Re: [RC] was: REACTION TO VACCINE? now: strangles - Heidi Smith
> Hopefully one of the vets will respond here. But,
> actually, leaving strangles alone -- or at most
> lancing the abscesses -- is debatably the best
> treatment. The use of antibiotics or attempts to
> lower the fever can possibly cause the abscesses to
> internalize. That can change it from an unpleasant,
> but usually harmless disease, to one that can kill...
> Of course, this is all highly debatable and everyone
> has their own opinions on how to treat strangles.
One really has to look at strangles on a case-by-case basis. The very
reason that the disease is called "strangles" in the first place is because
the inflamation in the throat can be so severe as to cut off the horse's
ability to breathe. I had this happen to one of my own horses several years
ago, and had we not been able to provide sufficient relief by giving bute
and DMSO (this was pre-Banamine days), our next step would have been to do a
tracheotomy to literally save his life. His upper trachea was so
compromised that he was literally hanging his head between his knees gasping
for air, and starting to get a bluish tinge from lack of oxygen. You'd
better believe that antiinflamatory drugs are indicated in cases like that!
Use of antiinflamatories does NOT cause the disease to internalize. What
causes an increased risk of internalization is using antibiotics that are
inappropriate to be used in the face of abcessation, one of those being
penicillin. Some antibiotics arrest the growth of the abcesses temporarily
while the antibiotic levels are high, and then they start building again
when the horse comes off of them. Sulfas, on the other hand, will control
the systemic spread of infection while still allowing the abcesses to
enlarge and come to a head. Hence they can be used with relative safety.
(There IS some debate about penicillin use, and some papers out about
penicillin being quite efficacious in strangles, but I'll stick to the
pharmacological basics of how penicillin works in the first place.)
It is helpful in most cases to drain the abcesses when they have headed out
sufficiently to lance, but one can also cause complications by digging
around for them too early. Basic protocol--monitor the horse to make sure
he is continuing to eat, drink, and can breathe. Use antiinflamatories as
necessary to ensure the above and to control fever if it gets too out of
line. Use antibiotics in selected cases, when the severity and symptoms
indicate. Lance abcesses in selected cases when they reach a point that
they can be lanced without undue digging. Monitor, monitor, monitor, and
make the decisions based on each individual case, as needed.
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- RE: [RC] was: REACTION TO VACCINE? now: strangles, Zephyr Arabians