Horse in paddockA horse in South Carolina was recently diagnosed with rabies. While rabies is common in some animal species in some regions, it’s a pretty rare disease in horses, so it’s a noteworthy event.

This case has a couple of important takeaway messages.

  • Rabies can be sneaky. Rabies (especially in horses and cattle) isn’t always obvious at the start. Affected animals can have vague signs that point to other types of disease, such as colic (intestinal tract disease). (I’ve had a few cases in the past in which we took a horse to surgery for severe abdominal pain, nothing was found, then in recovery it started to act neurologically abnormal. That’s an “oh crap” moment when you start thinking about how many people have been exposed. Fortunately, none of those ended up being rabid, but I know of cases just like that in which the horse was rabid). In this case, the horse was reported to be lame the day before the onset of obvious neurological disease. Rather than real orthopedic pain, that was likely actually the onset of signs of rabies. That’s not to say that every horse with a sore leg or belly should be considered a rabies suspect. It means that we have to be aware that rabies doesn’t always occur in textbook form.
  • Rabies in horses is a public health risk. Yes, that’s a given. However, in horses, the main risk is probably being injured or killed from a neurologically abnormal horse that might attack or fall on someone. I’m not aware of any case of transmission of rabies from horses to people, but I am aware of people who have been killed by rabid horses. In this case, two people were exposed and are undergoing post-exposure prophylaxis.
  • Rabies vaccination is cheap protection. It always surprises me that some people are reluctant to vaccinate against rabies. It’s a rare disease but it kills. The vaccine is cheap, effective and safe. By nature of their lifestyle, horses are at almost constant risk of exposure to wildlife (the main source of rabies in North America). So, why every horse isn’t vaccinated is beyond me. Rabies vaccination is a minuscule fraction of the cost of keeping a horse and should be standard of care.