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  Discussion on Swelling and enlarged glands at throatlatch and up to ears
Author Message
New Member:
Jkissel

Posted on Thursday, Dec 21, 2006 - 2:49 pm:

Help! I am very disturbed by my 6 y/o warmblood mares's chronic yet sporadic swelling at her throatlatch and up into her ear area. It is painful when it first starts then it seems to itch a bit as it subsides, usually the next day. This has been going on for several years but has escalated in frequency and severity to at least once a week. She extends out her neck, flexing must be painful, and won't let anyone but me get near her for fear of being touched there. It is very lumpy, primarily on one side but some on the other. I have had an inconclusive allergy panel done, hormone blood work, an MRI of the head and explored feed/allergy issues, pasture vs. stall, insect bites and had her gutteral pouches scoped. She has also had a long course of antibiotics, just to cover the bases. She is a fussy, temperamental mare who is extremely oral, she will wind suck if given the chance. I have also had an equine dentist check her thoroughly. I am desperate as she is a competition mare and one of these episodes at a show will be problematic. I have had three vets plus the dentist consult with no conclusion. To give a complete history she had "pigeon fever" in that same area as a yearling(that is why I wanted the MRI, to see if there was still a pocket--long shot) and foaled last year. My one vet suggested dexamethasone to relieve symptoms but steroids and show horses don't mix!}
Member:
Scooter

Posted on Thursday, Dec 21, 2006 - 5:54 pm:

Hi Janice I saw this once, last summer in a horse boarded where I work The owner was a working student there and she said her horse had it forever also, it would come and go, I never saw anything like it before. She had to ride him in a halter when it acted up. She had vets and dentists look at it over the years and finally one equine dentist said it was an impacted or infected molar. It never showed up on x-rays until this year, No one knew why. Antibiotics really didn't seem to help it. The equine dentist said it needed to be removed, but the girl didn't have the money, so she gave him to a family that did and they were going to take care of it. Unfortunately this is where my story ends, the working student left and the horse is gone, so I don't know how it turned out. It was almost exactly the way you describe. The funny thing is the horse always kept eating and never DrOpped weight.?
Moderator:
DrO

Posted on Friday, Dec 22, 2006 - 7:54 am:

Welcome Janice,
Boy, an MRI(?) you are serious about this. I have a few questions:
1) How well documented was the Pigeon Fever and exactly where did the abscesses develop.
2) What antibiotic was used, at what dose, and for how long? Was there any improvement while on it?
3) Has the horse been carefully scoped including having the guttural pouches carefully examined and cultured?
4) Has one of the lymph nodes been biopsied and cultured while enlarged?

Diane, I think the description you give seems very unlikely to be a infected tooth root. The generalized swelling and lack of localizing signs on what normally presents as a remarkable local disease: heat,swelling over the tooth root, difficult chewing, maybe swelling of the lymph nodes on the infected side.
DrO
Member:
Jockyrdg

Posted on Friday, Dec 22, 2006 - 8:35 am:

Hi Janice; It will be interesting sharing the findings the Doctor has requested. This looks like a case all will learn from.
I must admit to thinking hard about Diane's tooth post. In another species (dog) I had a similar situation. 12 year old dog started crying in pain, condensing several months into few sentences- he was fully examined, x-rayed, MIR'd, on massive anti-inflamatories, etc. Docs found nothing, he improved slightly and months later, still not himself, underwent surgery for a growth on the leg. While under, the vet wanted to clean his teeth. He came back from surgery with the story of this incredibly infected tooth and bone which never showed on x-rays. Dog came back 100%.
Yours will be an interesting case to follow. Not what you want to hear, I'm sure.
Member:
Scooter

Posted on Friday, Dec 22, 2006 - 8:54 am:

I know Dr.O. I really didn't think it presented as a tooth problem either. I did see the x-ray that finally showed a pocket under the tooth. I do wish I knew how it all turned out.

Janice I defineatly am not saying you have a tooth problem, but your story sounded very similar. I hope you find the problem.
New Member:
Jkissel

Posted on Saturday, Dec 23, 2006 - 2:10 am:

The Pigeon Fever was mild but persistent. Not much discharge at any point. It went off and on for a few months before it completely subsided. It was below the ear on the left(same) side. That is why I wanted the MRI to see if there was any pocket left or anything. The Pigeon Fever was 4-5 years ago.
After her guttural pouches were scoped and she had the unremarkable MRI the vet put her on 15 SMZ 2x/day for 30 days. No change since she didn't have symptoms at the time.
The vet report states "Upper airway endoscopy including guttural pouches was within normal limits.
She has had 3 episodes this week. The most severe was tonight. I called my local vet and he is stymied but suggested putting her on 12 mg of dexamethosone/day for 7 days along with some bute to possibly make her more comfortable. He also suggested that we do a punch biopsy of an enlarged node after this treatment if she still has symptoms.
Moderator:
DrO

Posted on Saturday, Dec 23, 2006 - 9:19 am:

Well Janice it sounds like a plan. I would consider a culture of those guttural pouches with an emphasis on strangles and pigeon fever. Both organisms display frequent resistance to TMP-SMZ. Radiographs might further explore the possibility of a infected tooth or other bone disease but I think they should have turned up on the MRI. The biopsy should help with many issues. Remember if this is infection the steroid will both potentiate it and hide it for awhile so be sure to keep a close eye out.
DrO
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