STRANGLES - Redwings

STRANGLES
speak out!
Do you know how to
spot signs of Strangles?
Would you know how to deal
with a Strangles outbreak?
Redwings guide to Strangles. Page 1

Using this guide
Strangles outbreaks are common. Any horse is at risk of
contracting the disease unless steps are taken to prevent it.
This guide gives all the information needed for you to understand Strangles, spot the signs
and prevent an outbreak. It contains a checklist of everything you need to set up a quarantine
area and has a quarantine protocol which can be circulated to everybody at your yard.
Part One
KNOW STRANGLES
To help ditch the Strangles stigma, we have included a poster in this pack for you to
display at your yard. We hope that this will get horse owners talking about the disease
and encourage yards to have a protocol in place to stop the spread and deal with it
effectively if the worst does happen.
Part One
KNOW STRANGLES
Page 3
About Redwings
Part Two
SPOT STRANGLES
Page 4
Part Three
PREPARE FOR STRANGLES
Page 6
Part Four
PREVENT STRANGLES
Page 9
Redwings Horse Sanctuary was established in 1984 and works across
the UK to provide and promote the welfare, care and protection of
horses, ponies, donkeys and mules. Its work has three main themes
– rescue and rehabilitation, specialist sanctuary care and prevention
through education.
Redwings currently cares for more than 1,200 horses, ponies
and donkeys that no longer have a working life but retain
a quality of life. Those with the potential for a working life
are re-homed through the charity’s Guardianship scheme
and currently around 500 horses and ponies are enjoying
active lives in Guardian homes across the East of England.
Part Five
IF IT HAPPENS…
Page 12
Part Six
AFTER RECOVERY…
Page 14
What is Strangles?
Strangles is the most commonly diagnosed equine
infectious disease in the world. It is a highly contagious
infection of the upper respiratory tract (nose and throat).
It can cause large abscesses, prevent swallowing and
restrict breathing.
Like many diseases, prevention is better than cure.
Strangles is both painful and distressing for the horse.
Infected horses are at risk of serious complications,
including death.
Why should I be concerned?
Strangles outbreaks are on the rise. This could be
due to the increasing movement of horses around
the country – in particular horses of lower value that
often end up at market. Markets and sales are great
harbouring grounds for the disease.
Not only is it painful and distressing for sufferers,
a large outbreak at a livery yard can cause serious
financial loss.
Although many of the horses rescued by Redwings are
suffering with Strangles, it is not always associated
with poor welfare standards. It can happen to anyone
– even the most responsible owner – simply through a
stroke of bad luck. This is why it is vital to be prepared.
Should I keep quiet if my horse
shows signs of Strangles?
No! Although it’s highly irresponsible, many owners do
keep quiet if their horse catches Strangles. Because of
its contagious nature, Strangles has a very unhelpful
stigma attached to it. Owners may feel that they will
be ostracized by others on their yard if they speak out.
This hinders a quick diagnosis as well as the effective
control of the spread of the disease.
A responsible owner will speak out about the disease,
and a responsible yard manager will have a protocol in
place to deal with it.
Our aim is to give you the information and tools you
need to protect your horse and others on your yard.
The key to success is preparation, prompt action,
and a co-ordinated effort from everyone involved.
This pack includes:
• How to spot Strangles
• How to prepare for an outbreak
• How to prevent an outbreak
• What to do during an outbreak
• What to do after an outbreak
Reading this information could not only save your horse
and others from a serious and potentially fatal disease,
but it could also save you a considerable amount of
time and money.
Redwings relies entirely on public
donations and receives no government
funding. To learn more,
telephone 0870 040 0033
or visit www.redwings.co.uk.
It could happen to you
Redwings guide to Strangles. Page 2
Redwings guide to Strangles. Page 3

Part Two
SPOT STRANGLES
Benny may look innocent,
but was in fact a Strangles carrier.
He had no symptoms except for
intermittent nasal discharge.
How serious is Strangles?
