|
|
Discussion on Vaccine Reaction-Tucked up and mild trembling
|
| Author |
Message |
Member:
Skeller
|
Posted on Monday, Mar 28, 2005 - 10:30 pm:
I've read the article and posts related to vaccine reactions. Cody appears to be having a pretty typical reaction (--The stiffness and soreness following vaccination can be remarkable accompanied by a short shuffling gait resembling founder--) 6 days post his vaccinations he's VERY sore and I was extremely alarmed to see him move like this tonight.
He was given the 5/1, Flu and West Nile in his neck on Wednesday. I also gave him 1 gm Bute (I'll increase this next year after reading the recommendations and continue it). He was sore the next few days, but so were quite a few of the others in the barn. Friday and Saturday he looked normal walking but was a little stiff in the neck and didn't want to trot at all (we had several other horses with the same problem and chalked it all up to the shots). Sunday was Easter so he wasn't let out any.
Tonight, in addition to the founder-like gait he's tucked up under in his hips and has some mild trembling. I'm thinking this is a reaction to pain. He also is letting down a lot (something he normally doesn't do). In fact I took advantage of the situation and cleaned his sheath on Saturday (poor boy). He is urinating and drinking fine. In fact in the stall he looks normal, it's mainly when we ask him to move. His gums are normal pink and he's not dehydrated, temp is 99.8 (99.5 on Saturday). I gave him 2 gms of Bute this evening (which he ate fine in a little grain laced with peppermints, no problem with appetite). And ate his nighttime hay like normal.
I'll reevaluate him tomorrow, but I'm worried about his posture and trembling. Is there any possibility he could be having a kidney/bladder problem as well? Or is this posturing typical of the stiffness and pain?
Thanks for the excellent articles, they have put my mind at ease tonight. Compared to the other posts on the board this week, I know my problem is minimal, but I want to make sure I'm not overlooking something or letting a problem go on too long.
|
Moderator:
DrO
|
Posted on Tuesday, Mar 29, 2005 - 8:46 am:
To still be this sore 6 days later is a bit more severe than the usual reaction. The main thing I would change you already have noted you would do. Be sure to follow the instructions in the article on preventing such reactions.
I am concerned about the new symptoms you describe as they may not be vaccine related or at least not typical. If they persist overnight I would call the vet.
DrO
|
Member:
Skeller
|
Posted on Tuesday, Mar 29, 2005 - 9:29 am:
Thanks Dr. O. The vet is going to be in the area today so she's going to stop by and check him out this afternoon.
It will also give me a chance to discuss using the intranasal flu next year. Nobody in this area has used it before, so being a less experienced horse owner I've gone along with the norm.
I feel I definitely under medicated him on Bute and will be sure to follow your recommendations next year.
|
Member:
Deggert
|
Posted on Tuesday, Mar 29, 2005 - 4:43 pm:
That tucked up and trembling stance doesn't sound normal, Skeller. Keep us posted on what the vet says. If my horses have any reaction after a second shot and the disease we are vaccinating for is not life threatening, we don't give it.
good luck, Debbie
|
Member:
Skeller
|
Posted on Tuesday, Mar 29, 2005 - 10:46 pm:
According to the vet, Cody appears to have slight laminitis. By this I mean that his hoofs were slightly warm (it was hard for me to differentiate but I was able to do that by comparing with this back ones), and he did have a slightly increased digital pulse (another hard one to call. But I could tell that the RF was stronger than the left). He did not react to the hoof testers in either front foot which was great news. And didn't have a problem with us picking up any of his feet. His stance in the stall is still normal, in fact he's doing the normal rest the hind leg thing that I would think puts more weight on his front feet.
We are giving him 1 gm bute 2x day for 5 days. We are going to have his shoes pulled tomorrow if he seems even the slightest bit worse. Plus I'm reevaluating his diet to cut down on the carbs (I'd been considering eliminating corn so this will work into that plan). He's in a deeply bedded stall on stall rest for 5 days or until the symptoms disappear.
Because I was asking 20 million other questions I failed to get info on one of the most important ones. Did the vaccinations lead up to the laminitis? Can you tell me if this is a reasonable theory.
This horse is 12. Even though I've only had him for 3 years, the previous owners are still at this barn and had him since he was 4. Absolutely no history of laminitis. He does have a slightly cresty neck but we always thought this was because he wasn't gelded until almost 4. The vet feels he does NOT present the typical cushings profile (other than a slightly cresty neck). However there's still the possiblity of insulin resistance and if this continues we could test for that. He's in good condition, well filled out but not fat (but shouldn't gain any more). The only changes in routine and diet is that he had his teeth floated on 2/22 which included pulling a wolf tooth and sedation. He was given his vaccines on 2/23.
I know it's really hard to say and it could be coincidence. Looking back, the laminitis issue was probably surfacing on 2/25 when we thought he had just a stiff neck.
Thanks for the comments Debbie, I am going to reevaluate my vaccine strategy next year. I was glad to find out that this vet now does the intranasal flu so that will be part of my change in addition to the bute predosing outlined by Dr.O.
Dr. O, should I insist that his shoes be pulled even if he seems the same?(he's flat shod with no pads). For a case that appears (keeping my fingers and toes crossed) to be this slight, should I ask about the nitoglycerin therapy? FYI, After this one, I'll be good and post all my other questions under the laminitis/founder topic.
