February 11, 2012

Streptococcus myositis – A Strangles vaccine reaction, part 3

Here we are back at the story of our little horse that was vigorous and strong only 3 weeks ago and now looks like it has lost 300 lbs, has a severe anemia in which the owner has given one blood transfusion, and has a fever that is on again and off again and has spiked now to 109.5! That is not a typo – the horse’s temperature was at 109.5 degrees during the day when the outside temp was near 90. Bathing the horse and putting it under fans and giving some Banamine reduced the fever, but that was very scary!

So what happened next. Well my friend who owns this horse being a small animal veterinarain asked me a simple question, can the horse still have immune mediated anemia and have a negative Coombs test. Well I’ll be – a question I did not know the answer to – LOL. So he asked a clinical pathologist, a doctor who specializes in reading blood results and other laboratory tests. He’s the doctor we get on the phone with when all the blood results look screwy and we have no idea what way the blood is directing us. He is the guy that makes sense of it all. So the answer came as a startling yes. The horse can have immune mediated disease and still have a negative Coombs test. OK well then what now?

The clinical pathologist then asked the most important question of them all, the one that solved this mystery. When was the horse last vaccinated and with what? Did it have a strangles vaccine recently? YES, it did have a strangles vaccine at the same time the Coggins test was pulled. Well looking at the results of the blood tests and the signs and symptoms of your horse, he believes the horse has vaccine induced immune mediated anemia. Otherwise known as Streptococcus myositis caused by a reaction to the Strangles vaccine. It is much more prevalent in Quarter Horses but can happen in any breed. The theory is if the horse already has a high titer to Strangles and the vaccine is given anyway it sends the immune system into overdrive and causes purpura hemorrhagica and results in a immune mediated myositis (muscle inflammation and deterioration).

So that is what I was seeing not a trauma induced bloddy nose but rather purpura hemorrhagica. Also the horse was tying up but the cause was not because of being cast but rather an immune mediated myositis. Here is a picture of what I saw – The picture is from the Merck Veterinary Manual Website -
purpura.jpg
Notice the nose looking like it was hit with something.

The horse seems to be doing better, however, we are not out of the woods quite yet. He still needs some TLC to get better and as I said before the Rapid Response is helping this horse tremendously. I will keep you posted on the events with this horse, but hopefully this story will help you realize as to how important it is to be informed on your decisions to vaccinate with what and when. It may be more important to not vaccinate for certain diseases as is my opinion with strangles. If you are not in a high risk environment (meaning stabled with a bunch of 2 year old show horses that come and go every weekend) then it is more important to pass on this vaccine. Your horse’s life may depend on not being vaccinated!

  • Anita Subbert

    Our Horse, a paint, presented with tieing up, depression, lack of appetitite, anemia,muscle & weight loss a few weeks after a long battle with strangles infection. She was treated with steroids and B12 shots for 1week. Now we have her home and are adding corn oil and red cell to her grain. She has a good appetite but had a tender nose the other day which confused us. She has been out of the vet for a month now, could her nose be related to the immune mediated myositis?

  • http://e-vet Anita Subbert

    Our Horse, a paint, presented with tieing up, depression, lack of appetitite, anemia,muscle & weight loss a few weeks after a long battle with strangles infection. She was treated with steroids and B12 shots for 1week. Now we have her home and are adding corn oil and red cell to her grain. She has a good appetite but had a tender nose the other day which confused us. She has been out of the vet for a month now, could her nose be related to the immune mediated myositis?

  • Frostylittleone

    An old post I know….but had to chime in.  My happy healthy APHA gelding was vaccinated IN with the strep equi vaccine this spring.  Upon an outbreak in the barn this summer, he did not get active strangles, but he DID get purpura, muscle loss/weight, febrile, painful, he was anemic a few weeks ago (the last CBC – just got it today – looked better, YES!).  We haven’t successfully kept him purpura free w/out steroids yet….    I’m kicking myself about how I could have been so flippant about OK-ing the vaccine, when typically I err on the side of side-effect paranoia.   Poor guy has been sick for a month..    I’m trying to find studies and/or statistics on this type of reaction, but nothing I’ve found looks very robust or consistent.  In my ‘hindsight is 20-20′ eyes, it makes total sense to me, but does anyone currently know the risk-benefit stats?  Are QH/APHA type breeds really  more at risk? This is the first I’ve heard of that.   I don’t want to spread rumors without scientific evidence, but jeez I’d hate for any of my fellow horse owner friends to go through this. 

  • http://evetclinic.com Daniel Beatty

    No it is not just AQH/APHA horses that have the problem with the vaccine. This story was actually from a case from a Paso Fino. Also there is no hard research on the risk-benefit, we know that purpura hemorrhagica can be caused by the vaccine. Also we know that many times the vaccine does not work and in most cases only limits the symptoms. No hard stats though I am sorry.

    Good luck to your little guy. I’m glad the CBC looks better.

  • Polgara1992

    if anyone is still checking comments on this article please reply

    My horse is presenting these exact symptoms after being vaccinated (for Strangles as well; we show), but without the purpura.  His nose looks fine, but other than that everything’s just like your article: we originally thought he was tied up, he’s dropped 200lbs in under 2 weeks, he’s depressed and unenergetic and still extremely stiff/sore.

    Does anyone know if it’s possible for them to react to the Strangles vaccine in this way and just NOT get the purpura?  And what is the treatment?????

    Thanks so much!

  • http://evetclinic.com Daniel Beatty

    Yes it can be a reaction to the Strangles vaccine; however it can be something else. You need to contact your veterinarian and have him examined and treated.

  • Polgara1992

    Thank you.  Our vet couldn’t pinpoint it so he’s with specialists at a university.  They’re having trouble pinpointing it too, which in my experience isn’t a good sign.  I’m still hoping for the best.
    Just FYI, they have ruled out vaccine reaction.  As far as I can tell, their two working guesses are abscess or tumour, but test results show nothing but inflammation, and the mass is close to his heart so they don’t want to do a biopsy.
    I’m hoping for the best :S

  • http://evetclinic.com Daniel Beatty

    Oh I’m sorry – let me know what happens. Praying for him.