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.
Burrell MH, Mackintosh ME, Taylor CE.Streptococcus pneumoniae was isolated from nasopharyngeal swabs and tracheal washings taken from Thoroughbred horses in training at three of four separate stables that were sampled during investigations into respiratory disease. The growth of Strep pneumoniae in culture was enhanced by an environment enriched with carbon dioxide. In one stable, five of 15 horses that were sampled repeatedly were found to carry the organism for at least four months. There was an apparent association between lower respiratory tract inflammatory disease and heavy growths (10(6) to 10(8) colony forming units/ml) p...
Zink MC, Yager JA, Smart NL.Of 131 cases of Corynebacterium equi infection in horses submitted for necropsy to the Ontario Veterinary College or Veterinary Laboratory Services, OMAF, Guelph, Ontario from 1958 to 1984, 115 were diagnosed as suppurative pneumonia, and of these 55 had associated ulcerative enterocolitis. Only five animals had intestinal involvement without pulmonary lesions. The remaining 11 cases included arthritis/cellulitis, skin abscesses and submandibular lymphadenitis. While the lung, intestine and associated lymph nodes yielded C. equi most frequently, in 21% of cases C. equi was also cultured from p...
Markel MD, Madigan JE, Lichtensteiger CA, Large SM, Hornof WJ.Over a 4-year period, vertebral body abscess was diagnosed in 5 young cattle. The laboratory findings in most of these cases did not suggest a diagnosis of vertebral body abscess. The most important basis for diagnosis of this condition was a thorough neurologic examination. In 4 cases, necropsy revealed abscesses in the lungs or thoracic cavity as well, suggesting that a history of pneumonia preceding paresis may favor the diagnosis of vertebral body abscess.
Yager JA, Foster SF, Zink MC, Prescott JF, Lumsden JH.Polymorphonuclear leukocytes from adult horses were separated from whole blood, using a 2-step Percoll gradient, and were tested for bactericidal function against Corynebacterium equi. Staphylococcus aureus, an organism against which equine neutrophils have proved efficacy, was a positive control. The percentage of uptake after a 15-minute preincubation of the neutrophils and bacteria in the presence of normal horse serum was also calculated. The results indicated that equine neutrophils effectively phagocytosed and killed C equi and S aureus. The percentage of uptake for S aureus (95% +/- 3%)...
Brock KA.A pharyngeal performation, probably associated with endotracheal intubation, occurred in a healthy 4 1/2-month-old colt. Inhalation anesthesia was carried out for elective surgery, but acute cervical cellulitis, pleuritis, and pneumonia developed after the surgery. Antibacterial and supportive therapy was ineffective.
Sweeney CR, Divers TJ, Benson CE.Anaerobic bacteria are important and overlooked bacterial pathogens of the lower respiratory tract in horses. Twenty-one of 46 horses with pleuropneumonia had anaerobic bacteria isolated from pleural fluid or from tracheobronchial aspirate. Bacteroides oralis and B melaninogenicus were the anaerobes most frequently isolated. Survival was significantly less for horses from which anaerobes were isolated than for horses from which anaerobes were not isolated. Putrid odor was associated with the pleural fluid and/or breath in 62% of the horses from which anaerobes were isolated. In these horses, t...
Prescott JF, Sweeney CR.Combined antimicrobial drug treatment was recommended for foals with Corynebacterium equi pneumonia. The preferred combination is orally administered erythromycin estolate (25 mg/kg of body weight, QID) plus rifampin (10 mg/kg, BID). Erythromycin estolate also can be combined for synergistic effect with sodium benzyl penicillin given IV (100,000 IU/kg, QID) or with ampicillin given IV (11 to 15 mg/kg, QID). A third choice is sodium benzyl penicillin IV with gentamicin IM (2.2 mg/kg, TID) or with kanamycin IM (10 mg/kg, QID). Gentamicin should be combined with penicillin G or ampicillin and not...