Thanks for shoring up my instinct to call the vet out. It didn't seem that bad, but something was definitely out of wack. I'm just glad I didn't wait a few days.
Sad thing is I'm feeling EXTREMELY guilty right now as I think his tucking up and trembling last night was caused by my ignorance. Because we thought it was a stiff neck, I allowed my daughter to ride him to see if he would loosen up. I was busy finishing a lesson on the other side of the barn when she brought him out and went into the ring. She was walking him for about 5 minutes before I saw him and then we stopped. I just hope this didn't cause any damage. She weighs about 100 lbs but I'm sure the extra weight and exercise caused the pain. Thank goodness he appears to be 20% better today and no trembling or tucking up. I'm just amazed at what a good guy he was about it all.
|
Member:
Vickiann
|
Posted on Wednesday, Mar 30, 2005 - 7:02 am:
Years ago I had an Appendix Reg. mare who was diagnosed with laminitis on 3 occasions. The first time was following a tetnus shot, the second time a penicillin shot and the third time a fall combination shot. She was severly lame, classic laminitic stance and would not walk. There were no signs of injection site problems. This came on by the following morning after the shot the first two times. The last time it came on much faster. This was a horse that needed to be worked regularly and kept a bit thin. It seemed that underwork and a bit too much food for the amount of work contributed to the times the laminitis happened. The first time my daughter's trainer had the horse on some extra daily corn oil to "fatten her up." Many other times she was fine after her shots. The case was discussed with a very experienced Vet. in our area who said there are a few horses who can mysteriously get laminitic due to endotoxins building up in their system following injections. It was not known at that time whether a reaction to something in the shot (drug carrying agent?), or why the shots set this into motion. This was years ago but that Vet's advice for future injections was a Banamine shot one hour prior to the planned shot, plus use of Tri-hist granules (twice daily I think) for one week prior to shots and continued through for one week after. We treated every case agressively and had no rotation. Good luck to you.
|
Moderator:
DrO
|
Posted on Wednesday, Mar 30, 2005 - 7:31 am:
If he does not improve, yes I would pull the shoes to support the soles and no I would not begin the nitroglycerin. Though we still list it as a possible help in refractory cases there are questions about its efficacy.
Often founder is brought on by adding together a combination of factors that predispose to founder, the vaccine may have pushed the horse over the edge. Rereading above, I don't think it sounds like he had founder over the weekend and it probably started when you noticed the horses standing with the hind legs tucked up under him.
DrO
|
Member:
Deggert
|
Posted on Wednesday, Mar 30, 2005 - 1:34 pm:
Skeller
I know when my older mare and pregnant mare came up sore, we did pull the one shoe because we needed to evaluate it better but on the older mare with a chronic case the vets were adamant about not disrupting the feet any more. We immediately put the "blue foam" on with duct tape with the shoes on, bute, ace to increase blood vessel dilation, we also did an initial dose of IV DMSO. I think they did put them on Nitro too. That was their protocol, and I am sure it varies by vet practice. My old mare was chronic with little or no rotation, the pregnant (just foaled) mare was an acute case.
Again, if the disease is not life threatening I would not take a chance again with the vaccine.
My acute founder mare may never get another vaccine in her life, we haven't made that decision yet because although her founder was more of a trauma founder she also displays reactions to most vaccines.
Good luck to you and your boy
|
Member:
Skeller
|
Posted on Sunday, Apr 3, 2005 - 8:34 pm:
Thanks Vicki, Debbie and Dr.O for the info and good thoughts. I wasn't responding earlier as we had our first horse show of the year on Saturday (Wind, Rain and Sleet of course - thank goodness we had a covered ring and warmup area - and it's gorgeously sunny today on Sunday). Thankfully it was local so I could still keep an eye daily on Cody. He's boarded with great folks, but you still want to watch your own kids. Plus only having owned my own horse for 5 years, I'm pretty lean on experience when it comes to illness (I guess I need to be thankful for this).
I'm concerned because Cody hasn't gotten any worse, but he doesn't seem to be improving much either.
The digital pulse has stayed the same. The Left Front which is also slightly dished seems warm on the outside quarter near the front. However it's very slight. Not having any experience with founder I'm not sure how much heat is bad so I'm feeling every horsey leg in the barn!
He still has a short stubby even gait and is resisting walking out of the stall (that's what really worries me). He is standing normally, not tucked up - since we started the daily bute. He is stocking up a bit at the elbows (but not the lower leg) which I think is from not moving much. I've done the lift one leg for 10 seconds test and he seems fine. You can see him shift his legs when I put it down, but he doesn't lift the leg that had all the weight on it up. I did notice a difference though when I lifted the leg on the right side and he put his weight on the left foot which has the dish. He didn't lift it up but seemed to be shifting weight off of it.
I'm going to have the vet out this week again to evaluate him. She'd mentioned doing xrays if he didn't improve. I was also going to ask her to go ahead and do blood work on him. Any other tests I should ask about. I've got a limited pocket book but feel it will be cheaper to do it now than on down the road. He's a great kid's and family horse so we'll do what ever we need to. I was wondering about testing him for Lymes disease because of his depressed attitude. And also have his thyroid checked.
