Pneumonia in horses is a respiratory condition characterized by inflammation of the lungs, often caused by bacterial, viral, or fungal infections. It can affect horses of all ages, though young and immunocompromised animals are more susceptible. Clinical signs of pneumonia in horses may include coughing, nasal discharge, fever, and labored breathing. Diagnosis typically involves a combination of clinical examination, imaging techniques such as radiography or ultrasonography, and laboratory tests including blood work and microbial cultures. Treatment strategies vary depending on the underlying cause and may involve antimicrobial therapy, supportive care, and environmental management. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, pathophysiology, diagnosis, and treatment of pneumonia in equine populations.
Spurlock SL, Spurlock GH, Donaldson LL.A 3-year-old Thoroughbred mare with signs of acute abdominal pain and chronic pneumonia was found to have pneumothorax. A single application of suction was successful in resolving the pneumothorax. The underlying pneumonia was treated with long-term antibiotic administration selected on the basis of results of bacteriologic culture and antimicrobial susceptibility testing of a transtracheal aspirate. The pneumonia resolved, and the mare returned to competition as a show hunter.
Bain FT, Brock KA, Koterba AM.High-frequency jet ventilation was performed on a premature foal for respiratory difficulty attributable to in utero-acquired pneumonia. The procedure involves delivery of compressed gas through a small-bore cannula at frequencies up to 400 cycles/min. Ventilation settings of drive pressure, frequency, and FIO2 were varied to optimize PaO2 and PaCO2 values. The foal was ventilated with this equipment for 14 hours. Evidence of a favorable response to this method of ventilation was observed in the form of improvement in arterial blood gas values as well as the foal's attitude and degree of respi...
Martens JG, Martens RJ, Renshaw HW.The capacity of hematogenous polymorphonuclear neutrophilic leukocytes (PMNL) to kill Rhodococcus equi was compared in horses of various ages. A radioisotope bactericidal assay was used to determine the capacity of PMNL to kill R equi. Assays were conducted on PMNL from horses in 3 groups: group I, 13 foals with a mean age of 3.3 days; group II, 10 group-I foals at a mean age of 35.7 days; and group III, adult dams of group-I foals. Bacteria were obtained from the lungs of a foal with R equi pneumonia and opsonized with fresh adult equine serum that contained R equi specific antibody. The mean...
Humber KA.After becoming entangled in safety lines and being submerged in a chlorinated swimming pool, a 2-year-old Thoroughbred gelding was evaluated and treated successfully. Treatment included antimicrobial agents, anti-inflammatory drugs, bronchodilators, diuretics, humidified oxygen, and surfactant transplant. The results of follow-up examination of the gelding 120 days after hospitalization were normal.
Murray MJ, Ball MM, Parker GA.A 3-month-old foal with a history of persistent fever and leukocytosis was found to have pneumonia, ulceration of the squamous portion of the stomach, and dilatation of the distal portion of the esophagus. The foal was euthanatized and necropsied. The distal portion of the esophagus was severely dilated, and there was severe ulceration and mural thickening of the stomach at the cardia. Because of the severe gastric ulceration and mural thickening, the gastroesophageal junction was fixed in an open position, permitting gastroesophageal reflux. The megaesophagus and pneumonia were considered to ...
Sweeney CR, Whitlock RH, Meirs DA, Whitehead SC, Barningham SO.Complications associated with Streptococcus equi infection developed in 15 (20.3%) of 74 horses on one farm included death, guttural pouch empyema, purpura hemorrhagica, upper respiratory tract obstruction, pneumonia, pleuropneumonia, agalactia, mesenteric lymph node abscessation, and periorbital abscessation. Death was attributed to pneumonia in 3 horses and to upper respiratory tract obstruction in 2 horses. One horse was euthanatized because of severe purpura hemorrhagica.
