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Strangles: Understanding, Preventing, and Managing the Equine Respiratory Challenge

Updated: Dec 8, 2023


Close up of horse nose shows strangles discharge

Picture, for a moment, the discomfort you experience when your throat is hindered by the wrath of strep or a severe respiratory infection—now, amplify that sensation. Strangles, an affliction haunting our equine companions, manifests as a distressing impediment. Imagine a horse, its throat constricted by its own lymphatic system, struggling for each breath. The agony is palpable, and the urgency to comprehend and address this ailment becomes imperative.


In this blog, we will delve into the intricacies of strangles—unveiling its nature, exploring the roots of its manifestation, identifying the initial warning signs, and uncovering the pathways to effective treatment. As we embark on this journey, our goal is not only to demystify strangles but to empower you with the knowledge needed to recognize, prevent, and manage this challenging condition in our beloved equine companions. So, fasten your seatbelt as we ride through the labyrinth of strangles, gaining insights that will prove invaluable in safeguarding the health and well-being of our horses.


Decoding Strangles: The Threat Within Equine Throats

streptococcus equi bacteria otherwise known as strangles
Photo credit: Brown Moss Equine Clinic

Strangles, as its evocative name suggests, is more than a mere equine infection; it is a menacing obstruction that takes root in the throat. The culprit behind this affliction is the bacterium Streptococcus equi (S. equi), a formidable intruder that swiftly establishes its presence on the tonsils and pharynx within hours of infection. The insidious journey of S. equi doesn't end there—it progresses to the lymph nodes beneath the horse's jaw, setting the stage for a cascade of distressing events.


As the infection advances, the lymph nodes undergo swelling and abscess formation, leading to a critical juncture. The swelling can reach such an extent that it obstructs the airways, creating a vice-like pressure around the horse's neck and throat. Breathing, a fundamental and instinctive act, becomes a laborious task, plunging the equine into a realm of discomfort and fatigue. Although strangles is rarely fatal, the intensity of the pain is such that it can leave the horse physically drained and emotionally distressed.

diagram of horse strangles course in lymph and guttural pouch
Photo credit: The Horse Hub

Contrary to the common misconception, strangles extends beyond nasal drainage. While the infection may cause nasal discharge due to abscess drainage into the guttural pouch and nasal cavity, it can also manifest externally under the jaw, presenting as a telltale yellow/white discharge. This discharge, aside from being a visible sign of the ailment, poses a substantial threat as it carries a high infectious potential, particularly for other equine companions.


The contagious nature of strangles demands vigilance from horse owners. It ranks among the most frequently diagnosed respiratory infections in horses aged six to ten years, spreading with alarming ease through shared surfaces such as tack, water buckets, stalls, and fences. Consequently, quarantining affected horses and implementing rigorous hygiene practices, including thorough cleaning of shared spaces, emerge as pivotal measures to curb the spread of this formidable equine malady. In unraveling the intricacies of strangles, horse owners equip themselves not only with the knowledge to recognize and address its symptoms but also with the tools to fortify their equine community against its insidious grasp.


Deciphering Strangles: Recognizing the Silent Signals of Equine Distress

horse nose with yellow strangles discharge
Photo credit: Kings Bounty

The initial stages of strangles in horses unfurl with a series of unmistakable signs, each a harbinger of the discomfort that follows. The first alarm bell rings with a fever soaring to an alarming 104 degrees Fahrenheit, accompanied by a sudden loss of appetite—an ominous duo indicative of an impending health challenge.


As the insidious grip of strangles tightens, the horse grapples with difficulty swallowing, a precursor to the more pronounced symptoms that follow. Swollen lymph nodes emerge as silent sentinels, clustering around the neck and jaw, betraying the internal battle waged by the Streptococcus equi bacteria.


The nasal narrative unfolds as a thin discharge, a mere prelude to the impending storm, transforms into a thick and yellowish secretion. Pus, an unwelcome intruder, may join this nasal symphony, further complicating the equine's respiratory distress. A poignant manifestation of the pain and discomfort is observed as the horse adopts a stance with its head lowered—an instinctual response to alleviate the throbbing ache.


Distinguishing between age groups, younger horses bear the brunt of severe symptoms, their vulnerability magnifying the impact of strangles. Conversely, older equines may exhibit milder signs, underscoring the variability in the disease's presentation across different age demographics.


