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  Discussion on Heatstroke in a yearling filly
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Member:
ekaufman

Posted on Wednesday, Jul 4, 2007 - 10:26 am:

Hello HAers,

I had a yearling filly collapse this week. It was a dramatic sight-- she was walking and fell over sideways in a true victorian faint. This happened twice in a day. Having no idea what it was, and with my vet an hour away, I gave her a dose of banamine and cold hosed her (it was a hot day with a dry wind). I also dosed her with gatorade, because I'd run out of proper electrolytes.

We have bloodwork back at last, and we see two anomalies-- her potassium is slightly above lab normal, and her platelets are less than 10% of the lab low normal. My (excellent) vet believes we have a fairly classic heatstroke. Guess I'm glad I thought to hose her.

A couple of questions-- the low platelet count (which we are monitoring) puts her at high risk even with small injury or trauma. Any management advice? Any way (short of a transfusion) to get that platelet count back up?

Any management advice to help her adjust to the heat/altitude (she is a recent import from Spain to Northern Colorado)?

Any general thoughts on what to look for next (we will check for anhyDrOsis etc. when we are less afraid to touch her)?

The little fainting goat herself is looking better with TLC. I returned her to her buddies to keep her happy, and found all 3 curled in a big filly ball last night. Cute as long as the fainting goat doesn't get a boo-boo.
Member:
mrose

Posted on Wednesday, Jul 4, 2007 - 10:47 am:

Have you been having severely high temps? I've never heard of a horse fainting from heatstroke unless it's being worked hard. Also, parts of Spain get pretty darn hot. Had she been running around a lot before she fell over?

Did the vet have any ideas as to the cause of the platelet count being low?

Wish you had a picture of your "filly ball!" It sounds so cute! I sure miss having little ones bounding around and love looking at others pictures.
Member:
ekaufman

Posted on Wednesday, Jul 4, 2007 - 11:28 am:

It's been at or over 100' here. I think that would be exceptional for northern Spain, and she's had an altitude gain as well. She had been laying out sleeping in the sun before she got up and (apparently) fainted, so that could have contributed to over-heating.

Keeling over from heatstroke isn't unheard of here. The story is that the altitude makes the radiant effect greater, so heat-susceptible horses get hit harder. I don't know whether there's research to back that up or not.

A low platelet count could be an effect of the heatstroke, or an underlying cause. The first question is whether it recovers now, crashes further, or stays low. Wish I could feed her a steak!

The filly ball was a really great sight, especially after a long run of sleepless nights. I do believe these animals care for each other in ways that we can't offer them. She looked so safe and happy.
Member:
mrose

Posted on Wednesday, Jul 4, 2007 - 3:06 pm:

I know about the strength of the sun at high altitudes; we currently live at 6500' but used to live at 8000'. You can burn to a crisp in no time, summer or winter, if you aren't careful! I didn't realize you were so high up.

We've been having the same kind of heat...quite a bit hotter than normal, esp. for this time of year.

Our horses (Arabians) certainly develop deep bonds that are wonderful to see. I love watching all the interactions going on when they are turned out. We used to have a mare that always wanted her best friend near her when she foaled. I'd often see mare and foal sleeping with the older mare standing guard over them.

I hope your filly is o.k. and the platelet count was due to the heatstroke. I bet she's a beautiful girl.
Moderator:
DrO

Posted on Friday, Jul 6, 2007 - 6:28 am:

Hello Elizabeth,
For information on caring for horses in the heat see, Horse Care » Routine Horse Care » Summertime, Caring for Your Horse in the Heat.

I looked for a relation between hyperthermia and thrombocytopenia (low platelets) and could not find one and other than avoiding situations that can cause injury, good general care, and nutrition there are no specific recommendations for promoting platelet formation that I am aware of.

Be sure to have a large animal thermometer available to double check the diagnosis. As you describe it the lack of signs of illness prior to going down makes heat stroke suspect, see the article referenced above for more on this.
DrO
Member:
ekaufman

Posted on Friday, Jul 6, 2007 - 9:23 am:

Thanks Dr. O,

I read the article, but started my thread here because it seemed a better fit. I know for certain she collapsed, but heat stroke as described there didn't seem such a great fit. Of course, we have a lot of good folks all saying "yah, I've seen that," but that could just mean that really sick horses sometimes fall down in the heat.

We will draw more blood today. If her platelet count is coming back and the rest of the bloodwork remains unremarkable, I guess I'll just watch for further symptoms. If the platelet count is the same or has crashed further, then we're in the hunt for something bad. My gut tells me we aren't done with this, but my gut is never optimistic around a falling-down horse!

The fainting goat herself hasn't shown me any further collapses, and is eating and drinking with interest.
Member:
mrose

Posted on Friday, Jul 6, 2007 - 10:52 am:

Elizabeth, never discount a horse's ability to keep you on edge! I'm not sure why, but it seems to be an inborn trait to want to keep owners in a state of worry and confusion as much as possible. And if they can also run up expenses, so much the better!

Keep us posted.
Member:
paardex

Posted on Friday, Jul 6, 2007 - 11:38 am:

I am keeping my horses away from the computer afraid they learn some new [and costly] tricks.
This fainting would certainly appeal to some of them especially on working hours!
Jos
Member:
ekaufman

Posted on Friday, Jul 6, 2007 - 12:54 pm:

Just a small update: my vet came out for more bloodwork this morning. Vitals are all normal and the patient resented being taken from her hay.

The working hypothesis is Disseminated Intravascular Coagulation brought on by heatstroke. My vet has consulted with CSU and with the folks at Littleton Large. We are now in a ghoulish contest with Littleton for lowest living platelet count. They have one in ICU with a "9" while mine at home has a "14" from the same lab. I'm getting extra credit for home nursing, apparently, though I believe this filly has a better chance of recovery here than in the hospital (not because I'm so great, but because stress seems very dangerous right now).