Barton MD, Embury DH.Pyogranulomatous pneumonia was induced in Thoroughbred foals by intranasal challenge with freeze-dried cultures of Rhodococcus equi (previously Corynebacterium equi). The incubation period was about 18 days and clinical signs were not seen for a further week. There were marked seasonal and individual foal differences in responses to infection. Elevations in serum caeruloplasmin oxidase activity and copper concentrations appeared to be sensitive indicators of infection. Serum zinc concentrations and serum alpha-mannosidase and alkaline phosphatase activities fell in the more severely infected f...
Nakazawa M, Isayama Y, Kashiwazaki M, Yasui T.A protein antigen that reacted in the agar gel diffusion (AGD) test and which had equi factor(s) activity, was partially purified from the culture supernatant of Rhodococcus equi by successive column chromatography on diethylaminoethyl cellulose and Sepharose 4B. Employing a standard foal serum, the concentration of this antigen was adjusted for the AGD test. Optimal dilutions of the antigen reacted in the AGD test with sera from foals naturally infected with serologically different R. equi. The antigen prepared was considered suitable for use in field surveys of R. equi infection. Accordingly...
Chirino-Trejo JM, Prescott JF, Yager JA.Two groups of three one to three week old foals were immunized orally on four occasions over five weeks with two strains of Rhodococcus equi, a clinical isolate from a pneumonic foal and a laboratory passaged Congo red negative variant of this strain. Three nonimmunized foals of similar age acted as controls. Three weeks after the last immunization, all foals were challenged on five occasions over seven days by aerosol infection with about 10(10) of the pneumonic foal isolate on each occasion. Control foals became seriously ill and were euthanized. Immunization with either strain protected foa...
Morris DD, Whitlock RH.Equine antiserum to core lipopolysaccharide (LPS) was evaluated in a double-blind prospective study for therapeutic benefit in suspected septicemia in neonatal foals. Forty foals younger than 7 days of age were included in the study by satisfaction of clinical and laboratory criteria, suggestive of gram-negative septicemia. Twenty-two foals were treated with core LPS antiserum (plasma produced from horses which were hyperimmunized with rough gram-negative mutant bacterin) and 18 foals received "nonimmune" plasma (from horses prior to immunization against core LPS). All foals received antimicro...
Hillidge CJ.The selection of lipid-soluble antibiotics capable of intracellular penetration is considered critical for the successful treatment of Rhodococcus equi pneumonia and lung abscesses in foals. Two such antibiotics: erythromycin (25 mg kg-1, three times daily) and rifampin (5 mg kg-1 twice daily) have been used in combination for this purpose at the University of Florida since 1981. Positive evidence of R. equi was present on culture of tracheal aspirates in 57 foals, most of which exhibited radiographic evidence of extensive lung abscessation. The duration of therapy ranged from 4 to 9 weeks. Mi...
Woolcock JB, Mutimer MD, Bowles PM.Normal horses of all ages regularly show evidence of having responded immunologically to R. equi, thus adding serological support to epidemiological evidence that this organism is a normal intestinal inhabitant. More animals from "diseased" farms show a stronger antibody response when compared with foals from "healthy" farms. Various serological tests have been used to detect evidence of infection and to relate antibody level to severity of disease. Anti-R. equi IgG antibody levels, as measured by ELISA, are raised significantly during natural infection. Clinical severity of pneumonia can be c...
Takai S, Kawazu S, Tsubaki S.Humoral immune response to Rhodococcus equi in experimentally infected foals was studied with the enzyme-linked immunosorbent assay (ELISA) method. Class-specific antibodies were measured by ELISA in the sera of foals after intratracheal or oral inoculation with R. equi ATCC 6939 or T 48 and in the lung washings of a foal after intratracheal inoculation or of normal horses. After intratracheal or oral inoculation with R. equi, serum antibodies were first detected in immunoglobulin G (IgG) followed by IgM and IgA classes, but significant levels of IgM and IgA developed only in the foal infected...