Strangles is a very unpleasant disease for your horse to
go through. It will be exhausting and upsetting to deal
with if you are not prepared.
There is at least a 10% risk of further complications
such as ‘bastard Strangles’ where the infection spreads
to other parts of the body and is almost always fatal,
or Purpura Haemorrhagia caused by a complication
within the immune system as it fights the Strangles
bacteria causing damage to blood vessels around the
body. This leads to severe swelling in the limbs, head
and other areas of the equine’s body.
Lymph node swelling
What are the symptoms?
Early signs could be any one of the following:
• Sore throat – shown by loss of appetite, difficulty
eating, or difficulty extending the head
• Lymph node swelling (area where head
and neck join)
• Depression
• Fever (temperature above 38.5C)
• A cough
Advanced signs:
• Thick yellow nasal discharge
• Abscesses on the side of the head,
on the throat, or under the jaw
Atypical Strangles symptoms
• Mild short term fever
• Mild clear nasal discharge
• No abscess formation
It’s important to know your horse’s vital signs
(temperature, pulse, respiration rate) to help spot when
something is wrong.
Vital Signs:
Temperature – 100–100F (38C)
Pulse – 32–42 beats per minute
Respiration rate – 8–14 breaths per minute
These vary between horses, so make a note of
your horse’s vital signs over the course of a week
and keep a record.
Some of these clinical signs are also signs of other
diseases (e.g. nasal discharge is a sign of a dust
allergy), so it is important to call a vet straight away
to get an accurate diagnosis. It could be another
disease that will have less impact on your yard. Or, if
it is Strangles, an early diagnosis gives a much better
prospect of a quick recovery.
How is it passed on?
Strangles is not airborne. It can be passed through
direct contact with an infected horse or indirectly
through sharing water, feed buckets, equipment,
pasture, cars travelling from one site to another, or a
human passing the bacteria on their clothing or skin.
It normally takes between 7 and 14 days between
contact with the bacteria and symptoms showing.
I’ve heard that some horses can have
Strangles and not show symptoms?
Around 10% of horses that have suffered with Strangles
in the past will continue to carry Strangles bacteria in
their guttural pouches (air chambers at the top of the
neck) without showing any clinical signs of disease.
These horses are known as ‘carriers’.
Carriers may have occasional nasal discharge, which
could go unnoticed or is thought to be something else.
This is another reason why you must speak to a vet if
you notice anything different about a horse, such as a
small period of nasal discharge.
A carrier will shed bacteria during increased periods
of stress – such as moving to a new home, or ill health
– and pass Strangles on to other horses. You may not
know your horse is a carrier until this has happened.
The newly infected horse will need to be isolated, and
it is important that any horse that has been in contact
with it is isolated too, even if they are not showing any
symptoms, so you can identify the carrier.
Carriers can be treated and go on to live happy lives.
Are all horses at risk? I’ve heard that
some become immune once they’ve had it.
All horses are at risk of Strangles. Young, old, and
horses with weaker immune systems are especially
at risk. Horses that have previously had the disease
may form a certain level of immunity, but this is highly
variable between horses and is not worth the risk.
Is there a Strangles vaccination available?
Thick yellow nasal discharge
Abscesses
Strangles is passed on
through physical contact
There is a vaccination available, but it is best to discuss
with your vet whether a vaccination programme is right
for you. The vet will assess wether your horse is
‘at risk’ of Strangles. Like many vaccines, it does not
completely rule out the risk of getting the disease and
is not a replacement for good yard practices.
Redwings guide to Strangles. Page 4
Redwings guide to Strangles. Page 5

Part Three
PREPARE FOR STRANGLES
Foot dip
The first step in preparing for a Strangles outbreak is to
never think it won’t happen to you! Every yard should
have protocols in places for how to deal with a Strangles
case, as well as other contagious diseases.
This section will tell you how to set up a successful
quarantine facility. Have quarantine equipment readily
available before a Strangles case occurs. Having
quarantine measures in place is also useful in case
of other infectious problems, such as lice, ringworm
and respiratory infections, not to mention the increasing
risk of exotic diseases.
