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Journal of veterinary internal medicine2016; 30(4); 1305-1312; doi: 10.1111/jvim.14369

Retrospective Evaluation of Horses Diagnosed with Neuroborreliosis on Postmortem Examination: 16 Cases (2004-2015).

Abstract: Equine neuroborreliosis (NB), Lyme disease, is difficult to diagnose and has limited description in the literature. Objective: Provide a detailed description of clinical signs, diagnostic, and pathologic findings of horses with NB. Methods: Sixteen horses with histologically confirmed NB. Methods: Retrospective review of medical records at the University of Pennsylvania and via an ACVIM listserv query with inclusion criteria requiring possible exposure to Borrelia burgdorferi and histologic findings consistent with previous reports of NB without evidence of other disease. Results: Sixteen horses were identified, 12 of which had additional evidence of NB. Clinical signs were variable including muscle atrophy or weight loss (12), cranial nerve deficits (11), ataxia (10), changes in behavior (9), dysphagia (7), fasciculations (6), neck stiffness (6), episodic respiratory distress (5), uveitis (5), fever (2), joint effusion (2), and cardiac arrhythmias (1). Serologic analysis was positive for B. burgdorferi infection in 6/13 cases tested. CSF abnormalities were present in 8/13 cases tested, including xanthochromia (4/13), increased total protein (5/13; median: 91 mg/dL, range: 25-219 mg/dL), and a neutrophilic (6/13) or lymphocytic (2/13) pleocytosis (median: 25 nucleated cells/μL, range: 0-922 nucleated cells/μL). PCR on CSF for B. burgdorferi was negative in the 7 cases that were tested. Conclusions: Diagnosis of equine NB is challenging due to variable clinical presentation and lack of sensitive and specific diagnostic tests. Negative serology and normal CSF analysis do not exclude the diagnosis of NB.
Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
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Publication Date: 2016-06-21 PubMed ID: 27327172PubMed Central: PMC5094551DOI: 10.1111/jvim.14369Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research investigates the diagnosis and pathology of Neuroborreliosis (NB) in horses, a manifestation of Lyme disease difficult to identify due to variable symptoms and lack of accurate testing methods. It sheds light on potential indicators of NB in horses, accentuating that negative test results do not disregard the presence of the disease.

Objective and Methodology of the Research

  • The main objective of the study was to provide a detailed explanation of clinical symptoms, diagnostic methods, and pathological findings associated with equine Neuroborreliosis (NB), which is a manifestation of Lyme disease in horses.
  • The study retrospectively reviewed medical records of 16 horses which were diagnosed after death to have been affected by NB. The review included a survey conducted via the American College of Veterinary Internal Medicine (ACVIM) listserv.
  • The inclusion criteria for the records were potential exposure to Borrelia burgdorferi and autopsy findings consistent with previous reports of NB without any other additional condition.

Findings from the Reviewed Cases

  • The clinical signs of the disease were found to vary extensively. These included muscle atrophy or weight loss (12 cases), cranial nerve deficits (11 cases), ataxia or irregular gait (10 cases), changes in behavior (9 cases), trouble swallowing (7 cases), muscle twitches (6 cases), stiff neck (6 cases), erratic respiratory distress (5 cases), inflammation of the uvea in the eye (5 cases), fever (2 cases), joint effusion (2 cases) and heart rhythm irregularities (1 case).
  • A serologic examination testing positive for B. burgdorferi infection was found in only 6 out of the 13 cases where it was carried out. Hence, the disease could be present, even if the serologic test is negative.
  • Deviations in Cerebrospinal fluid (CSF) were identified in 8 out of 13 tested cases. This included xanthochromia (yellow coloration of the CSF) in 4 cases, increased total protein (5 cases), and an excess of neutrophils or lymphocytes (8 cases). PCR testing for B. burgdorferi in CSF was negative in all 7 tested cases. Thus, even if CSF analysis was normal, it did not rule out the presence of NB.

Conclusion of the Research

  • This study concludes that diagnosing equine NB is demanding because of the inconsistent clinical presentation and the absence of both sensitive and specific diagnostic tests.
  • Even if the serological test for the bacterium B. burgdorferi is negative and the CSF analysis yields standard results, the possibility of NB cannot be discounted. The clinical signs should also be considered as a significant part of the diagnosis process.

Cite This Article

APA
Johnstone LK, Engiles JB, Aceto H, Buechner-Maxwell V, Divers T, Gardner R, Levine R, Scherrer N, Tewari D, Tomlinson J, Johnson AL. (2016). Retrospective Evaluation of Horses Diagnosed with Neuroborreliosis on Postmortem Examination: 16 Cases (2004-2015). J Vet Intern Med, 30(4), 1305-1312. https://doi.org/10.1111/jvim.14369

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 30
Issue: 4
Pages: 1305-1312

Researcher Affiliations

Johnstone, L K
  • University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, PA.
Engiles, J B
  • University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, PA.
Aceto, H
  • University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, PA.
Buechner-Maxwell, V
  • Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA.
Divers, T
  • Cornell University College of Veterinary Medicine, Ithaca, NY.
Gardner, R
  • B.W. Furlong & Associates, Oldwick, NJ.
Levine, R
  • Henderson Veterinary Associates, Elizabethtown, PA.
Scherrer, N
  • University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, PA.
Tewari, D
  • Pennsylvania Veterinary Laboratory, Pennsylvania Department of Agriculture, Harrisburg, PA.
Tomlinson, J
  • Cornell University College of Veterinary Medicine, Ithaca, NY.
Johnson, A L
  • University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, PA.

MeSH Terms

  • Animals
  • Female
  • Horse Diseases / microbiology
  • Horse Diseases / pathology
  • Horses
  • Lyme Neuroborreliosis / pathology
  • Lyme Neuroborreliosis / veterinary
  • Male
  • Retrospective Studies

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