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Frontiers in veterinary science2024; 11; 1484970; doi: 10.3389/fvets.2024.1484970

Survey of the approach to the diagnosis and management of bacterial pneumonia in adult horses by equine veterinarians.

Abstract: 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 survey responses were received of which 244 were complete and used in the final analyses. There are significant differences in the ways that different equine veterinarians diagnose and treat bacterial pneumonia based on practice type and training of the practitioner. The majority of practitioners treat with antimicrobials for longer than 2 weeks, and only 53.3% of respondents reported that they "always" or "most of the time" used culture and antimicrobial susceptibility testing to guide therapy. There is a need for guidelines to reduce the duration of therapy and improve antimicrobial stewardship when treating bacterial pneumonia in horses.
Copyright © 2024 Hepworth-Warren and Love.
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Publication Date: 2024-12-23 PubMed ID: 39764370PubMed Central: PMC11700971DOI: 10.3389/fvets.2024.1484970Google 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 article surveys how equine veterinarians diagnose and treat bacterial pneumonia in adult horses, highlighting the lack of standardized guidelines and urging the need for policies to improve antimicrobial stewardship.

Survey of Diagnostic and Management Approach

The primary goal of this study was to understand how equine veterinarians diagnose and manage bacterial pneumonia in adult horses. To this end, a 22-question survey was shared across multiple platforms to these specialized veterinarians. The survey explored various elements of this diagnosis and treatment process including:

  • The frequency with which specific clinical findings were identified
  • The utilization of certain diagnostic tools or modalities
  • The strategies used for antimicrobial and adjunct therapy

Findings and Analysis of Surveys

A total of 309 responses were received, out of which 244 fully completed surveys were used for final analysis. The study identified significant differences in the diagnosis and treatment methodologies based on the practice type and training of the veterinarians. This inconsistency implies the lack of standardization in handling equine bacterial pneumonia among the practitioners, suggesting the need for universally accepted guidelines.

Treatment Duration and Antimicrobial Use

Findings from the survey revealed that majority of focusing on the length of treatment and usage of antibiotics. The majority of practitioners provided antibiotic treatments that lasted over 2 weeks, which may be unnecessarily prolonged or could promote antimicrobial resistance if the treatment is not suitably tailored to the severity and causative agent of the infection. Additionally, only a bit more than half of respondents (53.3%) stated that they “always” or “most of the time” used culture and antimicrobial susceptibility testing before deciding on an antibiotic therapy.

Call for Guidelines

The research highlights the urgent need for creating guidelines for diagnosing and treating bacterial pneumonia in horses. These guidelines should recommend appropriate duration of medication and promote responsible use of antibiotics. By doing so, the animal health sector could drastically reduce the duration of therapy and foster better antimicrobial stewardhip, helping to mitigate the rise of drug-resistant microbes.

Cite This Article

APA
Hepworth-Warren KL, Love K. (2024). Survey of the approach to the diagnosis and management of bacterial pneumonia in adult horses by equine veterinarians. Front Vet Sci, 11, 1484970. https://doi.org/10.3389/fvets.2024.1484970

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 11
Pages: 1484970

Researcher Affiliations

Hepworth-Warren, Kate L
  • Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.
Love, Kim
  • Consultant, Athens, GA, United States.

Conflict of Interest Statement

KL was employed by K. R. Love Quantitative Consulting and Collaboration. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