In summation, a vigilant horse owner should be attuned to a checklist of signs and symptoms:

horse with swollen lymph nodes from strangles
Photo credit: Atlantic Equine Services
  • Raised Body Temperature: An abrupt spike in fever.

  • Loss of Appetite: A sudden disinterest in food.

  • Difficulty in Swallowing: A precursor to more pronounced respiratory challenges.

  • Difficulty in Breathing: A distressing consequence of the disease's progression.

  • Painful Cough: A vocalized expression of discomfort.

  • Swollen Lymph Nodes: A palpable sign around the jaw and neck.

  • Head Down Stance: An instinctual response to alleviate pain.

  • Nasal Discharge: Starting thin, evolving into a thick and yellowish secretion.

  • Fatigue or Poor Performance: Indicators of the physical toll exacted by strangles.

  • Irritated Behavior: Observable shifts in the horse's demeanor, signaling internal distress.

This comprehensive catalog equips caretakers with the knowledge needed to swiftly identify and respond to the multifaceted symptoms of strangles, paving the way for timely intervention and effective management of this challenging equine ailment.


How Strangles Finds Its Equine Host

In the intricate world of equine health, understanding the transmission dynamics of Strangles, facilitated by Streptococcus equi, is paramount. This contagious bacterial culprit orchestrates its spread through a labyrinth of direct and indirect avenues.


Transmission Mechanisms

Streptococcus equi, the stealthy agent of Strangles, exploits various channels to make its way from one equine host to another:

horses touching noses can catch strangles
  • Direct Contact: The most immediate route of transmission occurs through direct contact with an infected horse. Whether encountering a carrier or a horse in the recovery phase, the risk is palpable.

  • Shared Spaces: Strangles thrives on communal elements. Shared drinking troughs become potential hotspots, acting as reservoirs for the bacteria. Similarly, shared equipment or bedding can harbor the infectious agent, turning these seemingly benign items into conduits for transmission.

  • Common Resources: The communal nature of feeding areas, including shared food, amplifies the risk. Even seemingly innocuous elements like fencing and gates can serve as silent carriers of the contagion.

  • Airborne Transmission: Flies, often underestimated vectors, can play a role in disseminating the bacteria. These airborne agents may carry the infection from one horse to another, contributing to the stealthy spread of Strangles.

The Intrusion into Lymph Nodes

Once the Streptococcus equi bacteria infiltrates the equine realm, it zeroes in on the lymph nodes nestled in the jaw and neck. These nodes become the battleground where the bacteria induce swelling and provoke the formation of abscesses. It is within this battleground that the insidious nature of Strangles takes hold, setting the stage for the characteristic signs and symptoms that follow.


In essence, decoding the transmission dynamics of Strangles unveils a complex interplay of direct and indirect pathways, urging horse caretakers to be vigilant in mitigating the risk factors and fortifying preventive measures.


Is it contagious?

Yes, as stated above, it is highly contagious. An infected horse can transmit the bacteria to a healthy horse during direct contact or indirectly through clothes, water, food, or infected equipment. It can even transmit through humans. If a human comes in contact with an infected horse, he can transfer the bacteria to a healthy horse. Contaminated water especially leads to the spreading of the disease as the bacteria can live in water for up to a month.


Diagnosing Strangles: Unraveling the Equine Health Puzzle

Diagnosing strangles is an intricate process that requires a keen eye for clinical presentation and the judicious use of diagnostic tools. While the signs and symptoms are often evident, confirming the presence of strangles involves a combination of visual cues and specialized tests.


Veterinarians rely on the observable signs and symptoms presented by the horse to make an initial diagnosis. The clinical picture, encompassing elevated body temperature, nasal discharge, swollen lymph nodes, and other distinctive indicators, forms a crucial aspect of the diagnostic process. The experienced eye of a veterinarian can often discern the characteristic features of strangles based on these visual cues.

strangles lymph eruption under the throat of horse
Photo credit: Brown Moss Equine Clinic
  • Nasopharyngeal Swab: To definitively confirm the diagnosis, a nasopharyngeal swab is commonly employed. This simple yet effective method involves collecting a sample from the back of the horse's throat, where the infection typically resides. This sample is then subjected to laboratory analysis, providing concrete evidence of the presence of Streptococcus equi.