Right now he's just in a deeply padded stall, no extra support. And unfortunately the farrier has been out of town so his shoes are still on - but I am going to get them pulled ASAP since there's no real improvement.
Debbie, Is the blue foam the same as the dense foam insulation in the hardware store? I've heard of the old timers using clay also but this would surely be a lot more cushy!
|
Moderator:
DrO
|
Posted on Monday, Apr 4, 2005 - 7:03 am:
We have articles and discussions on these diseases:- Equine Diseases » Lameness » Diseases of the Hoof » Founder & Laminitis » Founder & Laminitis an Overview
- Equine Diseases » Endocrine Disorders » Hypothyroidism in Adult Equines
- Equine Diseases » Fever of Unknown Origin » Lymes Disease » Discussion on Lyme disease
|
Member:
Deggert
|
Posted on Tuesday, Apr 5, 2005 - 2:52 pm:
Skeller
sorry didn't reply sooner, not on my computer yesterday. I would ask your vet, ( surprised he didn't recommend this) what they use on laminitic horses for the feet. WE used the hardware foam before, it just crushed easier. YOu tape it on, let him crush it into the sole area, then tape more on to that. Try https://www.equisearch.com/magazines/practicalhorseman/holistichelp_020504/ this link it show how to put them on, I think there is info on this site too, you will find plenty with founder search as Dr O said. My mare wore foam for weeks, sometimes when you change them the horse will get a little sore again, Founder is very frustrating but see what the vet says. Is he/she doing anything besides bute, was there any acute treatment regimen? We put her on Zantac during all this pain treatment so we did not get a gut problem on top of it all.
|
Member:
Skeller
|
Posted on Tuesday, Apr 5, 2005 - 11:28 pm:
Thanks Debbie, I loved the article with the illustrations on how to apply the foam.
Thanks Dr. O. I've read these articles and more. My brain is beginning to feel pretty mushy. (especially trying to figure out how to calculate the diet).
The farrier will be there tomorrow to pull shoes and the vet is coming out on Friday to do Xrays and blood tests.
Cody is doing some better but now has some different symptoms. He did not have a noticeable digital pulse tonight and his feet were definitely cool. Before I was confused as to how significant his previous pulse was since I didn't have a benchmark. I can now say it was significant.
He still does not want to move out of his stall unless encouraged and seems generally depressed when moving. (he looks his normal self when standing but is still very calm). I'm really worried about his depressed attitude. This horse has always been a kids type horse and easy to work around. However he always came out of his stall with energy and wanting to get to the arena. He's a saddlebred and is shown in pleasure classes, trail ridden, and driven.
At home we always said that Cody has a union card. He acts lazy if he can buffalo the rider, but after he knows you will make him work, he'll go. We had been doing a lot of driving with him this winter and he was developing a nice extended trot. At a horse show he definitely has more motivation and energy. But is the type of horse who is great for the young rider at their first show. (Ok so I'm trying to justify his "poor performance at home" he is lazy!
I was also concerned tonight as there seems to be a pad of swelling on his loin and part of the croup. I thought it was more firm than mushy. I was doing some brushing with a very soft rubber grooma and he didn't have an overt show of pain, but definitely moved himself so I was working on other areas.
His gait is better in the front, but strange now in the rear as he is putting his hind legs under him more while walking (not while standing though - I thought this was weird as the founder seems to be resolving some now).
Dr. O, is it possible that the initial founder is being followed by a case of Tying Up? His profile fits with the symptoms (especially the poor performance), however I couldn't fit a probably cause into the picture. He was worked regularly, 5 days a week. Ridden once. Driven or Long-Lined the rest. I don't know if the stress from back to back procedures (tooth being pulled Tuesday and then shots on Wednesday) could be a contributing factor.
I was happy to see that the treatment for Tying up and Founder are pretty close. We've gradually switched him over this week so he is getting all pellets and adjusted his pellet ration down since he's not getting any exercise (and I wonder why he looks depressed). He gets a very good quality grass hay 3x a day. As soon as I can get my brain in gear I will be doing some nutrition analysis. I'll start adding fat tomorrow.
Should I be concerned about these new developments? Or is having the vet out Friday soon enough. Do you think Tying up could be a possible addition to the case.
Sorry for the long post, but I really don't have any experience in this area to go on. As a novice, we tend to be long winded. Thank goodness for all your articles even if I start to feel like a horsey hypochondriact
|
Member:
Skeller
|
Posted on Wednesday, Apr 6, 2005 - 7:50 am:
Oh, and because of his history of "poor performance" I'm looking into EPSM. However I'm trying real hard not to be a horsey hypochondriact and take this one at a time
|
Member:
Contilli
|
Posted on Wednesday, Apr 6, 2005 - 8:12 am:
Hi Skeller-
I am so sorry to hear about your boy’s reaction to his shots. It is very stressful for you and I hope you are coping well. I just lost a colt (long story) for the same reason. Please make sure you palpate the injection sites and also around for an abscess. This can be life threatening! We would have missed mine if I didn’t check for it myself.
