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  Discussion on Pregnant mare with unknown high fevers for 4 weeks
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New Member:
beth99

Posted on Sunday, Apr 15, 2007 - 6:11 pm:

Hello,
I have an 8 year old Friesian mare who is 10 months pregnant. Just about 4 weeks ago she started a fever of 104.2. The vet looked her over and could not find any evident reason for the fever, i.e. runny nose, chest sounds were clear, etc. She was treated with Banamine ( for 1500 pds) and initially it took the fever down. However about every 24 hours it would come back. This lasted for about 4 days, with the fevers reaching as high as 105.2. The first week or so she was fairly lethargic, but was still eating, drinking, pooping and peeing normally. She had also been started on antibiotics on the second day. By the 4th day the high fever was only coming on every 36 hours. The 7th day the fever seemed to stop all together, but at that time she was not being checked between 11pm and 6am. There is a possibility she was having the midnight fevers that she experienced later in the hospital. On the 11th day she had no poop in her stall in the morning. I took her temp and it was at 104.8, she was also showing signs of colic. The vet gave her mineral oil which she passed about 16 hours later. The next day she was still acting somewhat colicky (kicking at her stomach) and still running the high fevers. Our vet thought it was in her best interest to go to the hospital.
When we first arrived she was put on fluids (she was slightly dehydrated) and blood tests were ran. Initially her white blood cell count was high, but within a few days of a new antibiotic, they came down. Over the last week of her hospital stay her blood work has remained fairly normal except for recently she has a minute low protein level. To the best of their ability, due to the position and size of the foal, they have ultra sounded her heart, chest, liver, spleen, udders (one udder had recently swollen,), and everything appears to be normal. The thickness of the placenta is good, the heartbeat of the foal and the fluid all look normal. She has had fecal and blood cultures done, all come back negative. She was on penicillin, and another antibiotic, (I do not have a list of the antibiotics with me), for 6 days. During that time the fever had somewhat subsided again, but rising to about 102.8 around midnight. That only lasted for a few days. Then the fever started getting higher again and her stools started to soften. They decided to give her a break from the antibiotics for a few days. Once she was off the antibiotics, the fever came back again more consistently and at a higher degree, 104. and above.
Since eurlikia had not been ruled completely out and the other antibiotics were not working, they decided to try tetracycline. The first time it was given to her over an hours time followed by a flush. Twenty four hours later the fever still came back and her stools had hardened, so they gave her another dose. The second time about half way through, she started to sweat, nostrils flaring, her breath was heavy and rapid. Her heart rate was he low 60s (normal for her is 40s to 50s). They took her off the tetracycline immediately, thinking she was having an allergic reaction. However just 24 hours later, when her fever was escalating again, she had another spell.
The doses of Banamine she has been getting for about the last week have been for a 500 lb horse. They do not want to upset her stomach too much with the larger doses, Yesterday, they decided to give the Banamine early before the fever escalated. It worked at the time but now this morning the fever came back only after 16 hours when it had been going 24 the last few days. She is currently on gasterguard (has been since the 2nd day), a protein supplement, and regumate. They are considering trying her on low dose of steroids starting tomorrow.
I cannot say enough good things about the vets that I am working with. They have called different vets around the country to try to help diagnosis this. But unfortunately they cannot do a stomach tap or get a clear feel or view of the abdomen due to the baby. There are so many things I am told this can be, but the fact that the high fever is the only real symptom it is making it very difficult to figure out.
Except for when she was feeling very lethargic in the first week, she has always had an appetite and been drinking normally. She has never gone completely off of her food or water. Her attitude is generally in good spirits except when the fever is really high. The last few days she has gotten a bit cranky, but she is in a 16 x 16 stall and is not getting much exercise. I have noticed that she seems to be sagging more in her back and her hip bones are showing more (they never have before) but we do not think she has lost weight. We think she has lost some muscle from being in the hospital stall for two weeks.
I know that I barely scratched the surface as far as all of the details over the last three and a half weeks but I tried to give a summary of what is going on. If there is anyone that could offer any suggestion it would be greatly appreciated.
Sincerely,
Beth
Moderator:
DrO

Posted on Tuesday, Apr 17, 2007 - 8:30 am:

Welcome Beth,
Sorry to meet you over such a worrisome problem. What is the latest complete (normal and abnormal) blood count with differential results, fibrinogen levels, and lab results. I will need the units and the lab normals also.

Until you figure this out I would consider returning to an antibiotic regimen that was effective for lowering the fever if it is deemed safe for the pregnancy and twice daily low dose banamine. I would consider steroids only if infection is thought to not be a likely cause.
DrO
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