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  Discussion on Unilateral runny nose
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Member:
lmiller

Posted on Monday, Oct 1, 2007 - 3:05 pm:

Hello DrO,
My 9YO APHA mare came out Saturday noon with a crusty discharge glued to her right nostril. We were at a horse show, so I figured it was dustier than at home. I cleaned her up and she was fine all afternoon, though cranky to still be out at 10 PM (we all were).

Sunday morning (8AM) my trainer said her nose was a little crusty, but wasn't concerned since she had eaten and drunk plenty of water, eyes bright, and good attitude. By Sunday 2PM her nose was actively running all afternoon with yellow watery fluid, just on the same right side.

This morning (7:30AM) the discharge seems a little thicker, and not so copious. Still no fever, hungry and eating, and she is relaxed, responsive, but not lethargic at all.

Neither I, my trainer, nor her assistant detect any unusual or foul odor in her nose, or on her breath. I have observed no swelling, fever, lumps. She's eating and drinking, pooping no problem. Her demeanor seemed pretty normal, other than whinnying a lot, which she doesn't do at home.

She was hauled Fri. afternoon. The show facility is about 60 mi. from home, and is in a relatively windy area in So. California (though it was not windy until Sunday PM). Was fine on Friday. She hasn't had any recent dental work done, and is current on exams and vaccinations. Any ideas? Thank you, Laurel
Moderator:
DrO

Posted on Tuesday, Oct 2, 2007 - 9:49 am:

Hello Laurel,
Have you taken a flash light and peered up the nostril for a foreign body or injury? Otherwise the unilateral nature suggests a bacterial sinus infection (sinusitis) or guttural pouch infection. Sinusitis can be either primary or secondary. If this persists this may require antibiotics and if not responsive further diagnostics like scoping and/or radiography.
DrO
Member:
lmiller

Posted on Tuesday, Oct 2, 2007 - 5:13 pm:

Dr O,
Thanks for your reply. We did look up her nose and couldn't really see anything on Sunday. Monday the vet cam out for an exam, at which point Sabrina seemed a little punky. No fever, and I would say she is somewhat off her feed as well. (Normally an enthusiastic eater.) Also, she was chewing up wads of hay an spitting them out - not all, just some. Basically he said it was either an infected tooth or guttural pouch infection. He was less suspicious of sinusitis, because of the way her sinuses sounded.

The vets in this practice like to take a step process for treatment options before they yank out the big (and expensive) procedures. So, he prescribed SMZ antibiotic (15tabs/2x day), bute and took a culture of the discharge; results due Wed/early TH. On dental he found no obvious infection in her teeth, but did use the opportunity, since she was sedated for the exam, to grind off some sharp points in hopes that might help a) help her chew her food more effectively and b) ID source of infection. She showed no real reaction to the dental work, so the verdict is still out. The plan is to see how she responds to the antibiotics and re-evaluate on Friday. If not much improved, we will take her off the meds, and take her for radiographs and scoping next Monday.

I saw her today, and the discharge is much improved. She's still not eating voraciously, but did go out to roll and play. She seemed perkier than Monday.

I've done some investigating and can't decide which DX is going to be the easiest to deal with, both from recovery and monetary standpoints.

Will let you know what we find.

(copied from original misplaced post)
My 9YO APHA mare came out Saturday noon with a crusty discharge glued to her right nostril. We were at a horse show, so I figured it was dustier than at home. I cleaned her up and she was fine all afternoon, though cranky to still be out at 10 PM (we all were).

Sunday morning (8AM) my trainer said her nose was a little crusty, but wasn't concerned since she had eaten and drunk plenty of water, eyes bright, and good attitude. By Sunday 2PM her nose was actively running all afternoon with yellow watery fluid, just on the same right side.

This morning (7:30AM) the discharge seems a little thicker, and not so copious. Still no fever, hungry and eating, and she is relaxed, responsive, but not lethargic at all.

Neither I, my trainer, nor her assistant detect any unusual or foul odor in her nose, or on her breath. I have observed no swelling, fever, lumps. She's eating and drinking, pooping no problem. Her demeanor seemed pretty normal, other than whinnying a lot, which she doesn't do at home.

