Medical management and positive outcome after prolonged recumbency in a case of equine herpesvirus myeloencephalopathy.
Authors: Mannini A, Ellero N, Urbani L, Balboni A, Imposimato I, Battilani M, Gialletti R, Freccero F
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: EHM Recovery Through Intensive Medical Management A 17-year-old mare with acute equine herpesvirus myeloencephalopathy (EHM) caused by Varicellovirus equidalpha 1 (EHV-1) presented with fever, neurological deficits and bladder dysfunction, progressing to recumbency despite initial fluid therapy and anti-inflammatory treatment. Hospitalisation for 10 days enabled comprehensive management including parenteral support, antimicrobial therapy for secondary E. coli cystitis, prolonged sling support (21 days) and bladder lavage, with EHV-1 DNA confirmed in nasal, blood and urine samples collected between days 13–25 post-onset. Whilst the mare's neurological signs—predominantly hind limb ataxia and proprioceptive deficits—improved substantially over 34 days to the point of discharge, she retained mild residual weakness, though eight-month follow-up demonstrated marked functional recovery. The case illustrates that even severely affected EHM horses can achieve meaningful outcomes with aggressive supportive care, proactive management of secondary complications (corneal ulcers and pressure sores), and extended rehabilitation, though the resource intensity and duration required should inform realistic prognostic counselling and owner expectations during the acute phase.
Read the full abstract on PubMed
Practical Takeaways
- •EHM cases presenting with recumbency may have favorable long-term prognoses with intensive supportive care including sling support, fluid therapy, and aggressive management of secondary complications.
- •Prolonged bladder catheterization and lavage, combined with systemic antimicrobials, effectively prevent and manage secondary urinary tract infections in recumbent EHM horses.
- •Monitor for multiple secondary complications (ophthalmic, dermatologic, urinary) in recumbent EHM cases and implement preventive measures early, as these resolve well with appropriate treatment.
Key Findings
- •A 17-year-old mare with EHM recovered functional mobility using a full-body support sling for 21 days combined with medical management including antimicrobials, NSAIDs, and supportive care.
- •EHV-1 DNA was detected in nasal swab, blood samples on day 13, and urine samples on days 13 and 25 post-fever onset.
- •Neurological signs improved over 34 days with marked improvement in locomotory function achieved by 8-month follow-up despite initial severe recumbency.
- •Secondary complications including cystitis, corneal ulcers, and pressure sores were successfully managed and resolved within 2 weeks post-discharge.