  • Blood Tests: In cases where a horse may be asymptomatic—showing no overt signs of illness—blood tests become instrumental. These tests can detect the presence of antibodies or the bacterium itself, offering a diagnostic avenue for horses that may carry the infection without displaying apparent symptoms.

  • Guttural Pouch Endoscopy: For a more comprehensive understanding, veterinarians may opt for guttural pouch endoscopy. This procedure allows them to visualize the interior of the guttural pouch—the common site for abscess formation in strangles cases. Simultaneously, a sample can be taken during this endoscopic examination, providing a dual-purpose diagnostic approach.

The combined use of these diagnostic methods ensures a thorough and accurate assessment of strangles in horses. While the clinical presentation serves as an initial guide, confirmatory tests contribute to a more precise diagnosis, enabling veterinarians to tailor treatment plans and biosecurity measures accordingly.


Surviving Strangles: Navigating the Challenges and Triumphs

Strangles, despite its intensity and painful manifestations, is a condition that horses can often overcome with proper care and timely intervention. Understanding the potential outcomes and complications is crucial for horse owners and caretakers.


Recovery and Prognosis

Surviving strangles is not only possible but, in fact, quite common. The condition, while inflicting significant discomfort, is rarely fatal. A horse typically takes three to four weeks for a full recovery, during which it may exhibit fatigue and a decline in performance. Despite these temporary setbacks, the overall prognosis for strangles is generally favorable.


The mortality rate of strangles hovers around 10%, underscoring the importance of early detection and prompt treatment. With timely intervention, horses can often avoid developing severe complications that may arise if the infection is left unchecked.


Complications and Potential Risks

horse with bastard strangles or purpura hemorrhagica
Photo credit: AVMA Journals
  • Bastard Strangles: In some cases, the bacterial infection can take a more insidious turn, spreading from the original site in the lymph nodes around the head to other areas of the body. This form, known as bastard strangles, results in abscess formation in different regions and poses a potentially fatal threat.

  • Purpura Hemorrhagica: Another serious complication is purpura hemorrhagica, characterized by aseptic necrotizing vasculitis. This condition, while initially presenting as edema, can escalate rapidly. Severe cases may lead to skin sloughing, affecting not only the exterior but also internal organs such as the lungs, gastrointestinal tract, and muscles. Purpura hemorrhagica is highly fatal, but intensive treatment involving high doses of steroids and antibiotics may offer a lifeline. It's noteworthy that strangles vaccines can trigger this response, adding a layer of complexity to the management of the condition.

In conclusion, surviving strangles involves a delicate balance between timely intervention, vigilant monitoring, and understanding potential complications. While the majority of horses recover fully, the severity of the condition underscores the importance of proactive veterinary care and measures to mitigate the risk of complications.


Understanding the Duration of Strangles in Horses

The duration of strangles in horses unfolds as a dynamic timeline, with each phase presenting unique challenges and considerations. Understanding this temporal landscape is essential for horse owners and caretakers to navigate the complexities of managing and containing the disease.


Timeline of Strangles Presence

  • Up to Six Weeks of Presence: Strangles can persist in a horse for as long as six weeks, marking a considerable span during which the equine is vulnerable to the infection. This extended timeline underscores the need for patience and diligence in the management and isolation of affected horses.

  • Minimum Three Weeks to Resolution: The resolution of strangles is a gradual process, necessitating a minimum of three weeks. Expecting a horse to fully recover before this duration is unrealistic. Even if symptoms seem to abate after a few days, premature release from isolation is ill-advised, as the infection may still be active within the horse.

  • Abscess Break and Drainage: A critical turning point in the timeline is the breaking and draining of the abscess. Typically occurring one to two weeks after the onset of symptoms, this event signals the beginning of the horse's movement towards recovery. Until this crucial phase occurs, strangles continues to thrive within the horse's system.

Carrier Status and Recurrence

  • Asymptomatic Carriers: Strangles introduces a unique challenge wherein a horse can carry the infection without exhibiting symptoms for an extended period, potentially over a year. Even after initial treatment, horses may function as carriers, with the ability to infect others without showing signs of illness.