Wilson WD, Baggot JD, Adamson PJ, Hirsh DC, Hietala SK.Sodium cefadroxil was administered as a single intravenous dose (25 mg/kg) to six healthy adult mares. Plasma samples were collected over a 24-h period and cefadroxil concentrations were measured by microbiological assay. The pharmacokinetic behavior of the drug was appropriately described in terms of a one-compartment open model. Values for the major pharmacokinetic terms were: extrapolated initial plasma concentration = 59.2 +/- 15.0 micrograms/ml; half-life = 46 +/- 20 min; apparent volume of distribution = 462 +/- 191 ml/kg; and body clearance = 7.0 +/- 0.6 ml/min.kg. In a subsequent study...
Falcon J, Smith BP, O'Brien TR, Carlson GP, Biberstein E.Thirty-nine foals with pneumonia were admitted to the Veterinary Medical Teaching Hospital at the University of California, Davis. Corynebacterium equi was recovered from each of them on bacteriologic culture of transtracheal aspiration specimens or lung specimens at necropsy. The foals were divided into 2 groups. Group I consisted of 20 foals that died because of C equi pneumonia and were subsequently necropsied. Group II consisted of 19 foals that were treated and discharged from the hospital. Radiography was performed on all foals. Clinical signs included increased respiratory rate, fever, ...
Larson VL, Busch RH.Differential cell counts were done on bronchial lavage specimens from 166 horses. Postmortem gross and histologic examinations were done to determine the pathologic diagnosis of the lungs from these horses. Ninety-two (55%) were normal, 18 (11%) had interstitial pneumonia, 13 (8%) had bronchopneumonia, 13 (8%) had focal eosinophilia, 11 (7%) had diffuse eosinophilia, 11 (7%) had chronic bronchitis, and 8 (5%) had suppurative bronchitis. Little relationship was found between cellular features of the lavage specimens and the pathologic status of the lungs of individual horses.
Baggot JD, Love DN, Rose RJ, Raus R.The serum concentrations of the aminoglycosides neomycin, kanamycin and streptomycin were determined after intravenous (iv) and intramuscular (im) administration. These values were then related to the minimum inhibitory concentrations (MIC) of a number of equine pathogenic bacteria to determine the duration of therapeutic serum concentrations of the aminoglycosides in the horse. Pharmacokinetic analysis of the data using neomycin as the example revealed a mean (+/- sd) peak serum concentration of 23.2 +/- 10.2 micrograms/ml present at 30 mins, and at 8 h the serum concentration was 2.8 +/- 0.8...
Benson CE, Sweeney CR.Streptococcus pneumoniae type 3 was isolated from seven tracheobronchial aspirates and one pleural tap of seven adult horses and one foal. There was no direct evidence in these horses that isolation of the pneumococcus was related to a specific disease syndrome. Presenting complaints included two horses with chronic cough, two horses with decreased exercise tolerance, one horse with exercise-induced pulmonary hemorrhage, and three horses with pneumonia. Antibiotic therapy resolved the primary clinical complaint. This is the first report of the isolation of S. pneumoniae type 3 from adult horse...
Whitwell KE, Greet TR.A flexible endoscope was used to obtain 223 tracheal washes from 191 horses in three clinical categories. Total cell counts, cytological and bacteriological examinations are reported and the features of the main cell types encountered described. The presence and degree of inflammatory airway disease was determined by a semiquantitative assessment of the neutrophil response and was an important consideration in the interpretation of the bacteriological results. Potential pathogens were isolated from approximately 30 per cent of samples. Cytological changes suggestive of lungworm infestation, vi...
Ellenberger MA, Kaeberle ML, Roth JA.A procedure was developed for isolating large numbers of purified polymorphonuclear leukocytes (PMNs) from the peripheral blood of horses. Equine PMN function was evaluated by three procedures: 1) Staphylococcus aureus ingestion, 2) nitroblue tetrazolium reduction, and 3) iodination. Four preparations of R. equi were added to polymorphonuclear leukocytes (PMNs) in each test system. Live bacteria, heat-killed bacteria, the washed pellet from heat-killed bacteria, and the supernatant fluid from heat-killed bacteria were evaluated for effects on equine PMN function. None of the R. equi preparatio...
