Today on StallSide, host Dr. Bart Barber welcomes Dr. Claudia Ferreira from the Rood & Riddle Equine Hospital internal medicine team to discuss Pigeon Fever — a bacterial disease making a resurgence in the Bluegrass. Dr. Ferreira shares insights on diagnosis, treatment, and prevention, plus how farm management, soil conditions, and flies all play a role. She also dives into her background, from interning at Rood & Riddle to completing her residency at Michigan State University, and even her side passion — professional cycling! ■ Topics Covered - What is Pigeon Fever and why it’s back in Kentucky - How to recognize symptoms and abscess types - Treatment options and antibiotic strategies - Farm management and biosecurity tips - Internal vs external abscesses and prognosis - Dr. Ferreira’s career and cycling adventures ■ Presented by Rood & Riddle Veterinary Pharmacy ■ Listen to more episodes: https://www.roodandriddle.com/stallside #EquineMedicine #RoodAndRiddle #StallSidePodcast #PigeonFever
Timestamp Topic / Visual Cue
00:00 Intro & sponsorship mention
02:00 Dr. Ferreira introduction
05:00 What is Pigeon Fever
15:00 Diagnosis & treatment tips
25:00 Internal vs external abscesses
35:00 Cycling discussion
End Closing & subscribe reminder
00:00 Dr. Claudia Ferreira: Hello today's episode of Starside podcast was brought to you by Rood & Riddle veterinary pharmacy today on the Starside podcast. I'm joined by Dr. Claudia Ferreira, who is part of our internal medicine team at Requin Hospital.
00:20 Host: She's recently joined us and she will be talking today about pigeon fever, which has had a resurgence on the bluegrass so without further delay will bring Claudia. OK Claudia welcome to the show. It's going to be thank you for taking time out of your day and being here with us and then welcome to Rood & Riddle.
00:40 Dr. Claudia Ferreira: We're so happy to have you here once tell us a little bit about yourself yeah thanks so actually I was a riddle intern back in 2020 so I was a Covid year.
01:00 Host: I went ahead from there and did my residency and internal medicine up in Michigan State, and then following Michigan State actually returned back home to California and was working in field service at UC Davis so the grand return to California kind of introduced I think my colleagues and a lot of of the vets in the area to potentially the pigeon, fever and being claimed or pronounce that what I like to call the pseudo expert I buy no means I'm an expert of fever and I certainly didn't bring it from California either, but I do seem it came with I didn't have the timing was a little suspicious so before we jump into that though, tell me a little bit about your background, why you why you became mission becoming a vet, veterinarian and specifically with horses actually, I think that my story is probably similar to a lot of veterinarians new since I was a little girl that I wanted to be a vet specifically with horses because I had a lot of really great role models particularly in college and specifically a Dr.
01:20 Host: Sprayberry, who actually had a lot of influencer in Kentucky back in her heyday as well, so OK that's fabulous. Did you grow up with with horses?
01:40 Dr. Claudia Ferreira: You had one horse growing up I did one of those one dollar geriatric horses that of course cost way more than one dollar and you know from there at snowball and became an obsession and now a career.
02:00 Dr. Claudia Ferreira: Well, you brought up the pigeon fever that we've been seeing here in Kentucky and that's that's a little bit nude to us in fact of our veterinarians when they started seeing it we're like what the heck is this and and people start talking and you know that someone one person's got a complication and somebody's got another couple cases and so it's it's kind of opportune time for you to be here with us because this is not new to you yeah certainly being involved in a lot of the conversations and discussions about it it was a little yeah like being back at home because certainly that was our bread and butter and especially in field service we were seeing a lot of pigeon fever and kind of the I would like to call the reintroduction because this is certainly not something new here in the area.
02:20 Dr. Claudia Ferreira: Certainly if you look back at case reports and publications, they have retrospective cases where we have seen this in Kentucky so I think that the resurgence maybe. Just causing a little bit more panic, but it's been here before and it's more than likely going to stay and certainly throughout my careers.
02:40 Host: I've seen cases but probably not quite as many concentrated like we have now there's this seems to be quite a few so what is it when you know we're used to seeing the we talk well but I'll let you take over but but what is pigeon fever pigeon fever and it's a cute little term that was coined basically because the presentation is very reminiscent of a full breasted pigeon, right so pigeon fever is actually termed carny bacterium suited tuberculosis.
