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  Discussion on Rhino? strangles?
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New Member:
Marym

Posted on Monday, Dec 8, 2003 - 7:06 pm:

Last Tuesday afternoon when I visited my horse, I was informed he'd not eaten his grain that morning. He was shivering and still not eating grain, but he was eating his hay. I bundled him up and tried soaking his pellets in hot water.

Wednesday morning, he still wasn't eating much -- just picking -- and now had 1 small yellow snot. The vet said to give him bute and if he wasn't eating by the afternoon she'd come out. If he was eating, she'd see him on Friday when she had an appointment for another horse.

With bute, he ate on Thursday but now had developed extensive snotty nose. When the vet examined him Friday he was looking much brighter, still on bute, although his nose was still dripping heavily. His glands were very slightly swollen, but not enough to be concerned. His gums looked good. We didn't take his temperature because he gets so stressed. She left sulfa for him and said to wait a few days, continue the bute and add some supplements to support his system. If he didn't clear up after a few days, to start the sulfa.

Since then, he's been steadily downhill. Unfortunately, I couldn't see him yesterday due to the storm. The reports were that he was improving, but I saw him today and he is far, far worse.

His glands are a little more swollen. He can't stretch his neck to the ground now, so we've put his hay in a net. He still has extensive snots and trouble swallowing. We gave him soaked beet pulp and alfalfa cubes which he started to eat with the first enjoyment he'd shown in a week. But then he choked on some and had a terrible time coughing. Then retreated to a corner and stopped eating. He tried a little while later, but stopped again.

The barn manager finally understands what I've been saying all along -- that he's clearly very sick. He said if he doesn't improve by noontime tomorrow, he's having the vet out on an emergency call.

His symptoms seem to me to be consistent with strangles, but as far as I know he hasn't been exposed. However I can't be sure, as we moved to this barn just a month ago. He has private turnout and private buckets. He was turned out one day with a group on November 2, but kept away from the other horses. He did have strangles 3 years ago -- we caught it very early and treated it aggressively with penicillan, so it never reached his glands. Would he be immune to it now?

Or could this be rhino?

Please, please help. I've had this horse 14 years and I can't seem to get the barn to take this seriously.
Member:
Reggie

Posted on Monday, Dec 8, 2003 - 7:40 pm:

Why wait until noon tomorrow? I would call my vet now and make sure he was out early tomorrow if not tonight. I had the same situation and my mare ended up in the hospital with pneumonia for 10 days. Nearly lost her.
Member:
Mrose

Posted on Monday, Dec 8, 2003 - 11:21 pm:

Your horse needs a vet NOW imo. Can't you call the vet and meet the vet at the barn? Has he been vaccinated for strangles?
Moderator:
DrO

Posted on Tuesday, Dec 9, 2003 - 7:07 am:

Hello Mary,
A case of Strangles 3 years ago will not insure current immunity so will not help you diagnose this. The article associated with this forum has a section on ways to differentiate strangles from viral upper respiratory disease however monitoring the body temperature sequentially is one of the most reliable ways. The article on Strangles also gives clue to diagnosing this.

Both the articles on viral disesases and strangles give you help in how to make your horse feel better, so review those, and if you have Strangles without abscesses you need to switch to penicillin, see the article on Strangles for more on this.

I agree with the other posters your vet needs to come on out and help you with this diagnosis and treatment.
DrO
Member:
Penner

Posted on Tuesday, Dec 9, 2003 - 12:05 pm:

Yikes! Call the vet pronto!!!!! Forget what the barn thinks!

You have a horse who can hardly eat, has a purulent discharge from his nose (a big clue that this is an infection, viral or bacterial), has to be on painkillers, Oh boy!