I hope all is well,
Denise
www.BryantFarm.com
|
Member:
Deggert
|
Posted on Wednesday, Apr 6, 2005 - 1:05 pm:
Skeller
I don't want to be an alarmist but his stance seems very "classic" lamintis with his hind legs pulled up, I would think his depression is pain and if he doesn't want to move I wouldn't move him. I don't get why the vet is not taking this a bit more seriously and treat it like the emergency it may be, every day lost with laminitis is crucial. Again, I hope I am wrong but the vet needs a fire lit under him. What meds is he on?
|
Member:
Skeller
|
Posted on Wednesday, Apr 6, 2005 - 11:33 pm:
Denise, I'm so sorry about your loss. I’m sure he felt very loved having someone like you looking after his welfare. Since this is the first time my horse has been REALLY sick I'm trying desperately not to miss something so I do appreciate the insight from everyone.
Cody still has a slightly elevated bump the injection site but doesn't seem to be really sore. I probed very hard. In fact he did his carrot stretches quite readily today stretching his neck around to both sides with his nose touching his side. I was amazed as I expected him to be much stiffer in the neck.
Thanks for the support Debbie, I'm getting very alarmed also. It took us 45 minutes to get this horse to walk 50 feet down a soft aisleway and back again tonight. It took at least 2 people (sometimes 3) an apple, several peppermints and hay all the way down and back. When we did get him to move several steps at one time he was stepping much better in the front. It was really hard to evaluate but not the foundery walk he was doing before. But he is super super stiff in the back end (body more than legs). In fact it seems that the trouble has switched ends. He does not want to back up at all (but can). And at one time when turning seemed to be loosing his balance. He was loosening up more at the end of the walk and seemed to be doing better. Right now he's on 1 gm bute a.m. and p.m.
I've never seen a horse this reluctant to move and it's really scaring me at this point. I will be calling the vet first thing in the morning to discuss if we are still following the same illness or it it’s switched on us. The only reason I'm not insisting on a midnight call is that if the horse doesn't move he looks fine. bright eyed and slick and normal head carriage. He still has the swelling on both sides of his loin, about the size of a dinner plate, but it's not elevated (just enough to tell). It’s firm, not mushy.
His shoes are off and feet look fine. I wasn’t able to contact the farrier but will keep trying. I’m very interested on if he got Cody to move or took the shoes off in his stall. One of the other owners lost a horse last year with chronic laminitis and has offered to let me use the frog/shoe pads that they kept.
I also started him on corn oil tonight (mixed with just a few oats he seemed to like it. He’s down to 3/4 scoop of pellets each feeding. He gets grass hay 3x day.
Dr. O, I just realized I promised to post in the more appropriate topic. However since his symptoms have changed I’m leaving it here. At this point i'm not sure where to put it. Hopefully the bloodwork and xrays will show more. I was wondering if I should go to the extent of having a muscle biopsy for EPSM done. But I really don’t want to stress him more so I’ll leave that for later.
Thanks again for everyone's comments. It really helps to be able to write this stuff down. Sandi
|
Member:
Contilli
|
Posted on Thursday, Apr 7, 2005 - 7:43 am:
Hi Sandi-
Geez that sounds terrible! The poor guy is so sore.
I have a TB mare that if you give her a shot in the neck she acts almost paralyzed for over 6 days. Literally she will not move.
My mare that abscessed (in the hip fro a vaccine) hardly had a bump. But I just knew something was wrong. She was walking funny, not eating as well as usual and she us usually a pig, etc. We stuck a syringe into the area and, look out, fire hose of puss. So we stuck a scalpel into that area and, I am not kidding, I flowed like a water fountain. It sprayed into the air!!! Completely disgusting.
She is fine now, but I am concerned that your guy is still “down”.
Did you get a second opinion? If so, I’m sorry if I missed that in a post.
Denise
www.BryantFarm.com
|
Member:
Skeller
|
Posted on Thursday, Apr 7, 2005 - 11:29 am:
My goodness that definitely was a hidden abscess. It must have been really deep. I hate to think of all the pressure behind it. (you really need a video camera at the barn sometimes, but when you need it there's never an extra hand to run it.) I'm glad she's ok. Did she react to your pressing anywhere on her hip.
I took care of the neighbors cat that had a chronic sinus infection. He had a nasty spot on the top of his head that I was worried was a warble and took him to the vet. It ended up being that the sinus infection formed a tract that opened up on the top of his head. We took care of him as the owner wasn't able (or didn't take the time) to give him his antibiotics. But at least the owner paid the vet bills! I just hate to think of the pain he went through until the pressure was relieved.
The Vet's coming out at noon. Actually it will be one of her associates so that will work for a second opinion. She is very concerned but has 45 horses on her schedule today. The farrier also said he'd make time to come out if we needed him today.
They are still leaning towards the founder still being active, but I feel like there's something else going on. Or Cody's being a wimp and thinks we are seriously underdosing him on bute. I'll let you know.
|
Member:
Chohler
|
Posted on Thursday, Apr 7, 2005 - 1:26 pm:
Sorry it's probably further up in the post and I just didn't notice how much bute are you using?
|
Member:
Skeller
|
Posted on Thursday, Apr 7, 2005 - 4:38 pm:
It was me, I don't think I specified it. It was 1 gm 2 x day (2 total), but we just upped it to 1.5 grams 2 x day by the vet (3 total).
However the farrier is recommending that we give him 2 grams 2x day (4 total). The vet did say that would be ok on short duration (5 days).
