Equine Health Update EHU 2020 Issue 02 | Page 40

EQUINE | CPD Article occurring most commonly. • Localization in joints results in arthritis (weeks or years after the acute phase of the disease). Timecourse • Local infection occurs within hours of tick attachment. • Due to a paucity of information the period until clinical signs occur is not known. • Arthritis may not occur until weeks or years after the acute phase of the disease. Epidemiology • Risk of infection from ticks is highest in the spring, early summer and autumn, in areas of woodland and forest where the vector and host most commonly live. • Larval ticks hatch and feed on infected rodents, then transmit the infection to a new host. Deer are the predominant host for adult ticks, with horses acting as incidental hosts. Diagnosis Presenting problems • General malaise. • Pyrexia. • Single/multiple joint arthritides. Client history • Resident in geographic areas with suitable vectors. • Dull, depressed, pyrexic. • One/several swollen joint(s). • Stiffness/lameness. • Uveitis. • Neurological disease, including ataxia and central disturbances. Clinical signs • Pyrexia. • Lymphadenopathy. • Pseudolymphoma at the site of tick attachment. • Swollen and painful joint(s). • Stiffness. • Lameness, including multiple legs. • Hyperesthesia. • Cardiomyopathy (rare). • Anterior uveitis (rare). • Neurologic signs of encephalitis. • Hepatitis. Diagnostic investigation Serology • ELISA or indirect immunofluorescence serum antibody levels - ELISAs have high false positive rates and some kits are species-specific - check with the lab. • Most ELISAs are based on the C6peptide antibodies consistent with B. burgdorferi exposure rather than infection. • Early in the disease antibody titers may be undetectable. • Positive antibody levels do not distinguish between clinical cases and inapparent infected individuals (exposure), especially in enzootic areas. Up to 58% of horses in northeastern US may be serologically positive, depending on the region. • Western blot is more specific for serologic assays. Bacteriology • Culture of the organism is rarely performed because: ○○ Difficult and requires enriched selective media. ○○ Inoculate with blood or cerebrospinal fluid. ○○ Slow growing. 40 • Equine Health Update •