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  Discussion on Scabs all over my horse --- autoimmune????
Author Message
Member:
Dolgeo

Posted on Thursday, Jan 30, 2003 - 9:30 pm:

I am having dificulty rejoining because my subcription ran out and the machine won't let me fill out a new application using my user name. Help!
Member:
Dolgeo

Posted on Thursday, Jan 30, 2003 - 9:51 pm:

Dear Dr. O.

I have been having difficulty posting messages but apparently it is now taking my messages. I want to renew my subscription and will try again to renew aftr sending this message if the computer takes it. Anyway, Harley is very sick again.

We went from the original 22 pr day pill regimen of dexamethasone and gold injections (8cc)every two weeks and gradually, two weeks at a time under careful vet supervision, reduced the amount to one 4 mg tablet of the dex twice a day and once a month on the gold salts (4 cc) by the second week in December. Progress was phenomenal. Very healthy, gaining weight, frisky and after about a week on the latter regimen, he crashed, practically overnight. Swollen sheath, soreness in legs, scabs, listless. Immediately called the vet, gave him eight piils twice a day and 8 cc gold salts. Brought him down gradually to thirteen pills a day (am/pm), gold salts injection once a month and he is due again.

There was an immediate an dramatic improvement for about a week and then he crashed again and is worse than he was when he crashed in December. He does not have the swollen sheath, the scabs are gone, but he looks sick, doesn't move around, has lost a tremendous amount of weight, and is extremely sore in his legs back and front. Hooves not hot and pulse not pounding.

The local vet thinks he may be having kidney problems and may be foundering. We have just about given up hope. His appetite is extremely good but he doesn't care much for any kind of grain. We are giving him canola oil but weight continues to DrOp, and giving him milenium gold twice a day with grain, which he eventually eats.

If there is anything we can do, we will. If in the final analysis there is nothing we can do and must put him down, would it be safe to donate his body for dog food for the mushers or is the disease transmittable to other animals? Can you give us any hope? Please answer as soon as you can because this is an emergency and none of us knows what to do.
Moderator:
DrO

Posted on Friday, Jan 31, 2003 - 4:31 am:

Hello Delores,
Your post does not tell me what might be wrong with your horse, I am afraid. He needs a good physical exam and complete laboratory work up and from there a problem list can be generated.

Founder will need to be diagnosed from the physical exam findings, laboratory work (to rule out similar looking diseases) and possible radiographs. Kidney disease is ruled out on laboratory work. We have articles on both of these diseases where you can read about diagnosis and treatment.

If the veterinarian is still not sure what the cause of the problem is you need a referral to someone who can figure this out. I know this seems tedious right now, but you have a very complicated situation. You have a horse with a permanant autoimmune disorder and receiving medications that are potentially toxic or at least may lead to other problems. This will require a cool head to figure out.

I wish I could give you more but take it a step at a time and if you feel euthanasia is your most humane alternative, make it knowing you have really worked hard to make this guy well. This disease is not transmitable but with the gold salts in his body I am not sure he would be considered suitable.
DrO
Member:
Dolgeo

Posted on Saturday, Feb 1, 2003 - 6:55 pm:

Dr. O., Thanks for responding. We had a vet out yesterday (Friday) to draw blood to find out what we can. We should hear back Monday or Tuesday. A very sad time for us, so thanks for your words letting us know you understand how hard we have worked.
Member:
Dolgeo

Posted on Thursday, Feb 6, 2003 - 10:10 am:

Dr. O.,

Sent this last night but apparently it didn't post. Got th lab results and will post the abnormals only unless you want the whole thing.


glucose 296 hi rang 60-125

creatinine 0.8 lo 1.0-2.2

alkaline phosphatase 348 50-250

chlorid 95 97-108

Under CBC thos clos to abnormal we:

hemoglobin 16.1 11.0-17.0

hmatocrit 46.6 32.0-50.0

MCV 54 34-58

MCH 18.7 12-19

MCHC 18.7 12-19

Under differential:

Neutrophils 9120 Hi 96% 2600-7500

lymphocytes 190 lo 2% 1500-7700

Apetite and attitude good, isn't lying down as much. Getting 2mg bute. On Tuesday gave him 7 pills (4mg) of dexamethsone at night only; Wednesday gave 5 in am, 3 in p.m. Seems like the reduction of the dexamethasone resulted in his being a little stronger. We reduced it because he is just about starving to death. Vet said we could give him some banamine as well. Also said that based on blook work, he may have an infection and is going to bring out some antibiotics today.