We put on lilly pads and did xrays and blood work. It's strange that he still tests fine in the toes (could be modulated by the bute) but is slightly sore in the heal. I'm checking this evening to see if the pads are making it worse or better and will take them off if necessary.
But I feel the same way as Debbie that I need to get aggressive about treating this. Unfortunately I'm not very experienced on this issue and tend to not be as agressive as necessary. (but I'm learning as I don't want to get the experience at the expense of my horse!)
I'll get the results of the xrays and blood work tomorrow and the other vet will be at the barn and check him again.
He is on only grass hay now (as much as he wants). No pellets.
The muscles in his rear are tight, but the vet seemed to think this was because of the strain of him trying to stand differently. He is going to go ahead and test for muscle enzymes though.
Dr. O, I'm thinking this has gone from mild to moderate at this point. Any other suggestions to slow the progression or avoid other complications?
|
Member:
Skeller
|
Posted on Thursday, Apr 7, 2005 - 9:25 pm:
Ok, Dr. O, I'm going to keep this posting here for a minute as I'm still considering it a vaccination reaction.
One of the experienced trainers in our area that works with an adoption program, and is well respected, has seen similiar reactions to the vaccinations (she's also seen a lot of foundered horses). Her strong recommendation is to give him an antihistamine. And the logic (from a lay persons view at least) seems right to me. He's reacting to the vaccination we need something to arrest it. Bute is acting on the symptoms, not the cause.
What do you think? I understand we can't definitely say it's the vaccination but this horse isn't one to stress founder. He's very layed back, and has always been calm for the vet. Two other horses reacted to the vaccination with quite a bit of soreness. It lasted 5 days. Our barn owner/trainer has over 30 years experience and she's never seen a reaction like this.
I took the lilly pads off. The vet thought it could possibly make things worse instead of better since he tested with a response in the heel, but not the toe. He asked me to try them for 4 hours. When I got to the barn the pulse was more elevated (not at much as on Tuesday when it first started) and feet were slightly warm. So I took them off. His feet were cool in about 2 hours and pulse down. Unfortunately I couldn't get him to move to a place where we could hose his feet. He decided to lay down so I didn't soak his feet either. On a good note, I added some fluffy shavings to his stall and he decided to roll and was able to get up ok on his own.
|
Member:
Skeller
|
Posted on Friday, Apr 8, 2005 - 8:53 am:
I've rereaad the articles on IDing lameness and navicular synDrOme. The positive hoof test in the frog points to this, but has anyone ever seen navicular have this type of onset? All navicular horses I've seen the onset has been very gradual. The article did mention one possible cause as being Ischemia or low oxygen levels in the tissues and it being painful.
I hope I haven't totally confused everyone with my posts but yes, I am paniced.
Any advice on what to ask the vet this morning would be appreciated.
While it will be an extreme hardship to take the horse elsewhere, I'm willing to do this if necessary. The closest to me is Virginia Tech. However I worry about how stressful it would be for him to travel 3-4 hours in a trailer.
Sandi
|
Moderator:
DrO
|
Posted on Friday, Apr 8, 2005 - 9:36 am:
Navicular disease and vaccine reactions generally do not present with the horse standing with the hind limbs pulled up underneath the horse. The biggest problem with the bute/antihistimine suggestion is the idea that the bute just acts on the symptoms. Vaccine reactions are inflammatory in nature, bute is a general potent antiinflammatory, so it actually cures the disease not just relieve the symptoms but it may take time. Recent work with founder also sugests it has a positive effect on outcome, not just a pain killer. This is not true with antihistimines. A histimine reaction generally causes whelps or hives and usually would be a small component of such a reaction.
Somehow I missed your questions in your earlier posts Skeller. You are doing right to continue your posts in this discussion. I don't see anything that suggests tying up and a easy check is to look at muscle enzymes, though a vaccine reaction may raise these levels also. The physical exam should direct whether further testing for tying up needs to be done.
If when the vet comes out he seems still uncertain as to what is going on consider a second opinion. If it is founder I would avoid moving him but if radiographs are negative for rotation on radiographs consider it with the horse riding backward on lots of padding.
DrO
|
Member:
Skeller
|
Posted on Friday, Apr 8, 2005 - 10:38 pm:
THANKS so much everyone for helping me get through my first horse emergency. If only these things presented themselves and then reacted like they are supposed to it would make life so much easier. At least next time I'll know to pull the shoes right away and put on the foam regardless of how minor it might seem. But I did agree with the vets initial accessment as he was walking readily and seemed to be a only little bit sore. It should have gotten better!
Cody is better today (we got him in the aisle without treats) and I feel very confident that the vet is treating him agressively. He does have a slight rotation (less than 3 degrees) in the RF. LF the xrays didn't turn out so it was taken again. We also took the back, even though it's unlikely, but hopefully to rule it out as he's really moving funny with his back end (he really doesn't want to back and seems weak and bends his back legs down quite a bit.)
