For the Health of It als ( fibrin , leukocytes and cellular debris ) obstruct these openings so there is complete separation of the two sides . Once this has occurred , it is possible for different bacteria to cause infections in the separate thoracic spaces , thus samples should be taken from both sides . In addition to sampling pleural fl uid , a transtracheal wash should also be performed and the fl uid cultured for bacteria . Adjunct diagnostics may be utilized to assess a horse ’ s systemic health and include a complete blood count , measurement of acute phase proteins ( e . g ., serum amyloid A ), chemistry panel and blood gas analysis .
The pillars of therapy for pleuropneumonia include drainage of pleural fl uid , antimicrobial therapy and supportive care . Indwelling chest tubes may be placed to facilitate constant drainage and allow for lavage and administration of intrathoracic medication . Intravenous antimicrobial administration is preferred over oral or intramuscular routes to reach higher drug levels in diseased tissue . Antimicrobials may also be nebulized to increase penetration into the lower airways while avoiding potential adverse systemic effects . Large volumes of fl uid can be lost each day from the thoracic cavity , therefore intravenous fl uid therapy is often required to ensure adequate hydration . Non-steroidal anti-infl ammatory agents are administered to reduce infl ammation , attenuate endotoxemia and provide analgesia . Supplemental oxygen , bronchodilators , intravenous nutrition , plasma transfusions , cryotherapy for laminitis prevention and surgical intervention may also be warranted . As the infection begins to resolve and lungs heal , horses can be transitioned from injectable to oral antimicrobials . Many horses are discharged for long-term antimicrobial therapy at home , and treatment may be necessary for multiple months . Once pleuropneumonia has resolved , horses can slowly return to work , and many go back to their previous level of performance .
CONTACT : Kate L . Hepworth-Warren , DVM , DACVIM ( LAIM )
Clinical Assistant Professor of
Equine Internal Medicine North Carolina State University College of Veterinary Medicine