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  Discussion on Chronic Diarrhea in older pony
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Member:
Npruitt

Posted on Thursday, Jan 1, 2004 - 8:06 pm:

Ok, this is a long-winded tale so please bear with me.
I have a thirty year old Welsh pony that I have owned for 18 years, since I was a little kid, but who I don't ride anymore. He has always been very healthy until the summer of 2002. My old riding instructor was using him that summer and around July I noticed that he was rapidly losing weight and looked horrible. Part of the problem was that she was not using Equine Senior for him, which I later found out, and the other part was that she was apparently not worming him regularly.
Well, needless to say, I took him away from her and took him to another barn. The day after I moved him to the new barn, he started to have diarrhea, which progressively got worse. We changed his feed, giving him Equine Senior, electrolytes and pro-Biotic and tried Pepto-Bismol. I also had him wormed, checked him for salmonella(it was negative), got his teeth looked at, and started him on preventative Strongid.
Well, he got better for a few days, but then he started with the diarrhea again, which eventually started to be projectile. And it went like that for a few months. I moved away from home and a family that I trusted began to care for him but nothing seemed to help his diarrhea. Then the vet thought that he probably still had worms, despite the fact that he was wormed regularly and was given Strongid. The vet thought he was still wormy because he was listless, with a bad coat. The vet then tube wormed him and he got better. The vet also gave the family a bottle of Zorbatox to use in case the diarrhea came back.
Well, he got better and started to be peppy again, and his stool was normal. Every now and then he would get a cow pie like stool but he did not have the diarrhea that he had had in the summer, the projectile kind. He also began to rapidly put on weight until he was healthy and shiny again.
This past August, however, his stool became soft again and the mother of the family became hysterical and told me that she didn't want to care for him anymore, and told me that he was too frisky for her children. So, I took him back and returned to the barn where he had convalesced before. He remained there with the cow-pie diarrhea through September but his weight was still good, although he seemed kind of tired, not at all frisky. A friend who has a barn with many older horses offered to let me board at her place and she started using my pony in lessons for beginner kids. She also had a mare that had chronic diarrhea and she told me that treatment of chronic diarrhea is really hit and miss. Over the past few months, my pony's diarrhea has gotten back to the watery type, and two weeks ago, my friend told me that my pony seemed less interested in his food. She also said that he was really slow in the lessons, to the point that the kids had to really kick him to make him move. This past week, his appetite improved but his diarrhea has progressed to the projectile type again. The vet came out and did a tube worming four days ago, but his diarrhea is still bad. The vet also took some blood for the lab. I am still awaiting the results.
The vet also ordered some Zorbatox to give him for the diarrhea, since it worked well before.
Today I washed his rear and put vaseline on it to keep him from chaffing and getting an infection. I noticed too, that he has some rain scald, which was hard to see with his furry coat. He also seemed to have some soreness in his sheath area because he kept trying to jab me with his hind leg to make me stop cleaning his sheath.
I am beginning to wonder if maybe there is more going on here than just worms. Could he have a bacterial infection as well, that is perhaps lowering his immune system to the point that he has skin infections and infections in the sheath and intestinal areas? He seems very perky, despite his behavior in lessons, and he has a good appetite, despite the appetite change a few weeks ago.
After reading the article about malabsorption synDrOme, I think that my pony might have that problem and I am going to ask the vet to get a biopsy for me. My pony doesn't seem to be in any pain but I worry that he is suffering because of the diarrhea.

I have called the vet about the possibility of MS and/or a possible bacterial infection (something we have not really considered), but he has not responded yet.
Also, my friend stopped giving him the Strongid and changed from Fast Track Pro-Biotic to yeast culture. I suggested to her today that we change back to the Probiotic and start using electrolytes so he doesn't get dehydrated. We have also been giving him Pepto-Bismol and the vet told us to give him corn oil in his feed so that he doesn't start to lose a lot of weight again. The vet also suggested that I give him a Panacure Powerpack in a few days. I am wondering if I should also put him back on the Strongid? Would it hurt his intestines, or would it be ok to use it to prevent worms?
I know that this message is really long but this is an on-going thing now with my old boy, and I don't know what to do. I would appreciate any advice any of you out there could give me.
Thanks.
Nicole Lopez-Pruitt
Member:
Npruitt

