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ForewordThis document was commissioned to provide UK veterinary surgeons with up-to-date information on Streptococcus equiinfection and to provide practical recommendations for veterinary surgeons in the field. The participants were selected to provide representation from a range of expertise and viewpoints and included practitioners, academics and social scientists. The document and practical recommendations were developed using a modified non-anonymised two-round Delphi process, considering published and unpublished research relating to ‘strangles’ using online discussion. The expert group was convened by UK-Vet Equineand Redwings and an online meeting held on 20th January 2021 with sponsorship from MSD and support from World Horse Welfare. The sponsors did not participate in the meeting and had no influence over editorial content. Each of the panellists was provided with a sub-topic and presented a review of the evidence pertaining to that area prior to taking two rounds of questions relating to the evidence presented. Where research evidence was conflicting or absent, collective expert opinion, based on the experience of the group, was applied. The opinions expressed are the consensus of views expressed by the authors who all approved the final manuscript. Where it was not possible to reach consensus, different viewpoints are presented.

Cellulitis is a common condition in equine practice and one that is frustrating to treat. Typically, antimicrobials and anti-inflammatories are administered and most cases resolve with time. Bacterial culture and susceptibility should be performed more frequently as they enable more responsible and informed decisions on antimicrobial choice to be made, especially when first ineffective. In cases that are refractory to initial treatment imaging modalities play a role in providing a better understanding of the extent of the underlying pathology and hence prognosis. Recurrence is common.

Autumn is traditionally a time when all horses are de-wormed with a product that is effective against tapeworms and both adult and larval roundworms. However, if management is good and appropriate testing has been performed for the presence of round and tapeworms, there may be no need to use anthelmintics. For tapeworms, a single test for antibodies to Anoplocephalaspp.provides reassurance that treatment is not necessary. For roundworms the situation is more complicated as there is no test for larval stages currently. There is therefore a reliance on repeated worm egg counts through the grazing season. The risk of exposure, albeit low, to large strongyles also needs to be considered.