Arthritis, panuveitis and hyperaesthesia associated with Borrelia afzelii infection in a warmblood gelding

Abstract

A 13-year-old warmblood gelding presented with a history of lameness, muscle atrophy and weight loss of 3 months. The horse demonstrated extensive hyperaesthesia over the left dorsal trunk, marked effusion of several joints, laryngitis and a dampened mental attitude. Synovial fluid analysis revealed arthritis of the left tarsocrural joint, being PCR-positive for Borreliaafzelii DNA. Subsequently, mild anterior uveitis of the right and severe panuveitis of the left eye with B. afzelii PCR-positive aqueous and vitreous humour, respectively, were diagnosed. Treatment included arthroscopy of the left tarsocrural joint, oral doxycycline administration for 6 weeks, ophthalmic and systemic anti-inflammatory therapy and left intravitreal preservative-free gentamicin (4 mg) injection. After initial improvement, the gelding’s clinical signs deteriorated resulting in peracute recumbency and sudden death 12 months later. Lyme borreliosis should be considered as differential diagnosis in complex cases of equine lameness, particularly when accompanied by hyperaesthesia and bilateral uveitis.

A review of investigated risk factors for developing equine recurrent uveitis

“…The bacteria responsible for Lyme disease, Borrelia species (primarily B. burgdorferi ), have also been associated with cases of equine and human uveitis 43,45,72–75 . Although exposure to B. burgdorferi appears to be widespread in horses, rates of borreliosis and Borellia ‐associated uveitis are not correspondingly high 44,73,76 .…”

“…The bacteria responsible for Lyme disease, Borrelia species (primarily B. burgdorferi), have also been associated with cases of equine and human uveitis. 43,45,[72][73][74][75] Although exposure to B. burgdorferi appears to be widespread in horses, rates of borreliosis and Borellia-associated uveitis are not correspondingly high. 44,73,76 In fact, experimental exposure of seven ponies to B. bergdorferi via a tick vector failed to trigger any notable histopathologic changes aside from skin lesions near the site of infection.…”

Equine Lyme borreliosis and equine granulocytic anaplasmosis Part 2 – Clinical relevance (Vet survey)

“…Auch hier kann lediglich geschlussfolgert werden, dass den beobachteten Veränderungen eher andere Ursachen zugrunde liegen und keine pathognomonische klinische Veränderung für die LB darstellt. Dennoch existieren durchaus Fallbeschreibungen im Zusammenhang mit klinisch-manifesten LB beim Pferd, die mit Gelenkschwellungen einhergehen (Burgess et al 1986, Hahn et al 1996, Sommerauer et al 2019.…”