Posted on Thursday, Jan 1, 2004 - 8:11 pm:

Oh, I forgot to mention that we have been using beet pulp with him since December of 2002, and we wet his food before giving it to him,
Moderator:
DrO

Posted on Friday, Jan 2, 2004 - 9:17 am:

As you have probably already read and your friend has advised you there is not any specific remedies we can recommend without a diagnosis and we cover the diagnostic techniques and empirical therapy (treatments without a diagnosis) in the article, Equine Diseases » Colic and GI Diseases » Diarrhea in Horses » Diarrhea an Overview. Right now it sounds like you and your Vet are working through the discovery process and we would like to know what you find.

Yes, lowered immunity to disease is common in older horses and usually secondary to Cushingnoid disease, perhaps specific therapy for it would help, see » Equine Diseases » Endocrine Disorders » Cushing's SynDrOme and Pituitary Tumors.

I don’t think there would be a problem with putting him back on the daily Strongid but if your vet has a reason to try the Panacur Powerpack I would go ahead it will kil encysted parasites the Strongid would not get.
DrO
Member:
Canyon28

Posted on Friday, Jan 2, 2004 - 11:29 am:

First-I would take him off the daily strongid and never use it again. His system probably cannot tolerate it anymore, he might have even developed an allergy from it. Old horses usually have reduced liver and kidney functions. I have heard nothing but problems from people that have had their horses on the daily wormers. For one thing, the worms build up tolerance to it, and would you want to take a daily dose of poison? that is esentially what you are giving your poor pony. this Pony is so old , he needs special care to not damage his organs any further. the corn oil will really help him keep weight on, just start slow with it, about 1/4 cup twice a day for a few days, then increase 1/4 every few days, until you are giving him at least 1 cup per day. In the spring and summer, I feed my 29 yo stallion up to 3 cups of soy oil per day to keep his weight up for breeding. He has never gotten diarrhea from it. I hope your Pony comes out of the diarrhea soon. His system is definitely in a mess right now.
Member:
Npruitt

Posted on Friday, Jan 2, 2004 - 1:09 pm:

Thank you for your advice, Dr. O and Christine.
I will let you know what I find out with the results and the possible biopsy.

Nicole
Member:
Npruitt

Posted on Friday, Jan 2, 2004 - 1:57 pm:

Dear Dr. O:
I have been looking over the site and on the Internet regarding the Permax. We tested my pony with the urine test for Cushingoid's and it came back negative but the vet said that he probably does have Cushingoid's, since my pony has all of the symptons, and that the only way to find out would to be the long drug test that you mention in your article. So, if we find out for sure that he has Cushingoids, would it hurt my pony to give him worm him regularly, and give him the Permax? Also, would it be ok to give him metronidazole and Permax? Thanks.
Nicole
Moderator:
DrO

Posted on Sunday, Jan 4, 2004 - 8:48 am:

We outline the pros an cons of daily strongid deworming in the article Care for Horses » Deworming and Parasite Control » Overview of Deworming. I think Christine's concerns about allergy and intolerance are very unlikely and no of no such problems.

Yes you can deworm and use Permax. I know of no tests that have looked at the use of it with Metronidazole but do not know of any problems.
DrO
Member:
Npruitt

Posted on Tuesday, Jan 6, 2004 - 11:12 am:

Dear Dr. O and interested parties:
Well, my pony, whose name is Farnley Gaylord, by the way, is a little bit better after his worming but he still has diarrhea, just not the projectile kind. I am waiting for the Panacur Powerpak to arrive so I can worm him again, at the vet's instruction. We are continuing with the corn oil and he is on Probiotic again.
His test results showed no signs of infection, just that he is slightly anemic, which he has been in the past. We have him on Red Cell, but the vet thinks that the diarrhea is exacerbating the anemia.
We are going to do the test for Cushingoid's disease at the end of this week, or the beginning of next week, and if he has it, and we are pretty sure he does, we are going to start him on pergolide(Permax), and see if he gets any better. I will keep you all posted.

