an e-Vet Clinic site about horse health and movement
David O’Connors continued reign of success – heres the article – David O’Connor Awarded Pfizer Equine Industry Vision Award
How does one man accomplish so much in one lifetime? He definitely has the keys to success – a Desire plus Persistence plus Faith minus Fear all multipled by Action. Look at his list of accomplishments in that article, I hope he is able to pass off the keys to success to the students he teaches, because it can certainly help in all aspects of life not just riding horses.
Here we are back at the story of our little horse that was vigorous and strong only 3 weeks ago and now looks like it has lost 300 lbs, has a severe anemia in which the owner has given one blood transfusion, and has a fever that is on again and off again and has spiked now to 109.5! That is not a typo – the horse’s temperature was at 109.5 degrees during the day when the outside temp was near 90. Bathing the horse and putting it under fans and giving some Banamine reduced the fever, but that was very scary!
So what happened next. Well my friend who owns this horse being a small animal veterinarain asked me a simple question, can the horse still have immune mediated anemia and have a negative Coombs test. Well I’ll be – a question I did not know the answer to – LOL. So he asked a clinical pathologist, a doctor who specializes in reading blood results and other laboratory tests. He’s the doctor we get on the phone with when all the blood results look screwy and we have no idea what way the blood is directing us. He is the guy that makes sense of it all. So the answer came as a startling yes. The horse can have immune mediated disease and still have a negative Coombs test. OK well then what now?
The clinical pathologist then asked the most important question of them all, the one that solved this mystery. When was the horse last vaccinated and with what? Did it have a strangles vaccine recently? YES, it did have a strangles vaccine at the same time the Coggins test was pulled. Well looking at the results of the blood tests and the signs and symptoms of your horse, he believes the horse has vaccine induced immune mediated anemia. Otherwise known as Streptococcus myositis caused by a reaction to the Strangles vaccine. It is much more prevalent in Quarter Horses but can happen in any breed. The theory is if the horse already has a high titer to Strangles and the vaccine is given anyway it sends the immune system into overdrive and causes purpura hemorrhagica and results in a immune mediated myositis (muscle inflammation and deterioration).
So that is what I was seeing not a trauma induced bloddy nose but rather purpura hemorrhagica. Also the horse was tying up but the cause was not because of being cast but rather an immune mediated myositis. Here is a picture of what I saw – The picture is from the Merck Veterinary Manual Website -
Notice the nose looking like it was hit with something.
The horse seems to be doing better, however, we are not out of the woods quite yet. He still needs some TLC to get better and as I said before the Rapid Response is helping this horse tremendously. I will keep you posted on the events with this horse, but hopefully this story will help you realize as to how important it is to be informed on your decisions to vaccinate with what and when. It may be more important to not vaccinate for certain diseases as is my opinion with strangles. If you are not in a high risk environment (meaning stabled with a bunch of 2 year old show horses that come and go every weekend) then it is more important to pass on this vaccine. Your horse’s life may depend on not being vaccinated!
Heres a continuation of yesterday’s story – A strangles vaccine reaction
So what happened next? The horse spiked a fever, the very next day; oh and not just a little 103, no it went big, spiking to 105-106 degrees! OK so now I am thinking this horse has an infection most likely shipping fever. The immune system is stressed the horse had been trailered several hours, it is in a new place, new bacteria, new viruses that it has never been exposed to, so great after all this horse has been through it now has shipping fever.
Well the Banamine knocked the fever right out and we continued giving the horse iv fluids (a treatment for the tying up); the horse’s temperature was back to normal within a couple of hours. The horse feels better and starts eating. So we put the horse on antibiotics as a preventative, and yes for all my holisic followers we were doing other things such as probiotics, immune support and Rapid Response. In fact the owners and myself feel that the horse benefitted the most from Rapid Response out of anything that we tried (again hindsite is 20/20 and considering the makeup of this product it makes sense that the horse received the best results from using it).
Well after some more bloodwork we noticed that the white blood cells (WBC’s) were still normal and the red blood cells (RBC’s) were getting lower (anemia). So this horse ‘s disease is now an anemia and a fever that comes and goes. We needed more diagnostics, so in going with the possibility of shipping fever we needed radiographs of the chest to determine if we were indeed dealing with a lung infection and possibly abscesses as the fever was coming and going and the WBC’s were remaining at a normal level. So we sent the horse to another friends place that had the facility to take such a radiograph (x-ray), luckily this is a small horse so it is possible to shoot an xray. Well fortunately for the horse, but unfortunately for diagnosis, the chest films were OK. Blood work done by this veterinarian showed that the liver enzymes were elevated. It concerned him more than me. He was thinking liver infection (hepatitis), but I was thinking the horse just tied up a few days ago and has been sick for almost two weeks now, the liver enzymes are going to be elevated. After a couple days of more fluids in our friends facility and a change in antibiotics the horse was brought home, looking no better with not very many answers as to what this horse had, the next step was a liver biopsy to rule out the hepatitis.
