Respiratory disease in horses encompasses a range of conditions affecting the respiratory system, including the upper and lower airways. These diseases can result from various etiologies such as infectious agents, environmental factors, or genetic predispositions. Common respiratory conditions in horses include equine asthma, equine influenza, and strangles. Clinical signs often associated with respiratory disease in horses include coughing, nasal discharge, and labored breathing. Diagnostic approaches may involve endoscopy, imaging, and laboratory tests to assess the function and health of the respiratory tract. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, and management of respiratory diseases in equine populations.
Stick JA, Boles C.Three foals with chronic cough, bilateral nasal discharge, and pneumonia were found to have a subepiglottic cyst as the inciting cause. Consistent findings were dysphagia and aspiration pneumonia, in addition to the abnormal respiratory noise usually found in the adult horse with a subepiglottic cyst. Histologic examination of the cysts suggested their origin was traumatic rather than embryonic.
Murphy JR, McPherson EA, Dixon PM.The effects of the bronchodilator drugs, atropine, isoprenaline and terbutaline, on normal horses and on horses affected with chronic obstructive pulmonary disease (COPD), were assessed by pulmonary function tests and clinical examination. Normal horses were not affected but COPD horses responded by a marked decrease in intrathoracic pressure, a decrease in respiratory rate, an initial decrease followed by an increase in arterial oxygen partial pressure and clinical improvement after treatment with all 3 drugs. These changes were temporary.
Sorenson PR, Robinson NE.Quasi-static pressure-volume curves and single-breath nitrogen washouts were performed simultaneously on eight anesthetized horses (average body wt = 485 kg) in left lateral, right lateral, prone, and supine postures (sequence randomized). The shift from prone to lateral or supine posture decreased expiratory reserve volume (ERV), vital capacity (VC), residual volume (RV), functional residual capacity (FRC), and total lung capacity (TLC); RV and FRC expressed as %TLC were unchanged, suggesting that in the lateral and supine postures a significant portion of the lung volume was not recruited by...
Mumford JA, Rossdale PD.Racehorses perform badly for many different reasons. Trainers often expect clinicians to determine the cause in individual cases and, more especially, where most of the immates of the stable are apparently affected by loss of form. Clinical examinations may reveal signs including fever, serous nasal discharge and the occasional cough. Haematology and blood biochemistry are commonly used aids to diagnosis in the field and may be helpful, but there is a need for facilities for virological investigations to be made readily available for use by clinicans as an adjunct to more commonplace laborator...
Murphy JR, McPherson EA, Lawson GH.80 mg sodium cromoglycate (SCG) was administered by inhalation to two COPD-affected animals known to have respiratory hypersensitivity to Micropolyspora faeni. SCG treatment 20-30 minutes prior to inhalation challenge with M. faeni prevented exacerbation of respiratory disease, usually seen 4-8 hours after challenge. duration of protection against antigen challenge after a single SCG treatment was 4-5 days. The duration of protection was not prolonged by reducing the frequency of antigen challenge. Multiple antigen challenge, using M. faeni and Aspergillus fumigatus, shortened the protective p...
Prescott JF, Markham RJ, Johnson JA.Transformation of peripheral blood lymphocytes from pony foals vaccinated and subsequently infected with Corynebacterium equi was studied. Three foals were vaccinated on two occasions using a formalinized C. equi vaccine with aluminum hydroxide as an adjuvant. Three nonvaccinated foals served as controls. Foals were challenged intratracheally with 9 x 10(9) C. equi six weeks after the initial vaccination. Foals survived this infection for one to two weeks. Significant lymphocyte transformation in response to C. equi antigens was detected in two vaccinated foals at the third week after initial ...
Orr JA, Busija DW.Unanesthetized ponies were given 4% CO2 (inspired CO2 pressure = 28 Torr) to breathe at two levels of arterial O2 pressure (PaO2): 1) near 75 Torr and 2) near 200 Torr. During 4% CO2 breathing, at either level of PaO2, the mean arterial CO2 pressure (PaCO2) was unchanged from control measurements (control measurements were made at the same PaO2, but with no CO2 in inspired air), suggesting that awake ponies can "clear" 4% CO2. The ability of individual ponies to clear 4% CO2 was quite variable: some ponies did not clear 4% CO2 and others cleared 4% CO2 on one day but not on the following day. ...
