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Discussion on Nodule~Lymph Node? Allergy?
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New Member:
jackieo
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Posted on Sunday, May 25, 2008 - 1:33 pm:
Day before yesterday, 4 yo filly brought up from pasture and presents with sizable nodule up under chin more on one side just inside the bony area. It is somewhat firm and when manipulated, she reacts. She is otherwise asymptomatic e.g. no fever, no runny nose, eating just fine, no lethargy. It seems to have gone down a little bit and does not seem quite as hard except in the very center. She has routinely been vaccinated for strangles since she was a yearling. She has not been anywhere and is pastured at my home with 2 miniature donkeys. As a yearling, she would get similar swelling (not as large) and had vet out. His diagnosis at that time was allergy, no treatment and eventually they resolved. Because it is much larger, I am more concerned. Any ideas? I can attach pictures later today. Thank you!
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New Member:
jackieo
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Posted on Sunday, May 25, 2008 - 10:53 pm:
Dr. O,
This afternoon, the 'bump' is now less pronounced, but more spread out over a larger area, if that makes sense. (wasn't able to photograph yet) When palpated, it has heat, is more soft and she does not want me applying any pressure. I got real close and examined for puncture wound or marks and found nothing. She remains otherwise asymptomatic, no fever, eating well etc. This is definitely different than the minor swellings as a yearling that were diagnosed as allergy induced. Any ideas? Thank you. 
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New Member:
jackieo
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Posted on Sunday, May 25, 2008 - 11:11 pm:
Dr. O et All,
So I am sitting here trying to glean more information and am wondering if my post should now be in the 'swelling' folder. It is most certainly in the submandibular 'area'. Of course it is Memorial Weekend so no vets available until Tuesday and I feel quite confident that 'we' can wait until then. I did ride her late this afternoon and she seemed her normal self. 
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Member:
scooter
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Posted on Monday, May 26, 2008 - 6:44 am:
Karen, years ago I had a mare with something similar sounding, I thought she had strangles altho she was fine otherwise. I had the vet out, he said no strangles, but didn't know what it was. It drained eventually and turned out to be an infected hair follicle.
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Moderator:
DrO
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Posted on Monday, May 26, 2008 - 10:46 am:
Hello Karen,
Most likely a enlarged submandibular lymph node. These lymph nodes enlarge in response to any inflammatory stimulus from the nose and throat region and often these are subclinical infections that are self resolving. Often once the l.n. is enlarged sufficiently it will break open and drain and should be treated like a wound. But this is all hypothetical based on your description and will require a examination to confirm.
DrO
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New Member:
jackieo
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Posted on Tuesday, May 27, 2008 - 12:00 am:
Hello Dr. O,
Thank you much for taking time out of your holiday weekend to respond! It is back to being really hard today and still more flat and she remains otherwise asymptomatic. She is suppose to go to the trainers Sunday so I may have the vet take a look and get a diagnosis. I don't want to compromise the health of other animals.
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Member:
jackieo
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Posted on Tuesday, May 27, 2008 - 12:08 am:
Hello Diane,
Thank you for sharing your experience. An infected hair follicle...who would have guessed. I am wondering if this isn't a from an insect bite or sting, but will see. Then again, might never know 'why'. Always something with these critters. 
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Moderator:
DrO
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Posted on Tuesday, May 27, 2008 - 8:07 am:
I would wait for this to resolve before moving the horse into a new population of horses.
DrO
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Member:
jackieo
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Posted on Tuesday, May 27, 2008 - 3:22 pm:
Hello again Dr. O,
I had the vet out this a.m. to pull a Coggins and to have him check the swelling. He thinks it looks VERY suspicious for strangles.  So, needless to say, she will not be going anywhere for sure and yes, I agree with you; she needs to stay put until this resolves. I shaved the area and applied ichthamol and will be applying hot compresses. She remains asymptomatic otherwise as of today. I guess time will tell. I called my trainer today and told her that there will be a delay. I think this filly brought this on in order to avoid 'boot camp'!  Thank you again for your help. Karen
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Member:
jackieo
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Posted on Tuesday, May 27, 2008 - 8:27 pm:
Hello Dr. O,
Since my vet came out while I was at the dentist, I have not been able to ask him this as of yet. I took her temperature again this afternoon and it is TOTALLY normal still, no nasal discharge. The original swelling is still there and now I can see and feel a line of swelling going up from the throat latch toward the back of her ear on both sides. She continues to eat and drink just fine. I am just puzzled that she has yet to have a fever and this all started 5 days ago. Everything I read regarding strangles states onset with fever. Is it possible to have this amount of continued swelling with no fever? Thanks again for your words of wisdom. I have learned so much from this site and continue to do so.
