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  Discussion on Green snot from one nostril - sinusitis?
Author Message
Member:
Imogen

Posted on Tuesday, Oct 21, 2003 - 4:53 am:

Dear Dr O

I wonder if you would mind just giving me an indication of how long I should wait for nature to take its course, or when I should call my vet on this one? My 12 yo mare has had an intermittent discharge from one nostril for 10 days.

It's green-grey, but sometimes clear, sometimes nothing at all so I convince myself she's improving, but doesn't seem to be getting any better. She's otherwise fine, not coughing, eating well etc. except a little bit run down because her foal was weaned 8 days ago so she got minimal feeding (hay and poor grazing) for a week before and a week after that.

Two new thoroughbreds arrived at our grazing about 3 weeks ago so I'm thinking they brought in a cold or herpes and now maybe she has sinusitis. However, neither they, nor my other mare, nor my foal have any symptoms at all... I don't want to leave it too long if it is an infection that needs antibiotics, but I also don't want to intervene unnecessarily if it's likely to sort itself out.

Thanks in advance for any advice you can give!

All the best

Imogen
Moderator:
DrO

Posted on Tuesday, Oct 21, 2003 - 6:45 am:

A unilateral clear intermittent discharge is very little indication that there is a serious problem. When a discharge turns purulent (containing puss) it needs to be looked at. I am not sure that your green-grey discharge is purulent but if you think it might be perhaps you should have it looked at. Purulent discharges are usually cloudy but vary in color.
DrO
Member:
Imogen

Posted on Tuesday, Oct 21, 2003 - 8:03 am:

Right you are... I'll keep an eye out for other horrible colours or smells or signs of pus. Yuck!

All the best

Imogen
Member:
Westks

Posted on Tuesday, Oct 21, 2003 - 9:44 am:

If It were me and I do this usually immediately upon seeing a yellowish/green discharge from the nostrils.
I would give a ( full grown horse 20 cc of regular pennecillian (NOT 3 day kind, it is not as effective) for two days. 3 rd day would give the 3 day. Or with horses difficult to give shots to I would do the first day shot and then 5 days of sulpha (softened w/hot/warm water)tabs in grain, or softened and put in mouth. If not completely gone in 5 days will continue sulpha tabs for another 5 days.
I do this because of the potential for this to really become a problem for me with the horse motel and horses coming and going from all over the country, and other countries.
Being it appeared after the new arrivals I would not be willing to let this continue to to show up even if off and on, how long before it takes hold and takes horse down.
Now I have no degree and this may be wrong in a vets eyes, well except all the vets here would do just that, and have told me to many times.
Moderator:
DrO

Posted on Wednesday, Oct 22, 2003 - 6:25 am:

This wold be proper treatment for Strangles, this would be improper treatment for viral diseases which I suspect would be the cause of the majority of the problems you see. The problem with doing this Janette is the problem of a serious reaction to the antibiotics (anaphalaxis or colitis) and the development of resistant pathogens in your horses. Over the years I have seen more horses die from antibiotic reactions (primarily colitis from sulpha tablet administration) than I have from upper respiratory disease.
DrO
Member:
Westks

Posted on Wednesday, Oct 22, 2003 - 10:28 am:

O my Dr O that means the vets here are treating all viral infections as strangles! Thank you so much for the heads up on sulpha tabs. The vets here hand out huge bottles for everything from puncture wounds/lacerations to reperatory infections. It is extremely upseting that I cannot find a knowledgeable equine vet within 400 miles!
Moderator:
DrO

Posted on Thursday, Oct 23, 2003 - 6:04 am:

The problem is not with just your veterinarians, this is a world wide problem that also laps over into human medicine. The greatest infectious crisis in the coming decades may not be the terrible but rare viruses that we hear so much about but the super strep and staph that are beginning to surface in our hospitals that are resistant to our antibiotics.

The proper use of antibiotics is one of the toughest issues facing health care professionals and the proper decision of their use not only effects the individual but everyone as a whole. For more on this issue see, » Equine Medications and Nutriceuticals » Antibiotics and Antimicrobials » Antibiotic Use in Horses: An Overview.
DrO
Member:
Imogen

Posted on Wednesday, Nov 5, 2003 - 3:18 pm:

Just a follow-up. I called the vet out after two weeks of unimproving snot and he said upper respiratory tract infection but not sinusitis (the exam seemed to involve lots of nose tapping to see if the sinuses on one side sounded different to the other).