Prescott JF, Coshan-Gauthier R, Barksdale L.Antibody to equi factor(s) in cases of Corynebacterium equi pneumonia in foals was detected using C. pseudotuberculosis exotoxin sensitized calf red blood cells. The test was standardized using antitoxin produced in rabbits by injection of equi factor(s). All sera from ten foals with culture-diagnosed C. equi pneumonia had antibodies to equi factor(s) (titre range 8-256, mean 74.0) and nine sera from 11 foals with suspected C. equi pneumonia also showed antibodies (titre range 4-512, mean 136.4). Two of five pneumonia foals with transtracheal aspirate cultures not yielding C. equi had such ant...
Vyslouzil L, Seidl K, Svarcová J, Landsmannová V.A case history of mass foal disease which affected ten of the total stock of 50 foals and killed eight is described. The disease was characterized by respiratory disorders and extensive pneumonias with abscess formation, metastatic abscesses in mesenterial lymph nodes and in other organs. As a result of the examination of two dead foals and three nasal smears from diseased animals, gram-positive bacteria were isolated from the lungs, pulmonary and abdominal abscesses and the nasal smears of the affected foals; with their cultivation, morphological and biochemical characteristics these bacteria...
Webb AI, Coons TJ, Koterba AM, Kosch PC.New developments in therapy for foals in respiratory distress are discussed. Therapy is based on preservation of the foal's life by maintenance of a patent airway, resuscitation with fluids and warmth, provision of humidified oxygen to raise the fractional concentration of inspired oxygen sufficient to avoid hypoxia and provision of ventilatory support when hypercapnia becomes critical. Ventilatory support described includes assisted and controlled ventilation, positive end expiratory pressure, continuous positive airway pressure and intermittent mandatory ventilation. The aims of these techni...
Kosch PC, Koterba AM, Coons TJ, Webb AI.Developments in evaluation of newborn foals with respiratory distress are discussed. Major causes of respiratory distress are outlined and discussed in terms of the similar respiratory signs exhibited by foals with this clinical syndrome. History, physical examination, clinical pathology, chest radiography and blood gas analyses are discussed as important elements of the evaluation of the condition of these foals. Foals with respiratory disease are grouped into three major categories on the basis of clinical signs and arterial blood gas profiles. The evaluation of foals with respiratory distre...
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 ...
Prescott JF, Travers M, Yager-Johnson JA.Corynebacterium equi was cultured from manure or soil on five horse-breeding farms in Ontario at monthly intervals on three occasions during the summer of 1982. The organism was widespread. Contamination by C. equi of the loafing paddock and pasture areas was significantly greater in a farm established 30 years than in two established for four and six years and there was a significant correlation between the C. equi burden in stables, paddocks and pastures and the length of use of the five farms for horses. In all farms, numbers of C. equi in pasture soil exceeded numbers in fresh manure, sugg...
Heidelberger M.Data accumulated over many years are brought together on cross-reactions of 46 among the more than 80 pneumococcal serological types, with the idea of correlating cross-reactions with the structures of the relevant type-specific capsular polysaccharides, insofar as these have been determined. The precipitin reaction was carried out with the polysaccharides and antibodies raised in horses, rabbits, and a mule. Quantitative values (micrograms of antibody nitrogen per milliliter of antiserum at 0 to 1 degree C) are given in many instances and discussed, together with arbitrary qualitative data, i...
