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Strangles (equine distemper) is a contagious upper respiratory tract infection of horses and other equines caused by a gram-positive bacterium, "Streptococcus equi". As a result the lymph nodes swell, compressing the pharynx, larynx and trachea and can cause airway obstruction leading to death, hence the name Strangles. Strangles is enzootic in domesticated horses worldwide. The contagious nature of the infection has at times led to limitations on sporting events.
A horse with strangles will typically develop abscesses in the lymph nodes of the head and neck causing coughing fits and difficulty swallowing. Clinical signs include fever up to 106 °F and yellow coloured nasal discharge from both the nose and eyes.
Abscesses may form in other areas of the body, such as the abdomen, lungs and brain. This is considered a chronic form of strangles called "bastard strangles" and can have serious implications if the abscesses rupture. Horses develop this form of strangles when their immune systems are compromised or if the bacteria rapidly invades the body.
Strangles has a 8.1% mortality rate. Mortality is lower in cases without complications than it is in cases of bastard strangles. The disease is very contagious and morbidity is high. Precautions to limit the spread of the illness are necessary and those affected are normally isolated. An isolation period of 4–6 weeks is usually necessary to ensure that the disease is not still incubating before ending the quarantine.
External abscesses are the most common form of pigeon fever seen in horses. Abscesses develop on the body, usually in the pectoral region and along the ventral midline of the abdomen. However, abscesses can also develop on other areas of the body such as the prepuce, mammary gland, triceps, limbs and head. The fatality rate for this form infection is very low. The abscess is often drained once it has matured.
This is the least common form of pigeon fever seen in horses. It is characterized by severe limb swelling and cellulitis in one or both hind limbs and can lead to lameness, fever, lethargy and loss of appetite. Antimicrobial and anti-inflammatory treatments are required to prevent further complications such as limb edema, prolonged or recurrent infection, lameness, weakness and weight loss.
Purpura haemorrhagica is a rare complication of equine strangles and is caused by bleeding from capillaries which results in red spots on the skin and mucous membranes together with oedema (swelling) of the limbs and the head. Purpura hemorrhagica is more common in younger animals.
The most common clinical sign is subcutaneous edema of the limbs and hemorrhages on mucous membranes. Other clinical signs include depression, anorexia, fever, elevated heart and respiratory rate, reluctance to move, drainage from lymph nodes, exudation of serum from the skin, colic, epistaxis and weight loss. Rarely, horses may also develop disseminated intravascular coagulation (DIC), leading to infarction of various organs, or chronic myositis and muscle atrophy.
The first symptom is a sudden onset of swelling of the face, which develops within two days into papules and pustues on the lips, nose, and around the eyes. These pustules release a purulent discharge, causing a crust to form on the skin. There is also lymphadenopathy (swelling of lymph nodes) in the main lymph nodes of the head. The feet, body, prepuce or perianal area may be affected. Pustular otitis externa can occur, with the pinnae (ear flaps) becoming thickened by edema. Affected areas are painful but not itchy. Approximately half of affected puppies have lethargy and depression. Less common symptoms include pyrexia, anorexia, and joint pain, caused by sterile suppurative arthritis.
Juvenile cellulitis, also known as puppy strangles or juvenile pyoderma, is an uncommon disease of dogs. Symptoms include dermatitis, lethargy, depression and lameness. When puppies are first presented with what appears to be staphylococcal pyoderma, juvenile cellulitis, a relatively rare condition, may not be considered.
Strangling involves one or several mechanisms that interfere with the normal flow of oxygen into the brain:
- Compression of the carotid arteries or jugular veins—causing cerebral ischemia.
- Compression of the laryngopharynx, larynx, or trachea—causing asphyxia.
- Stimulation of the carotid sinus reflex—causing bradycardia, hypotension, or both.
Depending on the particular method of strangulation, one or several of these typically occur in combination; vascular obstruction is usually the main mechanism. Complete obstruction of blood flow to the brain is associated with irreversible neurological damage and death, but during strangulation there is still unimpeded blood flow in the vertebral arteries. Estimates have been made that significant occlusion of the carotid arteries and jugular veins occurs with a pressure of around , while the trachea demands six times more at approximately .
As in all cases of strangulation, the rapidity of death can be affected by the susceptibility to carotid sinus stimulation. Carotid sinus reflex death is sometimes considered a mechanism of death in cases of strangulation, but it remains highly disputed. The reported time from application to unconsciousness varies from 7–14 seconds if effectively applied to one minute in other cases, with death occurring minutes after unconsciousness.
Strangling is compression of the neck that may lead to unconsciousness or death by causing an increasingly hypoxic state in the brain. Fatal strangling typically occurs in cases of violence, accidents, and is one of two main ways that hanging may cause death (alongside breaking the victim's neck).
Strangling does not have to be fatal; limited or interrupted strangling is practised in erotic asphyxia, in the choking game, and is an important technique in many combat sports and self-defence systems.
Strangling can be divided into three general types according to the mechanism used:
- Hanging—Suspension from a cord wound around the neck
- Ligature strangulation—Strangulation without suspension using some form of cord-like object called a garrote
- Manual strangulation—Strangulation using the fingers or other extremity
Skin disease may result from deficiency or overactivity of immune responses. In cases where there is insufficient immune responses the disease is usually described by the secondary disease that results. Examples include increased susceptibility to demodectic mange and recurrent skin infections, such as Malassezia infection or bacterial infections. Increased, but harmful immune responses, can be divided into hypersensitivity disorders such as atopic dermatitis, and autoimmune disorders (autoimmunity), such as pemphigus and discoid lupus erythematosus.
Skin disorders are among the most common health problems in dogs, and have many causes. The condition of a dog's skin and coat are also an important indicator of its general health. Skin disorders of dogs vary from acute, self-limiting problems to chronic or long-lasting problems requiring life-time treatment. Skin disorders may be primary or secondary (due to scratching, itch) in nature, making diagnosis complicated.