Lawson GH, McPherson EA, Murphy JR, Nicholson JM, Wooding P, Breeze RG, Pirie HM.The sera of horses affected and not affected with chronic obstructive pulmonary disease (COPD) were examined for precipitins to Micropolyspora faeni and Aspergillus fumigatus. Precipitins to both antigens were not restricted to COPD cases but occurred more frequently in animals affected with COPD. Many animals without detectable precipitins responded clinically to inhalation challenge with these antigens.
Barnes GR, Brennan M, Goulden BE, Kirkland J.One problem in the diagnosis of subclinical roarers is that abnormal auditory signals occur only during a fast gait, and these fade quickly. This paper offers a novel technique to assist this problem. Sound recordings were obtained from five horses following exercise; two roarers, two non-roarers, and one suspected roarer. These signals were converted into spectrograms by Rayspan processing. All frequencies in the 0 to 2.25 kHz range during both inspiration and expiration, as well as occasional noises in the 2–4 kHz band, characterised roarers. Signals from non-roarers consisted of frequenci...
Matthews AG.Three major antiprotease components in equine serum were identified and characterised. These were the acidic prealbumin Pr, the homologue of human alpha-1 antitrypsin and 2 protease binding proteins, the acidic prealbumin Xc and alpha-2 macroglobulin, both capable of inhibiting the proteolytic activity of trypsin, but with only limited inhibitory effect on its esterolytic activity. The possible role of these serum antiproteases in the onset of chronic obstructive pulmonary disease (COPD), analogous to the hereditary dysproteinaemia of alpha-1 antitrypsin in man, was investigated. There was no ...
McPherson EA, Lawson GH, Murphy JR, Nicholson JM, Breeze RG, Pirie HM.Breed, age, weight, type of work performed, seasonal onset, poor ventilation and exposure to moulds in the habitat were investigated in relation to the occurrence of chronic obstructive pulmonary disease (COPD). COPD was most commonly detected in showjumping and hacking horses. The older a horse, the more likely it was to become affected although most were 6 to 10 years of age. Of the horses in this sample of the population, which was not a random one, thoroughbred horses were affected least and ponies most often. The high incidence in ponies was related to their more frequent exposure to poor...
McPherson EA, Lawson GH, Murphy JR, Nicholson JM, Breeze RG, Pirie HM.Micropolyspora faeni and Aspergillus fumigatus were identified as common causes of respiratory hypersensitivity in horses affected with chronic obstructive pulmonary disease (COPD). Rye grass pollen and an Actinomycete evoked respiratory allergy in a few horses. Not infrequently, individual horses were found to have respiratory hypersensitivity to two or more antigens. The methods used to examine for allergy were intradermal testing and inhalation challenge with environmental antigens. An intradermal test using an M faeni extract was demonstrated to be suitable for diagnostic use in horses pre...
Stanek KA, Nagle FJ, Bisgard GE, Byrnes WC.Published reports of oxygen consumption (VO2) during exercise in hyperoxia are equivocal. By and large, when measured at the lung using respiratory gas equations, VO2 is elevated in hyperoxia and, when measured at the blood-tissue level using the cardiovascular Fick (CVF) equation, it is unchanged. We sought to provide some insight into this problem by making through the use of both equations simultaneous determinations of VO2 during hyperoxia in exercising ponies. In normoxia, during treadmill exercise (115 m/min, 10% grade) of seven ponies, there was no difference in exercise VO2, whether it...
Lavoie-Lamoureux A, Martin JG, Lavoie JP.Neutrophils are the predominant cells recruited in the airways of horses suffering from heaves. These cells have been shown to express arginase in some species. The metabolism of l-arginine is thought to be involved in chronic inflammation, and airway obstruction and remodeling. The aim of this study was to assess the expression, regulation, activity, and functional role of arginase isoforms in equine neutrophils. Arginase I, arginase II, ornithine decarboxylase (ODC) and ornithine aminotransferase (OAT) expression were assessed in resting and stimulated (IL-4, LPS/fMLP, PMA; 5 and 18 h) blood...
