Treatment of Equine Purpura Hemorrhagica Following Strangles


Horses with a compromised immune system may develop Purpura hemorrhagica following an outbreak of common strangles. Although rare, this complication occurs when blood vessels swell due to a poor immune response. Purpura Hemorrhagica cases may arise prior bouts of strangles or influenza. Unlike strangles, Purpura Hemorrhagica is not contagious to other horses. In rare cases, Purpura Hemorrhagica may develop following an upper respiratory infection.

Symptoms of Equine Purpura Hemorrhagica  

Symptoms of Purpura Hemorragica include damage to blood vessel walls causing artery leakage. Blood seeps into the tissue, and then swelling occurs. Symptoms of Purpura Hemorragica often appear two to four weeks after a respiratory infection, and may include the following:

  • Swelling in the head, legs and underbelly

  • Red spotting on the gums and other mucous membranes from bleeds

  • Serum may seep from the skin

  • Purpura Hemorrhagica systemically affects the entire body, including the lungs, muscles and kidneys; thus may lead to other signs including:

  • Lameness

  • Laminitis

  • Colic

  • Weight loss

  • Neurologic signs


Contact your veterinarian if you see symptoms of Purpura Hemorrhagica after a respiratory infection, or a strangles vaccine. Your veterinarian may make a diagnosis based on the history and exam findings. Blood samples, or a skin biopsy may be used to confirm a Purpura Hemorrhagica diagnosis. 


For topical treatment of symptoms, apply PF Wonder Salve as directed. PF Wonder Salve kills multiple strains of bacteria, including staphylococcus on contact. PF Wonder Salve rapidly contracts wound size, and provides an outstanding cosmetic result with minimal scarring. It is easy to use. Just brush on a thin layer, as directed. 

While the symptoms appear alarming, this disease is often mild and horses typically recover well. In severe cases the horse may die or need to be put down. Catching Purpura Hemorrhagica early is key to a good outcome. With that said, several horses exibiting catastrophic symptoms have fully recovered with PF Wonder Salve applied topically to the lesions. 

The photos shown are provided from a PF Wonder Salve customer

How to Prevent Purpura Hemorrhagica

Purpura Hemorrhagica is difficult to predict, or prevent. Your veterinarian may recommend not using the strangles vaccine again, if your horse reacts to it. 

Research indicates that horses with high levels of antibodies to strangles may be at higher risk of Purpura hemorrhagica. High antibody levels are likely after horses are exposed to and vaccinated for strangles.

Bottom Line

You may want to avoid the strangles vaccine as a preventative measure. 

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