Mistakes that (almost) kill

A friend of mine (who will remain so nameless I’ll only refer to her as ‘her’ or ‘she’, or ‘Friend’) tried to kill her horses last month.

We all make mistakes. Hers was a doozy.

She’s been a horseman her entire life. Her three kids are all horsey. Even her dogs are horsey. Only her husband steadfastly refuses to have anything to do with horses “except pay for the damned things’ (although he’s rather proud of the fact that his middle child, who began riding cross country at the age of 8, is so singularly male in an overwhelmingly female sport that “he’ll never have to chase a girl for a date”.)

The mistake was compounded by Friends’ friend, a veterinarian. I don’t know if they’re still friends, now.

Friend was planning on towing three horses out of state to a Pony Club cross country trial.

Being a wise and experienced horseman, she decided to vaccinate for strangles.

Strangles (aka distemper or ‘shipping fever’) is an absolutely filthy, horrid disease. Caused by Streptococcus equi, it is your worst case of strep throat on steroids. It’s highly contagious. Vaccination for strangles ‘frequently leads to an abscess at the injection site, and does not prevent infection, but does result in a milder disease in infected animals” (The Merck Veterinary Manual, 7th Edition, 1991, pp. 745-746.)

What does this mean? It means that, even given the vaccine, your horse can still contract strangles.

Vaccination also only lends a temporary prophylactic effect. A horse that was vaccinated five years ago, and hasn’t left the farm in all that time, can be as vulnerable to infection as the newest foal on the farm.

Nevertheless, the vaccine does seem to work, because I’ve not seen a case of strangles in a very long time. Either everyone vaccinates for strangles on an annual basis, or it’s not as prevalent as it used to be. I have to believe it’s the former, because people seem to take their horses everywhere. Most boarding stables don’t even quarantine horses anymore.

A ‘strangles lump”, the lump that results from the horse’s reaction to it, is so common that it hardly elicits a ‘what’s that?”

If you’ve never seen a horse suffering from strangles (or ‘bastard strangles’, an even worse form of it), let me tell you a little of what I’ve seen. Mind you, I’m no vet.

Warning: some of the pictures I found on Google Images and have included here are stomach turning.  If you have a tetchy tummy, don’t click on the extremely long URLs.

The first indication that something is wrong is your horse stops eating and runs a high fever. Then his nose gets snotty.  The amount of mucus he produces rapidly increases from a trickle into a river of evil looking, smelling, mucus that is ferociously infectious. The horse’s head swells up when the infection invades the guttural pouches, the sinuses and the lymph nodes. His trachea is inflamed and makes it almost impossible for the animal to breathe without pain. (Remember, horses cannot breathe through their mouths, so a horse with strangles is not only trying to breathe through an inflamed wind pipe, but is also forced to  inhale and exhale through the mucus equivalent of a shower cap over their nose).

Here’s a photo of one poor horse that I took from Google Images.

I find the tinyurl works best if typed in, rather than copy and pasted. If it doesn’t work, click on the incredibly long link.

http://tinyurl.com/lbj8asf

http://www.google.com/imgres?hl=en&biw=1024&bih=726&tbm=isch&tbnid=XUAWz3m_3yvsGM:&imgrefurl=http://www.horsecoursesonline.com/college/healthanddisease/lesson_six_723.htm&docid=5yLvapr0WvHJTM&imgurl=http://www.horsecoursesonline.com/college/healthanddisease/lesson_six_723_files/image003.jpg&w=229&h=342&ei=lF7TUd2MEsqFiALel4HoAQ&zoom=1&ved=1t:3588,r:26,s:0,i:168&iact=rc&page=2&tbnh=205&tbnw=137&start=14&ndsp=18&tx=61.60003662109375&ty=91

The torment the horse goes through continues for several days. The infected lymph nodes abscess. Eventually they break open (although sometimes they don’t, which makes surgery inevitable). The resulting drainage stinks so badly that you better not eat before handling the horse.  Almost always, a secondary strep (or maybe it’s a Staphylococcus) infection infects the open abscesses.

In bastard strangles, the disease infiltrates the lymph nodes in the horse’s belly and chest. When they abscess, the skin eventually splits open (after several days of suffering).

http://www.google.com/imgres?hl=en&biw=1024&bih=726&tbm=isch&tbnid=miN5LEuodjffkM:&imgrefurl=http://steinbeckequine.com/pigeonfever.shtml&docid=n_JURNMqqlOzzM&imgurl=http://steinbeckequine.com/images/article12-03.jpg&w=380&h=364&ei=lF7TUd2MEsqFiALel4HoAQ&zoom=1&ved=1t:3588,r:12,s:0,i:117&iact=rc&page=1&tbnh=192&tbnw=195&start=0&ndsp=14&tx=121.60003662109375&ty=74

In worst case scenarios, bastard strangles invades the mesentery, the membrane that holds and supports the internal organs. Such an infection is almost always a death sentence. When those abscesses break open, the result is peritonitis and death.

Before you sit back and think, well, MY horses are vaccinated and I NEVER touch a horse with a snotty nose, just remember. Every time you trailer to someplace other than your home, you have a chance of someone touching your horse after contacting one with strangles. How often are you in a show barn, or rent a stall at a show? You KNOW they don’t disinfect stalls between horses. How many times have you had a horse crazy girl come up to your horse to just pet it?  You do it yourself. You do. You touch other people’s horses all the time. We can’t help ourselves. We’re horse people. We touch horses.

Never, ever forget: EVERYTHING, and I mean your boots, your hands, the horse trailer,  a paper towel,  a lead rope, the handle of the water bucket; ANYTHING that comes into contact with the mucus or the pus produced by S.equi is virulently infectious.

