Equine survivor’s story shines light on rare infection

q-acvim-animal-survivorQ, a yearling Rocky Mounted Saddle Horse in Washington state, recovered from proliferative enteropathy, a rare infection caused by the bacterium Lawsonia intracellularis. Veterinarian Chantal Rothschild suspected the rare infection after blood tests showed extremely low protein levels, a key indicator of the infection, which often leaves the animal unable to absorb dietary protein. Dr. Rothschild initiated treatment before receiving test results, saying, “If we’d waited, we might not have been able to save him.” Q’s treatment and recovery earned the case recognition from the American College of Veterinary Internal Medicine. The Horse (6/14)

Trainer Julie Blacklow thought Q’s quiet demeanor and willing attitude had to do with her team’s excellent training skills at Rosebud River Ranch in Snoqualmie, Wash. In reality, the yearling Rocky Mounted Saddle Horse gelding was critically sick with proliferative enteropathy, a diseased caused by the bacterium Lawsonia intracellularis and something Blacklow, a veteran horsewoman, had never heard of.

She’s not alone.

The American College of Veterinary Internal Medicine (ACVIM) is trying to change that by making owners more aware of L. intracellularis in horses. At the 2013 ACVIM Forum in Seattle, the organization introduced Q as part of its “Animal Survivor” program, which highlights animals that—thanks to advances in veterinary internal medicine—have lived through severe disease.

Q’s survival story started when he spiked a temperature of 104°F (99-101°F is normal). He also became lethargic and stopped eating, a sign to Blacklow that something was very wrong with the young horse. After an inconclusive initial exam by a general practitioner, Blacklow sought a specialist’s second opinion. She contacted Chantal Rothschild, DVM, Dipl. ACVIM, of Northwest Equine Veterinary Associates in Maple Valley, Wash.

Rothschild performed ultrasounds of Q’s chest and abdomen looking for the source of the infection causing his fever. Then the gelding’s blood work came back with extremely low protein levels. This is a telltale clinical sign of proliferative enteropathy, a spreading infection of the intestine most common in foals two to seven months old that renders the animal unable to absorb protein from the diet. Edema (swelling) had also developed around the horse’s jaw and down into his chest.

L. interacellularis is common in pigs, and certain wild animals are thought to carry it, Rothschild said, adding that the disease is believed to be contracted when horses ingest bacteria from infected animal feces. Rothschild had treated equine cases during her time practicing in Texas and at Washington State University on the eastern edge of the state. “But I’d never seen a case in the Seattle area,” she said.

After examining Q, Rothschild recommended treating him for proliferative enteropathy immediately rather than waiting for test results confirming L. interacellularis infection. “It would take too long to get a positive test back, so I asked the owners to trust me,” Rothschild said. “If we’d waited we might not have been able to save him.”

Q responded within three days and started acting less like the calm horse Blacklow knew and more like an energetic youngster. “He was trying to bite us, and we couldn’t catch him,” Blacklow said about Q’s reversal. “I called Dr. Rothschild and told her.”

“I was like, ‘Yay! That’s what we want!’” Rothschild said.

Q’s intensive treatment continued for six weeks, multiple times per day, and required dedication from the farm’s workers and the horse’s patience. Q was an excellent patient, Blacklow reported, and has since made what she considers a full recovery.

“Sometimes you have patients that really want to live, and Q was one of those,” Rothschild said. “He helped us help him.”

In addition to Q, the ACVIM named four dogs with diseases ranging from cancer to neurologic conditions as Animal Survivors. For more information visit www.WeAreAnimalSurvivors.org.

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