Peer-reviewed veterinary case report
Infarctive purpura hemorrhagica in five horses.
- Journal:
- Journal of the American Veterinary Medical Association
- Year:
- 2005
- Authors:
- Kaese, Heather J et al.
- Affiliation:
- Department of Veterinary Population Medicine · United States
- Species:
- horse
Plain-English summary
Five horses were seen because they showed signs of muscle stiffness and severe belly pain. All of them had been around a bacteria called Streptococcus equi within the last three weeks or had high levels of antibodies against it. The horses experienced ongoing pain and had swollen areas in their muscles. Unfortunately, four of the horses had to be put down, but the fifth horse improved with treatment using penicillin and a steroid called dexamethasone. After three weeks, the treatment continued with another steroid called prednisolone for ten more weeks, leading to a successful recovery for that horse.
Abstract
Five horses were examined because of signs of muscle stiffness, colic, or both. All 5 had been exposed to Streptococcus equi within 3 weeks prior to examination or had high serum titers of antibodies against the M protein of S equi. Horses had signs of unrelenting colic-like pain and focal areas of muscle swelling. Four horses were euthanatized. The fifth responded to treatment with penicillin and dexamethasone; after 3 weeks of treatment with dexamethasone, prednisolone was administered for an additional 10 weeks. Common hematologic and serum biochemical abnormalities included neutrophilia with a left shift and toxic changes, hyperproteinemia, hypoalbuminemia, and high serum creatine kinase and aspartate transferase activities. Necropsy revealed extensive infarction of the skeletal musculature, skin, gastrointestinal tract, pancreas, and lungs. Histologic lesions included leukocytoclastic vasculitis in numerous tissues and acute coagulative necrosis resembling infarction. These horses appeared to have a severe form of purpura hemorrhagica resembling Henoch-Schönlein purpura in humans and characterized by infarction of skeletal muscles. Early recognition of focal muscle swelling, abdominal discomfort, neutrophilia, hypoalbuminemia, and high serum creatine kinase activity combined with antimicrobial and corticosteroid treatment may enhance the likelihood of a successful outcome.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/15934258/