This article includes 51 references
  1. Hallowell KL, Hepworth-Warren KL, Dembek K. An updated description of bacterial pneumonia in adult horses and factors associated with death.. J Vet Intern Med (2024) 38:2766–75.
    doi: 10.1111/jvim.17141pmc: PMC11423443pubmed: 39005215google scholar: lookup
  2. Estell KE, Young A, Kozikowski T, Swain EA, Byrne BA, Reilly CM. Pneumonia caused by Klebsiella spp. in 46 horses.. J Vet Intern Med (2016) 30:314–21.
    doi: 10.1111/jvim.13653pmc: PMC4913652pubmed: 26492860google scholar: lookup
  3. Ferrucci F, Zucca E, Croci C, Di Fabio V, Martino PA, Ferro E. Bacterial pneumonia and pleuropneumonia in sport horses: 17 cases (2001–2003).. Equine Vet Educ (2008) 20:526–31.
    doi: 10.2746/095777308X354255google scholar: lookup
  4. Reuss SM, Giguère S. Update on bacterial pneumonia and pleuropneumonia in the adult horse.. Vet Clin North Am Equine Pract (2015) 31:105–20.
    doi: 10.1016/j.cveq.2014.11.002pubmed: 25600453google scholar: lookup
  5. Tomlinson JE, Reef VB, Boston RC, Johnson AL. The association of fibrinous pleural effusion with survival and complications in horses with pleuropneumonia (2002–2012): 74 cases.. J Vet Intern Med (2015) 29:1410–7.
    doi: 10.1111/jvim.13591pmc: PMC4858045pubmed: 26259510google scholar: lookup
  6. Lappin MR, Blondeau J, Boothe D, Breitschwerdt EB, Guardabassi L, Lloyd DH. Antimicrobial use guidelines for treatment of respiratory tract disease in dogs and cats: antimicrobial guidelines Working Group of the International Society for Companion Animal Infectious Diseases.. J Vet Intern Med (2017) 31:279–94.
    doi: 10.1111/jvim.14627pmc: PMC5354050pubmed: 28185306google scholar: lookup
  7. Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America.. Am J Respir Crit Care Med (2019) 200:e45–67.
    doi: 10.1164/rccm.201908-1581STpmc: PMC6812437pubmed: 31573350google scholar: lookup
  8. Rule EK, Boyle AG, Redding LE. Antimicrobial prescribing patterns in equine ambulatory practice.. Prev Vet Med (2021) 193:105411.
    doi: 10.1016/j.prevetmed.2021.105411pubmed: 34147960google scholar: lookup
  9. Same RG, Amoah J, Hsu AJ, Hersh AL, Sklansky DJ, Cosgrove SE. The association of antibiotic duration with successful treatment of community-acquired pneumonia in children.. J Pediatr Infect Dis Soc (2021) 10:267–73.
    doi: 10.1093/jpids/piaa055pmc: PMC8023315pubmed: 32525203google scholar: lookup
  10. Vientós-Plotts AI, Masseau I, Reinero CR. Comparison of short- versus long-course antimicrobial therapy of uncomplicated bacterial pneumonia in dogs: a double-blinded, placebo-controlled pilot study.. Animals (2021) 11:3096.
    doi: 10.3390/ani11113096pmc: PMC8614313pubmed: 34827828google scholar: lookup
  11. Wayne A, Davis M, Sinnott VB, Bracker K. Outcomes in dogs with uncomplicated, presumptive bacterial pneumonia treated with short or long course antibiotics.. Can Vet J (2017) 58:610–3.
    pmc: PMC5432153pubmed: 28588336
  12. Wickham H, Vaughan D, Girlich M. tidyr: Tidy Messy Data.. (2024).
  13. Ogle D, Doll J, Wheeler A, Dinno A. FSA: simple fisheries stock assessment methods.. (2023).
  14. Arroyo MG, Slovis NM, Moore GE, Taylor SD. Factors associated with survival in 97 horses with septic pleuropneumonia.. J Vet Intern Med (2017) 31:894–900.
    doi: 10.1111/jvim.14679pmc: PMC5435057pubmed: 28271546google scholar: lookup