Yard managers should share this information with staff
and livery yard members. Why not hold a one hour
session with everybody on the yard so they are well
aware of the protocols in place?
It is also beneficial to have a quarantine yard set up for
new arrivals to the yard, which you can read more about
in Part Four.
Will this cost a lot of money?
Setting up a quarantine facility will cost much less than
dealing with a large outbreak. The costs of dealing with
a large outbreak are extremely high, especially when an
outbreak happens at an equine related business, such as
an event yard or riding school.
A large outbreak will result in the whole yard being ‘shut
down’ for months. We know of some yards that have had
to close permanently because of loss of business whilst
on ‘shut down’. It will be beneficial to all yards to spend
time and a small amount of money now, as the costs of
an outbreak may be insurmountable.
What do I need to set up a
successful quarantine area?
On the next page, you will find a list of equipment
that you will need for a quarantine area. However, it
will only be successful if yard staff and livery yard
members adhere to quarantine rules. You will also find
a quarantine area protocol overleaf. Read the protocol
thoroughly.
We suggest that you circulate the protocol to all staff
and livery yard members. Keep one copy in the
quarantine area and the other on the main yard.
You could set up a make-shift quarantine area and train
all staff and livery yard members on how to use it. You
can also find a presentation on our website to use for
training purposes.
Quarantine set-up checklist
You will need:
- An allocated area away from other horses.
- Cordon tape or a barrier to mark the quarantine area if a case occurs.
This needs to be at least 8ft from the front of the area to allow for
equipment storage. It also needs clearly marked entrance and exit points.
- Signage to mark the quarantine area. You will find example signage
in this pack.
- A separate set of equipment (stable tools, headcollars etc).
Label all equipment “For quarantine use only”.
- Separate storage for feed, forage and bedding. Soft feeds will help
as infected horses will have a sore throat.
- Appropriate disinfectant, such as Safe4. We use Safe4 at Redwings
because it is non-toxic to animals and humans, and is easy to dispose of.
It is also non-corrosive so it is safe to use when cleaning down equipment.
- Plenty of overalls in different sizes. They must be big enough to cover
neck-collars, shirt-cuffs and trouser-cuffs, otherwise you will easily transfer
the disease onto your own clothes. Overalls must be disinfected and
washed at a high temperature after each use. You can also get
single-use overalls.
- Four bins. Two for foot dip and two to soak used overalls. Place one of
each at the entrance and exit. Both dips must be made up of diluted
disinfectant. See the manufacturer’s instructions for details.
- Two bins with lids. One clearly marked for clean overalls,
and one clearly marked for dirty overalls waiting to be disinfected.
- Spray bottle with diluted disinfectant.
- Disposable gloves.
- Hand wash and/or hand sanitiser specifically for this purpose
(such as Safe4’s hand wash and sanitiser).
- A large number of thick bin bags or old feed bags for muck and
soiled bedding.
A clearly marked
quarantine area
- An area to store muck and soiled bedding. It needs to be disposed
of separately to your normal muck heap.
EVERY piece of equipment in that
area will need to remain there until
quarantine is lifted. If it needs to
be removed at any time it must be
Redwings guide to Strangles. Page 6
Redwings guide to Strangles. Page 7
thoroughly disinfected first.

Quarantine protocol
To be circulated to all staff/livery yard users
Keep one copy in quarantine facility and one on the main yard
Part Four
PREVENT STRANGLES
ONLY ENTER QUARANTINE AREA WITH
PERMISSION OF YARD MANAGER
When entering quarantine area:
• Use designated entry point.
• Only take in things you will need. Anything that
comes back out will need disinfecting i.e. caps,
jewellery, mobile phones etc.
• DO NOT ENTER UNLESS YOU ARE WEARING
CLEAN OVERALLS. Make sure they are the right size
for you. They need to cover your clothes underneath,
including shirt cuffs and bottoms of trousers.
