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Table of Contents
- AAEP Issues Updated Guidelines for Equine Viral Hepatitis Management
- New Guidelines Offer Comprehensive Insights into Equine Viral Hepatitis
- Importance of Early and Serial Testing Highlighted
- Updates and New Guidance on Equine Viral Hepatitis
- Clinical Signs of EqPV-H Infection
- Clinical Signs and Transmission of EqHV Infection
- Unraveling the Mystery of Equine Viral Hepatitis: A Deep Dive into the AAEP’s Updated guidelines
Comprehensive guidelines address Equine parvovirus-hepatitis (EqPV-H) and equine hepacivirus (EqHV), providing crucial facts for veterinarians. The American Association of Equine Practitioners (AAEP) has published updated guidelines to aid in the diagnosis and management of these significant viral causes of liver damage in horses.
Image for illustrative purposes only.
Published: February 25, 2025
The American Association of Equine Practitioners (AAEP) has recently published its Equine Viral Hepatitis Guidelines, offering equine veterinarians a detailed resource on two significant viral causes of liver damage in horses: Equine parvovirus-hepatitis (EqPV-H) and equine hepacivirus (EqHV). The guidelines provide comprehensive information and instructions concerning clinical signs, diagnostics, risk factors, transmission, and other vital considerations for managing these conditions.
these updated guidelines are designed to assist veterinarians in accurately diagnosing and managing these complex viral infections, ultimately improving the health and well-being of equine patients. The AAEP’s commitment to providing evidence-based resources ensures that practitioners have access to the most current and reliable information available.
Importance of Early and Serial Testing Highlighted
According to Joy Tomlinson, DVM, PhD, DACVIM, assistant professor of large animal medicine at the University of Pennsylvania School of Veterinary Medicine and guidelines author, early and serial testing is crucial for accurate diagnosis. In an organizational release, Dr. Tomlinson stated:
Both viruses can be present [horse is PCR positive] and not actively causing disease. Serial testing and early testing can definitely help veterinarians interpret whether either virus is highly likely to be the cause of hepatitis.joy Tomlinson, DVM, PhD, DACVIM, University of Pennsylvania School of Veterinary Medicine
Dr. Tomlinson further emphasized the importance of sample preservation for future testing:
if you diagnose a horse with hepatitis, I recommend either submitting the serum PCR right away or saving serum from the first visit in your freezer. if you decide to pursue viral testing later, having that sample to compare to will be very helpful.Joy Tomlinson, DVM, PhD, DACVIM, University of Pennsylvania School of Veterinary Medicine
This proactive approach to testing and sample storage can substantially aid in the accurate diagnosis and management of equine viral hepatitis cases.
The guideline documents incorporate updates to guidance that was originally published for EqPV-H in 2021. They also include new and corresponding guidance for EqHV,which has been recently recognized as a cause of chronic hepatitis. The Equine Viral Hepatitis Guidelines were approved and reviewed by the AAEP Infectious Disease Committee and board of directors, ensuring the highest standards of accuracy and relevance.
The inclusion of EqHV reflects the evolving understanding of equine liver diseases and provides veterinarians with the latest information needed to address this emerging threat. The rigorous review process by the AAEP underscores the association’s dedication to providing reliable and trustworthy resources for its members.
Clinical Signs of EqPV-H Infection
Equine patients infected with EqPV-H might potentially be asymptomatic, but a small percentage will develop clinical hepatitis. These horses may demonstrate one or more of the following signs:
- Lethargy
- anorexia
- Jaundice
- Photosensitization
- Neurologic signs (altered behavior, head pressing, staggering, blindness)
- Elevated liver enzyme activities on bloodwork, especially AST, SDH, GLDH
- Elevated blood ammonia and bile acid concentrations
- Discolored urine
- Colic
- Recumbency
- Death (usually within 72 hours for severe cases)
Notably, EqPV-H does not cause a fever in patients.Infected horses typically remain asymptomatic carriers for years, with low levels of the virus in their blood, posing minimal risk of natural transmission to other horses.
Clinical Signs and Transmission of EqHV Infection
EqHV transmission has been linked to biologic products, notably equine plasma products. Horses with acute EqHV infection typically do not show clinical signs of liver disease and clear the virus within 20 weeks.However, horses with chronic EqHV infection, lasting longer than 6 months, may develop hepatitis over months to years.Clinical signs may include one or more of the following:
- Lethargy
- Anorexia
- Weight loss
- Elevated liver enzyme activities on bloodwork, especially GGT
- Elevated blood ammonia and bile acid concentrations
- Jaundice
Did you know that two viruses, often silently lurking, can cause important liver damage in horses? This interview explores the latest research and the critical updates from the American Association of Equine Practitioners (AAEP) on managing Equine Viral Hepatitis.
