What is strangles in horses?

Imagine how much pain you would feel if something blocked your normal throat function. It could be similar to the feeling you get when you have strep throat or a severe respiratory infection, but worse. You won't even be able to breathe, and it's unbearable, right? Strangles is something like that. The condition in which the horse’s throat is being blocked by its own lymph and breathing becomes difficult.
In this article, you'll learn what strangles actually is, how it is caused, the first sign to catch, and the treatment.
What is strangles?

As the name indicates, strangles is an infection that blocks the throat. This infection is caused by bacteria called Streptococcus equi (S. equi). It settles in the back of the throat on the tonsils and pharynx within hours of infection. It then moves to the lymph nodes under the jaw. When the bacteria reaches the lymph nodes, it causes it to swell and this is when the bigger problems begin.
When the lymph swells and abscesses, it can become so swollen that it blocks the airways. The horse feels compression around his neck or throat. Ultimately, breathing becomes difficult. It is rarely fatal but so painful that the horse becomes fatigued.

Most horse owners associate strangles with nasal drainage. This is from the lymph abscess draining into the guttural pouch and into the nasal cavity. The abscess can also drain externally, under the jaw. In both locations, you will see the yellow/white discharge. The discharge is highly infectious to other horses.
Strangles is a highly contagious infection for other horses. It is one of the most common respiratory infections diagnosed in horses aged six to ten years. Since it can be spread by contaminated surfaces (shared tack, water buckets, stalls, fences etc.), it's important to keep the horse quarantined and wash surfaces.
What are the first signs of strangles in horses?

Fever with extremely high temperature (104 degrees Fahrenheit) and loss of appetite are the very first sign you will see in a horse suffering from strangles. It will be followed by difficulty swallowing and swollen lymph nodes around the neck and jaw. Nasal discharge will be thin at first but soon becomes thick and yellowish. You may also find pus in the nasal discharge later. The horse may stand with its head down to relieve pain and discomfort. Younger horses exhibit severe signs, while older horses have mild symptoms.
To sum up, here is a list of signs and symptoms that you must notice:

Raised body temperature
Loss of appetite
Difficulty in swallowing
Difficulty in breathing
Painful cough
Swollen lymph nodes around jaw and neck
A horse always standing with the head facing down
Nasal discharge
Fatigue or poor performance
Irritated behaviour of the horse
How does a horse catch Strangles?
Streptococcus Equi is transmitted through direct or indirect contact. If a horse comes in contact with a horse that is a disease carrier or in the recovery phase, he can transmit the bacteria. It can be transmitted through shared drinking troughs, shared equipment or bedding, food, fencing, gates, or even flies. The bacteria infects the lymph nodes in the jaw and neck of the horse, causing swelling and the formation of an abscess.
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.
How is strangles diagnosed?
A vet diagnoses strangles on the clinical presentation of the horse. The signs and symptoms are pretty clear to make the diagnosis by visual cues. However, a nasopharyngeal swab is satisfactory for confirming the diagnosis. Blood tests are also advised to make the diagnosis in an asymptomatic (with no symptoms) horse. Another method is guttural pouch endoscopy to visualize the pouch from the inside, along with taking the sample.
Can a horse survive strangles?
Yes, this condition is rarely fatal despite being extremely painful. It usually takes three to four weeks to recover from strangles fully. The horse is tired and exhibits poor performance during this time, but the prognosis is good.The mortality rate of the disease is 10%. Early diagnosis can save the horse from developing complications, i.e., bastard strangles and purpura hemorrhagica. If left untreated and the condition gets worse, death may occur.
Bastard strangles: The bacterial infection spreads from the lymph nodes around the head to other areas in the body. This creates abscesses in different regions of the body and is a potentially fatal form of strangles.
Purpura hemorrhagica: this is an aseptic necrotizing vasculitis that looks like edema from the outside. Severe edema may cause sloughing of the skin or oozing skin tissues. It can also affect the lungs, GI tract and muscles. Purpura is highly fatal but treatment using high doses of steroids and antibiotics may be able to save your horse. Strangles vaccines can also trigger this response.

How long do Strangles stay in horses?

Strangles can stay on a horse for as long as six weeks. It takes a minimum of three weeks to resolve. You should not expect a horse to be okay before this duration. Even if the horse doesn't exhibit symptoms after a few days, you should not release him from isolation. Strangles continues to thrive until the abscess breaks and drainage occurs. Usually, it takes one to two weeks for the abscess to break and drain. Once it does, the horse moves toward recovery.
Your horse can also be a carrier for strangles and not show any symptoms for over a year. So, even after the first treatment, they may continue to have recurring episodes and infect other horses over different periods of time. However, this is not very common.
How to Prevent Strangles in Horses
It is easier to prevent strangles than to treat them. Good biosecurity protocol that includes washing, changing, and isolating should be followed to prevent the spread of disease. Here are some key points of prevention that you must keep in mind:

Quarantine new horses from others for 7-30 days depending on the risk they may bring.
Do not overcrowd the yard. Maintain a safe distance between horses in the yard. There should be enough space for each of them.
Avoid shared drinking or food troughs for all horses until you're sure they are bacteria free. Do not let your horse drink from a public place.
Regularly check the temperature of the horses and note any unusual signs or symptoms.
Do not allow new horses in the barn unless they've been fully vetted for infection through blood tests.
Do not use shared equipment or tack. Disinfect everything before use. Use a disinfectant for fences, stalls, gates, and other surfaces. Make sure the pasture is not contaminated.
Isolate the horse suspected or diagnosed for having Strangles. Keep the horse isolated for three to four weeks, even if the symptoms subside.
Is there a vaccine for strangles?
Vaccines are available in live and killed versions. The killed version vaccine is the older one and comes with side effects such as abscess formation at the site of injection. The newer live version of the vaccine is sprayed intra-nasally, but it is only effective when combined with biosecurity. One drawback of the newer version is that it requires frequent booster doses.
Vaccines are only for prevention and not treatment. They also do not guarantee 100% protection. The can also cause purpura hemorrhagica or other reactions. Ask your vet if your horse can get a titer test before vaccination to see the risk in your horse.
How to Treat Strangles
There is no proper treatment for strangles. Supportive treatment with rest is advised. However, the vet may start a dose of antibiotics to avoid the severity of symptoms and prevent complications. Hot packs are recommended to ease the pain and swelling of lymph nodes. Iodine solution can be applied to the abscess after drainage. You can feed the horse wet food to ease the difficulty in swallowing. Quarantine and complete rest is the best treatment in the case of Strangles. Be sure to always follow your vets recommendations.
Does acupressure therapy help with strangles?
Acupressure is a great way to support your horses natural immune system. Having your horse on a routine acupressure plan will help prevent strangles or lessen the severity. Preventative care is the best thing you can do for your horse. As a horse owner, we know it can be expensive to have your vet come out. Preventing conditions like strangles can reduce future vet visits.
Since supportive care is really the only option once a horse has strangles, acupressure will work best as a complementary supportive option. It can encourage the body to heal, rid itself of pathogens, and repair tissues. When pressure is applied to the acupoints, there is an increased flow of blood, so healing occurs faster. Plus, it boosts the immune system and strengthens the horse to deal with the condition.

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