Martens RJ, Martens JG, Renshaw HW, Hietala SK.The opsonic capacity of serum containing R. equi-specific antibody was compared with antibody-deficient sera using luminol-dependent chemilumenscence (LDCL) and bactericidal assays. These assays incorporated peripheral blood polymorphonuclear neutrophilic leukocytes (PMNL) exposed to R. equi opsonized with neonatal equine pre-colostral serum (control) or serum from foals with R. equi infections (principal). All sera were complement inactivated at 56 degrees C for 30 min. Bacteria were obtained from the lung of a foal with R. equi pneumonia. Neutrophils were obtained from one adult horse for LD...
Skalka B.The occurrence of equi-factor antibodies in sera of mares and their foals was studied on two horse breeding farms, one of which (Farm A) had a positive and the other (farm B) a negative history of R. equi infection of foals. The equi-factor neutralization (EFN) and the reverse Elek-Ouchterlony (REO) precipitation were used as assays. On Farm A, 25 mares positive in both tests (EFN+ REO+) and 25 mares negative in both tests (EFN- REO-) was chosen. On Farm B, a group of 25 EFN- REO+ mares and a group of 25 EFN- REO- mares were studied. The first serum samplings in mares were 1 week ante partum a...
Yager JA, Duder CK, Prescott JF, Zink MC.Polymorphonuclear neutrophil leukocytes (PMNL) from 8 healthy foals (2-14 weeks of age) and 2 foals with bacterial pneumonia were separated from whole blood using a 2 step Percoll gradient. Purified PMNL were tested for bactericidal function against Rhodococcus equi and Staphylococcus aureus in the presence of normal horse serum. The percentage uptake after a 15-min pre-incubation of PMNL and bacteria was also calculated. Ultrastructural examination of the interaction of R. equi and normal foal PMNL was performed after 15 min incubation. Results indicated that foal PMNL effectively phagocytose...
Yager JA.The pathogenesis of Rhodococcus equi pneumonia in foals is reviewed. The main routes of infection are respiratory and alimentary. The latter is probably the chief route of exposure in all foals and probably leads to development of specific immunity. Susceptible foals, those whose maternal immunity wanes before generation of their own immune response, readily develop disease if exposed aerogenously to sufficient numbers of R. equi. Management and environmental circumstances have a major role to play in determining the magnitude of this challenge and, therefore, in the prevalence of the disease....
Sweeney CR, Sweeney RW, Divers TJ.Case records of 48 foals with pneumonia due to Rhodococcus equi were reviewed. Twenty of the 48 foals survived and 28 died or were euthanized. There was no significant difference between the survivors and non-survivors in the age of onset of illness, duration of illness prior to admission, the mean white blood cell (WBC) count, or the mean plasma fibrinogen content. All foals had R. equi isolated from a tracheobronchial aspirate or lung specimens obtained at necropsy. All organisms were susceptible in vitro (Kirby-Bauer) to erythromycin and gentamicin. Susceptibilities to other drugs were: tri...
Chirino-Trejo JM, Prescott JF.The antigens extracted from strains belonging to seven capsular serotypes of Rhodococcus equi, as well as from two wild strains isolated from pneumonic foals, were examined. Whole-cell antigens and soluble products present in broth culture supernatants were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, electroblotted onto nitrocellulose, and stained with serum from hyperimmunized rabbits or foals. Foal sera used included sera from pneumonic animals with known titer to equi factors; from animals bled monthly on a farm with enzootic pneumonia, and from animals bled mont...
Blue J, Perdrizet J, Brown E.Acute myelomonocytic leukemia was diagnosed in a 2-year-old Standardbred mare that had hind limb edema and fever unresponsive to antibiotics. The mare had anemia, thrombocytopenia, and leukocytosis, with circulating myeloblasts and monocytoid cells. A bone marrow specimen was hypercellular, with myeloblasts and monocytoid cells. Peroxidase, chloroacetate esterase, and alpha naphthyl acetate esterase activities were detected in many bone marrow cells. Interstitial pulmonary densities were seen radiographically. The mare was euthanatized and necropsied. Infiltrates of leukemic cells were found m...