Bute 2 gms 2x day (for about 4 days with gastro guard), Nitroglycerin gel for increased circulation and will start him on Pergolide as soon as I can get it. (He's cresty and has a fat bump on his rear. At this time the treatment is only going to hurt my pocketbook - I'll be eating lots of pnutbutter and doing odd jobs! If we decide to do the test for Cushings it will be after the founder has resolved. I know it says that the test is ok in active cases but I really don't want to put his system through something else when it's trying to recover from the vaccinations). She feels strongly that the Pergolide will help. He's got foam rubber shoes on right now. An interesting sight. His lab work came back <0.4 on thyroid (low - but I read the article and that's how the vet feels to), Liver enzymes were low (nothing to worry about in the low range), muscle enzymes were normal.
So if his back feet check out ok, things will be looking a lot better. He seemed to move around the stall better about 45 minutes after I put the nitroglycerin on. Does it work this fast?
|
Member:
Skeller
|
Posted on Saturday, Apr 9, 2005 - 9:44 am:
The LF turned out to be significantly more. She hasn't measured it but right now I'm working on getting some Redden shoes ASAP. The vet is worried that it's metabolic and the situation hasn't stabilized.
|
Moderator:
DrO
|
Posted on Saturday, Apr 9, 2005 - 4:34 pm:
The cresty neck is more indicitive of Equine Metabolic SynDrOme rather than Equine Cushingnoid Disease with which you treat with pergolide. Go back to the endocrine disease section and look at the difference in the 2 and see if you agree, there are important treatment differences, which are also addressed in the article. I have quit trying nitroglycerin as I did not see an effect. The last few research articles looking for a positive effect from its use, both well designed, did not see an effect either.
DrO
|
Member:
Skeller
|
Posted on Monday, Apr 11, 2005 - 12:41 pm:
I'm gathering from the vet that they also think it's more the Equine Metabolic SynDrOme. I'm sure you'll have to put up with more questions from me as I figure out his diet .
Cody has finally stabilized and is doing much much better.
Since we were unable to get the Redden shoes over the weekend, Our trainer figured out how to keep the foam shoes on him and we also elevated the heel. So he's getting sole support from the foam, and the elevated angle to take the tension off the deep flexor tendon. If I hadn't seem the turn around I wouldn't have believed it. At 11 a.m. he wouldn't move or back up. I put our "redesigned" foam shoes on him and setup camp outside his stall to monitor him. (taking notes in case we needed to refer him). At 3 p.m. we opened his door not to see if he would move around more. He walks out - with an almost normal stride - heading to go outside. We caught him before he got to the grass. Also his back muscles smoothed out.
Sunday he walked down the aisle with very little hesitation (other than searching for any food that may have been DrOpped). Today the report was that he looks good and is doing the normal horsey thing of resting his back legs.
I almost hate to switch shoes as he's doing so good, but the advantage of the Redden shoes is that you can control the angle and gradual decrease it down after he's sound with no bute. With my foamies, we built up the heel to give him release, but I can't be accurate on the angle.
Digital pulse seems normal (I have a very had time finding it now). Heat, I don't trust myself to give and accurate accessment of this. It seems gone to me, but my hands just aren't educated enough.
|
Member:
Deggert
|
Posted on Monday, Apr 11, 2005 - 1:16 pm:
Skellar,
I think I wouldn't change just yet, let him stablize in the foam. Not only that but you can
remove the foam, reshape, reset it, yourself. that come in handy on these founders as daily it can change. Are the REdden shoes the rocker shoes?
Can you tape them on? Debbie
|
Member:
Skeller
|
Posted on Monday, Apr 11, 2005 - 10:08 pm:
I'm really impressed with the foam and will but this on immediately the next time I see that shuffling walk (hopefully never!).
Actually we tried to mimic the Redden shoes with the foam. I didn't have any special foam, but used the stuff that they sell for covering shop floors that you can put together like a jig saw puzzle. Two layers taped together worked great. There are 3 layers at the heal. Here's the link:
https://www.nanric.com/item.jhtml?UCIDs=1113352%7C1203880&PRID=1143639
(in case this doesn't work they are under Redden Modified Ultimates).
It's not a rocker shoe. It's only meant to be used for horses on stall rest. They work by lifting up the heel to reduce the action of the deep flexor tendon. There's also an elastic polymer that you shape to the sole when you put them on to provide sole support. You have 2 options for application. They can be either glued on (more permananent) or taped on. I'm planning to tape them on. My vet says that I should be able to apply them myself. (the instructions say one roll of vetwrap per foot. My farrier is recommending wrapping his legs in cotton prior to putting on the vetwrap).
I bought them since because they come with different angles, so during his rehabilitation as he stabilizes I can gradually reduce the angle down to normal. Because the foamies crush down, I don't have control of the thickness at the heal.
I am worried about changing now since we are making progress. I'm calling the vet tomorrow to see if we should use foamies until the weekend.(the kids say he has Nikes on since they are covered with bright blue vetrap and silver ducttape).
I'd be interested in hearing opinions on the Redden shoes.
We let him walk a short way down the aisle again tonight and he went willingly without needing to be cajoled (but didn't want to go back in his stall poor boy). I thought he was slightly limping though. I'm wondering if even this short walk is too much.
|
Moderator:
DrO
|
Posted on Tuesday, Apr 12, 2005 - 8:51 am:
Skeller have you posted how many degrees of rotation your horse has?
DrO
|
Member:
Skeller
|
Posted on Tuesday, Apr 12, 2005 - 9:51 pm:
RF < 3 and LF 5. Sole thickness ok
I'm meeting with the vet to go over the xrays at the office and get all the measurements.