Powers SK, Beadle RE, Thompson D, Lawler J.The purpose of these experiments was to examine the temporal pattern of arterial carbon dioxide tension (PaCO2) to assess the relationship between alveolar ventilation (VA) and CO2 return to the lung at the onset and offset of submaximal treadmill exercise. Five healthy ponies exercised for 8 min at two work rates: 50 m/min 6% grade and 70 m/min 12% grade. PaCO2 decreased (P less than 0.05) below resting values within 1 min after commencement of exercise at both work rates and reached a nadir at 90 s. PaCO2 decreased maximally by 2.5 and 3.5 Torr at the low and moderate rate, respectively. Aft...
Tulleners EP, Harrison IW, Raker CW.By use of endoscopy, 75 horses with respiratory noise and/or exercise intolerance were determined to have structural arytenoid cartilage abnormalities (60 primary, 11 after previous laryngeal surgery), or failed left laryngoplasty (4 horses) for laryngeal hemiplegia in which the arytenoid cartilage still appeared normal. Eighty-eight percent of the horses were either Thoroughbred (54 horses; 72%) or Standardbred (12 horses; 16%) racehorses; only 9 horses (12%) had occupations not related to racing. Seventy-six percent of the racehorses were 2 to 4 years old; all non-racehorses were greater tha...
Shappell KK, Stick JA, Derksen FJ, Scott EA.Between 1981 and 1986, permanent tracheostomy was performed in 46 ponies and 1 adult Quarter Horse. Tracheostomies of 19 ponies and the horse were examined in June 1986 and evaluated for vertical length of stomal orifice (mean = 25.0 +/- 4.7 mm in the ponies and 55 mm in the horse), degree of tracheal obstruction (0/20), regrowth and apposition of epidermis (3/20), and whether or not stomal airflow occurred with nasal occlusion (20/20). In addition, the animals were evaluated to determine whether dyspnea developed during exercise. Records of 27 ponies were evaluated. Six of the 27 were not dys...
Dagleish MP, Pemberton AD, Brazil TJ, McAleese SM, Miller HR, Scudamore CL.Man and horses both suffer from neutrophil mediated pulmonary diseases however there are striking species differences in the underlying pathology. In particular while pulmonary emphysema is a common pathological sequel to human respiratory disease it is not a major feature of the common equine neutrophil mediated condition, chronic obstructive pulmonary disease (COPD). The proposed reason for this difference is that equine neutrophils contain less elastase than equivalent human cells and therefore there is a reduced risk of excess and/or uninhibited elastase activity, which is considered the m...
Luna SP, Taylor PM.Halothane depresses cardiorespiratory function and activates the pituitary-adrenal axis, increasing beta endorphin. In horses, beta endorphin may enhance the anaesthetic-associated cardiorespiratory depression and mortality risk. The authors studied endogenous opioid effects on cardiorespiratory function and pituitary-adrenal activity in halothane-anaesthetised ponies by investigating opioid antagonism by naloxone. Six ponies were anaesthetised three times (crossover design). Anaesthesia was induced with thiopentone and maintained with 1.2 per cent halothane for 2 hours. Immediately after indu...
Tulleners E.Transendoscopic laser surgery provides equine surgeons with a safe, reliable, and minimally invasive method of performing many surgical procedures in the upper respiratory tract. Although the Nd:YAG laser has proven efficacy, other newer lasers such as the diode and holmium: YAG lasers may prove to be useful tools for equine upper respiratory tract surgery. Long grasping forceps and a high quality fiberoptic or video endoscope are critical components necessary for performing transendoscopic laser surgery. For many of the most common upper respiratory tract abnormalities, a laryngotomy can be e...
Hoffman AM, Viel L, Prescott JF.Despite the high incidence of distal respiratory tract infection of undetermined cause on farms, to our knowledge, the microbiologic effects of conventional antimicrobial treatment for this condition have not been studied. We evaluated the possible pathogenic role of bacterial isolates from the distal airways of foals with clinical respiratory tract disease, by correlating changes in their numbers (increase or decrease) with clinical, endoscopic, and pulmonary cytologic signs of disease resolution during treatment with antimicrobial drugs. We also determined qualitative changes in in vitro ant...
Dacre KJ, McAleese SM, Knight P, McGorum BC, Pemberton AD.Mast cell mediators are believed to play a central role in inflammatory lung disorders such as human allergic and occupational asthma. Equine heaves is characterized by reversible neutrophilic airway inflammation and airway obstruction, primarily due to bronchospasm and mucus hypersecretion, following exposure of susceptible horses to organic stable dusts. As such, heaves shares many similarities with human occupational dust-induced asthma and therefore it is proposed that mast cells may also be implicated in the pathogenesis of heaves. Tryptase, a mast cell-specific proteinase, can be used as...