  • Recurring Episodes: Some horses, albeit less commonly, may experience recurring episodes of strangles even after the initial treatment. This recurrence, coupled with the potential for infecting other horses, necessitates ongoing vigilance and monitoring.

In summary, the duration of strangles in horses encompasses a multifaceted timeline, from the initial weeks of infection to the critical phase of abscess drainage. Recognizing the nuances of this timeline is pivotal for horse caretakers, allowing them to implement informed strategies for isolation, treatment, and ongoing biosecurity measures.


How to Prevent Strangles in Horses

Preventing strangles in horses is a proactive and essential aspect of equine management, requiring a robust biosecurity protocol. The emphasis lies in preemptive measures, as averting the onset of strangles is often more achievable and less taxing than treating its aftermath. Here's a comprehensive guide outlining key strategies for strangles prevention:

quarantine horse to prevent strangles outbreak
  • Quarantine Measures: Quarantine new horses for a duration of 7-30 days, depending on their perceived risk of carrying the infection. During the quarantine period, closely monitor the newcomer for any signs of illness before introducing them to the existing herd.

  • Yard Management and Spacing: Avoid overcrowding in the yard, maintaining a safe and hygienic environment. Provide ample space between horses to minimize the risk of direct contact and airborne transmission.

  • Drinking and Feeding Practices: Refrain from using shared drinking or food troughs until the health status of all horses is verified. Discourage your horse from drinking in public places where contamination risks are higher.

  • Regular Health Monitoring: Implement a routine health check regimen, including regular temperature monitoring of horses. Be vigilant for any unusual signs or symptoms that may indicate the onset of illness.

  • Vetting Procedures for New Horses: Prior to introducing new horses to the barn, ensure they undergo comprehensive vetting, including blood tests to rule out potential infections.

  • Equipment and Tack Hygiene: Avoid using shared equipment or tack; each item should be dedicated to a specific horse. Thoroughly disinfect all equipment before use to prevent cross-contamination.

  • Disinfection of Facilities: Employ a rigorous disinfection routine for all surfaces, including fences, stalls, gates, and other high-contact areas. Regularly clean and ensure that pastures are free from contaminants that may harbor infectious agents.

  • Isolation Protocols: If strangles is suspected or diagnosed, promptly isolate the affected horse. Maintain isolation for a minimum of three to four weeks, even if symptoms subside, to prevent the potential spread of the infection.

By diligently adhering to these preventive measures, horse owners can significantly reduce the risk of strangles within their equine communities. Building these fortifications not only safeguards individual horses but contributes to the overall health and well-being of the entire herd.


Strangles Vaccines: Balancing Protection and Potential Pitfalls

Vaccination against strangles represents a pivotal aspect of equine health management, offering a layer of defense against the insidious Streptococcus equi bacteria. However, understanding the nuances and potential drawbacks of available vaccines is essential for horse owners seeking to strike the right balance between protection and potential risks.


Types of Strangles Vaccines

  • Killed Version: The older killed version of the strangles vaccine is administered through injection. This version, while effective, is associated with side effects such as abscess formation at the injection site.

  • Live Version: The newer live version of the vaccine is administered intra-nasally, offering an alternative delivery method. Its efficacy is contingent on stringent biosecurity measures alongside vaccination. A drawback is the requirement for frequent booster doses to maintain effectiveness.

Considerations and Limitations

  • Prevention, Not Treatment: Strangles vaccines serve as preventive measures and are not designed for treating an active infection.

  • No 100% Guarantee: While vaccines significantly reduce the risk of strangles, they do not provide foolproof protection. Horses can still contract strangles despite vaccination, emphasizing the need for comprehensive biosecurity practices.

  • Potential Side Effects: Both versions of the vaccine can lead to adverse reactions, including the development of purpura hemorrhagica or other undesirable responses.

  • Titer Test Consideration: Before vaccinating, consult with your veterinarian about conducting a titer test. Titer tests assess the horse's existing immunity, helping gauge the necessity and potential risks of vaccination.

Navigating the strangles vaccine landscape involves a careful consideration of the advantages and potential pitfalls. While vaccines play a crucial role in preventing the disease, horse owners must collaborate closely with their veterinarians to tailor vaccination strategies to individual horses. Understanding the limitations and risks associated with each vaccine type allows for informed decision-making, ensuring the well-being of horses while maintaining a proactive stance against strangles.


