Pleuropneumonia is the most-severe form of bacterial pneumonia a horse can contract; it occurs when pneumonia extends from the main airway to the thin membrane on the surface of the lung (the pleura) and the thoracic cavity. Affected horses produce large amounts of protein-rich fluid and are at risk of developing endotoxemia, which then puts them at risk of laminitis and death.
The condition is often associated with long-distance hauling (also called “shipping fever”), but it can develop after a horse chokes and develops aspiration pneumonia. When hauling horses, it's best to allow horses the ability to put down their head to clear their airways. Hay bags hung directly in front of the horse cause constant inhalation of debris and bacteria, which settles in the lower airways and leads to inflammation and infection.
Pleuropneumonia doesn't develop right away – it can days or even weeks after the event for a horse to develop a cough, nasal discharge, or an increased respiratory rate – and not all horses affected by the condition will develop these signs. The horse may also spike a fever or go off his feed.
Diagnosed from ultrasound lung imaging, radiography of deeper lung tissues and fluid samples from airways, the condition often requires long-term hospitalization and intensive care to resolve.
Horses have small slits between the right and left sides of the thoracic cavity that allow for small amounts of fluid to move between sides. When a horse has pleuropneumonia, inflammatory materials obstruct these openings, completely separating the two sides. Two different bacteria can cause infections in these spaces.
A horse with pleuropneumonia will often have the pleural fluid drained, then be given antimicrobial therapy and supportive care. Horses often leave the clinic while still on long-term antimicrobial treatments; these are often administered for multiple months.
Many horses with pleuropneumonia return to their previous level of work.
Read more at HorseTalk.
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