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  Discussion on Blood Loss Anemia after a colic episode
Author Message
New Member:
tbhack

Posted on Sunday, May 24, 2009 - 12:55 am:

Hi,
My name is Kate... can anyone diagnose these symptoms or offer ideas for things I should look for next...? Anyone had similar issues? I'm at a loss, just spent $2k on vets, not getting anywhere fast enough really...

Symptoms - he has daily spells of going off hay, being lethargic, wobbly, very pale gums, like he will fall over but doesn't quite, stumbles if walking, will bang into the gate. Normally a very alert horse. He eats feed enthusiastically. Just noticed what looks like ringworm developing (about 3 tufts of hair gone, round-ish shape, one was VERY itchy for him on shoulder just before he broke the scab, others not itchy that I saw). He is recovering from colic... 'impaction' which they cleared with fluid and drugs and then turned to 'spasmodic' colic, which we think is still around as vet said very active gut sounds, he seems to have LOTS of gas when eating.

Blood test yesterday - vet said "slightly anaemic" and "low red blood cells" and data suggests some "blood loss" happening (must be internal, he's had no external injury), all other stuff normal, no infection, etc.

Medications - through the colic (about 10 days ago) he had usual sedation, fluid, anti-spasmodic, bute.

Horse details: 9y0 16.2 TB gelding, off track 1 year, had him 8 weeks

Feeding (light 10 days post impaction then spasmodic colic) - meadow hay, paddock grass, 2 x per day feed (lucern chaff, oaten chaff, small amount of extruded multivate gumnuts as gentle easy disgest feed for older horses normally).

Worming - had him 8 weeks. Wormed yesterday and I was told (but don't know) before I got him. Off the track 1 year, so probably wormed while on track. He had the equine influenza vaccine a few years ago too, on his record.

What might this be??? So confused right now! What else can I look for in paddock or ask vet to look for or do next?

Thanks kindly,
Kate
Member:
erika

Posted on Sunday, May 24, 2009 - 11:45 am:

Welcome Kate. Sounds pretty serious to me. Some thoughts that come to my mind are:
a.) possible ulcers from the bute and stress that could be causing internal blood loss.
b.) heavy parasite load leading to the same result. Along with the possibility of overloaded system from die-off after worming.

You say "normally a very alert horse". Did you know him long before purchase? If he has been through the surgery, etc. just in the eight weeks you've had him, it sounds like a lot to recover from and he may just need more time.

But, I'm no vet. I wait eagerly to hear Dr. O's theories.
Erika
Member:
hollyw

Posted on Sunday, May 24, 2009 - 12:12 pm:

I guess my post to Kate this a.m. got lost? I don't know . . . but I wondered about ulcers, as well . . .
Also, the itchy skin patches may not be related, but I wonder if they are parasite related?

Did the vets check for parasites when they were working on him? What wormer did you use? What kinds of parasites do you find most commonly in your area?

Is he drinking normally? What does his manure look like? (If my other post ended up somewhere else, forgive the repetition.)
Member:
vickiann

Posted on Sunday, May 24, 2009 - 2:13 pm:

Erika and Holly make good observations about ulcers and parasites.

Does the horse have any sand in his environment? One of mine will get excessive gut sounds due to sand build up.

The lethargy, wobbling and pale gums are frightening symptoms.

Possible toxins in the environment could be involved including plants that are excessive up-takers of selenium or nitrates in pasture or hay or grain made from them, as well as viral or other illnesses.

A friend of mine had a horse who over the years had repeated colic episodes and eventually died. An enterolith was suspected as the cause by the Veterinarian.

There seems to be more than colic going on with this horse.

We need Dr. O's opinion.
Moderator:
DrO

Posted on Sunday, May 24, 2009 - 6:47 pm:

Kate you currently have two main symptoms, lethargy and either incoordination or weakness or maybe both, and if I understand your post right they occur episodically during the day and everyday he has normal periods. Is this right? There is nothing in your post that explains these symptoms as mild anemia would not.

Can you confirm what I have written and fill in a few details of what a typical day is like? I would also like to see what were the veterinarians physical findings and the lab results. With the labs be sure to include the units and the lab normals.
DrO
Member:
tbhack

Posted on Friday, May 29, 2009 - 7:32 pm:

Thanks all for your posts Vicki, Holly Erika.

Dr O. thanks. Yes those are the two main symptoms - lethargy and lack of co-ordination. And these are both in episodes, which seem to be less frequent now, but the last one was 3 days ago, and he recovers in about an hour (i.e. starts eating grass again and brightens up, even runs around the paddock). A typical day - small feed in morning and evening with hay (he usually eats both, sometimes picky on one or the other). When I come out, can only get there twice a day, he's either fine or not. 3 days ago he was 100% when I cam out and then walking him back to paddock (after a feed) he got what seems like 'dizzy', his feet drag and he might cross a front leg or walk into something. Sometimes he will get that with no feed also I see it happening in the paddock.

The vet is posting me his bloods, he couldn't email for some reason. I will post them ASAP as soon as they arrive. Thank you. We are doing bloods again in 5 days, hopefully to see some improvement. Vet says don't change anything for now.