Can you tell us anything with thes results?
Member:
Dolgeo

Posted on Friday, Feb 7, 2003 - 2:30 am:

Dr. O. -- don't know why but seems I am having to post my messages twice. It looks like they post but then when I check, the message isn't there. Will try again on this one.

One of the vets gave us some antibiotic powder called "uniprim" powder for horses, The packet contains 37.5 grams and we gave it to him tonight along with 3 dexamthasone tablets (gave him 5 this morning). He remains on bute; we did not give him the banamine because he looked better, stronger today. Maybe the lowered dosage of steroids is letting him get back a little weight.
Are we doingthe right thing -- the uniprim antibiotic was prescribed because of the high neutrophils, I believe he said. Let us hear soon as you can. Thanks.
Moderator:
DrO

Posted on Friday, Feb 7, 2003 - 8:12 am:

Dolores even with the information you provide I cannot examine the horse and make treatment decisions. This has to be done by the examining veternarian. I can provide information however.

I think the high blod glucose, increased liver enzymes, neutrophilia, and lymphopenia could be do to the steroid administration, it has this effect. More important to help answer the infection question is the cytological features of the neutrophils. The low creatinine indicates his kidneys are fine.

Remember that the skin problems are related to the disease process but the systemic problems may be related to over administration of the gold salts (toxicity), over administration of the dexamethasone (Cushings), or too rapid a decrease in the dexamethasone (Addisons). These possiblities must be always considered when the horse shows systemic signs. We discuss the steroid related problems at » Equine Medications and Nutriceuticals » Anti-inflammatories, Steroids, and Arthritis Treatment » Overview of the Steroidal Anti-inflammatory Drugs. I discuss gold salts above.
DrO
Moderator:
DrO

Posted on Friday, Feb 7, 2003 - 8:21 am:

Delores we have not received other reports of posting problems and posting to this board over 30 times a day, over the internet like you do, I have not experienced any problems. Be sure you save your post following each posting.
DrO
Member:
Dolgeo

Posted on Tuesday, Feb 18, 2003 - 1:50 am:

Dr. O.:

Harley has ben diagnosed as having laminitis by our vet. He attributes it to the steroid/gold salts. We have reduced the steroids to thre dexamethasone a day (4mg) for a week and it hasn't brought about any new skin problems. However, he is really sore in front. His weight loss seems to have stabilized. He is also on one and a half grams of bute each day. The vet says the laminitis is in the acute phase and doesn't feel there is much we can do about it given that Harley must have continued steroids. Do you have any suggestions for treating the laminitis? Also, what about the alternate day treatment? We would like to begin the alternate day therapy in hopes it will assist with his weight gain but we are afraid to let him go a day without the steroids because it was such a scare when Harley crashed in December. At what point does one go to alternate day therapy? We have read the articles you mentioned but can you tell us what circumstances allow a person to do the every other day thing?
Moderator:
DrO

Posted on Tuesday, Feb 18, 2003 - 4:18 am:

First we should note that the steroid induced founder is conjectured and not written in stones. It may be possible to continue to treat the autoimmune disease and the founder. It should be treated like other founders, see » Equine Diseases » Lameness » Foot and Sole Problems » Founder & Laminitis for more.

ADT is usually attempted after control of the allergic/inflammatory disease is achieved with daily treatment. The proper dosing of steroids, whether daily or ADT, is always experimental and what dosages and frequency that will be effective is different for every case so must be established by trial and error.
DrO
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