While I’ve never heard of a human contracting something nasty from equine distemper or strangles, still: streptococcus is nasty, nasty shit. These days, when overuse of antibiotics has kicked the bacteria’s evolution of resistance to available antibiotics into warp drive, you cannot be assured that somehow, that S. equi won’t find a way to cross the species barrier and infect YOU. Bacteria swap genes faster than a teenager swaps tweets.

Strep normally lives on our skin and in our upper respiratory tract, but  various ‘groups’ can cause such horrible things such as meningitis, pneumonia, strep throat, pink eye, erysipelas and necrotizing fasciitis. There’s a species that you can only catch if you allow your dog to lick your face. I cannot tell you how many dog lovers I know let their dogs ‘kiss’ them on their lips. I am not one of them. I don’t even kiss my horse (although he tries to kiss me).

Streptococcus is one of the many reasons I never, ever handle a horse without gloves. I lost most of my lymph nodes in my armpits after my successful battle with breast cancer. Hence, I am at increased risk of infection from all the myriad bacteria genera out there,  should I be so stupid as to allow some bacterial infection to infect my hands. I’ve gotten strange looks from people who should mind their own business, when I wear gloves around the barn. I am old enough now to ignore them. I don’t give a damn if they think I’m a sissy or a weenie. Yeah, they’re right: I DON’T like getting my hands dirty. Doesn’t mean I still can’t outwork my hecklers.

Over the years, I’ve grown so used to wearing a good pair of gloves that I don’t even notice them anymore. I prefer the blue rubber Atlas brand. Yeah, they’re clumsy and make me look like a cartoon character, but which is worse: having to take a few moments extra to clean out a hoof, or spend months and money fighting a Pseudomonas (another monster that lives in the barn) infection?

Have I frightened you enough? Good. Whether you agree or disagree with vaccinating your horse, you should be responsible enough to keep your horse at home when he shows ANY sign of ill health. That’s how you break a strangles epidemic: don’t take a sick horse anywhere but to the equine vet clinic. Quarantine all infected horses, and clean and disinfect everything that comes in contact with them, including you.

Friend’s horses are fit, well cared for, lovingly handled. They’d never had a sick day in their lives.

So where did Friend go wrong?

Well, I am working on a flimsy platform here, as all I know is what Friend told me. I wasn’t there, and Friend is still distraught , almost inarticulate, and furious at herself to fully elucidate, but this is what I gather happened.

Her friend, the vet, gave her three doses of the strangles vaccine. Vet knew that Friend has been vaccinating her own horses for years. Many of us do. (I don’t.)

Friend telephonically asked for reassurance: I vaccinate in the neck, correct?

Correct, said the vet.

Except that the vaccine she gave Friend wasn’t the type that one injects.

It was the nasal spray type.

I don’t know how the two types are formulated. I suspect the nasal type, being that it is almost instantly absorbed by the horse’s mucous membranes, is more powerful than the type one gets in the injectable form.

I don’t know if the vet mixed up the vaccines, or if Friend mistakenly assumed the vaccine was the injectable type.

Trusting her friend the Vet rather than checking the bottle of vaccine, Friend injected her horses with the nasal spray.

I don’t know how long it took for the horses to react. But my husband, who does volunteer work with Friend, said he’d received a panicked phone call first thing in the morning, saying she wasn’t going to be there because ‘something happened to her horses’. My husband (who also refuses to submit to the Horse Force) didn’t ask. But I bet the reaction didn’t take very long.

The effects were devastating, and are still ongoing, five weeks later.

All three horses very nearly died, NOT from strangles, but from the reaction to the vaccination.

The Friend’s cross country season ended before it ever began. Her vet bills are astronomical and her horses ‘aren’t out of the woods yet’. I can’t get much more detailed than that, as Friend cannot speak of it without breaking down. All I can offer her is a hug.

How do you console someone who made such a well meaning yet disastrous mistake?

Not very well, other than to say, I hear. I will listen without judging or castigation.  I am so sorry. Even the best “how can I help” is useless as consolation, because I really can’t help monetarily.

I don’t know if the VET said “I’m sorry, I should have told you it was nasal.” Judging from Friend’s angry expression when she told me the Vet’s reassurances, I suspect Vet hasn’t apologized or taken responsibility.

But, the unspoken, heartfelt agony that Friend feels is that SHE is responsible, even more so than the vet. She Should Have Checked. She should have read the label. She should have not been so trusting. Legally, the vet is absolved of all responsibility when Friend assumed the responsibility of injecting her horses herself.

Friend knows that ultimately, she is responsible. It has slashed her heart into bleeding ribbons.

Yes, most of us are not veterinarians.  We are sometimes intimidated by them, especially when their attitude of ‘don’t question my diagnosis”  is really a threat, that you are pissing on their turf.  Nothing gains you a phone call from a lawyer faster than when a vet accuses you of  ‘practicing veterinary medicine without a license”.   Admittedly, sometimes it’s merely a case of a veterinarian not having the courage to admit that he’s not always right.

The lesson, learned at the near death of three horses is this:

If you have any sort of misgiving about something a vet says, question him.  Push the issue. You’re paying him or her, not vice versa.

They don’t like to admit it, but vets (like doctors, one of whose casual mistakes killed my mother ((may he rot in the lowest hell)) make mistakes, too.

Read the label. Pay attention to what you’re doing. Don’t be afraid (or too egotistical) to say, I think I’ll let an expert handle this.

Take the best precautions you can, and then continue to live your life and enjoy your horse. Chances are, your horse will never get strangles.

I’ll let you know how Friend’s three horses are doing when I learn more.

Oh, and a PS after a friend wrote me: bastard strangles is also known as ‘dryland distemper’, ‘dryland strangles’, or ‘pigeon fever’.

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About subodai213

Retired U.N.C.L.E agent. Living in Laurasia.
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