Respiratory disease in thoroughbred horses in training: the relationships between disease and viruses, bacteria and environment.

A longitudinal study of respiratory disease in racehorses was carried out to assess its relative associations with different infectious agents and to examine any role that the environmental conditions might play. The relationships between coughing, nasal discharge, pyrexia and lower respiratory tract disease were also examined to provide information for improving clinical diagnosis, particularly of disease of the lower respiratory tract. Lower airway disease was closely associated with infection with Streptococcus zooepidemicus. It was also found that equine herpesvirus seroconversions and S pneumoniae infections were independently associated with the development of nasal discharge. Coughing was a specific, but insensitive measure of lower respiratory tract disease (specificity 84 per cent, sensitivity 38 per cent). However, horses that coughed were very likely to have had lower airway disease for more than one month. Horses housed on straw in loose boxes were twice as likely to suffer from lower airway disease as those kept on shredded paper in American barns. The study was not large enough to assess the significance of rarer infections but it did improve the definition of the problem of respiratory disease in racehorses and revealed some of the trends in the associations between viruses, bacteria and the environment in respiratory disease.

The microflora of the lower respiratory tract of the horse: an autopsy study.

A series of 31 thoroughbreds and 18 non-thoroughbreds was examined post mortem to assess what bacteria might be present in the lower respiratory tract, and to assess their significance by correlating the bacteriological findings with histological changes in the lung. The distal trachea and seven representative lung sites were swabbed in each case. Sixty-six per cent of the sites were sterile with remaining sites producing scanty growths of mainly coagulase negative Staphylococcus spp., E. coli, Bacillus spp. and Pseudomonas spp. Anaerobes, mainly Clostridium perfringens, Bacteroides fragilis and Bacteroides oralis, were only recovered on enrichment media and were isolated more frequently from the right lung than the left. More bacterial species were isolated from thoroughbreds than non-thoroughbreds. Significant inflammation was absent in the majority of lungs examined and this correlated well with the large percentage of sterile sites and low number of potential pathogens. The results indicate that the lower respiratory tract of horses is normally sterile or may contain small numbers of bacteria of low pathogenicity. Chlamydia and respiratory viruses were not isolated from any horse.

Role of anaerobic bacteria in equine endometritis.

This study, performed over 3 breeding seasons, surveyed anaerobic and aerobic bacterial isolates from 362 clitoral and endometrial swabs and uterine washes from 263 Thoroughbred maiden, foaling, foal heat and barren mares, and from 113 urethral, urethral fossa, preputial and pre-ejaculatory fluid swabs from 29 Thoroughbred stallions. The significance of isolates was determined by their association with acute endometritis, as determined by concurrent endometrial smear results and by consideration of age and reproductive status before and after the survey. The results suggest that the horse uterus may harbour obligate anaerobes as surface commensals. These organisms normally inhabit the external genital surfaces of mares and stallions and are periodically introduced into the uterus at coitus or in association with genital pathology, e.g. pneumovagina or vagino/cervical injury. They may act as opportunist pathogens when there is epithelial damage, e.g. during the post-partum involutionary period. Synergism with aerobic bacteria may result in mixed infection and active endometritis. In the mare, the predominant uterine anaerobic species is Bacteroides fragilis. This species is predominantly penicillin- and aminoglycoside-resistant, a feature which is pertinent when intrauterine antimicrobial therapy for endometritis is considered. Detailed anaerobic diagnoses are unavoidably time consuming and as mixed infections are common, nitrofurantoin or metronidazole should be included in antibiotic mixtures. Failure to do this may account for some cases of aerobe-negative persistent endometritis.

Isolation of Streptococcus pneumoniae from the respiratory tract of horses.

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) predominantly of Strep pneumoniae or of that organism together with large numbers of Strep zooepidemicus obtained from tracheal washings. Twelve strains of Strep pneumoniae isolated from three stables were all of capsule Type 3. Only one strain, which was of capsule Type 9, was isolated from nose and throat swabs taken from 32 staff working in one of the stables and suggested an absence of cross infection between horses and their handlers in this instance.

Observations on vaccine and post-infection immunity in contagious equine metritis.

The vaccination of four ponies on two occasions with a formolised culture of Haemophilus equigenitalis produced a high circulating antibody titre to the organism in each pony. Three out of four vaccinated and all of three unvaccinated ponies developed typical symptoms of contagious equine metritis (CEM) when subsequently challenged with a vaginal exudate containing H equigenitalis. Similarly, three ponies which had previously been infected with H equigenitalis and which had recovered spontaneously also developed contagious equine metritis when rechallenged with the organism. The clinical and bacteriological symptoms in the vaccinated ponies and in the rechallenged ponies were less severe than those observed in the unvaccinated ponies but H equigenitalis was still recovered 17 days after challenge from the three vaccinated ponies which had developed CEM. The vaccinated pony which remained free from infection did not exhibit the highest circulating antibody titre of the vaccinates before challenge.