I will post an update when I have the bloodwork back. She *seems* better than when she was laying on the ground with her eyes closed....
Member:
ekaufman

Posted on Friday, Jul 6, 2007 - 11:56 pm:

So good news tonight on my fainting goat. Her platelets are up from 14 to 115 (lab low normal is 125), and other values are within normal range. When this blows over, the plan is to check for factors that may make her particularly heat-sensitive.

Going to take a fist full of Benadryl and sleep through the night, I hope.
Moderator:
DrO

Posted on Saturday, Jul 7, 2007 - 8:56 am:

Hmmm DIC from heat stroke, well I guess it possible Elizabeth but I believe they have reached out might far on a limb without a temperature being taken to confirm the diagnosis of heat stroke. On the other hand I don't have any better ideas.

Elizabeth have they begun any specific therapies for the DIC? Usually anticoagulants are started but it does require intense monitoring of coagulation parameters.
DrO
Member:
ekaufman

Posted on Saturday, Jul 7, 2007 - 10:30 am:

Hi Dr. O,

By the time we took her temperature I had cold-hosed her for 30 min. and administered a dose of banamine, so that data is lost. Her temp. at that time was normal. I think there is some anecdotal diagnosis going on, if only because I ruined anyone's chance at doing better. (In my defense, I honestly thought she might never be getting back up.)

She has recently come from Spain, so she cleared 3 quarantines but also had a huge amount of stress and environmental change. It seems to me that moving a horse farther than she would naturally travel on her own has all kinds of systemic effects that could be at play here. Or perhaps that's just guilt!

Given the uncertainties in diagnosis and her rapid rebound on homecare, everyone is recommending that I monitor her closely and hold off with major intervention. So no medications of any sort-- just hovering and the usual TLC. She looks pretty darn bright this morning, I must say, at least on the outside.
Member:
frances

Posted on Sunday, Jul 8, 2007 - 3:05 am:

Good luck Elizabeth. Glad things seem to be heading in a good direction.
Moderator:
DrO

Posted on Sunday, Jul 8, 2007 - 8:06 am:

Elizabeth, in my experience it takes well over 30 minutes to get a hyperthermic horse or cow back to normal and sometimes requires hours. However it appears that right now the only abnormality is the clinical one of thrombocytopenia so we will watch and I will keep my fingers crossed for you. Keep us appraised.
DrO
Member:
ekaufman

Posted on Friday, Jul 13, 2007 - 9:36 am:

Just an update on my fainting goat-- her bloodwork this week is all within normal ranges. The entire "first grade" has the baby snots, which seems to be unrelated. One interesting piece of additional info. is that she and the other new yearling both titre positive for WNV exposure (we are crawling with it this year, and these girls arrived unvaccinated).

As her bloodwork mends, her sweet submissive temperament is "mending" as well-- she was chasing the other two around the paddock this morning with a rather un-sweet look. Makes me wonder if she arrived sick.

Absent further symptoms, I think it will be a bit of a mystery. Things I would do differently include:
1) hold them for WNV vaccination before bringing them to Larimer "skeeter" county in high summer (dodged a bullet, I hope)
2) take baseline bloodwork the second day here
3) take her temp. as soon as I began hosing her after the collapse

She looks good today, anyhow.
Member:
leilani

Posted on Friday, Jul 13, 2007 - 3:57 pm:

Good news Elizabeth. Funny how once they start to 'come around' that sweetness departs. Love it! Leilani
Moderator:
DrO

Posted on Saturday, Jul 14, 2007 - 12:55 pm:

Thank you for the update Elizabeth. Note this past week we had a very similar incident in a 3 week old foal that after history, exam, chemistries, and response to treatment is most likely a pyrethrin toxicity case. They used a very high concentration "Spot On" like treatment on this foal that resulted in a fast onset of incoordination and depression to the point of being comatose that improved remarkably quickly following repeated bathing with shampoos. Despite the high concentrations the product stated that is was safe for foals and to use a half dose on them. The owners are awaiting a company response.
DrO
Member:
ekaufman

Posted on Saturday, Jul 14, 2007 - 2:32 pm:

Interesting Dr. O. The missing data point in my case history is that I have been doing premise spraying for mosquitoes. The spray is a pyrethin formulated with a citrus oil for a very small micron bead. Of course we do not spray it on the horses, so her exposure is less than if I were applying fly spray. Though I suppose the drift may mean she is ingesting some spray on her hay. How did you identify pyrethins as the cause? Perhaps she is hyper-sensitive to the spray? Is there a safe test that would be a rule-out for this as a cause?
Moderator:
DrO

Posted on Sunday, Jul 15, 2007 - 7:23 am:

There is no specific test for pyrethrin toxicity Elizabeth, but the exposure, timing, clinical signs, no other cause was found, and complete recovery from incoordination requiring 48 to 72 hours all match very well. What type pyrethrins are you using and the concentration are in your premise spray and how often do you spray. I agree that based on the amount they are likely exposed to this does not look likely.
DrO
Member:
ekaufman

Posted on Monday, Sep 24, 2007 - 4:02 pm:

Ok, I just wanted to post an update to this thread. The filly returned to normal behavior and bloodwork with no other collapses (that I saw).

The revised theory now is that her collapse was related to WNV, not heatstroke. I don't find any data connecting thrombocytopenia with WNV in horses (seems there may be a connection in dogs, but she isn't a dog). But my vet is pretty confident that complications from fighting the virus combined with shipping stress, heat, etc. explain the collapse adequately.

I still watch her with a bit more attention. Lacking a great scientific explanation, I have a feeling I may see another episode any time. But she looks great right now.
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