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Case AP07-2606

Case AP07-2606. Danielle L. Brown NC State University, College of Veterinary Medicine Co-presenters: Dr. Talmage Brown, Dr. James Guy. History and PE Findings. 7-year-old Paint Horse mare Presented for 2 day history of colic, anorexia, and depression Normal TPR

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Case AP07-2606

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  1. Case AP07-2606 Danielle L. Brown NC State University, College of Veterinary Medicine Co-presenters: Dr. Talmage Brown, Dr. James Guy Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  2. History and PE Findings • 7-year-old Paint Horse mare • Presented for 2 day history of colic, anorexia, and depression • Normal TPR • Rectal examination within normal limits Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  3. Clinical Pathology Data and Case Progress • CBC: Leukopenia with neutropenia and lymphopenia, thrombocytopenia • Chemistry panel: Elevated liver enzymes (ALP, AST, GGT, Bilirubin), Elevated CK • Next morning: • Dyspnea, mucopurulent nasal discharge • Toxic mucous membranes • Very uncomfortable • Laterally recumbent • Humanely euthanized and submitted for necropsy Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  4. Gross examination • Moderate subcutaneous edema • Intestinal serosal petechiae and ecchymoses • Hepatic blood vessels prominent and congested • Several small strongyles within large colon • Lungs: • Failed to collapse • Mottled appearance with coalescing slightly firm white foci Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  5. Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  6. Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  7. Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  8. Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  9. Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  10. Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  11. Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  12. Morphologic Diagnosis Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only Liver: Multifocal to coalescing, severe, acute hepatic necrosis with intranuclear inclusion bodies and fibrinoid vascular necrosis Etiology: Equine herpesvirus-4 isolated from liver and kidney

  13. EHV-1 vs EHV-4 Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only Show considerable cross-reactivity Until 1981 were considered as subtypes of same virus Both are endemic in horse populations worldwide Horses are repeatedly infected by both viruses in nature and disease signs become less severe with progressive episodes later in life Both cause rhinopneumonitis EHV-1 is main cause of abortions, paresis, and neonatal foal deaths

  14. Pathogenesis Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only Mainly transmitted through inhalation Virus first replicates in upper respiratory epithelium and local lymph nodes Results in leukocyte-associated viremia Virus later replicates within endothelial cells Latency in lymphoid and neural tissues demonstrated for both viruses

  15. Unusual presentations of equine herpesvirus infection • Neonatal mortality due to EHV-4 in a foal (O’Keefe et al, 1995) • Necrosis and intranuclear inclusions seen in lung, liver and small intestinal mucosa • PCR detected EHV-4 • Disseminated EHV-1 infection in a 2-year-old filly (Hamir et al, 1994) • Random necrosis seen in lung, liver, spleen, and adrenal glands with numerous intranuclear inclusion bodies Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  16. Acknowledgements • Dr. Talmage Brown • Dr. James Guy • Sandra Horton and rest of NCSU-CVM histology laboratory staff • Resident mates and senior pathologists Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  17. Questions? Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  18. References • Reed SM and Toribio (2004) Equine herpesvirus 1 and 4. Vet Clin Equine 20:631-642. • Hamir AN et al (1994) Disseminated equine herpesvirus-1 infection in a 2-year-old filly. JVDI 6:493-496. • O’Keefe JS et al (1995) Neonatal mortality due to equid herpesvirus 4 (EHV-4) in a foal. Aust Vet J 72:353-354. • Patel JR and Heldens J (2005) Equine herpesviruses 1 (EHV-1) and 4 (EHV-4) – epidemiology, disease and immunoprophylaxis: a brief review. Vet J 170:14-23. • van Maanen C (2002) Equine herpesvirus 1 and 4 infections: an update. Vet Q 24:58-78. Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

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