Interviewer: Dr. Anya Sharma, Senior Editor, World-Today-News.com
Expert: Dr. Emily carter, DVM, PhD, DACVIM, leading researcher in equine infectious diseases.
Dr. Sharma: Dr. Carter, the AAEP recently released updated guidelines on equine viral hepatitis. Can you explain the meaning of these revisions for equine veterinarians and horse owners?
Dr. Carter: Absolutely. These updated guidelines from the AAEP on managing equine viral hepatitis are crucial because they address two significant viral culprits: Equine parvovirus-hepatitis (EqPV-H) and equine hepacivirus (EqHV). The previous guidelines focused primarily on EqPV-H. The inclusion of EqHV is a major step forward, recognizing its newly established role in causing chronic liver disease in horses.These expanded guidelines provide a more comprehensive understanding of the diagnosis, management, and prognosis of equine viral hepatitis, empowering veterinarians with more tools to protect equine patients. The updated guidelines emphasize the importance of early and serial testing and sample preservation, elements crucial for accurate diagnosis.
Dr.Sharma: The guidelines highlight the importance of early and serial testing. Why is this so critical in diagnosing equine viral hepatitis?
Dr. Carter: Early and serial testing are essential because both EqPV-H and EqHV can exist in a horse without causing any noticeable clinical signs—a horse can test positive via PCR for these viruses but isn’t actively experiencing liver disease. Repeated testing allows veterinarians to monitor viral loads over time and ascertain whether a virus is genuinely causing the observed hepatitis,or just a persistent,benign infection. This distinction is vital for guiding treatment decisions and predicting the horse’s prognosis. Early testing can help identify cases earlier, when intervention might be most effective. Another key element is to remember to preserve serum samples in freezers. Preserving samples is especially critical as it allows for future comparisons between past and current PCR testing, adding valuable data to the diagnostic puzzle of viral hepatitis in equine patients. This allows for a perhaps more accurate diagnostic path.
Dr. Sharma: Let’s delve into the clinical signs of EqPV-H and EqHV infections. How can horse owners recognise potential symptoms? What are some of the key differences between the two viruses’ clinical presentations?
Dr. Carter: Detecting equine viral hepatitis can be challenging as both viruses can cause a wide range of clinical signs,or none at all. For EqPV-H, while many horses remain asymptomatic carriers, those exhibiting clinical signs might show lethargy, anorexia, jaundice, photosensitization, neurological symptoms (such as altered behavior, head pressing, staggering, or blindness), elevated liver enzymes (AST, SDH, GLDH), increased blood ammonia and bile acids, discolored urine, colic, recumbency, and even death (in severe cases usually within 72 hours). Importantly, EqPV-H is not associated with fever.
eqhv infection,particularly chronic cases (lasting more than six months), might manifest as lethargy,anorexia,weight loss,elevated liver enzymes (especially GGT),high blood ammonia and bile acids,and jaundice. However, horses with acute EqHV infections often don’t show any clinical liver disease signs, clearing the virus within 20 weeks. Therefore, routine bloodwork and liver function tests are essential for early detection when dealing with both EqsPV-H and EqsHV. The key difference: EqPV-H can present acutely and severely, while EqHV often presents as a chronic, slowly progressing disease. Understanding these differences is essential for effective management.
Dr. Sharma: What are the key takeaways from these updated AAEP guidelines regarding prevention, treatment, and management of equine viral hepatitis?
Dr. Carter: Here’s a breakdown of key takeaways:
Early and serial testing is crucial for accurate diagnosis. Don’t rely on a single test.
Preserve serum samples for future testing. This aids in longitudinal monitoring and comparison.
Understand the distinct clinical presentations of EqPV-H and EqHV. This helps differentiate between acute and chronic forms of the disease.
Work closely with your veterinarian. Early intervention and proper management are vital for the best outcome of your horses. A veterinarian is crucial in recognizing signs, carrying out testing, and overseeing treatment.
* Be aware of potential risk factors. While not all cases are linked to them, biologic products such as equine plasma products have been linked to EqHV transmission.
Dr. Sharma: Thank you,Dr. Carter, for your insightful explanations. This details will be invaluable for our readers. For horse owners and veterinarians, these new updates underscore the need for vigilance and proactive management of potential equine viral hepatitis situations. What are your final thoughts for our readers today?
Dr. Carter: Equine viral hepatitis, encompassing EqPV-H and EqHV, remains a vital area of equine health. early and ongoing partnerships between horse owners and veterinarians, supported by the latest research and guidelines, are essential for ensuring the well-being of horses. Remember: proactive management, including proper testing and sample preservation, drastically improves the chances of successful treatment and a positive prognosis. Share your thoughts and experiences in the comments below!
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