Mair TS, Stokes CR, Bourne FJ.The immunoglobulin (Ig) content of serum and tracheal lavage fluid was measured in 50 horses suffering from chronic obstructive pulmonary disease (COPD) and 40 control horses. The mean immunoglobulin: albumin ratios of the lavage fluids of both groups were significantly higher than the corresponding values for serum, which indicates significant local production of immunoglobulins in the lower respiratory tract. The IgA: albumin ratio of lavage fluid was significantly higher in diseased compared with normal horses, which implies increased local production of IgA in this disease. The IgG: albumi...
Liu IK, Walsh EM, Bernoco M, Cheung AT.Two bronchoalveolar lavages, 24 h apart, were performed on 15 foals, ranging in age from 1 to 21 days. In the first lavage, a numerical deficiency in alveolar macrophages was demonstrated in foals up to 2 weeks of age when compared with older (2-3 years of age) horses. Alveolar macrophages obtained from the lungs of 2-3-day-old foals also demonstrated significant impaired chemotactic function. In the second lavage, although an increase of alveolar macrophages was noted, a dramatic increase of polymorphonuclear neutrophil (PMN) mobilization occurred in the foals, thus providing a phagocytic bac...
Foreman JH.Differentiation of diseases of the equine respiratory tract is based on history, clinical signs, auscultation, endoscopy, imaging, and sampling of airway exudate. Upper respiratory therapies include surgical correction of airway obstructions; flushing of localized abscesses (strangles), guttural pouch disease, or sinusitis; and oral or parenteral antibiotic and anti-inflammatory therapy if deemed necessary. Pneumonia usually is treated with antimicrobials, anti-inflammatories, and bronchodilators. Pleural drainage is indicated if significant pleural effusion is present. The most commonly used ...
Giordano A, Castagnetti C, Panzani S, Paltrinieri S, Freccero F, Veronesi MC.In newborn babies, endothelin 1 (ET-1), a potent vasoconstrictor, increases during septicemia and severe respiratory syndromes. Because equine neonatal sepsis (ENS) and perinatal asphyxia syndrome (PAS) are major causes of morbidity and mortality in newborn foals and because no information on the concentration of ET-1 in healthy and sick foals has been reported yet, the aims of this study were (1) to define the serum concentration of Big ET-1 in healthy neonatal foals during the first week of age; (2) to preliminarily explore the diagnostic and prognostic role of Big ET-1 during ENS and PAS. S...
Tobin T, Swerczek TW, Blake JW.This report concerns the detection and acute toxicity of pine oil (a commercially available disinfectant) after intravenous administration in horses. alpha Terpineol was identified as a major constituent of pine oil. alpha Terpineol was recovered from equine tissues by extraction into heptane and detected by gas chromatography, using either flame ionization detection or pentafluoropropionic anhydride derivatization and electron capture detection. After intravenous injection of 0.1 ml/kg, death due to massive pulmonary edema occurred within minutes. In this animal blood and tissue levels of alp...
Hoffman AM, Viel L, Staempfli HR, Muckle CA, Yager JA.One indication for referral of horses to veterinary hospitals is for diagnosis of the microbiologic cause of pneumonia, particularly when the initial treatment fails. Although endoscopic methods have long been available for microbiologic sample collection, accuracy of these methods under these conditions have not been studied in detail. We compared the bacteria isolated from samples obtained by bronchoalveolar lavage (BAL) with those obtained by protected catheter brush (PCB) from foals with unilateral pneumonia induced by inoculation with Klebsiella pneumoniae. As part of previously described...
Richard EA, Pitel PH, Lemaitre L, Jas D, Lekeux P, Pronost S, Fortier G.The aim of this study was to investigate neutrophil stimulation following experimentally-induced airway inflammation in healthy horses. Six horses received dexamethasone and four were then inoculated with equid herpesvirus-2 (EHV-2). Significant neutrophilia was detected in tracheal wash and bronchoalveolar lavage fluid for up to 6 days. Concentrations of neutrophil elastase (NE) and myeloperoxidase (MPO) were significantly increased compared to baseline for up to 14 days in tracheal washes and both markers were significantly correlated with neutrophil counts. Serum levels of surfactant protei...