03:00 Dr. Claudia Ferreira: But it causes more than often these basic external abscesses, and probably the predominant location that they manifest are going to be right there on the pectorals of the horse so again that's how I got that coin to pigeon fever cause they made them look like little pigeons but that's not the only location obviously they can get them on their underbelly.
03:20 Dr. Claudia Ferreira: They can get them up in the groin area, but I would say probably over 90% of them are going to manifest as these external abscesses.
03:40 Dr. Claudia Ferreira: Life-threatening or something that comes and goes to shit owners be worried about this yeah great question I would say that over 99% of the horses that get pigeon fever and they manifest as these external abscesses meaning these big pockets of pus on their body that are able to basically be drained.
04:00 Dr. Claudia Ferreira: Those are gonna have the best prognosis and with proper treatment and you know attention medical attention they go on to be happy horses again so definitely something to seek medical attention like call your veterinarian out because the best prognosis is always gonna be those cases that see the veterinarian earlier than rather than later.
04:20 Host: So that that would be my kind of advice to owners so where are they getting these? Where are they getting the disease from?
04:40 Dr. Claudia Ferreira: Yeah so this is a bacteria like we kind of alluded to earlier so it's caused by very specifically like this grandpa positive bacteria it lives in the soil and it's pretty hardy so it's going to you know it's not gonna be an activated or killed in direct sunlight and it lives in soil for a good portion of time so the main location or area that they are kind of manifesting or repopulating in the soil are going to be directly from these abscesses so that draining pus.
05:00 Dr. Claudia Ferreira: Is just a huge load of bacteria.
05:20 Dr. Claudia Ferreira: It's just kind of this petri dish if you will so the biggest kind of concern I would say with treating these is when we pop these abscesses, it could be super satisfying to relieve that discomfort for the horse and"" kind of fix that problem, but we can't just leave all of that pus material on the ground.
05:40 Host: That's gonna be a direct motive transmission from horse to horse and it's carried by not just us but flies are gonna be the predominant one that are gonna be actually picking up that material I'm on their legs and then bringing it to the next horse. So did you see it in farms that were endemic for it then did you?
06:00 Host: Is it like the same farm ghetto get it over and over again or oh yeah so once this is in the soil, it's ubiquitous so it's a really hard thing to eliminate next to impossible, I would say so once that it's in the soil and one horse gets it, I would say obviously do your due diligence and and try to minimize the exposure to other horses, but I would say that it's basically on that property.
06:20 Host: And unlikely going to be on the property next-door so that's gonna be something that I think it's a hard pillow swallow but one that I think will hopefully minimize some of the panic involved with us OK will continue with management do you have any photos of that she's talked about what these look like and we're yeah and again I eluded to the predominant manifestation of this disease, causing external abscesses so right here I have some of the most common locations that I chatted a little bit about so the pectoral region I'm giving this kind of pigeon like appearance in this one is actively draining as you can see, but not all of them are actually going to be this nice kind of already draining abscess a lot of of them present with just a hard swollen mass and many of the horses that get those swollen masses or or sometimes present as lame actually so that is something to kind of always be on the lookout.
06:40 Dr. Claudia Ferreira: They may not present nicely as a pigeon fever. They may actually present as a lameness and then here's one that's on the vent trim or the underside of the horse that's probably next common. After the actual pectoral region, and then of course there's gonna be some in the groin and this is going to be.
07:00 Dr. Claudia Ferreira: I've had one that actually was up there in a memory gland, but certainly up there in the prep area for the males as well, so those would be that the predominant sites for the external abscesses and again this is gonna be probably how over 90% of the horses present and they have a really good prognosis for a return to.
07:20 Host: I'm a happy you know healthy life after falling treatment. That's interesting. Those those remind me a lot of like strangle abscesses that we see how is this disease different from strangle?
07:40 Host: Do you need to worry about it as much as you do something like that yeah that's a great question and I would say it act similarly, and that the pus material is contagious just like strangles.
08:00 Dr. Claudia Ferreira: But I put this lower on my list of things to ""panic about so bio security wise strangles is not necessarily endemic on most farms, whereas pigeon fever that lives in the soil it's impossible to get rid of.
08:20 Dr. Claudia Ferreira: I'm so now this is endemic and there's some level of this is going to stay here but on top of that our prognosis for pigeon fever when it comes to these external abscesses in particular has a great prognosis they're easier to treat they're not requiring you know advanced diagnostics Like.