Next thing you know, he will colic from the stress, or dehydration because he can't drink easy.
Rely on your gut instincts.
Member:
Marym

Posted on Tuesday, Dec 9, 2003 - 7:28 pm:

Thank you all. I have been begging this vet to come out but she basically refuses by postponing until some new change to watch for. I wanted her out on an emergency call in the very beginning, and she refused. I now know that her answering machine states that she won't make emergency calls for nonclients, and this was my first call to her which made me a nonclient. Then when he took a turn for the worse on Saturday, she point-blank refused to come out again. Sunday was impossible due to the blizzard conditions, and they told me on the phone he was improving. Monday she delayed again, even though it was clear he *hadn't* improved. I am new to this area and have been having a hard time finding a good vet. She is the 3rd one I've tried, and believe it or not, she's the best so far. At least when she did finally examine him she paid attention, seemed knowledgeable and didn't abuse him.

Dr. O, I've read your article on strangles and also did additional research on atypical strangles/catarrhal in older horses that have had strangles in the past. That is what his symptoms seem most consistent with. They have had a couple horses on their property in the last year with strangles, but he is in a brand new stall, in a brand new paddock and so has had very limited exposure to any horse that might have been shedding live virus.

I haven't been able to monitor his temperature. He was abused as a baby (A-circuit halter with gingered tail and possibly cattle-prodded) and until he is very sick it is extremely difficult to try to take his temp anally. In the beginning of this illness, he was feeling very strong and it wouldn't have been safe. I will try to get it tomorrow.

As an update, by first thing this morning, he cleaned up his evening feed, which included his normal pellets mashed plus a mix of alfalfa cubes and beet pulp also mashed, and was getting a good start on the same for breakfast. Plus he had eaten most of 2 good-sized flakes of hay from the night before.

By 2 hours later, he'd finished the hay and started a new batch, plus had eaten half his breakfast feed. He wanted to go outside and it was sunny and windless, so I let him. He ate slowly but pretty steadily until 1pm, and then stopped to nap. He's also eating snow and drinking lightly. He was able to stretch down to the ground again and was eating both hay and snow from the ground even with the option of eating it at shoulder level. His snotty nose seemed considerably drier in the afternoon. His gums are the same as yesterday.

There seemed to be more manure in his stall today. I haven't seen him urinate, which concerns me, but his stall does seem to have normal wetness in it. All his food is soaked to help with hydration as well as eating. I haven't been able to monitor his water buckets to know how much he's drinking, but I have seen him sip water and eat snow, which he always prefers in winter. His gut sounded more active today than last Saturday, although it still isn't as loud as normal. So far he passes the pinch test, although I forgot to take it today.

I got an update this evening that he ate his grain and is now picking at his hay. If he is not significantly improved in the morning I will beg the vet to come out.

This is a very horrible situation for me. I am so disappointed with the farm and the way they have handled this. I came there because I met somebody who works there and she seemed very conscientious and knowledgeable. I am paying 50% more than the local board rate for supposed premium care and instead find my horse first neglected and now in trouble. I am new to this state and find that the veterinarians here do not operate at all the way they did where I came from. Nobody seems to cover for anybody else, nobody will come out for an emergency and it's difficult to get anybody to take positive action. They seem to want to let things become dire and drive your horse into the nonexistant hospital.

I honestly don't know what to do to get action here.

Member:
Marym

Posted on Tuesday, Dec 9, 2003 - 7:32 pm:

I forgot to mention that when we spoke with the vet on Monday, she wouldn't come out but said that if he didn't improve by evening to start the sulfa. I started the sulfa at noontime yesterday.
Member:
Mrose

Posted on Tuesday, Dec 9, 2003 - 8:19 pm:

Mary, I feel for you. I too live in an area where the vets don't co-operate with each other, no one is "on call" if your vet is out of town, etc. Plus, there is only one good large animal vet in our area. It makes it very difficult at times.

The fact that your horse is eating is encouraging. But, I'd still be concerned about fluids. Is there any way you can think of to monitor the water intake?

btw-Why does he eat snow instead of drinking? All horses nibble at snow kind of out of curiosity, but it takes LOTS of snow to equal their normal intake of water. Is his water clean? frozen? Glad you (or someone) is mixing wate in his feed. That will help. You can give him warmish water with flavoring, too-like some grain, alfalfa, carrot juice, gatoraid, whatever he might like.

If he won't let you take his temp. annally can you do it in his ear (with digital thermomoter) or "armpit style?" This might not be quite as accurate, but if you establish a base line, it will give you a guide/general idea of where he's at.