Johnson JA, Prescott JF, Markham RJ.Six foals were inoculated intrabronchially with a suspension of Corynebacterium equi. Six weeks before this challenge, three foals were vaccinated with a C. equi bacterin. Three foals were unvaccinated controls. All foals developed a severe bronchopneumonia in the inoculated lung, indicating that vaccination was not protective. Three foals (two vaccinated, one control) were killed eight to nine days after infection. One control died on day 9 with lesions of disseminated intravascular coagulation. The remaining two foals (one vaccinated, one control) were killed on day 17. C. equi was cultured ...
Cho SN, Collins MT, Reif JS, McChesney AE.Attempts to infect horses with Legionella pneumophila were undertaken to determine pathogenicity and to evaluate the possibility that horses serve as a reservoir for the organism. A previous study showed that the prevalence of antibodies to L pneumophila in the equine population exceeded 30% of over 600 sera examined. Horses were infected experimentally with the Philadelphia 1 or Bloomington 2 strain of L pneumophila IV or by aerosolization. Signs of clinical illness were restricted to a transient febrile response. A transient decrease in circulating lymphocytes occurred 2 days after inoculati...
Newsholme SJ.Gross, histological and ultrastructural findings are described in 6 natural cases and in 2 experimental cases of African horsesickness. From the gross lesions the cases were divisible into 2 groups which represented the previously described pulmonary and mixed forms of the disease. Histologically, abundance of fibrin and inflammatory cells in oedematous lung suggests that the pulmonary lesion is an exudative pneumonia. Lymphoid depletion and necrosis in germinal centres were consistently present. Electron microscopy failed to demonstrate virus particles or virus-associated structures in the ti...
Prescott JF, Hoover DJ, Dohoo IR.The pharmacokinetic parameters of erythromycin in foals were determined following intravenous administration of 5.0 mg/kg to animals aged 1, 3, 5 and 7 weeks. The distribution of the drug was described by a two-compartment open model, and no significant differences were observed between coefficients on which the parameters were based. Pharmacokinetic values were also determined for four mares given 5.0 mg/kg intravenously and for six 10-12-week-old foals given 20.0 mg/kg intravenously. The half-life of erythromycin for all groups of animals (foals less than 7 weeks, mares, foals 10-12 weeks) w...
Raphel CF, Beech J.Of 122 horses with pleural effusion, 90 (73.8%) had pleuritis secondary to pneumonia or lung abscessation. Fifty-one horses died or were euthanatized. The highest prevalence was in Thoroughbred and Standardbred racehorses. Eleven (12.2%) horses were postsurgical patients and 22 (24.4%) horses had been transported over 500 miles. There was no relationship between final outcome and the age, sex, breed, hematologic values, or laboratory findings pertaining to pleural fluid except for the bacterial isolation of Escherichia coli from the pleural fluid, as this was more frequently associated with de...
Martens RJ, Fiske RA, Renshaw HW.Subacute pyogranulomatous pneumonia was experimentally induced in 3 neonatal foals following multiple challenge with aerosols containing Corynebacterium equi. On each of 7 consecutive days the foals were exposed to approximately 3.5 X 10(7) viable C equi in droplets small enough to reach the terminal airways. Clinical, pathological and bacteriological features of the induced syndrome were indistinguishable from those exhibited by cases with spontaneous subacute C equi foal pneumonia. Radiographic evidence of advanced pulmonary damage preceded the appearance of clinical signs and ante mortem cu...
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...
Winder NC, Pellegrini A, von Fellenberg R.A peroxidase antiperoxidase technique was used to identify alpha 2-macroglobulin in formalin-fixed sections of normal equine lung and liver and in tissue sections and bronchoalveolar lavage fluid from horses with various lung diseases. Equine peripheral blood leucocytes and bronchoalveolar lavage samples from clinically normal horses were negative for alpha 2-macroglobulin. It was concluded that liver and pulmonary macrophages may be potential sources of alpha 2-macroglobulin. Although alpha 2-macroglobulin may play a role in various chronic bronchointerstitial pneumonias of the horse, it is d...