We got the Redden ultimates on tonight.
It wasn't too hard of a process at all including the spongy plastic you molded to his foot. But you definitely need at least 2 people
It was a team effort. One person holding the horse, one person manning the vetrap, one person distracting the horse and one person taking pictures and the fifth person supervising. If anyone is interested in what they look like I'll see if I can post some of the pictures.
I saw an increase in his stall movement right after putting them on.
|
Member:
Skeller
|
Posted on Tuesday, Apr 12, 2005 - 9:58 pm:
I also bought the "Understanding Laminitis" Book by Dr. Redden.
On page 19 Under "Looking for Clues" it lists "Has your horse...Recently received innoculations and injections?" and another reference on the page " has the horse recently received an influenza vaccination or any other kind of injection."
That's why I started this whole thread so I thought someone else may be interested. However the book doesn't say anything else about this correlation. I'm going to try and email Dr. Redden's site and see if they will respond with more information.
|
Moderator:
DrO
|
Posted on Wednesday, Apr 13, 2005 - 5:55 am:
Ric loves to talk to folks and will probably respond quickly so we will have to wait for his response to know but I conjecture 2 possibilities:
1) Common vaccine reactions can look like founder.
2) He believes founder is a common reaction to vaccines.
Let us know what he says.
DrO
|
Member:
Deggert
|
Posted on Wednesday, Apr 13, 2005 - 1:01 pm:
Skeller, Dr O
I am in this situation of risk vs benefit on my foundered mare. Although the founder in her one foot was not directly caused by vaccines, she does have increasingly significant vaccine reactions. Even before the founder my vets recommended only life threatening vaccines. I haven't spoken to them in a while but will soon because she is due for 3-way,West Nile - she has recovered well so far from the founder and will most likely have 100% recovery. She is very sound right now but I am still babying her in terms of exercise, only walks now in hand. During her last pregnancy we had to stop rhino and the 3-way even gave her a fever and severe stiffness. I will catch up on her at her post soon, "Foundered mare with foal at side".Thanks
|
Member:
Skeller
|
Posted on Wednesday, Apr 13, 2005 - 10:15 pm:
I'm going to be debating a lot next year on what to do about spring shots. Right now I'm thinking only tetanus, but haven't really researched it. Definitely not the influenza. So far I haven't heard back from Dr. Redden but it's been less than 24 hours and sometimes it takes me days before I read my email! I'll let you know what I hear. I thought it interesting that the book specifically mentioned the influenza vaccination. Cody didn't have a fever, but did have severe stiffness.
|
Member:
Skeller
|
Posted on Sunday, Apr 17, 2005 - 10:22 am:
Debbie, I discussed the problem of next years vaccinations with one of the vets at Fort Dodge who were very nice (and I was surprised very accomodating to talk with me). Maybe I'm jumping the gun, but I figured it was easier to look at this now when all the details are fresh in my mind. Of course she said it's something to discuss with my vet, but she recommended as you say, determining which ones are life threatening and then giving each of them individually a week apart to prevent overloading his system. The other recommendation, which is the same as Dr. O, is pretreat with Bute (2 gms) and then 1 gm 2x a day the next day.
|
Member:
Skeller
|
Posted on Tuesday, Apr 26, 2005 - 7:19 pm:
Well, Cody has also been diagnosed as being Cushinoid (how this was determined I’ll get into later but right now I need to understand it.) It’s obviously a complex subject. I’ve read and reread the articles on EMS and ECD and find the information on cortisol levels conflicting. It’s probably me understanding the terminology, but I would really appreciate some clarification.
Dr. O, in the article on Equine Metabolic SynDrOme (Peripheral Cushings) it states:
“Since there is neither impaired thyroid function nor primary cortisol elevation, which defines endogenous Cushings…..Another primary cause of insulin resistance is high levels of glucocorticoids like cortisol which is the hormone released by the adrenal glands. High levels of glucocorticoids can cause a constellation of signs referred to as Cushings Disease. High levels of cortisol are released in response to stress including the pain of laminitis.”
This correlates with my naïve logic that a horse with Cushings SynDrOme would had increased cortisol levels in their blood.
However the article on “Cushing's SynDrOme and Pituitary Tumors in Horses” states:
“Unlike other forms of Cushing's SynDrOme blood cortisol levels may be normal to decreased making the term Equine Cushinoid Disease (ECD) may be preferable”….”Traditional Cushing's SynDrOme is related to an increase level of corticosteroids….. In horses there has not been a consistent finding of increase cortisol.…. It is suggested that the equine pituitary synDrOme does not correspond to human or dog Cushing's Disease, as generally accepted, but is related to the overproduction of several pro-opiomelanocortin (POMC)-derived peptides by the cells of the tumor or hyperplastic nodules. These peptides may have cortisol-like activity among other actions.” ….”Cushing's synDrOme in other species is related to an increase level of corticosteroids. But, in horses there has not been a consistent finding of increase cortisol and in fact can be normal or low.”