McBeath DG, Wells PW, Eyre P, Hanna CJ.This paper attempts to relate the practicalities of vaccine development to the ideals which should be aimed for in a new vaccine. The type of immune response induced is dependent upon the nature of the antigen in the vaccine and the site and timing of its presentation to the immune system. In this respect the influence of age, maternal immunity and antigenic competition are discussed. The possible side effects associated with vaccination are defined and vaccines which are currently available for horses are reviewed. These vaccines are mostly for the prevention of respiratory disease. Finally, ...
Harkins JD, Robinson NE, Woods WE, Lehner AF, Smith MD, Gates RS, Fisher M, Tobin T.Clenbuterol, a beta2 agonist/antagonist, is the only bronchodilator approved by the US Food and Drug Administration for use in horses. The Association of Racing Commissioners International classifies clenbuterol as a class 3 agent, and, as such, its identification in post-race samples may lead to sanctions. Anecdotal reports suggest that clenbuterol may have been administered by intratracheal (IT) injection to obtain beneficial effects and avoid post-race detection. The objectives of this study were (1) to measure the pharmacological efficacy of IT dose of clenbuterol and (2) to determine the ...
Krpan MK.Transtracheal aspiration is used to obtain samples for culture and cytologic examination of respiratory tract secretions and exudates. A 15-cm-long area of the ventral midcervical region is surgically prepared, a small site infiltrated SC with 2-3 ml lidocaine, and a stab incision made in the skin. A trocar with cannula is inserted through the incision and annular ligament into the trachea and the trocar removed. An 8-Fr polypropylene catheter is inserted about 35-40 cm down the trachea and attached to a 30-ml syringe, containing 20 ml sterile saline, with a 3-way stopcock . The saline is rapi...
Gehlen H, Bubeck K, Rohn K, Stadler P.The aim of this study was to investigate the potential haemodynamic effects of valvular insufficiency and recurrent airway obstruction (RAO) in horses with atrial fibrillation (AF). Therefore in ten healthy horses (group 1) and 40 horses with AF a clinical examination, a lung examination, echocardiography and right heart catheterization for measurement of intracardic and pulmonary pressures were performed. According to the clinical findings the horses with AF were subdivided into 4 groups (group 2: AF; group 3: AF/valvular insufficiency; group 4: AF/RAO; group 5: AF/valvular insufficiency/RAO)...
Hassanpour A, Moghaddam S.Early detection of Rhodococcus equi pneumonia in foals is essential for horse health and for veterinarians. Objective: This study aimed to demonstrate the usefulness of assessing the serum concentration of acute-phase proteins (APPs) in the early diagnosis of pneumonia. Methods: The study evaluated APPs in 19 Arabian foals with R. equi pneumonia and compared them with 18 normal Arabian foals in equestrian clubs in Tabriz, Iran. Affected foals were identified through history, clinical findings and bacterial culture of tracheal washing. Biochemical methods and polymerase chain reaction tests wer...
Jensen K.Examination of nasopharyngeal secretion and organ material from clinical cases of respiratory diseases in horses, using inoculation of embryonated hen eggs and rabbit and horse kidney cell cultures, resulted in the isolation of influenza virus and herpes virus. In 2 cases, both viruses were present in the same specimen. On the basis of the physio-chemical, cytological and serological criteria, the viruses were found to be identical with influenza virus type A equi 2 and herpes virus equi type 1. The methods for serological diagnosis and characterization of the influenza and herpes viruses are ...
Littlejohn A, Button C, Bowles F.Mean modal vectors of P1, P2 and QRS were determined in the 3 planes of a semi-orthogonal EKG lead system in 17 horses and ponies with chronic obstructive pulmonary disease (COPD) and in 17 clinically normal horses and ponies. Subjects were paired so that the heart rates of each pair were not dissimilar by more than 2 cycles per minute. Probably significant differences were observed between the mean angles of P1 vectors in the transverse and sagittal planes (T plane, normal = 324 degrees +/- 24,6 degrees, COPD = 342 degrees +/- 21,0 degrees, t = 2,0, P less than 0,05; S plane, normal = 331 deg...
