case ap07-2606 danielle l. brown nc state university, college of veterinary medicine co-presenters:...
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Case AP07-2606Case AP07-2606
Danielle L. Brown Danielle L. Brown NC State University, College of NC State University, College of
Veterinary MedicineVeterinary Medicine
Co-presenters:Co-presenters:Dr. Talmage Brown, Dr. James GuyDr. Talmage Brown, Dr. James Guy
Presented at SEVPAC 2008 – Permission granted for use on SEVPAC
website only
History and PE FindingsHistory and PE Findings
7-year-old Paint 7-year-old Paint Horse mareHorse mare
Presented for 2 Presented for 2 day history of day history of colic, anorexia, colic, anorexia, and depressionand depression
Normal TPRNormal TPR Rectal examination Rectal examination
within normal within normal limitslimits
Presented at SEVPAC 2008 – Permission granted for use on SEVPAC
website only
Clinical Pathology Data and Clinical Pathology Data and Case ProgressCase Progress
CBC: Leukopenia with neutropenia and CBC: Leukopenia with neutropenia and lymphopenia, thrombocytopenialymphopenia, thrombocytopenia
Chemistry panel: Elevated liver enzymes Chemistry panel: Elevated liver enzymes (ALP, AST, GGT, Bilirubin), Elevated CK(ALP, AST, GGT, Bilirubin), Elevated CK
Next morning:Next morning: Dyspnea, mucopurulent nasal dischargeDyspnea, mucopurulent nasal discharge Toxic mucous membranesToxic mucous membranes Very uncomfortableVery uncomfortable Laterally recumbentLaterally recumbent
Humanely euthanized and submitted for Humanely euthanized and submitted for necropsynecropsy
Presented at SEVPAC 2008 – Permission granted for use on SEVPAC
website only
Gross examinationGross examination Moderate subcutaneous edemaModerate subcutaneous edema Intestinal serosal petechiae and ecchymosesIntestinal serosal petechiae and ecchymoses Hepatic blood vessels prominent and congestedHepatic blood vessels prominent and congested Several small strongyles within large colonSeveral small strongyles within large colon Lungs:Lungs:
Failed to collapseFailed to collapse Mottled appearance with coalescing slightly firm white Mottled appearance with coalescing slightly firm white
focifoci
Presented at SEVPAC 2008 – Permission granted for use on SEVPAC
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Morphologic DiagnosisMorphologic Diagnosis
Liver: Multifocal to coalescing, Liver: Multifocal to coalescing, severe, acute hepatic necrosis with severe, acute hepatic necrosis with intranuclear inclusion bodies and intranuclear inclusion bodies and fibrinoid vascular necrosisfibrinoid vascular necrosis
Etiology: Equine herpesvirus-4 Etiology: Equine herpesvirus-4 isolated from liver and kidneyisolated from liver and kidney
Presented at SEVPAC 2008 – Permission granted for use on SEVPAC
website only
EHV-1 vs EHV-4EHV-1 vs EHV-4
Show considerable cross-reactivityShow considerable cross-reactivity Until 1981 were considered as subtypes of Until 1981 were considered as subtypes of
same virussame virus Both are endemic in horse populations Both are endemic in horse populations
worldwideworldwide Horses are repeatedly infected by both viruses Horses are repeatedly infected by both viruses
in nature and disease signs become less severe in nature and disease signs become less severe with progressive episodes later in lifewith progressive episodes later in life
Both cause rhinopneumonitisBoth cause rhinopneumonitis EHV-1 is main cause of abortions, paresis, and EHV-1 is main cause of abortions, paresis, and
neonatal foal deathsneonatal foal deathsPresented at SEVPAC 2008 –
Permission granted for use on SEVPAC website only
PathogenesisPathogenesis
Mainly transmitted through inhalationMainly transmitted through inhalation Virus first replicates in upper Virus first replicates in upper
respiratory epithelium and local lymph respiratory epithelium and local lymph nodesnodes
Results in leukocyte-associated viremiaResults in leukocyte-associated viremia Virus later replicates within endothelial Virus later replicates within endothelial
cellscells Latency in lymphoid and neural tissues Latency in lymphoid and neural tissues
demonstrated for both virusesdemonstrated for both virusesPresented at SEVPAC 2008 –
Permission granted for use on SEVPAC website only
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
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
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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