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  Discussion on Tumor Related to Vaccine?
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New Member:
Trotter

Posted on Tuesday, May 13, 2003 - 6:30 pm:

Our horse recently had to be put down (5/9) after a series of what I would consider a reaction to his vaccinations.

It's been a long sequence of events with many twists and turns, but here goes. He was a very healthy 7 year old thoroughbred gelding. He was vaccinated on April 8th for C Rhino,D EW/Tet, PHF, J Flu, WNV #1 afterwhich he developed a few hives -- mainly on his neck. Nothing unusual for him.

Around April 14th he had a slight cut near his hock on his left hind leg. It started to swell somewhat, was not hot and did not cause any lameness.

On April 18th he was given his Rabies vaccine. By that evening he was covered with hives and large 3-4 inch welts under his coat and his hind knee started to swell more. The hives were not oozy with the exception of possibly the ones under his chin. He was miserable. We gave him Benadryl per our vet's instructions and a dose of Bute. The next morning he was much more comfortable but still covered with hives, welts and his knee more swollen. The vet examined him and thought he had the start of a little cellulitis near his hock from the cut and hives from the vaccines. We gave him 7 days of antibiotics (Sulfamethoxazole & Trimethoprim -- which he's been on in the past without any negative reaction). During that first week we also gave him Benadryl at night on three or four occasions when his hives were more pronounced. The left hind leg swelling went down to normal but the hives remained - some days more pronounced than others.

He was off the antibiotics for two full days and the hives seemed to be going down.

April 28: He swelled up like a balloon...I've never seen anything like it...stomach, chest, all four legs to and including the knees but no swelling in the lower leg. Our vet described how he looked as a football player with pads. Knees were not hot, there was no lameness, and he was not sore to the touch. No fever. Just major edema. Blood was drawn and initial blood work came back normal. He was given a small dose of steroid and a diuretic (Naltrazone?) The swelling was a little better the next day. He was given a second dose. The obvious swelling went down significantly.

As soon as the swelling started to diminish, he stopped drinking and eating and started pawing, laying down, etc. The vet was seriously concerned about this sequence of events and the amount of reflux fluid from his stomach. There was no blockage found in his intestine upon rectal exam.

April 30: We took him to the nearest equine hospital about 2 hours away. Ultrasounds revealed some abnormal finding in the large intestine but could not be reached upon rectal exam. It was not clear what it was. Also noted were sections of the wall of the large intestine containing pockets of fluid.

He was treated medically and started to respond. Three days later a few significant stomach ulcers were discovered. Upon further medical treatment he started to improve and be back to his usual self. Hives were intermittently present. With a low dose of steroids and antacids the swelling resolved completely, his appetite returned and his bowels seemed to be functioning normally.

May 8: After three days of remaining stable he was ready to come home. We were ecstatic.

May 9, 2003. The morning he was to come home he started to colic again only more severely. The abnormality in his large intestine was still visible upon ultrasound and exploratory surgery was performed.

What was found is perplexing to the veterinarians and ourselves. A very large tumor was located in his large intestine mostly blocking it and a smaller tumor in his small intestine. The large tumor was inoperable. (I don't know the correct terminology, but the large tumor was located in the part of his large intestine near his back where the intestine is attached to the abdominal wall) The surgeon reported that it felt like a large fibrous tissue mass but an autopsy is being done.

This entire episode he did not have a fever and his blood work was consistently normal. He wasn't colicky in the hospital and once the antacids were introduced his appetite really picked up and so did his mood.

We were told that it was highly unusual for such a young horse to have such a tumor. We've known our horse for almost two years and he has never been colicky. Could this tumor have been there the entire time and we not know it? How fast could something like that grow in his intestine? Could it be from this whole reaction he was having? The doctors are baffled and we are in shock. I have only questions and a heartbroken 16 year old.

One more extremely disturbing event. I spoke last night with another person in our area who lost a horse this spring following vaccination (West Nile in that case) with incredibly similar scenario up to and including the tumor in the same section of the intestine. That horse also had to be put down. It was also young and athletic. Very healthy.

I'm so perplexed. What could cause this type of tumor/cyst or whatever it was? And what was his system reacting to? His immune system just went haywire... Too many questions, too few answers. Sorry to ramble on, we're just devasted. 1st horse synDrOme??? I hope someone will have the answers and possibly save some other horses from this fate.
Moderator:
DrO

Posted on Wednesday, May 14, 2003 - 6:06 am:

My condolences Judy. I think your questions will be answerable once we get the information back on the cellular nature of the tumor. Please post the information here when you get it.
DrO
Member:
Trotter

Posted on Sunday, Apr 25, 2004 - 11:12 pm:

Below is the necropsy report of our horse Indeed -this is a follow up from my post of almost one year ago.

Any information on the diagnosis of multisystemic eosinophilic epitheliotropic disease (in laymen's terms) and how vaccines may have triggered such a response would be welcome.

Cornell Equine Hospital

Indeed
DOB: Feb. 9, 1996
Breed: Thoroughbred
Bay gelding
Admission Date: 4/30/2003

Problems: colic, diarrhea, urticaria, gastric ulcers [post vaccination]

Visit Summary: “Indeed” presented to the Cornell University Hospital for Animals on 4/30/03 with a history of peripheral edema 2 days prior to admission that resolved with treatment. He had received a vaccine and an antibiotic treatment during the onset and duration of the edema formation. One day prior to admission he showed signs of colic including lethargy, inappetance, pawing, and going down. The referring veterinarian administered banamine and xylazine. A nasogastric tube was passed and 3L of reflux were recovered. A rectal exam at that time was unremarkable. Prior to this episode, which seemed to follow a repeat vaccination, the horse was reported to have allergic (skin) reactions to vaccines in the past. [He had severe skin reaction pre-admittance, post vaccinations consisting of raised patches of fluid – some 3-4” in diameter, over his neck and body.]