When in the quarantine area:
• Only use allocated quarantine tools and equipment.
• Limit contact with horses in quarantine. Strangles
spreads through touching.
• When cleaning out the horse’s water container,
tip any remaining water into a bucket and add
neat disinfectant to it before disposing of it as
it will be contaminated.
• Feed bowls need to be washed out with neat
disinfectant after each use.
• Any nasal or abscess discharge on the floor needs to
be covered with neat disinfectant before washing or
sweeping away.
On exit of the quarantine area:
• Use designated exit point.
• Remove your overalls at the quarantine area exit point.
Avoid rubbing your clothes on the outside of the
overalls. Peel overalls off inside out and do not turn
back the correct way until they have been disinfected
and washed. Place the dirty overalls in the provided
disinfectant solution ensuring they are completely
submerged.
• Before leaving the quarantine area, disinfect hands
by using hand sanitiser and dip your boots in the
disinfectant provided to cover the sole and exposed
part of the boot. Disinfectant will not work if it is
contaminated with mud or muck, so make sure dips
are clean and any mud on boots or equipment is
cleaned off before disinfecting.
• Foot and overall dips will be changed every two days
by the yard manager or allocated person. Check
disinfectant instructions to see dilution rates.
Horses are most at risk of picking something up when
away from home, or from new arrivals to your yard.
Share this information with your yard staff or livery yard
members. The key to success in preventing a Strangles
outbreak is co-operation from everyone involved.
Four steps: away from home…
1. Always take your own drinking water and buckets.
Never allow your horse to drink from a shared supply.
2. Do not allow your horse direct contact with other horses.
3. Only handle your own horse. If you do handle another
horse, wash your hands before touching yours again.
4. Do not allow your horse to graze close to other horses.
Take your own hay nets and forage with you.
New arrivals to your yard
• You should quarantine new arrivals even if the
horse looks perfectly healthy and/or you know the
owner. Find out how likely it is that this horse has
Strangles – see page 10 for more.
• Quarantine new arrivals in a stable and field for a
minimum of two weeks. Infected horses will usually
show signs of Strangles within this period. Observe
them closely and take their temperature regularly.
• Use separate equipment for that horse, such as
grooming kits, buckets, and hay nets until the
quarantine period has passed. Keep their muck
separate from your normal muck heap. You can
dispose of it in the normal way at the end of the
quarantine period if there is no problem.
• Act quickly if any symptoms are spotted. If you are
unsure, extend the quarantine period and only mix
with other horses once you are deeply confident
there isn’t a problem.
The owners of new arrivals to your yard may question
why you are doing this. It is important that you explain
that it is a matter of course, and is beneficial to both
them and the rest of the horses on your yard.
• Ensure you follow the correct procedures for the
disposal of muck from quarantine yard.
• ALL equipment, including empty hay nets and head
collars, needs to be dipped and thoroughly soaked in
disinfectant before removing from the area.
Only handle your own
horse when away from home
Redwings guide to Strangles. Page 8
Redwings guide to Strangles. Page 9

We suggest you use full quarantine measures and test every
new arrival to the yard. Treat a new horse as if it is positive
for Strangles.
Even if you are confident the risk is low, you should still limit the contact with
other horses and observe closely for any early signs of Strangles for at least two
weeks. Take its temperature daily for two weeks, which will give you an early
indication of any problems.
Even if just one answer falls into the medium or high risk categories, it is strongly
advised that you use full quarantine measures and testing for every new arrival.
What’s the risk?
Find out the following things about a new arrival:
Is the risk high or low?
Low risk Medium risk High risk
1 History of origin
• Private sale from a source known to you.
• Owner has a complete ownership history.
• The source has good bio-security measures
in place.
• From a reputable equine charity.
• Private sale with some ownership history
and some history of vet checks.
• Previous location seemingly of a
good standard.
• No ownership history available
• From a busy field/yard with lots of horse
movements, or onsite competitions.