Nicole Lopez-Pruitt
Member:
Npruitt

Posted on Wednesday, Jan 21, 2004 - 10:29 am:

My 30 year old pony Gaylord wast tested for Cushingoid's disease with the dexa test last week and it came back negative yesterdat, so we have tested him twice now, this past week and two months ago, and it appears that he doesn't have it. The vet gave him ivermectin during the tube worming towards the end of December, and I gave him the Panacure Powerpac, and it seems to finally be working. We are also giving him the corn oil, electrolytes, beet pulp, Equine Senior, and Fastrak Pro-Biotic, and those things have helped bring his weight back up.
His rainrot has also improved, his coat is now silky and smooth, but very hairy, and he doesn't seem to have a sheath infection anymore, as he let me clean it a few weeks ago with no problems.
He is also perky, and he tries to push me over every time I bring him treats.
Two days ago, I went out to the barn and his back end is finally dry, and it appears that he does not have that chronic diarrhea that he has had, although his stool is not firm yet; it looks like a cow pie.
The vet says that if he get bad again, he is going to try something called a Bio Sponge that is sort of like a tube worming that you have to do over the course of one or two days.
Dr O. and anybody else, have you ever heard of a Bio Sponge?
Also, do you think that Gaylord would benefit from some vitamin C put into his food? And if so, would kind of supplement should I get to give him Vitamin C?
Thanks.

Nicole Lopez-Pruitt
Moderator:
DrO

Posted on Thursday, Jan 22, 2004 - 8:16 am:

BioSponge, is essentially a mineral, smectite, found in types of clay. Recent work was done on it and this was the finding:

Equine Vet J. 2003 Nov; 35(7): 638-41.
Evaluation of in vitro properties of di-tri-octahedral smectite on clostridial toxins and growth.
Weese JS, Cote NM, deGannes RV.
Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada.

REASONS FOR PERFORMING STUDY: Clostridial colitis and endotoxaemia of intestinal origin are significant causes of morbidity and mortality in horses. Intestinal adsorbents are available for treatment of these conditions; however, little information exists supporting their use. OBJECTIVES: To evaluate the ability of di-tri-octahedral smectite to bind to Clostridium difficile toxins A and B, C. perfringens enterotoxin and endotoxin, inhibit clostridial growth and the actions of metronidazole in vitro. METHODS: Clostridium difficile toxins, C. perfringens enterotoxin and endotoxin were mixed with serial dilutions of di-tri-octahedral smectite, then tested for the presence of clostridial toxins or endotoxin using commercial tests. Serial dilutions of smectite were tested for the ability to inhibit growth of C. perfringens in culture broth, and to interfere with the effect of metronidazole on growth of C. perfringens in culture broth. RESULTS: Clostridium difficile toxins A and B, and C. perfringens enterotoxin were completely bound at dilutions of 1:2 to 1:16. Partial binding of C. difficile toxins occurred at dilutions up to 1:256 while partial binding of C. perfringens enterotoxin occurred up to a dilution of 1:128. Greater than 99% binding of endotoxin occurred with dilutions 1:2 to 1:32. No inhibition of growth of C. difficile or C. perfringens was present at any dilution, and there was no effect on the action of metronidazole. CONCLUSIONS: Di-tri-octahedral smectite possesses the ability to bind C. difficile toxins A and B, C. perfringens enterotoxin and endotoxin in vivo while having no effect on bacterial growth or the action of metronidazole. POTENTIAL RELEVANCE: In vivo studies are required to determine whether di-tri-octahedral smectite might be a useful adjunctive treatment of clostridial colitis and endotoxaemia in horses.

The last sentence says it all, this product shows potential for use in clostridial colitis but whether it actually helps is unknown. Yes vitamins, including C may be beneficial, we have specific recommendations on these and other supplements at: Care for Horses » Routine Care & Procedures » Geriatric Horse: Problems and Care and Care for Horses » Nutrition » Vitamins an Overview.
DrO
Member:
Npruitt

Posted on Thursday, Jan 22, 2004 - 10:54 am:

Thanks, Dr. O:
Your article says to give 4oz brewer's yeast. I already give Gaylord Fastrak Probiotic, which has some yeast and other things as well. Should I also give him brewer's yeast, or will the Fasttrak be enough? Thanks.

Nicole
Moderator:
DrO

Posted on Thursday, Jan 22, 2004 - 8:40 pm:

I would recommend switching to the brewers yeast.
DrO
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