Boldur I, Cohen A, Tamarin-Landau R, Sompolinsky D.The lungs of 139 calves presented for autopsy and 29 healthy slaughtered calves were examined for Legionella by culture and by direct immunofluorescence (DIF) with fluorescein-conjugated antisera. About 17% of the cadaver lungs and 4% of lungs from slaughtered animals were positive by DIF. Legionella organisms were only isolated from the lungs of two cadavers (L. pneumophila, serogroup 1). In a prevalence study of antibodies to Legionella in domestic and wild animals of various species, titers of greater than or equal to 64 were demonstrated by indirect immunofluorescence in sera of 10% of dai...
Hietala SK, Ardans AA.This study was undertaken to examine the neutrophil response to Corynebacterium (Rhodococcus) equi, and to assess the possibility of neutrophil immaturity or malfunction in predisposition to C. equi pneumonia in foals. Neutrophil phagocytosis of Corynebacterium (Rhodococcus) equi was studied in foals from birth to 6 months of age. Chemiluminescence (CL) and bactericidal assays were used to assay the phagocytic response of peripheral blood neutrophils to C. equi in vitro. Results of in vitro bactericidal and CL assays indicate that foal neutrophils are able to ingest and kill C. equi, however a...
Buergelt CD, Hines SA, Cantor G, Stirk A, Wilson JH.Proliferative and fibrosing interstitial lung disease was diagnosed in 20 horses submitted for necropsy between 1982 and 1985. Most of the horses were foals ranging from 3 days to 6 months in age. Six adult horses were affected. The macroscopic and microscopic characteristics of the lesions consisted of proliferative interstitial pneumonia and were similar to those of atypical interstitial pneumonia of ruminants. Based on morphologic features of the lesions, a toxic etiology is suspected for the induction of this naturally acquired primary equine lung disorder, but could not be specifically di...
Hultgren BD, Pearson EG, Lassen ED, Watrous BJ, Hedstrom OR.A conifer twig was responsible for severe fibrinopyogranulomatous adhesive pleuritis and pneumonia in a horse. At necropsy, the twig was found in a terminal bronchus and extended into the lung parenchyma, through the pleura, and into the accumulated exudate. Inhalation of plant material may be a more common cause of pleuritis than previously recognized. Meticulous examination at necropsy would be necessary to make the diagnosis.
Takai S, Iimori S, Tsubaki S.Quantitative culture of Corynebacterium (Rhodococcus) equi from feces of 17 foals on a farm (A) with an endemic C. equi infection problem and 26 foals on a farm (B) without the disease in the past decade was done with a selective medium at weekly or monthly intervals from April to August of 1984. Corynebacterium equi was observed in the feces of 16 of 17 foals on farm A, and 19 of 26 foals on farm B. The mean viable count of C. equi in one gram of feces was 4.1 +/- 3.7 (log10) on farm A, and 3.9 +/- 3.4 (log10) on farm B. Corynebacterium equi was recovered from feces of foals as young as two w...
Hillidge CJ.Corynebacterium (Rhodococcus) equi is becoming increasingly significant as a cause of bronchopneumonia and lung abscessation in foals. The organism can survive within macrophages and may thus escape normal pulmonary defence mechanisms, particularly in immunocompromised animals. The disease has hitherto been associated with mortality rates as high as 80 per cent, partly as a result of inappropriate therapy. The selection of lipid-soluble antibiotics capable of intracellular penetration is critical for the successful treatment of C equi lung abscesses. A combination of two such antibiotics, eryt...
Woodrow JS, Palmisano M, Kulp J, Hopster K.Complications from general anesthesia, including pneumonia and decreased wound healing, are influenced by changes in immune cell function secondary to sedatives and anesthetics. It was hypothesized that immune cell function would be depressed in the early postanesthetic period. The objective was to investigate airway immune cell function before and after a general anesthetic episode in an equine in vivo model using ex vivo cell stimulations with lipopolysaccharide (LPS) for assessment of immune function. Methods: Prospective experimental study. Methods: Six healthy, adult, institution-owned ...