Russold E, Ambrisko TD, Schramel JP, Auer U, Van Den Hoven R, Moens YP.To compare tidal volume estimations obtained from Respiratory Ultrasonic Plethysmography (RUP) with simultaneous spirometric measurements in anaesthetized, mechanically ventilated horses. Methods: Prospective randomized experimental study. Methods: Five experimental horses. Methods: Five horses were anaesthetized twice (1 week apart) in random order in lateral and in dorsal recumbency. Nine ventilation modes (treatments) were scheduled in random order (each lasting 4 minutes) applying combinations of different tidal volumes (8, 10, 12 mL kg(-1)) and positive end-expiratory pressures (PEEP) (0,...
Archer RM, Lindsay WA, Duncan ID.This study was designed to define a simple, unequivocal test for the evaluation of laryngeal function and the diagnosis of idiopathic laryngeal hemiplegia (ILH). ILH is a disorder that results from left recurrent laryngeal neuropathy and in which there is no movement of the left arytenoid cartilage and vocal fold. Laryngeal function was evaluated in seven horses using four techniques designed to stimulate laryngeal movements:-nasal occlusion, exercise, swallowing and administration of a respiratory stimulant. In addition, the effects of sedation and twitching on the endoscopic examination were...
Rapp HJ, Weiss R, Bockisch FJ, Becker M, Stechele M.Using the direct sedimentation method, the air pollution with fungal spores was measured in indoor riding arenas and compared to horse stables, outside riding arenas and covered sport courts. Depending on the location of indoor arenas and stables, the presence of "dust-nests", the number of horses ridden, and the moisture of the tread layer, an air pollution was measured which was equivalent to that in stables except at times of feeding and straw-giving. Outside and in sport arenas a low air pollution was found. Recommendations are given, regarding optimum air hygiene especially for horses wit...
Mavadiya SV, Raval SK, Mehta SA, Kanani AN, Vagh AA, Tank PH, Patel PR.A highly contagious virus infection in horses, influenza is the single most important equine respiratory disease in the world. This paper presents details of a one-year study (1 June 2008 to 31 May 2009) to determine the prevalence of equine influenza in the horses of Gujarat State in India. The prevalence of equine influenza A/equi-2 was 12.02%, but none of the samples were positive for equine influenza A/equi-1. The prevalence of equine influenza (A/equi-2) was 15.38%, 11.94%, 10.18%, and 9.09% in horses of the Kathiyawari breed, a non-descript breed, the Marwari breed and the Indian Thoroug...
Cornelisse CJ, Holcombe SJ, Derksen FJ, Berney C, Jackson CA.To determine the effect of a tongue-tie on upper airway mechanics in exercising horses. Methods: 5 Standardbreds. Methods: Peak inspiratory and expiratory tracheal and pharyngeal pressures and airflow were measured while horses exercised on a treadmill with and without a tongue-tie. Respiratory rate was also measured. Horses ran at speeds that corresponded to 50 (HR50), 75, 90 (HR90), and 100% of maximal heart rate. The tongue-tie was applied by pulling the tongue forward out of the mouth as far as possible and tying it at the level of the base of the frenulum to the mandible with an elastic g...
Vermedal H, O'Leary JM, Fjordbakk CT, McAloon CG, Løkslett H, Stadsnes B, Fretheim-Kelly ZL, Strand E.The laryngeal tie-forward (LTF) procedure is commonly used to treat intermittent dorsal displacement of the soft palate (iDDSP). There is a wide range in reported efficacy of treating horses with and without a definitive diagnosis of iDDSP. Objective: To evaluate the racing performance of harness racehorses in which iDDSP had been definitely diagnosed and treated solely with the LTF procedure. Methods: Retrospective case series. Methods: Ninety-five harness racehorses were treated with LTF for confirmed iDDSP. A definite diagnosis of iDDSP was made with high-speed treadmill or overground endos...
Heath SE, Geor RJ, Tabel H, McIntosh K.An enzyme-linked immunosorbent assay (ELISA) was developed for use in horses to determine serum titers of antibodies of the immunoglobulin classes IgA, IgG, and IgM to Streptococcus equi M-like protein and culture supernatant protein antigens. Serum antibodies were determined in 28 adult horses, including 9 horses with recent S. equi infections, 17 horses without known exposure to S. equi, but without a history of respiratory disease in the preceding 4 months, and 2 horses with clinical purpura hemorrhagica. Serum IgA titers to culture supernatant protein antigen were highest in recently infec...