  15. Hepworth-Warren KL, Wilgenbusch CM, Wong DM, Fales-Williams AJ, Wiechert SA, Sponseller BA. Intrathoracic oesophageal perforation and secondary pleuropneumonia: five cases.. Equine Vet Educ (2015) 27:283–90.
    doi: 10.1111/eve.12279google scholar: lookup
  16. Ito S, Hobo S, Eto D, Sato H. Bronchoalveolar lavage for the diagnosis and treatment of pneumonia associated with transport in thoroughbred racehorses.. J Vet Med Sci (2001) 63:1263–9.
    doi: 10.1292/jvms.63.1263pubmed: 11789602google scholar: lookup
  17. Austin SM, Foreman JH, Hungerford LL. Case-control study of risk factors for development of pleuropneumonia in horses.. J Am Vet Med Assoc (1995) 207:325–8.
    doi: 10.2460/javma.1995.207.03.325pubmed: 7628934google scholar: lookup
  18. Padalino B, Raidal SL, Hall E, Knight P, Celi P, Jeffcott L. Risk factors in equine transport-related health problems: a survey of the Australian equine industry.. Equine Vet J (2017) 49:507–11.
    doi: 10.1111/evj.12631pubmed: 27564584google scholar: lookup
  19. Padalino B, Raidal SL, Carter N, Celi P, Muscatello G, Jeffcott L. Immunological, clinical, haematological and oxidative responses to long distance transportation in horses.. Res Vet Sci (2017) 115:78–87.
    doi: 10.1016/j.rvsc.2017.01.024pubmed: 28160731google scholar: lookup
  20. Racklyeft D, Love D. Bacterial infection of the lower respiratory tract in 34 horses.. Aust Vet J (2000) 78:549–59.
    doi: 10.1111/j.1751-0813.2000.tb11901.xpubmed: 10979512google scholar: lookup
  21. Raidal S, Bailey G, Love D. Effect of transportation on lower respiratory tract contamination and peripheral blood neutrophil function.. Aust Vet J (1997) 75:433–8.
    doi: 10.1111/j.1751-0813.1997.tb14349.xpubmed: 9247695google scholar: lookup
  22. Raidal SL, Love DN, Bailey G. Inflammation and increased numbers of bacteria in the lower respiratory tract of horses within 6 to 12 hours of confinement with the head elevated.. Aust Vet J (1995) 72:45–50.
    doi: 10.1111/j.1751-0813.1995.tb15328.xpubmed: 7779032google scholar: lookup
  23. Chiavaccini L, Hassel DM. Clinical features and prognostic variables in 109 horses with esophageal obstruction (1992–2009): esophageal obstruction in horses.. J Vet Intern Med (2010) 24:1147–52.
    doi: 10.1111/j.1939-1676.2010.0573.xpubmed: 20707844google scholar: lookup
  24. Feige K, Schwarzwald C, Fürst A, Kaser-Hotz B. Esophageal obstruction in horses: a retrospective study of 34 cases.. Can Vet J Rev (2000) 41:207–10.
    pmc: PMC1476298pubmed: 10738598
  25. Hoblick S, Denagamage TN, Morton AJ, McCarrel TM. Antimicrobial prophylaxis is not indicated for horses undergoing general anaesthesia for elective orthopaedic MRI.. Equine Vet J (2024) 56:475–83.
    doi: 10.1111/evj.13978pubmed: 37531950google scholar: lookup
  26. Hepworth-Warren KL, Estell K, Cowles B, Amodie D, Crisman M. Utility of serum amyloid A in monitoring clinical response to antimicrobial treatment in horses with bacterial pneumonia.. J Vet Intern Med (2023) 37:1917–22.
    doi: 10.1111/jvim.16818pmc: PMC10473010pubmed: 37522636google scholar: lookup
  27. Husulak ML, Manning ST, Meachem MD, Burgess HJ, Epp TY, Montgomery JB. Does antimicrobial therapy improve outcomes in horses with severe equine asthma and a positive tracheal wash bacterial culture?. Can J Vet Res (2018) 82:184–91.
