Treatment for Equine Klebsiella

Klebsiella (or Klebsiella pneumoniae) is one species of bacteria that is responsible for causing contagious equine metritis in horses. CEM is a reproductive disease that is sexually transmitted. Some countries (such as the United States and the U.K.) require that you report cases of CEM to the goverment or federal animal health authorities. Though the U.S. is considered CEM-free, there are occasional outbreaks. According to a June 11, 2010, article in The Horse, a 23rd stallion in the U.S. was found to have CEM. He is in Wisconsin and epidemiologically linked to a previous outbreak that traces to a Wisconsin facility. The outbreak was first discovered in 2008.

  1. About Equine Klebsiella

    • Infection with klebsiella can be highly contagious. It can spread from mare to stallion or stallion to mare during breeding or teasing. It can also be transmitted during artificial insemination if the stallion’s semen is infected. It is also possible to indirectly infect a horse through contaminated water or instruments. The first cases in the U.S. were diagnosed on a thoroughbred breeding farm in Kentucky on March 9, 1978. The disease can cause infertility and sometimes abortion. The United States is considered free of CEM, according to an article in The Horse, although the country has suffered outbreaks and isolated cases. Mares will typically suffer from discharge from the vulva and inflammation of the uterus. Symptoms appear usually one to six days after infection. Mares can also be carriers of the infection and show no signs of infection but are still capable of infecting stallions. Infected stallions are typically passive carriers and do not show clinical signs of infection, according to the Department for Environment Food and Rural Affairs.

    Treatment

    • Treatment for mares will not be successful until the bacteria has been cleared from the uterus. This process could take months. The external genitalia of both mares and stallions can be treated with antibiotics and disinfectants. Consult your vet on how frequently to clean these areas.

    Treatment for the Mare

    • Most mares are able to rid themselves of the infection after a few weeks. Some vets may recommend uterine lavage for the infected mare. This procedure helps flush out debris and helps create a healthier environment in the uterus. During a lavage, about 1 liter of fluid is flowed into the uterus and then flushed out. It is usually repeated until the fluid coming back out is clear. Mares who are chronically infected can be treated by cleaning the clitoral area chlorhexidine surgical scrub and then applying nitrofurazone ointment. In severe cases, "surgical excision of the clitoral sinuses may be required to rid them of infection," according to the Merck Veterinary Manual.

    Treatment for Stallions

    • Infected stallions should not be bred or used for teasing until the infection has cleared. Inform all owners to whom stallion semen has been sent. Stallions should be treated by cleaning the extended penis with the chlorhexidine surgical scrub and then applying nitrofurazone ointment, according to the Merck Veterinary Manual. This should be repeated every day for five days. Ten days after treatment is completed, the stallion should be retested.

    Prevention

    • Check stallions and mares before breeding (a swab is usually all that is required). Do not breed infected horses until the infection has cleared. During breeding sessions, adhere to strict hygiene measures when handling all animals. Use sterile and when applicable, disposable, equipment. If an infected mare foals during the time she is infected, the placenta must be incinerated.