Karen
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Moderator:
DrO
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Posted on Wednesday, May 28, 2008 - 6:35 am:
Yes it is possible and common, to have remarkable lymphadenopathy without fever. I would not be so fast to jump on strangles unless there is a source of exposure: have you had any cases on your farm in the last few years? There are other streps and bacteria that are commonly associated with sub. mandibular lymphadenopathy that usually present with fewer systemic signs.
DrO
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Member:
jackieo
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Posted on Wednesday, May 28, 2008 - 6:28 pm:
Hi Dr. O,
Oh, ok. NO cases on this property ever. We purchased this property and it had never had any equine on it of any sort. This filly has not been anywhere since Sept. 07 and is pastured with 2 mini donkeys; one that I purchased 3 yrs. ago and the other one I purchased the end of March. And, the donkeys have been no where. There is one horse on each side of our property, but they are not within reach. I just came in from the barn and she again has no fever, no discharge and is feeling just fine! In fact, because she did not get turned out yesterday due to weather, she was bucking on the end of the lead this morning and proceeded to have a gay ole time when turned loose. The swelling seems a little less pronounced this morning. So, if this is due to some other form of strep or bacteria, can I expect it to still rupture? Also, how long might it take for this to resolve? Thanks again for your divine wisdom. (Please note: this is a post from early this a.m. Site was in maintenance mode, couldn't get it posted.)
Karen
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Moderator:
DrO
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Posted on Thursday, May 29, 2008 - 6:56 am:
We did have a cascading server problem that tripped the site into maintenance yesterday and thanks to those folks who rang our bell on the problem. Talking with our server guru he counts that it has been 388 days since we have had a problem with our dedicated Unix server. We have had a few days in the past year that we had software upgrades that prevented posting.
Whether they rupture and how long to resolve are difficult to answer without looking at them and even then can be difficult to predict because they usually move slow and occasionally very slow. Most of the time they resolve within a month.
DrO
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Member:
jackieo
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Posted on Thursday, May 29, 2008 - 9:03 am:
Sounds as though your server record is quite impressive. I just copied my original post and came back later and posted. No problem.
When I brought her up for the evening, I noticed it was draining a sticky light yellow serum. The opening is tiny at this point. It is still relatively hard. I cleaned it with Betadine scrub and reapplied some icthamol. Would you recommend I do anything else or different? I certainly do agree with you (at least from what I have read etc.) that this doesn't seem to be strangles. Does strangles ever present without a fever? I took her temperature again last evening and this morning...none. Still no discharge or cough or anything. Can one assume that this is not strangles based on the symptoms and non exposure? I know that I can have a culture done, and I still may. It is not that important that I definitively know whether or not it is strangles, but this is more an exercise in learning for myself. I hope you don't mind my inquisitive nature.
Thank you again!
Karen
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Moderator:
DrO
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Posted on Thursday, May 29, 2008 - 10:11 pm:
No, strangles remains on the possible list and yes, you seem to be treating this fine.
DrO
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New Member:
marciaw
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Posted on Friday, May 30, 2008 - 11:39 pm:
Hi Karen,
Have any of the vets that looked at your mare considered dry land distemper or by another name pigeon fever? I experienced it for the first time after I moved to the SW and have seen it come out in all kinds of places on my younger horses. I also had one filly the kept coming up with it from a fall to a spring stretch. Perhaps you have already thought of this and ruled it out.
Marcia
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Member:
jackieo
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Posted on Saturday, May 31, 2008 - 9:45 am:
Hello Marcia,
The vet has been out and no, it is not pigeon fever. Yes, I am familiar with pigeon fever. When we first moved to TX, eight years ago, we had an outbreak and the barn where I was boarding. Fortunately, my then horse did not succumb.
Now that her swelling has ruptured, I feel more confident that it is strangles or a lymphadenopathy due to some other pathogen. Since I have not had a culture done, I will never definitively know, but I am inclined to think strangles even though I am still puzzled as to 'exposure'.
Thank you for posting and I wish you the best of luck with your horses and bouts of pigeon fever. It can be nasty stuff.
Have a great weekend!
Karen
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