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  Discussion on Back Injury, or Infectious Disease?
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Member:
Aannk

Posted on Tuesday, Dec 23, 2003 - 10:15 am:

Dr. O.,
We have a QH/Welsh gelding at our place who recently became almost unable to walk. The vet has determined that it is tramua, but I'm not so sure.
Here is his history.
Has been found seizuring in the pasture from time to time, but not for a few years. Has post legged hind leg conformation, and has always been kind of stiff. Very heavily muscled. Lately, the past few months, he has been moving funny behind, sort of shuffling his feet forward very stiffly. He basically pulls them forward too far, then sets them down behind where they were in the air. He also has been pooping in his bucket, which he never did before. The owner has a natural practitioner who said he has a stiff tendon on one leg, and they have been stretching him. Last monday (9 days ago), he was found recumbent in the field, and when he got up, was stumbling on all four legs, and seemed to have trouble knowing where his legs were (perioperception or something like that). He also has some dysmetria (loss of control over the direction of his feet and range of motion), and does not seem to be able to control when he poops, and cannot lift his tail. We can't really do a lameness exam, as he can't move very well at all. Also, he is grumpy and snaps at people and horses, though he has always snapped at horses. The vet has done blood work, which was apparantly normal (though I'm not sure what he checked for).
Problem is, this matches so many infectious diseases, and the vet has only checked for West Nile. I am a little worried it may be EHV-1. If it is, how long would the rest of our horses show symptoms, and what can we do to prevent him spreading it?
Also, I guess I wanted to see what you thought, based on his symptoms. The vet has him on intravenous DMSO and sulfa.
New Member:
Savanah

Posted on Tuesday, Dec 23, 2003 - 12:58 pm:

What about EPSM (equine polysaccharide storage myopathy)? It is a form of tying up caused by the horse not being able to metabolize starches properly. Elevated muscle enzymes on the bloodwork would be a clue. Have to do a muscle biopsy to know for sure. Treatment is very high fat, low carb diet. There are a lot of articles available on the net about this disorder.
Member:
Aannk

Posted on Tuesday, Dec 23, 2003 - 1:18 pm:

Michelle,
My mare has EPSM, so I know all about it. I don't think that is what this is.
He went from being vaguely stiff to barely being able to walk. He may have EPSM also, I think all horses should be on that diet anyhow, but there is something else going on as well.
Alicia
Moderator:
DrO

Posted on Wednesday, Dec 24, 2003 - 6:46 am:

Certainly running muscle enzymes is an easy way to answer the EPSM question. Though there are many possiblilities a seizure resulting in trauma to the spinal cord in the neck would cause such a clinical picture.

Alicia, I think you misunderstand EHV1. It is a upper respiratory tract infection that can cause abortion and neurological disease. If your horse does not have a history of URT signs (nasal discharge, coughing, fever) then he is probably not very contagious. Past infections from all of the viral encephalitides can leave permanant though usually not progressive neurolgical deficits. For more on this see, » Equine Diseases » Nervous System » Equine Herpes Encephalopathy.
DrO
Member:
Marti

Posted on Wednesday, Dec 24, 2003 - 7:47 am:

If this was my horse I think I would have him check for EPM. The symptoms sound just like a horse I know that came up positive for EPM. The owner originally thought he had a sore back, this was because he fell. Turns out he fell because he had EPM and could not tell where to place his feet. He is being treated and is doing well with the treatment. Good Luck
Member:
Aannk

Posted on Wednesday, Dec 24, 2003 - 9:29 am:

Dr O,
OK, thanks for clearing that up. The literature I read did mention that, but didn't say that the symptoms would still be around when the neurological stuff started. Since I haven't been closely watching him, I have no idea if he had any upper respiratory symptoms, and assumed that he might have had them and I hadn't noticed.
Concerning EPM, yeah, I agree, but they aren't testing for it because the natural practitioner says his EPM points are not up (don't get me started on that one). Also, the really bad staggering happened all of a sudden, and they think that means it isn't EPM.
Saw him last night. Same staggering, he barely moves. Grumpy, pooping and peeing on everything. The DMSO was stopped last night because the catheter ripped out. I think someone also said that the vet said that if it hadn't helped by now, it wasn't going to.
Alicia
Member:
Aannk

Posted on Monday, Dec 29, 2003 - 9:45 am:

All,
Topper was put down Saturday. He had gone down Friday sometime before 3 (when I got to the barn, he was down) and had not been able to get up. They are taking him to the University of Maryland to do an autopsy for insurance purposes, and I will let everyone know what it was when the results are out. I have a strong feeling it was EPM, and I guess I will see.
Alicia
Member:
Marti

Posted on Monday, Dec 29, 2003 - 12:53 pm:

Alicia,
I am so sorry to hear you lost your horse. I know it must be a heart breaker. Words can not help your grief, only time will heal. He is in greener pastures now. I will watch this site and look forward to the autopsy report. My prayers are with you.
Marti
Member:
Aannk

Posted on Monday, Dec 29, 2003 - 1:16 pm:

Marti,
Thanks for the kind words. He wasn't my horse, however. I will pass on your well wishes to my friend.
Alicia
Member:
Aannk

Posted on Monday, Jan 12, 2004 - 8:54 am:

All,
The autopsy results are slowly coming in. Apparently, they have ruled out trama, EPM, and rabies. The titer on neurological rhino came back very high, so they are checking on that (I don't know exactly what they are doing, but I guess there is some way to confirm the diagnosis). I read up on this disease, and from what the books I have say (I have a few I bought from VA Tech's vet department), the virus can only survive in the environment for 6 weeks, and the incubation period is no longer than 2 weeks, so if we don't have any more horses fall ill in 8 weeks from when Topper left the property, we are clear. Is this correct? Also, I know this disease is really bad for abortion. Do I need to wait till next year for breeding? I was going to send my mare to a breeding farm to get her pregnant in April or May.
Alicia
Member:
Aannk

Posted on Friday, Feb 20, 2004 - 1:06 pm:

More news on this. Both my horses have abnormally high titers on EHV-1 too!!! I am very worried. My vet says that this makes it more certain that is what Topper died of, but all it really says is that both mine fought it off recently. He also said someone suggested doing an IgM, but he can't find anywhere that does it. Can anyone, Dr. O., suggest a place for me, or at least give me some insight into this!
I am worried, can you tell??!!
Alicia
Moderator:
DrO

Posted on Saturday, Feb 21, 2004 - 8:55 am:

Do any of your horses have symptoms of neurological disease Alicia?
DrO
Member:
Aannk

Posted on Monday, Feb 23, 2004 - 1:53 pm:

Dr. O.,
Well, not overt ones. My gelding seems to be kind of pointing his hind toes forward, then bringing them back before stepping down. Also, he had a short, strange colic the other day where he just stopped eating carrots while I was grooming, then went down in his stall, then got back up 5 minutes later and was fine. I still banamine'd him, but I have not seen anything like that before. I also don't interact with the other horses on the barn too much, so don't know if anyone else is having problems.
Alicia
Moderator:
DrO

Posted on Tuesday, Feb 24, 2004 - 6:23 am:

Alicia, I am unsure what you need insight into or what needs clearing up? If you are wondering is there any disease that this horse could have left something at your farm that will cause your horses to get sick now that it is 2 months later the answer is, no that is very unlikely.

All horses are exposed to EHV-1 at various times or another and the disease becomes endemic in a population, residing in the horses. High titers in your horses without any signs of disease suggest your horses were exposed to strains they were familiar with.
DrO
Member:
Aannk

Posted on Tuesday, Feb 24, 2004 - 11:30 am:

Dr. O.,
I guess what I wanted to know was where to get the IgM test. I know all titers reveal is that your horse fought off the virus, but I want to make sure they don't actively have it. Topper went from fine to dead in little over a week, and I don't want that to happen to mine too.
Alicia
Moderator:
DrO

Posted on Wednesday, Feb 25, 2004 - 6:46 am:

I don't know anyone who runs this routinely though you find it measured in research papers originating from Cambridge University in the UK. But this is not how you tell if you have an active infection Alicia: you look for clinical signs of upper respiratory disease and fever.
DrO
Member:
Aannk

Posted on Wednesday, Feb 25, 2004 - 1:55 pm:

Dr. O.,
I mentioned this before, the other horse who died of this NEVER showed signs of respiratory disease at any time before he became neurologically symptomatic. He may have had a fever, we don't know. I am, of course, watching for signs, and checking temperatures periodically.
Alicia
Moderator:
DrO

Posted on Thursday, Feb 26, 2004 - 7:56 am:

My point still stands, you tell if your horse has an active infection by the prescence of clinical signs, if your horses have not had signs of respiratory disease the chance he will come down with EHV neurological disease is much lower, particularly as closely as you have been watching.

Though IgM goes down faster than IgG it still does not tell you that you have an active infection. Concerning the necropsy did you ever get a confirmation of EHV? I find it odd that they could rule out EPM a very focal disease that can be quite hard to find on necropsy (many are thought to be missed even with necropsy) yet they did not report lesions characteristic of EHV, a more generalized vasculitis that should have been easier to detect on necropsy.
DrO
Member:
Aannk

Posted on Thursday, Feb 26, 2004 - 9:12 am:

Dr. O.,
Yeah, we are all sort of surprised at the non-results of the autopsy. They suposedly ruled some things out, but never had a real diagnosis. The insurance company seems OK with it, as they paid out to the owner. I just want to be careful and not have the same thing happen to mine.
Thanks for the help and information.
Alicia
Moderator:
DrO

Posted on Thursday, Feb 26, 2004 - 12:31 pm:

I think the lack of usual respiratory clinical signs combined with the negative necropsy findings much more significant than high levels of antibody. It makes EHV-1 very low on the list.
DrO
Member:
Aannk

Posted on Friday, Feb 27, 2004 - 11:37 am:

Dr. O.,
Well, then, do you have an idea of what you think it could have been? Remember, they ruled out trama and EPM. He had had strange gait abnormalities for several months, but that was put down to stiffness, not disease. He started pooping in his bucket about a week before showing really strong symptoms. What would your diagnosis be based on this info? Also, he tested negative for hypp.
Alicia
Moderator:
DrO

Posted on Friday, Feb 27, 2004 - 3:16 pm:

No from your posts there are not really any clues as to what may have been the cause. Even the negative finding on the EPM does not rule it out: it can be hard to find. On the other hand I don't think it sounded like EPM.
DrO
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