Strategies for Supportive Care and Management

Dealing with strangles in horses can be a challenging journey, primarily due to the lack of a definitive cure. Instead, treatment revolves around supportive care aimed at alleviating symptoms, minimizing complications, and fostering the horse's recovery. Here's a comprehensive guide on managing strangles in horses:


Supportive Treatment Strategies

  • Rest and Quarantine: Quarantine the affected horse to prevent the spread of the infection. Provide a quiet and comfortable environment for rest, minimizing stress on the horse's compromised immune system.

  • Antibiotic Therapy: While antibiotics do not eradicate the virus, they are often prescribed to mitigate the severity of symptoms and prevent secondary bacterial infections. Administering antibiotics early in the course of the disease can be crucial in managing the progression of strangles.

  • Hot Packs for Lymph Node Swelling: Apply hot packs to the swollen lymph nodes to reduce pain and promote drainage. This can be especially beneficial in easing the discomfort associated with the enlargement of the lymphatic system.

  • Iodine Solution for Abscess Care: After an abscess has naturally drained, applying an iodine solution helps maintain cleanliness and prevent secondary infections. This step is essential for ensuring proper healing and reducing the risk of complications.

  • Wet Food for Swallowing Difficulties: Feed the horse wet, easily digestible food to address difficulties in swallowing. Softer food can ease the discomfort caused by swollen lymph nodes and facilitate the horse's nutritional intake during the recovery period.

  • Veterinary Guidance: Always adhere to the recommendations of your veterinarian, who will tailor the treatment plan based on the individual circumstances of the horse. Regular check-ups and communication with the vet are crucial for monitoring the horse's progress and adjusting the treatment plan as needed.

In the absence of a cure, the cornerstone of strangles management lies in providing a supportive environment that allows the horse to rest and recover. Quarantine measures, combined with thoughtful and diligent care, contribute significantly to the overall well-being of the horse during this challenging period. Always consult with your veterinarian to ensure a tailored and effective treatment plan for your horse.


Exploring Acupressure as Complementary Support for Strangles Prevention and Care

In the realm of equine health, the ancient practice of acupressure emerges as a promising avenue for not only preventing but also providing complementary support for horses dealing with strangles. While it cannot replace traditional veterinary care, acupressure, when incorporated into a routine, can be a valuable element in promoting the horse's overall well-being.


Understanding Acupressure for Strangles

equine acupressure practitioner working on a horse for supportive care of strangles

Acupressure, rooted in ancient healing practices, stands as a proactive means of fortifying a horse's natural immune system. Introducing a regular acupressure regimen becomes a strategic approach to preventing strangles or mitigating its severity, emphasizing the value of preventative care.


One notable advantage of acupressure lies in its cost-effectiveness. In a landscape where veterinary visits may incur substantial expenses, acupressure provides horse owners with a pragmatic and economical strategy. Prioritizing preventative care through acupressure can potentially diminish the likelihood of conditions like strangles, subsequently curbing the need for extensive veterinary interventions.


Acupressure as Complementary Support

Acknowledging that supportive care is the primary recourse when a horse grapples with strangles, acupressure takes on a role as a complementary and supportive option. The application of acupressure holds the promise of nurturing the body's innate healing processes, aiding in the elimination of pathogens, and facilitating tissue repair.


The power of acupressure lies in its ability to enhance healing mechanisms. By applying pressure to specific acupoints, blood flow is increased, fostering a swifter recovery. This holistic approach not only expedites healing but also contributes to the overall well-being of the horse during the arduous period of strangles.


Beyond its physical effects, acupressure plays a pivotal role in boosting the immune system. By fortifying the horse's natural defenses, acupressure becomes an integral part of a comprehensive strategy to help the horse cope with conditions like strangles.


Comprehensive Supportive Care

While acupressure holds promise as a complementary support, its efficacy is maximized when integrated into a comprehensive care framework. Regular communication with a veterinarian remains paramount, ensuring that acupressure aligns seamlessly with the overall treatment plan for the horse. Through the harmonious combination of traditional veterinary care and holistic approaches like acupressure, horse owners can navigate a balanced path towards the health, resilience, and preventative well-being of their cherished equine companions.

equine vet with a horse after he recovers from strangles






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