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Reoccurring Staph infections
 Moderated by: DrDeb  
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Kay
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Joined: Sun Nov 25th, 2007
Location: Green Bay, Wisconsin USA
Posts: 10
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 Posted: Fri Feb 27th, 2009 03:18 pm
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I lease a 9 y/o Anglo-arab gelding who is currently suffering with a staph infection localized to his left groin area.  His owner has treated him twice before for the same type of infection in the same localized area using sulfa antibiotic medication and has had 2 infected abscesses lanced. The bout before this one was 8 months ago.  She having him treated currently with the same antibiotic and will have her vet lance it when it comes to a head. 

My question is how to alter his diet and/or supplement him in some way to help him get over this and avoid reinfection?  References and suggestions would be helpful and appreciated.

DrDeb
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Joined: Fri Mar 30th, 2007
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 Posted: Sat Feb 28th, 2009 09:53 am
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Kay, the first idea that occurs to me here is to ask where you reside -- is it outside of California? I think you are indeed wise to ask about prophylaxis at the level of the general health of the horse, because I don't believe these are "isolated" staph infections. I think instead that the horse has a diagnosable disease, but one which is not common in your area so that the vet may not have considered it. I think this particularly because (1) I've seen diseases missed before for this reason, and (2) I can't believe that if the infection is internal, i.e. it is not like a boil which locally invades through the skin but rather is located, and arises from, below the epidermis, that it's not systemic. If antibiotics were administered and were effective, then the prescribed treatment was systemic and its effects were systemic.

Why I ask whether you live in California is that this sounds like what is sometimes here called "atypical Pigeon fever". Pigeon fever is typically a California disease, but there is no law that says it cannot occur elsewhere. Nevertheless many vets outside of California have never heard of it. It gets its name because in typical presentation, it invades the lymph nodes of the horse's neck and causes them to swell. Eventually there is drainage downward, sometimes with quite a lot of pus and fluid accumulating low in the neck and/or between the forelimbs, which makes the horse look "pigeon-chested."

But I have also seen cases of Pigeon fever that were localized to the throat and to the groin area. In fact, this infection can manifest anywhere there are concentrations of lymph nodes. And when those nodes swell, they can look just exactly like a cyst or boil, except that they are too deep below the skin to be a boil.

It is usually not advised to treat Pigeon Fever with antibiotics -- or that was the last word about it that I have heard, the reason given being that such treatment simply tends to drive the infection underground -- it suppresses it but it does not eliminate it, and then it will come back and be worse than before. This also sounds like your case. What they generally advise here for Pigeon Fever is simply allowing the horse's body to fight off the invasion by itself, which in the end serves to strengthen the animal's immune system. Of course, if swelling causes the horse discomfort, you will have to ask "when" the discomfort arises, i.e. is he OK in pasture but uncomfortable when you are trying to ride him. If he's uncomfortable when you are trying to ride him, then I think you cannot justify treating him merely in order to be able make him rideable. The purpose of veterinary medical treatment should never be MERELY to squeeze performance or work out of a horse.

The cause of Pigeon Fever is a staph organism which invades the horse's body on a "general" or systemic level. The disease is somewhat similar to Mumps, which is caused by a different bacterium. Characteristic of Mumps when we all had it as kids, was that at a certain stage the lymph nodes behind the angles of your jaws, in front of your earlobes, would swell up. The swelling in Pigeon Fever is of the same nature: the infectious organism does not particularly target the lymph nodes; rather, the infection is system-wide, and there is a BIG internal battle going on between the immune system cells and the invading bacteria. After an immune system cell (a phagocyte) ingests and kills a certain number of bacteria, the toxins in those dead bacteria kill the phagocyte. Then their dead bodies find their way by the millions into the lymph system, which transports them to the lymph nodes, which are "holding tanks" for pus, which is all the accumulated dead cell bodies plus some serum. If the immune system takes a long time to win, pus may continue to accumulate at a rate faster than the body can flush it out -- the pus has to be detoxified in the liver before finally being excreted, primarily in the feces. So the lymph nodes swell as a function of the day-to-day balance between pus coming in and pus being flushed out.

What you now have to do is go back to your vet for a discussion of two main things:

(1) You need a specific diagnosis -- more specific than "recurring staph infection". You need to know whether you are dealing with Pigeon Fever, or if not that, then what systemic disease.

(2) You need advice from your veterinarian concerning supplementation, which I think is what you are mainly asking about -- i.e. should you use Tea Tree Oil or antioxidants or herbs that boost the immune system or whatnot. You need to get your vet's ideas on these things first, before you come to the Internet looking for hints. And what you need first, and most, is simply good hay, not too rich, clean, and not containing toxic species such as Phalaris or Lolium or Festuca, so that your horse doesn't have to be fighting battles on TWO fronts. Nobody on the Internet can see your horse, and you don't need this hint or that hint; you need a solid program. You seem educated and sensible and I'd hate to see you harking off after random hints.

So please write back after you've spoken again with your vet, and let us know whether they were willing to look up Pigeon Fever if it's a disease they had not previously been familiar with, or whether you live in California and the vet knew all about it anyway. Keep us posted, and good luck with this. -- Dr. Deb

 

 

Joe
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Joined: Mon Apr 16th, 2007
Location: Texas
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 Posted: Sun Mar 1st, 2009 01:14 am
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Pigeon fever is rarely seen outside the West Coast, but a few years ago during a bad drought in the central US it made a breakout and was seen in moderately large numbers in places as far east as Wyoming and Kansas.

If I recall correctly, there was something about dry dusty conditions that helped spread the disease organism.

JOe

Kay
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Joined: Sun Nov 25th, 2007
Location: Green Bay, Wisconsin USA
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 Posted: Sun Mar 1st, 2009 05:34 pm
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Thank you for your reply - I live in Wisconsin; we have had dry but not drought conditions for the last 5 years.  I will certainly discuss your points with the vet.  Pigeon Fever is not common here but bacteria and disease travel.  I will update as I find out more.

I want to tell you how valuable this site has been to me - I have been around horses for 30+ years and will continue to be a life long student of all things equine.   I am wading through the reading list and filling a lot of education gaps in the process.

Thanks again.


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