After reading this my understanding was that for horses, the cortisol levels are NOT increased and may in fact be lower. Since Pergolide works to decrease the cortisol-like peptides is this what we see an increase in and the EMS article is refering to them using a "generic" cortisol term?(i.e. primary cortisol elevation)
Thanks, I tried to VERY hard sort this out myself but my brain is now mush.
|
Moderator:
DrO
|
Posted on Wednesday, Apr 27, 2005 - 8:07 am:
Maybe you are confused because you are trying to put EDC and EMS in the same mold: they are different diseases, with different causes and different signalments and clinical signs. The fact that they both have insulin resistance and founder as part of there clinical pictures is incidental and do not occur for the same reason.
DrO
|
Member:
Skeller
|
Posted on Wednesday, Apr 27, 2005 - 10:22 am:
I am trying to figure out the differences.
But I'm interpreting the EMC article to say that EDC horses HAVE increased cortisol levels (It's pointing to this as one of the differences between EMC and EDC.) While the EDC article says they do not. Am I reading something wrong?
|
Member:
Skeller
|
Posted on Wednesday, Apr 27, 2005 - 11:38 am:
Just to be more specific Dr. O, (I'm trying to make it easier on you),
the EMC article states:
"Since there is neither impaired thyroid function nor primary cortisol elevation, which defines endogenous Cushings" (I'm interpreting this to mean that's one of the primary differences between EMC and EDC, that EDC horses have increased primary cortisol elevation).
However in the EDC article it states: "In horses there has not been a consistent finding of increase cortisol" and mentions decreased cortisol levels in other areas. (this tells me that EDC horses have decreased cortisol). Which is it, or can it be "All of the above?"
|
Moderator:
DrO
|
Posted on Wednesday, Apr 27, 2005 - 6:53 pm:
I see it is not EMS and ECD that you are confusing but Equine Cushingnoid Disease (ECD) with true Cushing's Disease. True Cushing's IS an increase in glucocortioids (cortisol and others). Like explained in the introductory paragraph on ECD, and precisely for the reason you are confused, I prefer the term Cushingoid or Cushingnoid (which means Cushing's like) instead of Cushing's which is generally used because ECD is not a true Cushings Disease.
DrO
|
Member:
Skeller
|
Posted on Thursday, Apr 28, 2005 - 8:17 am:
Thanks for the clarification!
This is one of those areas where it's hard to get your brain trained to go a different direction than what is currently accepted by many horse people - like understanding that true hypothyroidism is not common in horses.
Is true Cushings ever seen in horses? I have a friend who reported cortisol blood levels 7x normal on a horse several years ago. The vet called him "walking dead" and he did pass on quite soon after that. Could this have been a true Cushings case or maybe the blood tests were different then?
|
Moderator:
DrO
|
Posted on Friday, Apr 29, 2005 - 9:40 am:
Yes the article explains several ways true Cushing's occurs and this applies to horses also however it is pretty rare and horses seem quite resistant to the iatrogenic (doctor induced) form compared to dogs. I suspect your friends horse had a tumor of the adrenal glands that resulted in overproduction.
DrO
|
Member:
Skeller
|
Posted on Sunday, May 1, 2005 - 10:50 pm:
I found this info while researching on the internet and thought it might be interesting to others. My interpretation (and please correct me if I'm wrong) is that Chronic Laminitis horses may become hypersensitive and the activity of the vaccination can "push them over the edge" which may have happened in my case.
Am J Vet Res. 2003 Mar;64(3):279-83. Related Articles, Links
Evaluation of systemic immunologic hyperreactivity after intradermal testing in horses with chronic laminitis.
Wagner IP, Rees CA, Dunstan RW, Credille KM, Hood DM.
Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4467, USA.
OBJECTIVE: To determine whether systemic immunologic hyperreactivity exists in horses with chronic laminitis, compared with responses for nonlaminitic horses. ANIMALS: 7 nonlaminitic horses and 7 CL horses. PROCEDURE: In experiment 1, intradermal testing (IDT) was performed on 7 nonlaminitic and 7 CL horses to evaluate the response to a combination of 70 allergens at 15 and 30 minutes and 4 and 24 hours after injection. Three nonlaminitic and 3 CL horses used in experiment 1 were used in experiment 2 to determine whether histologic differences existed between the 2 groups. The H&E-stained tissue sections were evaluated on the basis of 3 criteria. For all analyses, 2-sample t-tests were used to determine significant differences between the groups. RESULTS: In experiment 1, CL horses had significantly higher total responses to IDT than nonlaminitic horses at the first 3 time periods. Also, CL horses had significantly fewer total scores of 0 than nonlaminitic horses at all time periods, except at 24 hours. In experiment 2, we did not detect significant differences between groups for any criterion. CONCLUSIONS AND CLINICAL RELEVANCE: Results support the hypothesis that CL horses develop hyperreactivity to various antigenic stimuli, compared with responses for nonlaminitic horses. Therefore, the possibility that antigenic challenge may result in exacerbation of clinical signs of laminitis should be discussed with horse owners. Chronic laminitis should also be a consideration when a horse becomes lame following antigenic challenges.
|
Moderator:
DrO
|
Posted on Monday, May 2, 2005 - 6:49 am:
When this report was first published we discussed it however I must say that over the years we have vaccinated horses with past histories of laminitis and have not noticed a exacerbation of their condition. We never vaccinate a horse during a founder episode however.
DrO
|
|
|