I hope you can get a vet to see him. Sorry you're having such a tough time with this.
Member:
Penner

Posted on Wednesday, Dec 10, 2003 - 12:37 am:

Oh Mary, How sad - you have got to be living (I bet) in an urban area - I've had the same problem with finding a vet when I lived in Chicago.

Anyway, cut to the chase... I don't know where you live, & I still think this is important for now & in the future, so try this link & enter where you live:
The Equine Connection® National AAEP Locator Service: [AAEP = American Association of Equine Practitioners, veterinarian].
)

Search for the names of participating AAEP member veterinarians nearest you. If you are traveling, have recently purchased a horse, or are relocating, we can help you find a veterinarian dedicated to the highest standards of equine medical care.

https://www.yourhorseshealth.com/getadvm/

Moderator:
DrO

Posted on Wednesday, Dec 10, 2003 - 6:50 am:

Sara, the hair coat and thicker skin of the horse will make the armpit idea unworkable: skin temperature will not reflect or even be proportional to body temperature. I am less certain about the ear (infrared) method but would be careful with interpretation of the results. I suspect that the much longer pina means you are not reading core temperature.

Excellent idea Penner.
DrO
Member:
Mrose

Posted on Wednesday, Dec 10, 2003 - 10:49 am:

Oh,well...was a thought. I thought it might give a baseline so she could tell if temp. was up or down. You try to think of anything and everything, you know.

Great resource, Penner!

Dr.O-is there any ethical or legal code regarding vets responding to calls when there is an emergency? This a problem in our area, also. Local vets won't respond to an emergency if you are not an established client. I actually know of someone who lost a horse because of this.
Member:
Marym

Posted on Wednesday, Dec 10, 2003 - 12:35 pm:

Thank you all so, so much for your advice and support. I'm happy to report two very positive changes as of this morning, both in terms of communication with the vet and my horse's progress.

First, my boy is looking more comfortable this morning, less snotty, and eating steadily and a little faster than yesterday. He cleaned up his grain and about 2 pounds (dry) of beet pulp/alfalfa cube mash from last night, along with a large amount of hay. He was working on a fresh batch this morning. When I see his bucket before it's been cleaned and refilled, he's been drinking about 3/4s bucket at night. I've been bringing him warm water outside. He doesn't drink as much during the day, but I have seen him sipping it. He's always enjoyed eating snow, so I'm happy to see him doing that. This morning I saw him drag some of his unsoaked hay through snow before eating it. I suspect the cold snow may give his throat additional relief.

Second, last night I left a message with the vet asking her to call me before 10am before I headed out. That way we could speak in private. She gave me enough info to fill in the missing pieces.

First, in recent months she's had a number of isolated horses that hadn't been exposed develop strangles-like infections that resolved with sulfa.

Even more likely, apparently a couple months ago this new barn shipped in a large number of horses all at once and yes, they developed a run of snotty nose. It wasn't strangles and resolved well with the sulfa that she has my horse on. Given his recent history, she initially wanted to wait a few days to ensure it wasn't viral before jumping to antibiotics. Given the farm's recent history and certain management practices there, she's pretty sure that is what he's got. This is probably part of the reason she was reluctant to make an emergency call (assuming she was, since info was being relayed through barn management much of the time). She assured me that if he has any setback that suggests the sulfa isn't working, we will switch to penicillan.

I also learned in this conversation that she did NOT tell the barn manager to give him 10 sulfa tablets twice/day for my 800 pound horse (another concern that was scaring me), but she did tell him to give him 8 tablets, which is what I had expected. So I straightened that out this morning with both the farm owner and manager, and have written it on his instruction sheet.

I also learned in this conversation that after I missed her return call on Monday morning she spoke with the barn manager and he told her my horse was improving. So today was the first she heard of his new and worsening symptoms since Saturday.

Given the barn owner's fear of the rumour mill and the barn manager's track record of prevarication (not to mention his absolute gall in changing a vet's prescription), from now on when I need to talk to the vet I will ask her to call me by a certain time so we can speak directly in private.