He left me 4 days of oral antibiotic for the mare (Trimethoprim plus Sulfadiazine).

Because I am always horrified at the way in which antibiotics are thrown at both humans and animals in this country for viral infections that they are useless to counteract, I held off giving the antibiotics for a further week to see if it would clear on its own but I had started to put this mare back into light work and was wanting to begin trot work and there was still no improvement.

So I gave her the antibiotics, it clearly was bacterial at this stage and not viral as all symptoms disappeared in 2 days (yes, of course I still gave her the full course...)

And now I have her fixed, the other mare's decided to give it just the occasional boff-boff on starting or finishing fast exercise - just when the hunting season is starting!

I'm assuming a touch of pharyngitis and that she must have had the cold too but showed few symptoms. I'm hoping it'll heal on its own without yet more expensive antibiotics (she's been at it about 2 weeks and Dr O's excellent-as-always article says it takes about 3 weeks to clear pharyngitis).

I doubt it's hay as the hay is good this year and this mare never had a hay allergy before.

Horses... they always get one better on you and it always costs money!

All the best

Imogen
Member:
Imogen

Posted on Sunday, Jan 18, 2004 - 7:02 am:

It's back again... well in truth, apart from while this mare was actually on the antibiotics, it never really went away completely but it was just a little trickle of green-grey snot in the left nostril after exercise and it wasn't getting worse so I assumed it would finally clear on its own.

Now it's getting worse but still only after exercise for about half an hour or so. I also think she is roaring slightly but she always did go in for heavy breathing after a canter because she gets very excited.

The vet I had out in November said if the antibiotics didn't work they could scope her or arrange to drain the sinuses (sounds expensive...). He also said it might be related to something wrong with her teeth but I have had those done at the specialist vet's since then and I told them about the infection and remaining slight trickle and asked them to check her teeth for anything which could be causing the problem - nothing.

So what I'd like to know is has anyone else experience of dealing with a nasal/sinus infection and is it worth trying different/longer period of antibiotics before getting involved with scoping or draining? The antibiotics she had before were just a standard oral (Trimethoprim plus Sulfadiazine, 4 days, divided into two feeds each day).

Thanks in advance for any info anyone has. You'd think with two horses neither of which are exactly veterans, I'd have managed a few more days hunting this year but it's looking suspiciously like both will now be out of action for a while... sigh. The hunting season is always shorter than you think (usually packs up on Paddy's Day - 17th March).

Imogen
Moderator:
DrO

Posted on Sunday, Jan 18, 2004 - 10:12 am:

The exam by the dentist does not rule out a tooth root problem though makes it less likely. Radiography will be necessary along with the scoping to get the best handle on the problem.

I had to treat a recurring sinusitis for 30 days Imogen after shorter courses failed. The question will be "has the earlier exposure created a organism resistant to TMPSMZ"? We were fortunate and that was not the case with the horse we treated.
DrO
Member:
Imogen

Posted on Monday, Jan 19, 2004 - 3:31 am:

Thanks for the excellent advice as always - I will be ringing the vet to report on the other horse today and will feel much more confident in discussing with him what to do next for this one.

All the best

Imogen
Member:
Imogen

Posted on Friday, Sep 3, 2004 - 3:31 am:

Well, she still has one snotty nostril... but now she's 4 months in foal. Is it safe to give TMPSMZ to in foal mares? I thought (again) that it had gone away on its own so I actually never gave her the second longer course, which I still have.

If it's safe I'll give it to her and see what that does because I need to get routine vet work done at the end of this month and I can then get further advice on that visit if the TMPSMZ doesn't do the trick.

All the best

Imogen
Moderator:
DrO

Posted on Saturday, Sep 4, 2004 - 10:47 am:

No not really safe, there are some concerns for more see the TMP-SMZ article for a explanation and recommendations on how you might use this safely in mares.
DrO
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