Well that is when I put my thinking cap on…so what do we have here…the biggest sign is the anemia all the other things going on with this horse are symptoms, so lets start with the anemia. The differential diagnosis (what disease cause anemia in horses) are stomach ulcers, chronic infection, Equine Infectious Anemia (Coggins test), cancer such as lymphoma, and immune mediated. Stomach ulcers – too quick of an onset for this horse and most of the time the horse does not have a fever, but still possible. Chronic Infection – this horse was extremely healthy and very strong just prior to coming to Illinois and the WBC are normal, which in chronic infection could happen, but not likely. Equine Infectious Anemia (EIA) – Coggins test taken last month was negative but this does not mean that the horse could not have contracted the disease since then, and all the symptoms fit – intermitten fever, anemia, none responsive to antibiotics – Uh-OH could it be my first time ever seeing a postive Coggins test??? Unfortunately we would have to wait 45 days to do another test to see if it was postive or not and this horse may be dead before then. Then again the only edema (swelling) seen was in the head and usually horses with EIA have edema along there belly. So we are not sure but it is fitting the best so far. Cancer (Lymphoma) – no other signs, this horse was extremely healthy two weeks before, and it is only 4 years old, again posible but not likely. So it must be immune mediated – we need to do a Coombs test. If it is postive we have our answer, if not back to the drawing board.
After this discussion I told the owners that I was out of answers you need to consult with an internal medicine specialist at a university. SO they did, they contacted the University of Illinois and talked with one of the internal medicine doctors there, who thought the EIA did fit the entire disease process but so did immune mediated disease, so he suggested continue supportive treatment and do a Coombs test.
Well the Coombs test turned out to be negative! The story continues tomorrow and you will not believe the one simple question that solved this riddle asked by yet another doctor.
I have been saying for years that the majority of horses do not need a Strangles booster. In fact, I have been telling people that many times the reactions are just as bad as the disease itself. Well I have seen my first case of vaccine induced Streptococcus myositis. I wish I could tell you that I diagnosed it; however it was not a simple cut and dry case.
My client just purchased this horse about one month ago in Tennessee. A strong healthy horse when he bought it, he trailered it home after spending a week with it on trail. Within the first week the horses head swelled just primarily around the nose. Since I am friends with this individual he called me up wanting my opinion (he knows I no longer do traditional medicine but he values my opinion). My initial thought was trauma, but over the phone I could not rule out an allergic reaction. When I examined the horse I was positive it was trauma (WRONG, but hindsite is 20/20 – LOL), the horse had bleeding from the nostrils more on the right side than the left and swelling almost exclusively to the nose area and more to the right. It looked like the horse had smacked its nose against something. Also the right hind hock was swollen almost looking like a capped hock. So my thought was that the horse was cast and struggled to get up hitting its hock and nose. The horse would be fine.
A few days later I receive a call from my friend saying the horse is colicking! OK so we went through the treatment for colic. BTW my friend is a small animal veterinarian so he does most of the treatments himself with a little guidance. He was walking the horse, but as I told him walking has been proven not to do much of anything except for tiring a horse that is trying to recover. If your horse while colicking lies quietly there is no need to walk him, you may reduce the chances of recovery by causing exhaustion. Vets now use walking to give the owners something to do while we are on our way 
Now of course if your horse is thrashing on the ground it is important to get the horse up and moving to prevent head and body trauma, but otherwise just leave the horse lie quietly rousing him every 20 or 30 minutes to check gut sounds, gum color and heart rate.
Back to our horse… a couple hours later a call comes to me stating that the horse is urinating blood – hematuria! WHOA – if you did not listen to me about not walking the horse you better listen now – STOP walking the horse. Your horse is tying up and it is uncomfortable thus looking like a colic! My friend drew some blood and sure enough the horse is tying up otherwise known as Azoturia. OK so I thought this confirms my diagnosis of being cast, but one thing sticks out like a sore thumb why did the horse tie up days afterward and not the next day. It kind of didn’t make sense. The blood work also showed a slight anemia – where is that coming from?
Well what happened next threw another monkey wrench into the whole works, but you’ll have to wait until tomorrow for the rest of the story.