• From a yard or area that has previously
had a Strangles outbreak.
• From a sale, auction, or dealer.
• Has been ‘rescued’ by an individual
or an unregistered organisation.
2 Level of contact with
other horses
• Has spent a number of years with the same
companions all in the ownership of the same
person.
• From a yard or home with shared fields and
a number of different owners.
• It is not known what level of contact
the horse has had with other horses.
3 Medical history
• Has a complete history of regular
veterinary checks.
• Some medical history available
• Unknown medical history,
or from an unreliable source.
4 Current health
• Confirmed to have had a full Five Stage
Vetting, with additional testing for Strangles
within the last two weeks.
• Horse shows signs of all round good
health but has had no vet check or specific
Strangles testing.
• Currently has a respiratory problem
or nasal discharge
• Has recently had a nasal discharge or shown
symptoms of a respiratory problem.
• Intermittent undiagnosed nasal discharge.
5 Transport
• Travelled alone using owner’s own transport
that has been disinfected after every use.
• Commercial or hire transport used but
travelled alone.
• Commercial or hire transport used and
travelled with other horses.
Redwings guide to Strangles. Page 10
Redwings guide to Strangles. Page 11

Part Five
IF IT HAPPENS…
A new arrival to Redwings
has a routine endoscopy
You must quarantine any horse displaying symptoms
immediately. You must restrict the movement of any
horses that came into contact with that particular horse.
1) Physically move the horses on the yard into three
quarantine groups. Make sure each group is
easily identifiable:
Group One: Infected horses and those displaying
symptoms
Group Two: Those that have been in direct or close
contact with the infected horses
Group Three: Those that have not been exposed to
either of the above groups
Strangles has a 7 to 14 day incubation period. This
means that groups two and three will show Strangles
symptoms within two weeks if they have come
into contact with the bacteria. However, we would
recommend that you keep groups two and three apart
until quarantine has been lifted and you have been
given the ‘all clear’ by a vet.
2) Notify vets straight away. Tell them you suspect
Strangles and that you have set up quarantine areas
to ensure they arrive equipped with the required
drugs and equipment.
3) Ensure your quarantine areas are well stocked with
all the necessary equipment, as listed on the
‘Quarantine set-up checklist’.
4) Notify all staff and livery yard users of what is
happening, and make sure everybody has copies of the
‘Quarantine protocol’. Make sure you have a procedure
in place for the disposal of muck, leftover forage and
used bedding from the quarantine area. It is important
that everybody complies with the quarantine protocol,
otherwise your efforts will be fruitless.
5) Stop all movement of horses on or off the yard. Make
sure ‘Quarantine area notices’ are clearly displayed
and that the boundaries are clear.
6) Regularly communicate with those on the yard so
everybody is up to date with the situation. Advise any
neighbours who look after horses.
7) Disinfect the area where the horse showing clinical
signs was found.
Care and management of Group One
Your vet will advise you on antibiotics and pain relief.
They will diagnose Strangles through one of three
methods:
1) Swabbing is where three consecutive swabs are taken
at weekly intervals and sent for testing in a lab.
2) Testing via endoscopy is the most reliable method. A
sample is taken directly from the guttural pouch in the
throat and sent for testing. This can also determine
whether a horse is a carrier or not.
3) Blood tests identify if a horse has antibodies to the
Strangles bacteria in their bloodstream. Antibodies
are produced approximately two weeks following
exposure to the bacteria and last up to six months.
Horses that have been exposed to the bacteria in the
last six months will test positive.
Keep the horse in a stable if possible, as it will be feeling
unwell and will need to rest and stay warm.
Make all feeds nice and soft in texture. The horse may
struggle to reach the floor as it will have a sore throat.
You can use a stable manger or raise its feed bowl from
the floor using upturned tyres or a plastic bin. However,
if the horse has ruptured abscesses, feeding from the
floor can help them drain.
Bathe ruptured abscesses with cotton wool and warm
water. Use a warm compress on unruptured abscesses.
