Section 1 | Respiratory Diseases in Horses: Streptococcus equi

Ontario Equine
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Treatment of Strangles

The majority of Strangles cases require no antimicrobial treatment. Horses with strangles need proper rest in a dry, warm stall. These horses should also be offered soft, moist, palatable, high-quality nutrition.


Manage Pain and Inflammation

Nonsteroidal anti-inflammatory drugs (NSAIDs) can be administered to reduce pain and inflammation associated with Strangles.

Despite the severity of the clinical signs that horses show, most horses will recover in a few weeks — but they may still be shedding bacteria1

Why Are We Concerned About Using Antimicrobials?

Counter to what you might expect, antimicrobials have been shown to delay maturing and healing of abscesses associated with strangles in some cases. In other cases, abscesses may simply reappear once antimicrobial treatment is finished. These medications can also reduce the ability of the horse’s immune system to fight off future infections. And, giving antimicrobials when they are not needed can also contribute to the development of antimicrobial resistance.


The use of antimicrobials is only needed in severe cases, such as2:

  • Rapid and severe infection, where horses present with high fever and sickness, but abscesses have not yet formed
  • Horses with significantly enlarged lymph nodes and respiratory distress

Work with your veterinarian to determine the best course of treatment for your horse


  1. Waller, A.S. 2014. New perspectives for the diagnosis, control, treatment, and prevention of strangles in horses. Vet Clin NA: Equine Prac. 30:591-607.
  2. Boyle, A.G., J.F. Timoney, J.R. Newton, M.T. Hines, A.S. Waller, and B.R. Buchanan. 2018. Streptococcus equi infections in horses: Guidelines for treatment, control, and prevention of strangles – Revised consensus statement, J Vet Intern Med. 32:633-647.