I had mentioned that it is important to have a pair of EasyBoots for your emergency kit. It is imperative that you have these fit to your horse before you ever have the need to use them. Well Karen at EasyCare & Endurance Musings made mention of this point on her blog. So I surfed on over to her site to check it out and I found a good deal of important information when dealing with the use and care of EasyBoots. I think you need to go check her site out – Karen’s EasyCare & Endurance Musings
You may have known that “Street Sense” won the Kentucky Derby. You may also know that he placed second in the Preakness and still you may know that he is not racing in the Belmont. But did you know this horse has been treated and fed in a holistic manner?
Carl Nafzger is Street Sense’s trainer and is known to be holistically minded when it comes to feeding his horses. He feeds a mushroom mix to his horses for a more calm and focused horse.
Good for him, at least there is one thing that I can be happy about the racing industry. Some trainers do care a little about their horse’s overall health OR maybe they just want to win …OK there is my cynical side again. I’ll just leave it alone.
OK we all know that there is a possibility of a hay shortage this year, so there are articles coming out about what to do about it. Here is one Horse owners find ways to stretch limited hay supplies By Kylene Orebaugh that I read today and actually I am disgusted with the expert from Colorado State University Karen Hansen. Here’s the first quote that I take issue with and let me say before I put my foot in my mouth this may not be her fault I have been misquoted and misinterpretted when giving interviews so I guess I am taking issues with the quotes. OK here we go -
“Alfalfa is a good forage type for horses because it is nutrient-dense; that is, it has a high concentration of nutrients such as protein, digestible energy and calcium compared to other forages,” Karen Hansen with the Equine Science Department at Colorado State University said. “Due to the nutrient density of alfalfa hay and processed alfalfa (cubes and pellets), this forage must be fed with good management skills to prevent overfeeding and possible digestive disorders.”
First things first Alfalfa is NOT a good forage for horses, for dairy cows sure for horses NO. It is acceptable for it to be in combination with other grass hays and for performance horses it helps in their weight maintenance. However I prefer a 25% or less alfalfa in the mixture. Why? Overfeeding and digestive disorders are only the start, how about urinary tract problems, and respiratory problems from the increase in Ammonia levels that need to be excreted when feeding alfalfa hay. Barns that are feeding alfalfa are easy to notice when you first walk into them – the smell can bring a tear to your eye especially in winter with the barn doors closed.
Now she does state a generic acceptable premise that horses should be fed at least 1% of their bodyweight each day in good, clean, long-stemmed (hay) forage per day. Just remember the “long-stemmed” part for a second.
She recommends pelleted and/or cubed hay or even a complete ration with forage in it as alternative sources for hay. I understand in a hay shortage you have to do what you have to do but she states …
Pelleted or cubed hay is usually a standardized good quality forage that is just put in another form compared to baled hay… Pelleted and cubed hay may be a good alternative if available in a producer’s area, and may be affordable.
No and No. A horse REQUIRES a 2 inch minimum forage length to maintain proper digestion and bacterial count in their digestive tract. If it is less than this length many behavioral problems begin to appear such as wood chewing, cribbing, chewing off tails and destroying trees. The reason is two fold – one the horse will feel less full. Fiber of less than 2 inches in length are quicker to digest leaving the horses intestinal tract feeling empty most of the day. Second, it can produce a condition in the intestinal tract called acidosis which has a negative effect on the bacteria which then produces an increase in digestive upset, ie colic.
Lastly she says here about complete feeds -
Complete feeds which often contain a mixture of grains and roughage sources, and are designed to be fed without hay. It should contain at least 15 percent fiber if no hay is fed, but nutritionists do not recommend no hay being fed. Horses must have forage.
Yes the reason that nutritionists do not recommend no hay being fed is the long-stemmed 2 inches or greater fiber requirement. Hay cubes are acceptable if they meet this requirement however most of the time they are chopped smaller than 2 inches.
Here is an article from Purdue that supports my case..Selecting Quality Hay for Horses by Mark A. Russell, Department of Animal Sciences and
Keith D. Johnson, Department of Agronomy
Off my soapbox and my apologies if certain parts of the interview were left out or if Karen Hansen was misquoted.
Sugar Puff, a Shetland Pony, was put down on May 25th after “complicated health problems” made him collapse.
He was 56 years old owned by Sally Botting of West Sussex, UK. This definitely a testament on how good health care can really extend the life of your horse or in this case a pony.
Read the article about this news story in Horse and Hound
Thanks to Dr Alan Weldon for pointing out this story.
