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  Discussion on Pneumonia or something else??
Author Message
Member:
jebe

Posted on Monday, Dec 15, 2008 - 7:53 pm:

There is a 28 yr old horse that boards on my property that has been on antibiotics for over a month and is some better but still has a little bit of a cough, labored breathing, and a slight fever. I am hoping that maybe this will cause someone to suggest at looking at another possibility besides pneumonia. The horse started with a bad cough and heavy, labored breathing so we assumed heaves. She was put on ventipulmin and albuterol. Then in October she went off her feed and her fever shot up to 105. We gave her a shot of banamine to comfort her until the vet could come out-per the vet's instructions. The vet confirmed her high temperature, started her on 14 tabs of SMZ's 2 x daily, 5 tabs of Albuterol 2x daily, and 2 .5 cc's of ventipulmin 2x daily. Her breathing remained labored but her temperature would fluctuate from a normal range to 104. After 2 weeks she was taken off the antibiotics and her fever shot up again to 105. This time the vet put her on 30 cc's of Ampicillin and 30 cc's of Gentamicin once daily + 14 tabs of Metronidazole 3x daily + 5 tabs of albuterol and 2.5 cc's of ventipulmin 2x daily. Her fever again would fluctuate from normal to about 103 with continued heavy breathing but the cough wasn't as bad. This regimen was completed yesterday and her temperature is now down to 101, but her breathing is still labored. It is not as heavy as before as her nostrils are not flaring, but definitely labored. Her cough is practically gone.
When they did the original blood work the vet was surprised that her white blood count was only slightly elevated as she would have expected with a 105 temp to have the white blood count high.
Does this scenario seem like anything else that we should look into, or is this like human walking pneumonia that this older horse just can't shake? If pneumonia, is there a different course of antibiotics that should be considered?
Thanks for your input.
Member:
mrose

Posted on Monday, Dec 15, 2008 - 8:25 pm:

I'm obviously no vet, but am just curious; did anyone listen to her lungs? Is there any noise (rattle) in them? Was there initially?
Member:
jebe

Posted on Monday, Dec 15, 2008 - 11:02 pm:

Yes, the vet initially listened to her lungs and she said there was some wheezing and noise to indicate the possibility of pneumonia. I know they have listened to her lungs each time they have come out, but I have not heard any comments in that regard. I am not always here when they come out.
Moderator:
DrO

Posted on Tuesday, Dec 16, 2008 - 10:33 am:

Hello gaited lady,
What was the time frame from the original diagnosis of heaves to the time she developed a fever? It should be noted that simply putting a horse on bronchodilators will not cure or even effectively treat heaves. Were other steps taken?

Unfortunately this history will only get us so far and a firmer diagnosis may require more diagnostics. Otherwise as long as there are any clear signs of infection, antimicrobial treatment should continued. However there is no reason aggressive management for heaves cannot be instituted so as to cover this possibility, see . If continued antibacterial treatment is indicated I would suggest that once daily ampicillin is not very effective and should be replaced with procaine penicillin twice daily along with the gentamicin. If an alternative is sought you and your veterinarian could consider Naxcel (cetiofur). You will find more on these two drugs and other alternatives at Treatments and Medications for Horses » Antibiotics and Antimicrobials.
DrO
Member:
jebe

Posted on Tuesday, Dec 16, 2008 - 2:12 pm:

Thanks, Dr.O. As far as I know the only treatment for the heaves were the bronchodialators. On a 1000 lb. horse would it still be 30 cc's of the penicillin and gentimicin or would that be divided between the AM and Pm. Just curious trying to figure out why the vet had the horse get the medicine once daily rather than 2x daily as you suggested.
In an older horse, does it sometimes take this long to knock out a bacteria or was the treatment not aggressvie enough- or is there still a possibility of heaves? I noticed you made reference in your articles to an allergic pneumonia. Could their be some allergen that continues to irritate the lungs?
Thanks!
Member:
jebe

Posted on Tuesday, Dec 16, 2008 - 6:02 pm:

I forgot to tell you the time frame. It was probably about a month from the first episode of breathing to the high fever. During that time her breathing continued to be labored.
Moderator:
DrO

Posted on Wednesday, Dec 17, 2008 - 9:44 am:

Not knowing the concentration or even the type of penicillin used makes it hard to comment on dosage. You will find clear dosage recommendations in the articles on those specific antibiotics.

As to what "COULD" be the diagnosis most anything is possible. I think the history of breathing problems well before there is fever "MAY" indicate you have two different problems overlying one another what if your horse developed heaves just prior to developing an infection? To move past these conjectures however will take further diagnostic work as described in Diseases of Horses » Respiratory System » Chronic Lower Airway Disease.
DrO
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