DR WAQAS NAWAZ PMAS Arid Agriculture University, Rawalpindi Pakistan

1. Fiaz Hussain 11-Arid-932
Fatima Zahra Naqvi 11-Arid-934

2.  Rare complication of equine strangles and is
caused by bleeding from capillaries which
results in red spots on the skin and mucous
membranes together with oedema (swelling) of
the limbs and the head.

5.  It is more common in younger animals and is
often fatal.
 Traditionally, cases of purpura hemorrhagica
are associated with previous bouts of strangles.
Unlike strangles, purpura is not infective;
horses cannot catch purpura from other
horses.

6.  The immune system damages vessel walls,
causing them to become leaky.
 Blood components leak into the tissues,
resulting in swelling.
 The head, legs and underbelly of the horse are
most often affected.
 Hemorrhage into the tissues may occur and
may be visible as areas of red spotting on the
gums and other mucous membranes.

7.  Hemorrhage into the tissues may occur and
may be visible as areas of red spotting on the
gums and other mucous membranes.
 Serum may begin to seep from the skin and, in
severe cases, the skin may die and slough off,
exposing the tissues beneath.
 Purpura is not limited to the skin.

8.  The effects extend to wherever blood vessels
run, including the lungs, muscles and the
kidneys.
 This body wide involvement can lead to other
clinical signs such as lameness, laminitis, colic,
weight loss, and neurologic signs.

9.  Hypersensitivity to streptococcal antigen;
secondary to respiratory tract bacterial or
viral infection, e.g Streptococcus equi ( S. equi
var equi ).
 equine influenza , wound infection or
idiopathic.

10.  Variable severity; edematous plaques 2-10 cm
diameter over neck, chest, thigh → edema of
distal limbs, head, ventral mid line → serous
exudation, fissures, necrosis and cellulitis ;
+/-pyrexia; petechial/ecchymotic hemorrhages
on mucous membranes

12.  Stiff, painful limbs, reluctance to move.
 Ventral edema
 Edema sometimes associated with the
intestinal tract → acute abdominal crisis
epidsodes
 Serosanguinous nasal discharge.

16.  Full thickness tissue necrosis or cellulitis of
dermal structures and pressure sites, eg lower
limbs, under rugs.
 Colic [Abdomen: pain - adult] and diarrhea,
due to intestinal edema

17.  Hematology,
 Blood biochemistry,
 Histopathology.

18.  Resolve underlying infection by antibiotics,
 Corticosteroids(dexamethasone),
 Diuresis.

19.  Sloughing and necrosis of severely affected
areas.
 Secondary complications, e.g pneumonia ,
suppurating lesions, myositis, renal failure
and laminitis .

20.  Fair to poor depending on severity;
complications may → death.
 Guarded to poor - if mild, but may be
protracted course.
 Grave - if severe (high mortality), if diarrhea or
respiratory distress present; if refractory to
initial treatment.

21.  It is difficult to predict and prevent.
 If a horse has experienced a reaction to the
strangles vaccine, a veterinarian may
recommend the horse not be administered that
vaccine again, at least without further testing.
Research has found that horses that have high
serum levels of antibodies to Streptococcus
equi may be at increased risk of developing
purpura hemorrhagica.

22.  Outcomes of purpura hemorrhagic vary
wildly.
 Many times the disease is mild and horses
recover well. Other times, horses are severely
affected and may die or are euthanized.