Hepworth-Warren KL, Love K.Bacterial pneumonia is a common disease in adult horses, but there are no guidelines for practitioners regarding risk factors, diagnosis, and management of the disease. The objectives of this study were to describe how a group of equine veterinarians diagnose and treat bacterial pneumonia in adult horses. A 22-question survey was distributed via multiple platforms to equine veterinarians asking questions regarding the frequency with which they identified specific clinical findings and used certain diagnostic modalities, and the approach to antimicrobial and adjunct therapy. Three hundred nine ...
Sun J, Xu X, Gao S, Pan Q, Liu Z, Huang Y, Lian Y.Prevotella heparinolytica is a Gram-negative bacterium that is commonly found in the oral, intestinal, and urinary tracts. It has been extensively studied in lower respiratory tract infections in horses, which has heparinolytic activity and can secrete heparinase and further induces virulence factors in cells and causes disease. However, no such cases have been reported in humans. Methods: A 58-year-old male patient from China presented to the respiratory clinic in Suzhou with a productive cough producing white sputum for 20 days and fever for 3 days. Prior to this visit, a chest computed to...
Mizuguchi Y, Tsuzuki N, Ebana MD, Suzuki Y, Kakuda T. is an intracellular bacterium that causes suppurative pneumonia in foals. T-helper (Th) 1 cells play an important role in the protective response against . In mice and humans, the directionality of IgG switching reflects the polarization of Th-cell responses, but this has not been fully elucidated in horses. In this 4-year study, we classified -infected foals into surviving and non-surviving group and investigated differences in IgG subclass response to virulence-associated protein A, the main virulence factor of , between the groups. IgGa, IgGb, and IgG(T) titers were significantly higher in...
Bergmann R, Schroedl W, Müller U, Baums CG.Streptococcus equi subsp. zooepidemicus (SEZ) is a major equine pathogen that causes pneumonia, abortion, and polyarthritis. It can also cause invasive infections in humans. SEZ expresses the M-like protein SzM, which recruits host proteins such as fibrinogen to the bacterial surface. Equine SEZ strain C2, which binds only comparably low amounts of human fibrinogen in comparison to human SEZ strain C33, was previously shown to proliferate in equine and human blood. As the expression of SzM_C2 was necessary for survival in blood, this study investigated the working hypothesis that SzM_C2 inhibi...
Hultgren BD, Pearson EG, Lassen ED, Watrous BJ, Hedstrom OR.A conifer twig was responsible for severe fibrinopyogranulomatous adhesive pleuritis and pneumonia in a horse. At necropsy, the twig was found in a terminal bronchus and extended into the lung parenchyma, through the pleura, and into the accumulated exudate. Inhalation of plant material may be a more common cause of pleuritis than previously recognized. Meticulous examination at necropsy would be necessary to make the diagnosis.
McGorum BC, Railton DI, Clarke CJ, Dixon PM, Woodman MP, Long KJ.Hydatid cysts (metacestode of Echinococcus grunulosus) are a
common incidental post-mortem finding in horses in the United
Kingdom (Cranley 1982), being found most frequently in the liver
and the lungs (Schwabe 1986). However, hydatid cysts are well
tolerated by horses and clinical hydatidosis is rare, even in
heavily infected animals (Thompson and Smyth 1975; Thompson
and Allsopp 1988). Clinical disease has been attributed to hydatid
cysts in the equine retrobulbar region (Bamett et ul. 1988), brain
(Gordon 1974, quoted by Thompson 1977) and liver (Barvaux
and Derzelle 1947). This is...
Turk MA, Klei TR.Eighteen parasite-free pony foals were infected orally with 500 third stage larvae of Strongylus vulgaris. At 56 days after infection, six ponies were treated with intramuscular ivermectin (22, 23-dihydroavermectin B1); six were treated with oral ivermectin; and six were not treated. Necropsy was done 91 days after infection to study the pathologic effects of migrating S. vulgaris larvae and to determine the efficacy of ivermectin in attenuation of S. vulgaris-induced lesions. Larval migration induced eosinophilic inflammation of the liver, spleen, mesenteric, colic and cecal lymph nodes, and ...