    pmc: PMC6040016pubmed: 30026642
  28. Manguin E, Pépin E, Boivin R, Leclere M. Tracheal microbial populations in horses with moderate asthma.. J Vet Intern Med (2020) 34:986–95.
    doi: 10.1111/jvim.15707pmc: PMC7096658pubmed: 31985115google scholar: lookup
  29. Rossier Y, Sweeney CR, Ziemer EL. Bronchoalveolar lavage fluid cytologic findings in horses with pneumonia or pleuropneumonia.. J Am Vet Med Assoc (1991) 198:1001–4.
    doi: 10.2460/javma.1991.198.06.1001pubmed: 2032901google scholar: lookup
  30. Couetil L, Cardwell JM, Leguillette R, Mazan M, Richard E, Bienzle D. Equine asthma: current understanding and future directions.. Front Vet Sci (2020) 7:450.
    doi: 10.3389/fvets.2020.00450pmc: PMC7438831pubmed: 32903600google scholar: lookup
  31. Wotman K, Wilkins PA, Palmer JE, Boston RC. Association of blood lactate concentration and outcome in foals.. J Vet Intern Med (2009) 23:598–605.
    doi: 10.1111/j.1939-1676.2009.0277.xpubmed: 19317836google scholar: lookup
  32. Johnston K, Holcombe SJ, Hauptman JG. Plasma lactate as a predictor of colonic viability and survival after 360° volvulus of the ascending colon in horses.. Vet Surg (2007) 36:563–7.
    doi: 10.1111/j.1532-950X.2007.00305.xpubmed: 17686130google scholar: lookup
  33. Gomez DE, Dunkel B, Renaud DL, Arroyo LG, Schoster A, Kopper JJ. Survival rates and factors associated with survival and laminitis of horses with acute diarrhoea admitted to referral institutions.. Equine Vet J (2023) 56:970–81.
    doi: 10.1111/evj.14032pubmed: 38083907google scholar: lookup
  34. World Health Organization. Antimicrobial stewardship interventions: a practical guide.. Copenhagen: WHO Regional Office for Europe; (2021).
  35. Chapman RS, Green C, Main JPM, Taylor PM, Cunningham FM, Cook AJC. Retrospective study of the relationships between age, inflammation and the isolation of bacteria from the lower respiratory tract of thoroughbred horses.. Vet Rec (2000) 146:91–5.
    doi: 10.1136/vr.146.4.91pubmed: 10682693google scholar: lookup
  36. Toombs-Ruane LJ, Riley CB, Kendall AT, Bolwell CF, Benschop J, Rosanowski SM. Antimicrobial susceptibilities of aerobic isolates from respiratory samples of young New Zealand horses.. J Vet Intern Med (2015) 29:1700–6.
    doi: 10.1111/jvim.13600pmc: PMC4895690pubmed: 26289293google scholar: lookup
  37. Awosile BB, Heider LC, Saab ME, McClure JT. Antimicrobial resistance in bacteria isolated from horses from the Atlantic Provinces, Canada (1994 to 2013).. Can Vet J (2018) 59:951–7.
    pmc: PMC6091118pubmed: 30197437
  38. Nocera FP, Capozzi L, Simone D, Pizzano F, Iovane V, Bianco A. Multi-locus sequence typing and in vitro antimicrobial resistance of equine Streptococcus equi subspecies zooepidemicus strains.. Vet Res Commun (2024) 48:215–24.
    doi: 10.1007/s11259-023-10165-3pubmed: 37626228google scholar: lookup
  39. Sweeney CR, Holcombe SJ, Barningham SC, Beech J. Aerobic and anaerobic bacterial isolates from horses with pneumonia or pleuropneumonia and antimicrobial susceptibility patterns of the aerobes.. J Am Vet Med Assoc (1991) 198:839–42.
    doi: 10.2460/javma.1991.198.05.839pubmed: 2026535google scholar: lookup
  40. Sweeney CR, Divers TJ, Benson CE. Anaerobic bacteria in 21 horses with pleuropneumonia.. J Am Vet Med Assoc (1985) 187:721–4.
    pubmed: 4055490