Thanks,
Kate
Member:
tbhack

Posted on Friday, May 29, 2009 - 7:37 pm:

Hi Vicki,
What you say about toxins has got me thinking. It is that time of year too I believe (i.e. moist... mushrooms in the paddock time). He doesn't have obvious harmful plans (e.g. nightshade, bad grasses, etc). How would I measure for level of toxins in paddock? He's got grass (both dry and green) few sand/mud patches k
Member:
tbhack

Posted on Friday, May 29, 2009 - 7:42 pm:

Hi Erika,
Thanks for your post. He hasn't been through surgery. We gave him 2 doses of bute (a couple of weeks ago now, with the colic). I am wondering if he already had ulcers or parasites. We just wormed week ago with a general wormer paste which included tapeworms. Since then he has improved a bit, the 'dizzy episodes' (or whatever they are) seem less frequent. But I do only see him twice a day during the week. Heading out to the paddock now! thanks again. kate
Member:
tbhack

Posted on Friday, May 29, 2009 - 7:44 pm:

Hi Holly,
Thanks for your thoughts. The vet didn't check for parasites, but told me to worm him (which we did). And his drinking and manure are both pretty good (manure a little less in size than I'd like, but OK).

k
Member:
vickiann

Posted on Friday, May 29, 2009 - 9:33 pm:

Kate,

I don't know much about the plants where you live, but toxins can be in pastures, paddocks, hay.

Let us know how things progress and I am hoping that improvement will happen.
Member:
vickiann

Posted on Friday, May 29, 2009 - 9:43 pm:

If you do a search for toxic pasture weeds plus your country, you may get some interesting results.

Here is just one site:

https://www.ruralsolutions.sa.gov.au/news/newspaper_articles/archive_newspaper_ar ticles/newspaper_articles_2008/articles_2008/2008_-_11_november/common_pasture_w eeds_that_may_poison_horses
Moderator:
DrO

Posted on Saturday, May 30, 2009 - 7:54 am:

Kate,
To investigate the possibility of recurrent poisoning you should start by identifying all the stuff the horse comes into contact with in his environment, including identification of the plants. From there you investigate the properties of each to see if anything matches up.

From your description it sounds like your horse is having transient mild seizures. I cannot rule out short bouts of colic which can cause depression, lethargy, and even the appearance of weakness but not typically running into things which suggest blindness or terrible pain. Terrible pain from colic generally does not appear this way.

"Seizure" is not so much a diagnosis as a constellation of symptoms and tracking down the cause of the seizures can be tough. For more on this see the articles in the topic Diseases of Horses » Nervous System » Seizures & Fainting.
DrO
Member:
tbhack

Posted on Monday, Jun 1, 2009 - 5:32 am:

Thanks Dr O. Here are the bloods (from a week ago, we will take again in 2 days time):

BIOCHEMISTRY
Sodium 1.35 mmol/L(133-143)
Potassium 4.3 mmol/L(3.0-5.0)
Chloride 100 mmol/L(96-104)
Bicarbonate 31 mmol/L(26-34)
Na:K Ratio 31.4(>29.0)
Anion Gap 8.3 mmol/L (6.0-18.0)
Glucose, flox 4.7 mmol/L(4.0-8.0)
Glucose, serum 4.6 mmol/L(4.0-8.0)
Urea 7.9 mmol/L(3.2-8.1)
Creatinine .14 mmol/L(0.08-0.16)
Calcium 2.9 mmol/L(2.7-3.3)
Phosphate 1.0 mmol/L(0.8-1.8)
Ca:P ratio 2.9 (1.8-3.8)
Protein, total 71 g/l(52-72)
Alubmin 24 g/l (LOW)(28-39)
Globulin 47 g/l (HIGH)(20-38)
Bilirubin, total 33 mmol/L (15-75)
ALP 177 IU/l (78-260)
AST 167 IU/l (LOW) (194-440)
CK 184 IU/l (113-375)
Cholesterol 1.7 mmol/L (1.6-3.5)
Magnesium .8 mmol/L (0.6-1.0)
Gamma GT 8 iu/l (LOW) (10-50)
GLDH 1 iu/l (<13)
Sample Appearance: Normal
Flox Sample Appearance: Haemolysed

HAEMATOLOGY
RBC 6.2x10x12/l (LOW) (8.0-10.8)
Hameoglobin 111 g/l (LOW)(120-160)
Haematocrit .29 l/l (LOW) (0.36-0.48)
MCV 47 fL (HIGH) (42-45)
MCH 18 pg (HIGH) (15-16)
MCHC 383 g/l (HIGH)(330-360)
Platelets - clumped and adequate
Platelet Count 152 x18x9/l (100-350)
WCC 8.2 x10x9/l (6.0-10.0)
Neutrophil% 74%
Neutrophil ABS 6.1 x10x9/l (2.8-8.0)
Lymphocyte% 18%
Lymphocyte ABS 1.5 x10x9/l (1.1-5.5)
Monocyte% 5%
Monocyte ABS 0.4 x10x9/l (<0.6)
Eosinophil% 3%
Eosinophil ABS 0.2 x10x9/l (<1.1)
Basophil% 0%
Basophil ABS <0.1 x10x9/l (<0.3)
Firbinogen 4.0 g/l (1.0-4.0)
Blood smear exam: Slight Act. Lymph
Moderate rouleaux

Mild-moderate anemia with concurrently decreased albumin is suggestive of blood loss. INcreased globulins may be due to inflammation/immune stimulation.
Moderator:
DrO

Posted on Monday, Jun 1, 2009 - 6:56 am:

While I agree with the suggestion of blood loss anemia, these values would not cause the symptoms you are seeing. Recurrent checking will let you know if you have some ongoing blood loss problem but does not explain the current symptoms. For more on this see Diseases of Horses » Cardiovascular, Blood, and Immune System » The Diagnosis of Anemia.
DrO
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