop.

 

This is dirt.

 

This is feed.

 

Underneath those feed buckets where you have that sloshed out feed, I mean, you should be doing that stuff anyway, but it comes really important.

 

You have to clean before you can disinfect.

 

And then the question always comes up, what about the dirt?

 

You know, if you got dirt floor stalls.

 

Great news, guys.

 

If it’s dry, it’s going to die.

 

It may not die that day, but give it a couple of days.

 

That bacteria will desiccate if it’s dry.

 

Yes.

 

So you can use different drying agents.

 

Lime, PDZ.

 

Was it PD?

 

PZ?

 

PDZ?

 

She’s saying yes.

 

Is it?

 

PDZ?

 

All right.

 

April, help me.

 

PDZ.

 

Thank you, April.

 

This is why we have producers.

 

But putting that stuff down in the stalls will help.

 

It will help kill it as well.

 

It’s going to dry that out and it’s going to desiccate or basically bacteria.

 

If you dry them out, they die.

 

That’s where a lot of proof.

 

That’s what you make beef jerky, right?

 

Without water, you can’t, the food can’t spoil.

 

Like if it’s dry, it can’t.

 

That’s where freeze drying came from.

 

So dry the dirt out.

 

It’s going to take care of it.

 

But it’s going to take more than like a few hours.

 

Yes, like days.

 

You need a couple days for this.

 

So kind of on the biosecurity front, if a horse is in a stall and that stall is contaminated, let’s don’t reuse that stall for a while.

 

And by a while, I mean, give it a few days.

 

If it’s been properly sanitized a few days, and it’s going to be fine.

 

Well, the same goes with pastures too.

 

There you’re supposed to rest those pastures for several weeks before you put new horses out there.

 

Right.

 

And we’ve got UV light.

 

UV light helps great.

 

Yes.

 

So, a lot of times, it’s the fence boards more than, it’s not like the grass so much, it’s the fences.

 

It’s the fences.

 

Interesting.

 

Yeah, that’s true.

 

The fences.

 

Get those dang cribbers that’s in there.

 

Just.

 

And like I said, sunlight does a lot of good.

 

Yes.

 

So.

 

Yes.

 

But yeah, and that’s, you know, when I’ve set some of these up, sometimes we take, you know, it’s always tough because you’re like, we’ll be better if we put the strangle horses outside.

 

But at the same time, the horses are sick.

 

So.

 

Yeah.

 

I mean, again, because when they’re in that acute phase, and they got those fevers, they do not want to be sitting out in the sun.

 

Yeah.

 

So I know we’re throwing a lot of stuff at y’all, but this is why it’s really important to work with your veterinarian, develop a plan.

 

This is one of those times we’re going to slow down, we’re going to stop, we’re going to sit down with you, and we’re going to lay out a plan.

 

We’re going to look at your situation.

 

We’re going to look at your environment.

 

We’re going to look at a lot of different risk factors, and each plan is going to be somewhat individualized.

 

These are the steps we’re going to take, but how we implement this is going to be based on the facility and your individual needs.

 

Yes, yes, because again, we take this very seriously.

 

If we get one of these calls, and even if we haven’t even gotten test results, if we’re just having a suspect case, we’re going to be saying, hey, we need to stop, and we need to come up with a plan.

 

We need everybody on board with this.

 

Everyone.

 

Everyone’s on board.

 

You know, that’s a lot of times when I have these types of situations, it’s a call to staff in.

 

Yeah.

 

And we are going to sit down, we’re going to have a meeting, and we’re going to really lay this out.

 

And if it’s in a boarding facility, we’re going to get the owners there.

 

We’re going to have a meeting, because if one person doesn’t follow the rules, it negates everything.

 

Everyone has to follow the rules.

 

Right, right.

 

This is very, very critical.

 

They have to follow the rules.

 

And again, that’s like, I don’t, if we’re kind of wrapping at least this kind of part one of the podcast up, like in the realm of how terrified should you be of this?

 

I don’t think this is one of the scariest things that we have out there by any means.

 

Like, but this is more of a, it’s a bear to deal with.

 

It’s an inconvenience, and it can be prolonged if you are not following the protocol and if you are being careless and not doing, you know, what’s recommended.

 

So it’s one of those things that, you know, you don’t need to be terrified of this, but you need to be aware of it and understand that this is a very serious thing.

 

Well, I think that’s the biggest thing.

 

Should you be terrified your horse is going to die?

 

No, it’s the inconvenience that’s going to come with it.

 

I think if there was any takeaway, I think that’s the thing to remember, it’s an inconvenience.

 

If it happens at the wrong time, like this time of year, you know, we got regionals, we got national finals coming for about every organization, we’ve got indoors, you know, there’s a, you know, the Medal Maclays are coming, we got the Futurity coming.

 

There’s a lot of end of the year stuff going right now.

 

And if you just think about it through those eyes, like this is a terrible time to have one of these outbreaks.

 

And so it’s all about how fast can we move through this.

 

And so I think that’s the big thing, this is an inconvenience.

 

Life threatening, probably not.

 

No.

 

Inconvenience, yes.

 

Absolutely, absolutely.

 

So, you know, unfortunately, this is definitely going to be a round two podcast because we haven’t touched on prevention and treatment.

 

So we’re going to get to that in another episode.

 

So let’s kind of sum it up like we always do, top takeaways you hope people get from this episode.

 

Yeah, so Strangles is there, it’s everywhere.

 

If you’re in the horse industry long enough, you’re going to see it, you’re going to hear about it.

 

Again, it’s not something to be terrified of, but it’s something to take very seriously, because like we’ve said, this can absolutely be an inconvenience and an annoyance.

 

And being aware, being on top of things is going to be our key to everything.

 

So if we get one of these suspect cases, you need to call your veterinarian as soon as possible and get a plan on board.

 

Yes.

 

I’m going to agree with that, call your veterinarian soon.

 

Early intervention is where you want to be.

 

Let’s get a plan laid out.

 

Cleanliness.

 

Yes.

 

Cleanliness.

 

If you learn nothing else from this episode, because this will just help you in any situation involving disease, your words, you have to clean before you disinfect.

 

Yes.

 

Two separate events.

 

Yes, they are.

 

One soap and water, the other one, we’re going to get some chemicals.

 

So that’s what I hope people get.

 

Yes.

 

Yes, absolutely.

 

So we’ll put a round two together.

 

We’ll take a, like I said, this is definitely going to be a deep dive.

 

So we’ll get round two put together and we’ll get that out.

 

So Dr. Brown, thanks for being here today.

 

Absolutely.

 

Never thought I could sit here and talk about strangles for more than an episode.

 

It’s a lot of fun.

 

It is.

 

Again, this is a very annoying one.

 

I get these and I’m like, oh crap, like, but I’m like, this is one of these ones that I’m like, I kind of enjoy talking about this.

 

It’s kind of fun.

 

We get to be closet epidemiologists.

 

A little bit, yeah, a little bit.

 

We’re weird people.

 

So it’s like, I don’t wish this on anybody, but you know.

 

Well, Dr. Brown, thanks for being here today.

 

We’re recording this episode on strangles.

 

We get round two cranked out.

 

April, thanks for helping us figure out what we actually put in the stall to make it dry.

 

And also recording this podcast.

 

Kasey, always thank you for editing.

 

And most importantly, thank you to our listeners.

 

If you like this podcast, please like and subscribe.

 

Keep sending in some ideas so that we have more topics to talk about.

 

We really enjoy doing this and looking forward to doing some more episodes.

 

So thanks for tuning in and we’ll see you next week.

 

Bye.