Medical management prolonged recumbency in a case of EHV-1

Medical management and positive outcome after prolonged recumbency in a case of equine herpesvirus myeloencephalopathy

J Equine Vet Sci. 2024 Apr 10:105063. doi: 10.1016/j.jevs.2024.105063. Online ahead of print.
Authors
A Mannini 1 , N Ellero 2 , L Urbani 1 , A Balboni 1 , I Imposimato 1 , M Battilani 1 , R Gialletti 3 , F Freccero 1
Affiliations

1 Department of Veterinary Medical Sciences (DIMEVET), University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano dell’Emilia, Bologna, Italy.
2 Department of Veterinary Medical Sciences (DIMEVET), University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano dell’Emilia, Bologna, Italy. Electronic address: nicola.ellero3@unibo.it.
3 Department of Veterinary Science, University of Parma, Strada del Taglio 10, 43126 Parma, Italy.

PMID: 38608970
DOI: 10.1016/j.jevs.2024.105063

Abstract

A 17-year-old mare presenting with acute fever, weakness and bladder dysfunction was diagnosed with equine herpesvirus myeloencephalopathy (EHM). The mare become transiently recumbent, underwent parenteral fluid therapy, plasma infusion, steroidal/nonsteroidal anti-inflammatory drugs (SAID/NSAIDs) and bladder catheterization. After 10 days the mare was hospitalized. Neurological evaluation revealed ataxia and proprioceptive deficits mainly in the hind limbs. The mare was able to stand but unable to rise from recumbency or walk. Secondary complications included Escherichia coli cystitis, corneal ulcers and pressure sores. A full-body support sling was used for 21 days. Medical treatment included systemic antimicrobials, NSAIDs, gradual discontinuation of SAIDs, parenteral fluid therapy and bladder lavage. The mare tested positive for Varicellovirus equidalpha 1 (EHV-1) DNA in nasal swab and blood samples on day 13 and in urine samples on days 13 and 25 after the onset of fever. Neurological signs improved over a period of 34 days and the mare was discharged with mild hind limb weakness/ataxia. Secondary complications resolved within 2 weeks. At the eight-month follow-up, marked improvement in locomotory function had been achieved.

Keywords: Ataxia; Corneal cross-linking; Horse; Urine, Real-time PCR; Varicellovirus equidalpha 1.

Copyright © 2024. Published by Elsevier Inc.