  41. Reimer JM, Reef VB, Spencer PA. Ultrasonography as a diagnostic aid in horses with anaerobic bacterial pleuropneumonia and/or pulmonary abscessation: 27 cases (1984–1986).. J Am Vet Med Assoc (1989) 194:278–82.
    pubmed: 2645254
  42. Törneke K, Torren-Edo J, Grave K, Mackay DKJ. The management of risk arising from the use of antimicrobial agents in veterinary medicine in EU/EEA countries—a review.. J Vet Pharmacol Ther (2015) 38:519–28.
    doi: 10.1111/jvp.12226pubmed: 25855219google scholar: lookup
  43. Wilson A, Mair T, Williams N, McGowan C, Pinchbeck G. Antimicrobial prescribing and antimicrobial resistance surveillance in equine practice.. Equine Vet J (2023) 55:494–505.
    doi: 10.1111/evj.13587pubmed: 35575046google scholar: lookup
  44. World Health Organization. Critically important antimicrobials for human medicine. 6th ed.. Geneva: World Health Organization; (2019). 4 p..
  45. Hepworth-Warren KL, Nelson NC, Dembek KA, Young KAS. General anesthesia does not induce ultrasonographic changes in the pleura of healthy adult horses anesthetized for elective magnetic resonance imaging.. J Am Vet Med Assoc (2023) 261:500–4.
    doi: 10.2460/javma.22.12.0550pubmed: 36753394google scholar: lookup
  46. Hepworth-Warren KL, Nelson N, Dembek KA, Young KAS. Comparison of thoracic ultrasonography and thoracic radiography between healthy adult horses and horses with bacterial pneumonia using a novel, objective ultrasonographic scoring system.. Front Vet Sci (2022) 9:991634.
    doi: 10.3389/fvets.2022.991634pmc: PMC9608548pubmed: 36311667google scholar: lookup
  47. Ribonnet C, Palmers K, Saegerman C, Vanderperren K, Van Galen G. Perioperative lung ultrasonography in healthy horses undergoing general anesthesia for elective surgery.. J Vet Intern Med (2022) 36:1160–72.
    doi: 10.1111/jvim.16408pmc: PMC9151480pubmed: 35322893google scholar: lookup
  48. Lo Feudo C, Stucchi L, Alberti E, Stancari G, Conturba B, Zucca E. The role of thoracic ultrasonography and airway endoscopy in the diagnosis of equine asthma and exercise-induced pulmonary hemorrhage.. Vet Sci (2021) 8:276.
    doi: 10.3390/vetsci8110276pmc: PMC8619806pubmed: 34822649google scholar: lookup
  49. Fernandes Rodrigues N, Giraud L, Bolen G, Fastrès A, Clercx C, Boysen S. Comparison of lung ultrasound, chest radiographs, C-reactive protein, and clinical findings in dogs treated for aspiration pneumonia.. J Vet Intern Med (2022) 36:743–52.
    doi: 10.1111/jvim.16379pmc: PMC8965265pubmed: 35247005google scholar: lookup
  50. Ward JL, Lisciandro GR, Ware WA, Miles KG, Viall AK, DeFrancesco TC. Lung ultrasonography findings in dogs with various underlying causes of cough.. J Am Vet Med Assoc (2019) 255:574–83.
    doi: 10.2460/javma.255.5.574pubmed: 31429645google scholar: lookup
  51. Bessat C, Boillat-Blanco N, Albrich WC. The potential clinical value of pairing procalcitonin and lung ultrasonography to guide antibiotic therapy in patients with community-acquired pneumonia: a narrative review.. Expert Rev Respir Med (2023) 17:919–27.
    doi: 10.1080/17476348.2023.2254232pubmed: 37766614google scholar: lookup

Citations

This article has been cited 1 times.
  1. Pimenta J, Cotovio M. Equine Veterinarian Perspectives on Mucocutaneous Tumors in Horses: A Survey-Based Study in Portugal. Animals (Basel) 2025 Jun 23;15(13).
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