Sonmez K, Gurel A, Takai S.The aim of the present study was to develop an immunocytochemical procedure for the early detection and demonstration of Rhodococcus equi in smears of tracheal aspirates taken from live foals in field conditions. Tracheal wash samples were collected from thoroughbred foals, aged 1-5 months and located in studs around Bursa and Istanbul, Turkey. Some foals were suspected of having R. equi infection on the basis of clinical examination (n=56) and others were unaffected control animals (n=54). Serum samples were also collected from each foal for testing for the presence of R. equi-specific antibo...
Thompson DB, Spradborw PB, Studdert M.Some details of the clinical and postmortem findings of an Arab foal that died as a consequence of adenoviral pneumonia superimposed on a combined immunodeficiency disease are provided. The foal was the 17th in a series of similar deaths that occurred on a farm since 1959. An adenovirus, which by haemagglutination inhibition and serum neutralisation tests was antigenically similar to 2 other equine adenoviruses isolated in Australia, was isolated from a nasal swab taken from the foal when it was 23 days of age.
Dyke TM, Hinchcliff KW.Ceftiohr sodium was evaluated as a therapy for respiratory
infections in horses. This cephalosporin antimicrobial was
administered intramuscularly every 24 h and at a dose of 2.2
mglkg (1.0 mgllb) of body weight. The efficacy of ceftiofur
sodium was compared with that of a positive control drug,
ampicillin sodium (recommended dose of 6.6 mg/kg [3 mg/lb],
given every 12 h). Both treatments were continued for 48 h
after clinical symptoms were no longer evident (maximum of
10 days). Fifty-five (55) horses with naturally acquired
respiratory infections were included in the study; 28 were
...
Boswinkel M, van der Lugt JJ, Sloet van Oldruitenborgh-Oosterbaan MM.Rhodococcus equi infection occurs worldwide and is especially a problem in foals, where it often causes colitis or pneumonia. Other organs are seldom affected, and their involvement is regarded as a complication of pneumonia and/or colitis. Vertebral osteomyelitis is one such rare complication and is probably caused by haematogenous spread from inflammatory lesions in the lungs and/or intestine. In rare cases, osteomyelitis can be caused by contamination of a wound. This case study describes a foal with vertebral osteomyelitis due to R. equi in which there were only minor inflammatory changes ...
Dixon PM, McGorum BC, Long KJ, Else RW.An outdoor pony which developed severe respiratory distress in February was shown to have acute interstitial pulmonary disease (alveolitis), which was characterised by a massive exudation of eosinophil rich fluid into the airways. While antibiotic treatment before referral was ineffective, the condition rapidly responded to corticosteroid therapy. No evidence of lungworm was present and it appears that this interstitial pulmonary disease had an immune-mediated aetiology. Bronchoalveolar lavage cytology was of great value in the diagnosis and monitoring of this case.
Gudmundsson G, Olafsson L, Nikulásson S, Jónsdóttir B.A young woman was admitted to Akranes Regional Hospital because of dyspnea, fatigue and fever. She was found to have bilateral pneumonia but etiology was not found. She was treated with antibiotics with good resolution and was discharged after eight days from the hospital. Four weeks later she noticed rapidly progressive dyspnea and was found to be hypoxemic, and to have restrictive spirometry and diffuse interstitial changes on chest radiography. Computerized tomography of the lungs showed diffuse ground glass changes. Transbronchial biopsies from the lungs showed numerous small granulomas. S...
Axon JE, Robinson P, Lucas J.A 6-year-old gelding was referred with a 3-month history of recurrent fever, inappetance, lethargy and weight loss. On clinical examination major findings were depression, thin condition, thrombophlebitis, nodules on the scrotal skin, leukocytosis, hyperfibrinogenaemia and hyperglobulinaemia. Pleural fluid and areas of lung consolidation were seen on ultrasonographic examination of the thorax. A diagnosis of chronic respiratory disease was made. Initially there was a response to antibiotic therapy but the horse was presented 3 months later with continued weight loss, recurrent fever and multif...