She was hauled Fri. afternoon. The show facility is about 60 mi. from home, and is in a relatively windy area in So. California (though it was not windy until Sunday PM). Was fine on Friday. She hasn't had any recent dental work done, and is current on exams and vaccinations. Any ideas? Thank you, Laurel

(DrO's reply)
Hello Laurel,
Have you taken a flash light and peered up the nostril for a foreign
body or injury? Otherwise the unilateral nature suggests a bacterial
sinus infection (sinusitis) or guttural pouch infection. Sinusitis can
be either primary or secondary. If this persists this may require
antibiotics and if not responsive further diagnostics like scoping
and/or radiography.
Member:
dwinans

Posted on Wednesday, Oct 3, 2007 - 11:16 am:

Laurel,

If you do a search on "runny nose" you will find my experience with a case similar to yours. It might give you some ideas of what to look for.

Dawn
Member:
lmiller

Posted on Wednesday, Oct 3, 2007 - 4:19 pm:

Hi Dawn,
I read your case first, with great interest. Did Remy's infection finally resolve completely? I am keeping fingers crossed we have a quick(er), and non-surgical resolution to all this. I've been lucky so far to have such a healthy girl. All the things I've read here have at least been touched on by my vet, so I feel pretty good about the course so far.

I just wish I knew which of the possible bad things this is, and which one I should be hoping it is!

Questions for you: could you ride during this 5 months of treatment? turnouts? Did your horse lose weight as a result?
Member:
dwinans

Posted on Wednesday, Oct 3, 2007 - 4:44 pm:

Yes, if my memory is correct, it took almost a year from start to finish before his nose was dry. It was a good 8 months after the surgery before it cleared up. Antibiotics were just not working and we stopped them when the surgery was done.

The tooth infection was diagnosed by skull radiographs which are pretty difficult to read - my vet sent them to CO State University to be read.

Through it all Remy was completely healthy - no weight loss, coughing, or anything. The discharge was just really icky (started out creamy, went to green, and then tinged with blood after exercise). After the surgery the discharge was basically clear and I kept a close eye on it in case it looked infected again.

I rode him during the treatment but because it was summer I gave him a few months off until it was healed up.

Good luck!
Member:
lmiller

Posted on Thursday, Oct 11, 2007 - 4:39 pm:

I got Sabrina's lab results back today. These bugs were found in the nasal discharge she had:
E. Coli (broth culture), Alpha Hemolytic Streptococci, Acinetobacter Lwoffii
All cultures came back with "few colonies."
So for now, the vet recommended staying with a 2wk course of SMZ, and playing the wait-and-see game for return of symptoms. The hope is that Sabrina has a simple sinus infection, and it will be taken care of with this course of antibiotics. If symptoms return (guarded prognosis), she'll go in to have her head examined. They still suspect a tooth problem, and hope it's not something with the guttural pouch.
Dr. O, want to weigh in?
Moderator:
DrO

Posted on Friday, Oct 12, 2007 - 5:33 pm:

Could all be contaminants but the Acinetobacter is suspicious: was it sensitive to the TMP-SMZ?
DrO
Member:
lmiller

Posted on Friday, Oct 12, 2007 - 7:54 pm:

Suspicious in what way? Maybe looking at her lab report will help. I think the S=sensitive, R=resistant, I=inconclusive?

Thanks DrO-
Laurel
text/rtfSabrina's lab report
SabrinaLabs.rtf (2.5 k)
Moderator:
DrO

Posted on Sunday, Oct 14, 2007 - 12:00 pm:

Suspicious as a possible pathogen LA, this genus is associated with respiratory infections but can also be found as a contaminant. The lab indicates it is sensitive to the TMP-SMZ.
DrO
Member:
lmiller

Posted on Sunday, Oct 14, 2007 - 4:16 pm:

DrO,
It seems good that this germ is sensitive to the SMZ. In reading about the bacteria on PubMed and other bio-journal sites, it can cause respiratory, blood, cardiac, and gastric infections in humans (in hospital settings mainly), and respiratory in birds. It is a commonly found skin bacteria. And, as a contaminant, I wonder where it came from, and how it got up Sabrina's nose.

Should I be concerned about pneumonia, gastric, or cardiac problems as a result of this finding?
Moderator:
DrO

Posted on Tuesday, Oct 16, 2007 - 8:55 am:

The chance a systemic infection will develop from a simple sinusitis, would be small in a horse with a healthy immune system.
DrO
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