Do not attempt to squeeze abscesses or put anything
in them.
All equine professionals that visit your yard – such
as farriers – should already know how to work within
quarantine. It is important you notify visitors that
there is a quarantine area on site. If you can, ask for an
appointment towards the end of the day to prevent the
farrier needing to shower and change clothes before
touching other horses. You can spray their equipment
with disinfectant before it is taken off site.
Care and management of Group Two
Keep human movement between areas to a minimum.
Only turn out in the designated area for the horses in
this category. Use separate equipment for this group.
Keep a close eye on the horse’s demeanour and appetite.
Record their temperature at the beginning and end
of each day. Ask your vet how to do this. If you see a
sudden rise, immediately move the horse to group one.
Discuss with your vet if there is any benefit in putting
these horses on antibiotics. This will depend on
circumstances and the level of exposure. Your vet will
also advise on using the vaccine Equilis Strep E.
Care and management of Group Three
Make sure these horses do not come into contact with
any equipment used in the quarantine area, or that used
for the horses that have been in close contact.
Make sure carers and owners of the ‘clear’ horses are
respectful and supportive of quarantine practices.
Keep a close eye on these horses for any clinical signs.
If you see any clinical signs, move them to group one.
Do not mix these groups until you have
been given the ‘all clear’ by a vet.
Any horse that has had Strangles must have
a negative test result before it is removed from
quarantine. It could continue to shed bacteria for
several weeks after clinical signs have stopped –
or it could be a ‘carrier’.
This may take months, so the quicker you act at the
beginning and the more attention to detail given to
ensure a high standard of quarantine – the sooner
things will get back to normal.
Record temperatures regularly
Redwings guide to Strangles. Page 12
Redwings guide to Strangles. Page 13

Part Six
AFTER RECOVERY…
It is important to disinfect any area and equipment that
any Strangles cases – and the people caring for them
– came into contact with. This includes the quarantine
area, and the area the horse was in when it first
started displaying symptoms.
Stable area/quarantine area
All walls, floors, and underneath any rubber matting,
must be thoroughly disinfected. This can be done
with a long-handled soft brush (such as a kitchen
broom) dipped into a bucket of diluted disinfectant.
All equipment – including feed buckets, hay nets,
rugs, wheelbarrows etc – must be disinfected too.
Horsebox/trailer
You will need to disinfect anything that potential
Strangles cases have used. You must clean the cab, as
well as foot pedals and steering wheel (as the driver may
have transferred bacteria) and the wheels. Any muck and
leftover forage must be disposed of in the correct way.
Field/turnout area
If Strangles cases were turned out, the whole area
will also be contaminated and will need to be cleaned
down. Use disinfectant in a knapsack sprayer. The
fencing, shelter and anything else they came into
contact with in the field (such as hay rings and water
troughs) will need to be cleaned down. All bedding in
field shelters will need to be removed and disposed of
separately to your normal muck. Clean the water tank
by adding disinfectant to the water before tipping out
onto the ground. The tank will need to be scrubbed with
disinfectant.
The grazing may also harbour bacteria. It is impossible
to spray a field with disinfectant, so you will need to wait
until it has been exposed to a long period of sunshine or
frost before allowing horses on there.
Recovered Strangles sufferers can
go on to lead happy lives!
Redwings guide to Strangles. Page 14

This pack was very kindly
sponsored by Safe4 who
made this project possible
If you need more information, our welfare team
would be happy to help. Please call us on 01508
481 008 or email us at welfare@redwings.co.uk
Redwings Horse Sanctuary was established in 1984
and has grown to become the largest horse sanctuary
in the UK, working to save horses, ponies, donkeys and
mules whose future would otherwise be bleak. Its work
has three themes: rescue and rehabilitation, specialist
sanctuary care and prevention through education. The
sanctuary currently provides more than 1200 horses,
ponies, donkeys and mules with specialist sanctuary
care and has 500 horses out on loan in Guardian homes.
Redwings guide to Strangles. Page 16