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  Discussion on 9mnth Welsh Cob filly
Author Message
New Member:
puppypie

Posted on Tuesday, Feb 26, 2008 - 9:57 am:

Hello Dr. O
I have a 9 month old filly who i bought in October. When i bought her she had a cold and a slight cough. We treated the cold with Penicilin & Streptermicine but it had no effect so we did a swab and it turned out that there were three bacteria present (sorry i dont know which ones) and the only thing that would treat all three was a course of Engermicine. She had the engermicine for 5 days, after each dose she seemed to act as if she had colic for about half an hour and was then fine but a little lethargic and seemed depressed. After the course had finished she started to exhibit stiffnes in her back legs so i called the vet again and he ran some bloods. Her bloods were as follows:
Haematology report
Red Blood Cells 8.09
Haemoglobin 12.0
Haematocrit/PCV 0.31
MCV 37.8
MCHC 39
WBC and Differential
White Blood Cells 10.6
Neutrophils 19%
Band forms 0%
Lymphocytes 79%
Monocytes 2%
Eosinophils 0%
Basophils 0%
Neutrophil: Lymphocyte ratio 0.24
Platelet count 312
Platelet comment - Number appear adequate on the smear
Film comment - no morphological abnormalities
Mild anaemia. Mild erythroid response based on anisocytosis.
Lymphocytosis suggests a chronic infection/hypersensitivity or prolonged antigenic stimulation.
Other causes incloude physical activity, fear or excitement, drug therapy and hypoadrenocorticalism.

Biochemistry Report
Alkaline Phosphataase 889
AST 699
Gamma GT 172
GLDH 5
LDH 1009
Bilirubin (total) 12.4
Total Protein 63
Albumin 36
Globulin 27
Albumin:globulin Ration 1.33
Urea 3.7
Creatinine 102
Calcium 3.25
Phosphorous 1.6
Calcium:phosporous ration 2.0
CK/CPK 388

Comments:
AP and GGT suggest a hepatopathy. Part of the AST may also be associated with liver but the mild increase in CK suggests some may be due to muscle origin, eg increased activity if colicky. GGT usually suggests chronic disease and cholestasis. Further assessment with bile acid, assesment of liver size and appearance (U/S) may be advised.

The vet was away so was unable to explain them to me, but i decided to have another test done 2 weeks later. The differences were:
Haematology report
Red Blood Cells 9.73
Haemoglobin 14.2
Haematocrit/PCV 0.37
MCV 37.5
MCHC 38
WBC and Differential
White Blood Cells 8.8
Neutrophils 14%
Band forms 0%
Lymphocytes 83
Monocytes 2%
Eosinophils 1
Basophils 0%
Neutrophil: Lymphocyte ratio 0.17
Platelet count 255
Platelet comment - Number appear adequate on the smear
Film comment - no morphological abnormalities

Comments:
Marginally decreased absolute Neutrophil count. This might have no clinical significances, but a repeat haemogram in a few days time is recommended to check if this is a developing abnormality.
Lymphocytosis suggests a chronic infection/hypersensitivity or prolonged antigenic stimulation.

Biochemistry Report
Alkaline Phosphatase 1023
AST 1190
Gamma GT 164
GLDH 95
LDH 1118
Bilirubin (total) 12.4
Total Protein 59
Albumin 36
Globulin 23
Albumin:globulin Ration 1.57
Urea 4.1
Creatinine 103
Calcium 3.14
Phosphorous 1.6
Calcium:phosporous ration 2.0
CK/CPK 569
Bile Acid 6.7

The liver results are consistent with hepatobiliary disease. There is evidence of hepatocellular injury and hepatocyte necrosis. Abdominal imaging and eventually biopsies for cytology/histology may prove helpful.

This filly is now about 9/10mnths old and in herself she seems ok, she still has a cough but the cold has gone and she does not cough very often. She is turned out every day from about 9 until 4 then is stabled at night. She is fed about 1kg of sugar beet, 1kg of Youngstock mix and 1kg of conditioning cubes twice a day. She has an endless supply of hay and water but does not appear to be putting on weight and is much smaller than she should be. there is nothing she can eat in her field which may be harmful to her.

I would desperately like your opinion and some advice on what to do now, my vet is away and has been for 2 weeks and i have no idea what to do. Thanks for your time, Claire Llewellyn
Moderator:
DrO

Posted on Wednesday, Feb 27, 2008 - 6:56 am:

Welcome Claire,
Your first step should be determining your foal's vital signs to help you decide if there is a serious underlying problem or not, see Diseases of Horses » First Aid » Taking Temperature, Pulse, and Respiration. If after carefully evaluating your foal you feel there is still not quite right you need to get another veterinarian out to examine the foal and see if they can determine what is wrong.

You should note that in general you do not treat abnormal lab values. You use lab work to help rule in and out diseases that are suspected on physical exam. And a diagnosis is what you are lacking right now. Some of the CBD's percentages and absolute values are readable from your post. But without the units and your laboratory's age adjusted normal values for the chemistries it is impossible for me to evaluate those other than to read the labs interpretation. The persistent lymphocytocis/neutropenia is concerning but of uncertain meaning as noted by the lab. The lab notes some abnormalities with liver enzymes so you should study Diseases of Horses » Colic, Diarrhea, GI Tract » Mouth, Esophagus, and Liver » Liver Disease and Failure. How sure are you that you do not have liver toxic plants in the field or hay? They are discussed in the article.

Besides wanting to know the vital signs of the foal I would like to know what is the generic drug in the Engermicine, what is the concentration, and what was your dosage?
DrO
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