1. Equine Coronavirus in a 12yr old Thoroughbred Gelding
Kathryn Golden, DVM
Carolina Equine Hospital
5373 NC Highway 150E
Browns Summit NC, 27214
Mentor: Mark Wallace, DVM, DACVIM

2. Signalment and Presenting Complaint
12 yr old Thoroughbred show horse
Presented for 2 day history of partial anorexia, lethargy, fever, and mild colic signs

3. History Patient spent time in Ocala FL 6 weeks prior to presentation
3 days before onset of clinical signs another horse on the property became febrile, lethargic and partial anorexia
Resolved with supportive therapy and NSAIDs
Patient hospitalized 2 days after onset clinical signs for supportive therapy

4. Clinical Findings Mild depression Temperature: 102.4oF
Heart Rate: 40 beats per minute
Respiration:16 breaths per minute, normal auscultation
Normal digital pulses
Mucous membranes pink with a capillary refill <2 seconds
Hypermotile borborygmi
Loose stool- semi formed, not cowpie consistency

5. Diagnostic Work-Up Rectal Examination Rebreathing Examination
Scant amount of loose stool
Rebreathing Examination
Normal bronchovesicular sounds
Thoracic and Abdominal Ultrasound
Not performed on initial presentation
Abdominocentesis
Nasal Swab for Respiratory Viruses
Due to the infectious nature of the disease and fever of unknown origin, respiratory disease was a top differential

6. Additional Diagnostics
Complete Blood Count
Chemistry and Fibrinogen
Fecal Panel- loose stool and infectious nature, concerning for infectious colitis
Feces for Equine Coronavirus PCR
Due to history of multiple horses affected on property, patient was placed in isolation.

7. Complete Blood Count Chemistry Fibrinogen
Select Parameters for Discussion
Hematocrit
35%
32%-50%
WBC
4.9x103/ml
x103/ml
Neutrophils
2,205/ul
2,600-7,500/ul
Lymphocytes
1,500-7,700/ul
Total Protein
6.0g/dL
g/dL
Albumin
3.3g/dL
g/dL
Globulin
2.7g/dL
g/dL
Total Bilirubin
3.7mg/dL
mg/dL
Fibrinogen
180mg/dL
76-230mg/dL
Interpretation
Hematocrit is within normal limits as well as total protein, indicating appropriate plane of hydration
Mild leukopenia with neutropenia
Total protein and albumin within normal limits
Increased total bilirubin consistent with history of anorexia

8. Equine Respiratory Panel
All horses on the property are regularly vaccinated for EHV 1/4 and Equine Influenza Virus. Due to the high morbidity of this disease with non-specific clinical signs, respiratory disease is an important rule-out.

9. Fecal Panel NEGATIVE Salmonella and Shigella species
Due to the infectious nature of the disease Salmonella was an important rule out,
E. coli Serotyping
Rotavirus Antigen
Clostridium perfringes Enterotoxin
Salmonella and Shigella species
NEGATIVE
a comprehensive fecal profile was the most cost effective option to rule out Salmonella

10. Equine Coronavirus PCR
Photo Source
POSITIVE
A positive fecal PCR with a negative respiratory panel and negative fecal panel, is highly suggestive of Equine Corona Virus as the causative agent.

11. Diagnosis: Equine Coronavirus
Abbreviated ECoV
Newly recognized illness in horses
Seen in the Northeast, most prevalent during colder months
RNA virus
Implicated in respiratory and enteric disease in other species
Photo source:

12. Equine Coronavirus Transmission Survival in environment
Fecal oral route
Survival in environment
Unknown
Age Prediliction
Adult horses >2yrs of age
Morbidity
20-57%, mortality is rare and due to secondary complications
Duration
Signs usually resolve in 1-4 days with supportive therapy

13. Changes in fecal character Leukopenia (neutropenia, lymphopenia)
Clinical Signs of ECoV
Anorexia
Changes in fecal character
Neurologic abnormalities secondary to hyperammonemia
Leukopenia (neutropenia, lymphopenia)
Hypoalbuminemia
Lethargy
Fever <104
Our patients clinical signs are highlighted

14. Treatment Plan
Intravenous Fluids- ongoing loss through loose stool and concern over impending colitis
20L LRS bolus
1.5x maintenance for 2 days
NSAID Therapy
Flunixin IV q12hr
Gastric Ulcer Prevention
¼ tube Ulcerguard PO q24hr
Platinum Performance BioSponge
Intestinal adsorbant

15. Outcome
Patient returned home following hospitalization with supportive therapy and returned to work.

16. Outbreak Summary Within a 2 week period 5 of 6 horses became clinical
3 horses were hospitalized and treated with supportive therapy
3 positive equine coronavirus fecal PCRs from 3 separate patients were isolated
Unknown exposure/introduction to herd
All horses recovered with supportive therapy and NSAIDs

17. References
Pusterla, N, et al. Emerging outbreak associated with equine coronavirus in adult horses. Veterinary Microbiology. 2013;162:
Yasuhiro, O, et al. Isolation of an equine coronavirus from adult horses with pyrogenic and enteric disease and its antigenic and genomic characterization in comparison with the NC99 strain. Veterinary Microbiology. 2011;150:41-48
Cornell University College of Veterinary Medicine Website (