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  Discussion on My horse has pemphigus
Author Message
Member:
Gillb

Posted on Sunday, Oct 10, 2004 - 2:03 pm:

My horse, an 11 year old Morgan, contracted pemphigus after a major operation to remove his penis due to squamous cell carcinoma. The vet thinks it likely that the disease was triggered off by the stress of the op.

Initially before the disease was confirmed, the vets thought it may be a severe uticaria and he was treated with an injection of dexamethasone, which seemed to improve him almost immediately. However when the steroid wore off the symptoms returned only worse. Over the next couple of weeks he was tried on varying doses of steroids but the only thing that worked was the high dose of dexamethasone. He was put onto prednisolone which did not seem to do anything and the disease really took hold; and he ended up absolutely covered from nose to tail in crusty oozing lumps.

Finally they took a skin biopsy which confirmed pemphigus and put him back onto a higher dose of prednisolone. He did not really seem to recover and was just 'ticking over', not able to move faster than a slow walk and still covered in lumps. He was kept on prednisolone for two weeks and was no different at the end of that period.

He was then put back onto opticorten (which I think is dexamethasone?) but this time he does not seem to have improved at all (however he is not worse).

He feels the cold a lot but I am reluctant to put a rug on him due to the state of his skin; however should I give this a try?

Do you think this means the prognosis for him is not so good?
Moderator:
DrO

Posted on Monday, Oct 11, 2004 - 8:15 am:

What a tough situation Gill, I know this is a tremendous stress for you. I think the blanket will be uncomfortable on the skin and should be avoided if possible: what is he doing that makes you think he is sensitive to the cold?

If the diagnosis is correct the prognosis for recovery is poor and that is the hardest thing I have had to write here in a long time. Have you tried moving him to a totally different environment and change his feed? With confirmatory biopsies it is a long shot but the best chance I can think of.
DrO
Member:
Gillb

Posted on Monday, Oct 11, 2004 - 9:16 am:

Thanks for the reply Dr O, even if it wasn't what I wanted to hear! I know he feels the cold because when it has been particularly windy (or worse, raining and windy) he is shaking. I am not surprised because his hair is matted and he obviously cannot insulate himself.

He was removed from my fields to the vet clinic, where his feed was changed and he was in their paddock for nearly a week. However, there was not really any difference.

Another train of thought is that UV light can be an irritant so I have been trying to keep him out of sunlight during the day, but to be honest I don't think it makes much difference, and grazing seems to be the only pleasure he has at the moment!

My concern is that he does not seem to be responding to the steroids; in fact after five days on opticorten he looks slightly worse. The vets tell me there is no alternative treatment and I am thinking that it might be cruel to try and keep him through winter. He is eating and grazing, but has no life in him.
Moderator:
DrO

Posted on Monday, Oct 11, 2004 - 11:24 am:

It is true that UV does seem to be a problem with some of these horses. If you are still turning him out in the day perhaps a light sheet would be a compromise and help block the wind. I have been working on a update to the article on autoimmune diseases and there have been recently some published data on alternatives, that are expensive fairly toxic and don't seem to change most cases but occasionally have had a benefit. Let me see if I can get it finished and uploaded in the next few days.

It is still early to judge but if 10 days go by with no improvement, uping the dose is your first move.
DrO
Member:
Gillb

Posted on Tuesday, Oct 12, 2004 - 10:09 am:

Thank you for your help Dr O. Today the horse is not looking good and the vet said it is obvious he isn't responding to the steroids. He is going to talk with the UK's leading expert on skin diseases and if there is any glimmer of hope with alternative treatments they will take him in. Failing that, I think we are looking at euthanasia. I will keep you updated.
Moderator:
DrO

Posted on Thursday, Oct 14, 2004 - 2:04 pm:

Gill I have that revision up now.
DrO
Member:
Gillb

Posted on Friday, Dec 31, 2004 - 5:26 pm:

Dr O just to update you on the above, unfortunately the horse had to be PTS, he was slowly deteriorating and was literally just kept ticking over on a high dose steroid, which in itself would have undoubtedly started to cause problems. I had to take the decision when he just could not cope with the cold weather and I could not rug him up. The only thing the vets didn't try was gold injections which worked out at £800 per month - even if they had helped in some way I could not have afforded them!

Thanks for all the help and advice.
Member:
Suzeb

Posted on Sunday, Jan 2, 2005 - 11:34 am:

I am so very sorry for your loss Gill. You did everything that you could to help him. Your decision to end his misery was a very loving and kind thing to do although very hard.
My thoughts are with you.

Susan B.
Member:
Eoeo

Posted on Monday, Jan 3, 2005 - 9:13 am:

Gill, sorry for your loss. We had to euthanize an 8 month old filly last month due to complications of choke. It tore us up. EO
Member:
Frances

Posted on Wednesday, Jan 5, 2005 - 9:01 am:

I'm so sorry, Gill. What a lot of suffering for him and for you. At least it's over.
Member:
Warwick

Posted on Wednesday, Jan 5, 2005 - 11:49 am:

Heartfelt wishes to you, Gill. Take solace in knowing he's not suffering any more and you did the right thing.
Member:
Kcovell

Posted on Thursday, Jan 6, 2005 - 6:47 am:

Gill I am so very sorry for your loss. Just reading these posts brings tears to my eyes. I know your horse is looking down on you and thinking of all the good times the two of you had together.
Member:
Gillb

Posted on Thursday, Jan 6, 2005 - 7:52 am:

Thanks for your best wishes everyone. Making the decision for this horse and seeing it through to the very end was the hardest thing I've ever had to do in my life, he was so, so special to me and I had been through so much with him. He leaves a very big gap indeed.
Member:
Lilo

Posted on Thursday, Jan 6, 2005 - 1:50 pm:

My condolences, Gill. That is the hardest part of owning an animal - that there will come a time when we have to make this decision for them. I am so sorry for your loss,
Lilo
Member:
Shirl

Posted on Thursday, Jan 6, 2005 - 2:15 pm:

Gill, I'm so sorry for your lose. I know how a very special horse can leave a huge hole in your heart, having lost my special friend in Oct. Prayers and wishes coming your way, and I know your guy is playing with my girl in sunny pastures.
The best, Shirl
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