08:40 Dr. Claudia Ferreira: Strangles cases are going to because we're not needing a scope. We're not needing you know strenuous or daily maintenance of this by billing and these cases I think I'm on a bio security management once we get these drained and all of the pus material. Out of there and you know do our due diligence on insect repellent.
09:00 Dr. Claudia Ferreira: These guys are not really contagious so I don't put these on such a high bio security risk management as I do the strangles so they're mostly picking it up in the soil, but you say they can direct contact with the with the ex from the pass that you can pass it to another Horseman cracked yeah so that's why we just wanna make sure that one we're actually Lansing these you know as great as that is for the horse and a lot of veterinarians that's one of their favorite things you know is funny.
09:20 Dr. Claudia Ferreira: It's especially female vet veterinarians for some reason they love opening abscesses they get excited. I will say that is one of the primary reasons I became that that's my favorite procedure.
09:40 Dr. Claudia Ferreira: Yeah, so yeah once you're done with that as fun of a procedure as that can be for some of that just making sure that we're really cleaning up after all of that not leaving that in a garbage can that flies are gonna be you know populating so it's in the soil is it weather related it like the hot dusty summer is that when we're mostly gonna see these cases and so there have been some publications on some retrospective studies like I was alluding too earlier they've found that this happens this fluctuates you know with all the season so it's not like we're going to this in one season, but they have seen a little bit of an increase a tick upward in the hot kind of dustier time period and especially after following a rainy season so maybe an especially rainy winter or maybe spring and that might have more to do with kind of the insect manipulation kind of ticking upwards.
10:00 Host: Gotcha. We mentioned that the external abscesses make up 90% of the cases where are the rest of them and external abscesses love these these are easy to treat great prognosis.
10:20 Dr. Claudia Ferreira: There's two other categories that actually are sometimes a little bit more tricky to both diagnose and treat so internal abscesses would probably make up the second you know.
10:40 Dr. Claudia Ferreira: Greatest population or pre-selection for these abscesses, and so those ones can be tricky to both diagnose and treat like I said, and then, following that the more rare, I have actually personally not seen one of these cases, but one of the lymphangitis cases and more specifically ulcerative lymphangitis, and I think you have some pictures of both of those yeah, so for internal abscesses, and these are tricky to treat in this came out of a publication related to both diagnosing and treating some of these, so this was in a liver as well as a kidney, and so these are gonna be the cases that sometimes are going to present as a fever of unknown origin or potentially even just an ADR and this is gonna be one advanced diagnostics and some of our more maybe unfamiliar bloodwork tests are gonna come into play and be really crucial for filling in the puzzle pieces so to speak I'm so ultrasound on these ones and then I'm very specifically doing something called is she test for tighter?
11:00 Dr. Claudia Ferreira: And so that is going to be testing the IGG related to basically one of the exotoxins that this bacteria releases, so those are gonna be crucial pieces and archive, putting this puzzle together, and trying to diagnose the internal abscess cause I had them remotely associated with I heard that it had that pigeon fever in it in its lungs is instead of that thing oh yeah, so the internal abscesses they like to be in a lot of the major organ so we're talking liver spleen, the kidneys they can even be deep within the abdomen, and those are the ones where if we're not able to ultrasound it and potentially you know with ultrasound assistance aspire those ones done really what we're relying on is that she tighter cause you know ultrasound is only gonna give us a superficial look into the abdomen.
11:20 Dr. Claudia Ferreira: I'm so these ones can really hide but they can go basically anywhere your imagination takes you so.
11:40 Dr. Claudia Ferreira: Much more dangerous with these abscesses then yeah so these ones and again this is all going to be based on retrospective cases they have 100% fatality if left untreated that being said if we do aggressive management of these probably 30 to 40%, have a good prognosis less than 50-50 if you internal so much different story compared to our external abscesses so are antibiotics effective against yeah so this is like we chatted about a very beginning and this is gram-positive so these ones are going to really take to like a K pen basically or beta lactone group is great against these that being said if we're handling this in the field something like giving the minocycline or doxycycline that has pretty good penetration the anabiotic that I would stray from or kind of avoid entirely that is a little bit I would say I always love to give us some diseases.
12:00 Dr. Claudia Ferreira: It's just something that you know most people can afford, and you know readily available. Yes, totally that is gonna be something that cannot penetrate these abscesses so that's gonna be the one that I would really stray from and it's unfortunately this is long-term antibiotics.