When I missed her call Monday, I also had asked the barn manager to check on the amount of bute we could safely give with sulfa. At the time, the barn manager told me that she said there was no reason to cut the bute.

After I called the barn manager on changing the prescribed sulfa this morning, he said she told him today to reduce the bute. So he now will be cut to 1 bute am and 1 bute pm. The vet has been waiting for a backorder shipment of banamine paste to arrive and we all will sigh relief when that happens. My biggest relief will be when I can get my barn done and bring him home...
Member:
Marym

Posted on Wednesday, Dec 10, 2003 - 12:41 pm:

Penner, thank you very much for the link. What a great resource to have!

We're actually in a very rural area...

When I'm able to talk directly to this vet, she seems very competent and very good. I think the problem was the barn manager as go between. I overheard him lie in the past, but changing a vet's prescription has me very scared. She knows, now, that he did that and hopefully read him the riot act.
Moderator:
DrO

Posted on Thursday, Dec 11, 2003 - 5:53 am:

Hello Sara,
No there is no such established code and if there were I don't think anyone would go in the profession: there are too many folks willing to call you out, then not pay their bill.

Ever since I have had children, I too have had such a policy in place. I found it neccesary in order to have regular time with my children in the evening and weekends. However when out of town I do have a associate take my calls and if she is not available a verbal agreement with at least one other veterinarian to take my emergency calls.

If a non-client calls with a emergency I do give them the option of hauling it in as we have a hospital barn to work in. Then again we are very lucky in this area in that we have over half a dozen equine veterinarians so folks who do not have a regular vet usually can find someone to come out, unless they owe everyone money.

I recommend every horse owner have a good working relationship with a veterinarian along with a established policy of what to do when they are out of town.
DrO
Member:
Marym

Posted on Saturday, Dec 13, 2003 - 3:02 am:

Now things are getting stranger. My horse is slowly recovering. But when I went to the barn today, the staff member told me she gave him 6 sulfa tabs that morning. The vet said 8 tabs, not 6. I've left it on a sheet of instructions on his stall. I had her give me 2 tabs and gave them to him immediately. I then told the barn manager he was to get 8 tabs, not 10 and not 6. He proceeded to lock up the meds. Then I told the farm owner he's to get 8 tabs, not 10 and not 6. That it's written down and there is NO excuse.

Nobody apologized, nobody said anything. They got together and had a meeting in the office without me.

There is something very strange going on in this barn. I'm now trying desperately to arrange to move him as soon as I possibly can.

I've never had anything like this happen in over 40 years with horses. I've never been in a situation where a barn wouldn't allow people to care for their own horses, where the vet gave the barn the medication and prescription instead of the owner, where I didn't have anybody there that I could trust to do the right thing.

I'm really at my wits end. He was supposed to come home this month. I'm now trying to make arrangements to get him out of there before they do anything more to put him at risk. I know that trailering him home will be risky, but at least there I can manage his care and manage the risks.
I don't know what else to do.
New Member:
Patseam

Posted on Saturday, Dec 13, 2003 - 2:07 pm:

Send in a complaint to the Better Business Bureau, Chamber of Commerce, local newspapers and whoever else can help make this situation known. It is intolerable. You'll be doing everyone a favor by putting a stop to this nonsense! Pat.
New Member:
Dblcreek

Posted on Saturday, Jul 23, 2005 - 10:12 am:

Hi, I have a filly(2 y/o) that has a mild, every once in a while cough, usually when she eats, but not all the time. She was vaccinated last year, but not with EHV-1/4. I now have the vaccine, the modified live virus, wondering if it would be okay to still give it to her now, even with the cough, or would it cause her to develop the virus with her immunity suppressed? She has a normal temperature, and isn't on any antibiotics, yet. Thanks!
Moderator:
DrO

Posted on Sunday, Jul 24, 2005 - 9:59 pm:

I don't believe the vaccine represents a significant risk concerning this cough Ralena. For more on "barn coughs" see Equine Diseases » Respiratory System » Chronic Cough Without Fever.
DrO
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