On admission his physical examination was fairly unremarkable, as was the rectal examination. On ultrasonography, a loop of thickened bowel could be seen in right cranial mid abdomen, close to the liver. In addition, more thickened bowel could be found more caudally. Hematology and peritoneal tap (attempted, without success) did not reveal any other significant changes. He was tubed with a gallon of mineral oil and treated with IV fluids.

Indeed continued to improve on 5/1/03. Several hives were noted on his body. His abdomen was ultrasounded again and fluid-filled loops of colon were noted in addition to a questionable lesion in the right abdomen. The apparent lesion had a bulls-eye appearance. An intussusception and foreign body were considered as possible differential, although Indeed showed no signs of colic. Since he was improving he was given free choice hay and bran mash.

On 5/2/03, Indeed passed normal manure and showed no signs of colic, but appeared more depressed and less eager to eat hay. During a visit from his owners he briefly appeared dysphagic, repeatedly grunted, and tried to go down. Another abdominal ultrasound revealed less fluid in the colon and similar appearance of the questionable lesion in the right abdomen as before. Multiple hives were still present on his body.

Endoscopy was performed on 5/3/03 and revealed multiple gastric ulcers. The nasopharynx and gutteral pouches appeared normal. Indeed was started on sucralfate and omeprazole to treat the ulcers. Again, the mass-like, edematous lesion in the right caudal abdomen was identified with abdominal ultrasound. It was also palpable as a spongy mass on rectal palpation. Indeed continued to show no signs of colic, had a normal appetite and passed soft manure.

Indeed was still depressed with soft manure on 5/5/03. A greater number of hives were present over his body today than previously and preputial edema was noted. A sweat wrap with magnapaste was put on his left front limb to treat edema distal to the carpus. A repeat ultrasound again revealed markedly edematous bowel in the region of the right dorsal or ventral colon. The mass-like structure was no longer palpable on rectal exam. Indeed was treated with desamethasone (corticosteroid) and hyDrOxyazine (antihistamine).

By 5/6/03 Indeed was brighter and the majority of the hives and the swelling of the left front limb had resolved. Abdominal ultrasound of the right caudal abdomen revealed no apparent abnormalities.

On 5/7/03, the hives had returned and were much more numerous than had previously been observed. A radiology consult was requested and abdominal ultrasound revealed a focal region of intestine (cecum or right dorsal colon) with thickened walls between the 12th and 17th intercostals spaces. Another dose of dexamethasone was given and hyDrOxyzine was continued.

On 5/9/03, Indeed showed signs of colic including pawing at the ground, flank watching, lying down, and rolling. The same thickened piece of bowel was identified on abdominal ultrasound but a rectal exam was unremarkable. An exploratory laparotomy was performed and revealed a mass extending from the wall of the intestine obstructing the transverse colon as well as the small colon. Due to the inoperable nature of the lesion as well as the poor prognosis for recovery, Indeed was euthanized.

After extensive pathological studies, the horse was diagnosed with multisystemic eosinophilic epitheliotropic disease. This is a systemic disease of eosinophilic infiltration, causing lesions in the intestine, skin, heart, pancreas and fatty tissues in his case. You may feel absolutely confident that you have made the correct decision about euthanizing Indeed, even though it was a very difficult decision and an extremely sweet companion. ….

Member:
Jcsmoon

Posted on Monday, Apr 26, 2004 - 10:06 am:

I am sorry for your loss, it truely sound as if you gave Indeed every chance. Thank you for posting that report, it was very interesting.

Dr.O, is that not the description of an auto immune issue?
Moderator:
DrO

Posted on Tuesday, Apr 27, 2004 - 9:36 am:

Eosinophilic epitheliotropic disease resembles a hypersensitivity reaction, however its cause remains unknown. If the hypersensitivity turns out to be to self antigens it would be labeled autoimmune. It has been associated with lymphosarcoma in the past and both intestinal parasitism and a as yet unknown virus have been proposed as causes in other cases.

The association with the vaccine that Judy describes above is difficult to evaluate. It does "look" like the vaccine caused the problem but it may be possible the disease was developing, still subclinical, but stimulated by the vaccine. Or perhpas this was a huge coincidence as I cannot find another case associated with vaccine administration. Also the nature of the distribution (epithelial tissue) is hard to understand as a vaccine reaction.
DrO
Member:
Paul303

Posted on Wednesday, Apr 28, 2004 - 9:36 pm:

Thank you so much for what I know was a difficult post. It is the pooling of all the knowledge and experiences of all the good people on this site, that helps us all to be better horseowners.
Member:
Creed

Posted on Thursday, May 6, 2004 - 7:49 pm:

Judy, I can feel your pain! I lost my first horse last September and it too was a young 6 year old healthy horse. I had and still have a lot of unaswered questions - the support I received from this forum has helped me a lot through the tough times. There isn't a day that goes by that I don't think about him and wish he was still here!
Member:
Mrose

Posted on Thursday, May 6, 2004 - 10:45 pm:

Judy, thank you so much for posting this. It's very interesting and something that most of us,thankfully, will never see.

I'm so sorry for the loss of your horse; it sounds like he was a "sweetie."


Dr.O-If someone knew early in "the game" that a horse had this condition, what if anything, could be done? Also, if a horse gets hives after an injection, could that mean that next time around it could develop into this? Thanks.
Moderator:
DrO

Posted on Friday, May 7, 2004 - 7:23 am:

Hello Sara,
There have not been any treatments that have worked with any consistancy. I have not seen such an association like this in any other case.
DrO
Member:
Mrose

Posted on Friday, May 7, 2004 - 9:19 am:

Thanks, Dr.O.
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