12:20 Host: We're not giving this for a week and seeing you know how it goes. This is at least 4 to 6 weeks so we're hitting this really hard to try to get the best outcome possible do you ever get involvement with these? I have not I have not yet, but I'm sure that that would be a possibility.
12:40 Host: Gotcha, and so you talk about diagnosis of diagnostics and internal lashes how important is it to get a diagnosed?
13:00 Dr. Claudia Ferreira: Did a firm diagnosis on your external abscesses so the external abscesses I would say first of all we chatted a little bit about doing the sheet tighter I do not do sheet tights for the external abscesses because if you think of it, they're going to have a high sheet tighter and we already see that I still think that it is important because.
13:20 Dr. Claudia Ferreira: One if they have external abscesses, they still could possibly have internal abscesses and how I diagnose them if they have an internal or external abscess would be gold standard is getting that culture if we culture that that's gonna be giving us one a definitive diagnosis of bacteria, but also too it gives us the chance to make sure that whatever drugs we select are actually going to work if we coupled out with the sensitivity but I would say if I were to put in my you know category of priorities I think that it's gonna be the priority to diagnose the internal abscesses, but it's a little hard to grow on the lab I understand i have not had problems with that but yeah that's what maybe a couple of our colleagues were sharing about the local labs here yeah OK well that's all very interesting.
13:40 Dr. Claudia Ferreira: What else do we need to know know about pigeon fever yeah so we covered a lot of that testing is gonna be really important again for these fever of unknown origins.
14:00 Dr. Claudia Ferreira: I think that it's been pretty routine at least in California for my experience to do both that SEM, which is testing for strangles but also doing the sheet tighter. I think that there is a lot of knowledge to gain by starting to put that on our routine list of to-do's for a few hours or a fever of unknown origins.
14:20 Dr. Claudia Ferreira: Just because I wonder if if there is a little bit more pigeon fever out here then we're able to report cause we're not testing for it so I think that that would be really valuable information just to one kind of start charting you know how many cases we're actually seeing and too this is the sooner we treat these horses that potentially have the internal abscesses or you know the ulcerative lymphangitis cases the better prognosis we have so I think that diagnosing these sooner and and running the appropriate test is going to be invaluable.
14:40 Dr. Claudia Ferreira: Well, I do hope you're wrong. I hope this is just something just a flip in the radar and it goes away, but it sounds like something that we're gonna have to keep an eye on and keep watching. Potentially and I mean again, I did not bring this from California.
15:00 Dr. Claudia Ferreira: It's been here just based on some of the previous publications, but yeah I do agree that it would be nice if this is just a blip and we kind of carry on from here without anymore complicated I think it is I think it is something I want to talk about you kind of eluded in the.
15:20 Dr. Claudia Ferreira: In introduction you're you're a biker right I am yeah so I do race professionally you do all right so what's what's on the horizon for you with that so I do have I'm on a amazing team. That's actually based in California.
15:40 Dr. Claudia Ferreira: It's called monarch I'm not sure if you're familiar with women's cycling, but that's the best team.
16:00 Host: I'm unbiased there obviously but will be racing a lot of races here in the country and will be actually heading over to Ireland come next September so we'll be rolling internationally yeah so distance dude so a lot of them are actually various distances so we do stage races so we do four to potentially six days of racing and a lot of it is going to be somewhere between 40 to 80 miles each day normally there's one or two days where we do an all out 10 mile or we do criteria racing, which is basically I always compare that to NASCAR's for bikes go round in a circle tight circle try not to crash out or get crashed out and then you know whoever wear those really cool long helmets oh yeah, the helmet that's gonna be for the all out like 10 mile and that is my specialty yeah that's pretty cool right you were hiding that all right so how are you enjoying your time riddle oh, I love it.
16:20 Dr. Claudia Ferreira: This is possibly the best place to work again unbiased but it's been great so far everyone's been super welcoming. You know the pigeon fever talk was that the first thing that was on my radar which I was happy to kind of help out with, but I'm looking forward to a really busy falling season.
16:40 Host: I know that's maybe not what everyone wants to hear so far, but I do really love working with the fall so that's great. We're thrilled to have you here and thanks for taking time with us to talk today about pigeon fever.
17:00 Dr. Claudia Ferreira: I don't think that that's your specialty but it's it but it's a part of it and it's some expertise that you have you can bring to us always happy to help. Thank you for joining us on stall today. We win with Dr. Claudia Ferreira speaking about pigeon fever see you next time.