This is an archived Horseadvice.com Discussion. The parent article and menus are available on the navigation menu below:
HorseAdvice.com » Diseases of Horses » Respiratory System » Strangles & Streptococcus equi »
  Discussion on Prolonged Strangles (Strep Equi) on hip/flank
Author Message
New Member:
horsepwr

Posted on Wednesday, Jun 17, 2009 - 2:09 am:

I have what seems to be a very unusual case of Streptococcus equi.
In october of 2006 while in Oklahoma for the USTRC National Finals, i bought a 5 year old mare from a friend of a friend. The mare had a large lump/knot on her left side about 3" by 2". This knot was hard and the mare showed no signs of discomfort or pain when i touched it or palpated it. The seller told me she had had strangles that summer prior (summer '06) and when i asked about the knot he said his vet diagnosed it as a hematoma, thought she had been kicked and that it would eventually go away.

After bringing her home to California i continued to ride her and compete on her. In november i went to Arizona for the winter, continuing to ride and compete on my mare. She never showed signs of discomfort, being lethargic or sick and continued to have a strong appetite and was a very high energy horse. A week before Christmas of 2006 i noticed the knot on her left side was gone. About 3 days later it suddenly reappeared, just above and to the left of her patella, same size and hard as a rock, on her hip. I now knew that this was no ordinary "hematoma".

~December 28th: i took my mare to a veterinarian in Buckeye Arizona. I told them her story, about her having strangles 6 months ago, about the knot on her side disappearing and reappearing now on her hip, and i asked if they felt comfortable and confident that they could identify what we were dealing with. Initially they felt it was a sliver or foreign abject, which i discounted. After an ultrasound on her hip, no mass of fluid was detected, which when lanced resulted in very little fluid being drawn out. A culture of fluid and blood was sent to the lab, anaerobic and aerobic tests as well as antibiotic tests done, which came back negative/inconclusive. Not cancerous, showed no signs of antibiotic susceptibility, and unable to identify any disease. I was instructed to flush the area with water and Betadine. SMZ antibiotics were also prescribed. They could not identify what the cause was or a positive identification. I asked if this was contagious and was told probably not. I was a little disappointed to say the least. Vet recommended i continue to ride her, only good news!

~January 7/8th: the area where the knot/abscess was soft and ready to burst. I took my mare back to the vet in Buckeye, they drained the fluid out and flushed it with Betadine and water and put a stint in to allow it to drain. I continued flushing and cleaning her wound/knot for the next 10 days, also continuing with the SMZ's. After a few weeks my mare became very fussy about her left side being approached let alone touched. It was an extreme hassle to doctor her and handle her at all. The stint was removed after 7 days. the mare was on SMZ's for approximately 30 days.

Febuary '06: The knot that had appeared on her hip that was treated, healed and went away. Now new smaller knots/abscesses formed, going through there cycle of bursting and slowly healing and disappearing. There were usually 1 to 3 knots at a time on her lower hip, all about the size of a half dollar (~1 to 1 1/2" diameter).

~April 2007: returning to California i decided to stop all antibiotics due to some recommendations by friends. By this time i had talked to virtually everyone and anyone i knew that had ever owned a horse. trying to learn if there was something i was not doing or that i needed to do to help my horse get healthy and conquer this unknown disease/ailment. I then tried Silver Lining herbs; Immune Builder and Kidney Flush. This seemed to help somewhat, no new knots formed for the next 2 months.

July '07: I decided to take my mare to my usual veterinarian in Salinas California. They have a full surgery facility and a staff of 9 vets. I felt that they would surely identify exactly what my mare had.
Ultrasound again, collected fluid again, sent to lab again, and again nothing conclusive. No identification made. Penicillin G and Gentamicin were prescribed. Penicillin G 33cc twice a day and Gentamicin 33cc once a day. The vet recommended a heavy dose due to the mare being infected for such a long time (over a year at this point). Lab tests were done again and results came back negative/inconclusive, again. I gave her two rounds of Penicillin and Gentamicin. My mare really hated me by this point, turning away from me and walking to the furthest end of the pen. Asked if i should continue to ride her and was told yes, that if no signs of pain or her being sick then was a good idea to continue to keep her in shape. Still have no clue what the heck this is.

Sept-Nov '07: A few knots/abscesses during this time, not as heavy as in the past. Still continued to ride and compete on her with no sickness or signs of discomfort.


Dec '07: Las Vegas Nevada, World Series of Team Roping Finals; small knot (1' diameter) on her flank burst, doctored and cleaned, very little fluid.

Jan-May '08: continued to ride and compete on her, no new abscesses/knots at all other than the small abscess in her flank area which continued to ooze/leak fluid occasionally.

June '08: Mare tears left hind deep digital flexor. I took her down to Los Olivas, ultrasound shows a moderate tear (7 on a scale of 1-10), stem cells injected, confined to stall for 90 days. Also, i asked my vet to see if he could identify what was going on on her hip, explained her history and that no one had positively identified what it was. A MIRACLE!!!! Evidently when you need to identify something as unusual as what my mare was experiencing you need to do a biopsy, a tissue same needs to be taken and sent to the lab. Ahhhhhh, Van you are a genius!!! And what do ya know.....results come back as a strain of Streptococcus Equi.....only 2 known antibiotics are affective on this particular strain, dose of 30 pills a day prescribed.

Sept '08: checkup shows positive growth in tendon, but 90 days stall confinement prescribed.

early Nov '08: Mare is losing weight, topline is weak and overall muscle mass deteriorated. 6 months of stall confinement taking its toll. I increased her feed and nutrition.

Dec '08: Checkup shows positive tendon regrowth, given green light to start rehabbing her.

Jan '09: still no new abscesses/knots, but flank knot is still active and occasionally leaking. Took my mare to a friend that has extensive knowledge in rehabilitation and a full facility.

late Feb '09: Abscess on flank is closed......new knots suddenly appear on hip and up high just below pelvis bone and one large abscess inside on groin area.

Mar-April '09: Abscesses continue. I called my Vet that identified the Streptococcus and did the stem cells, asked if another round of antibiotics should be done, he said no, he recommended that if she didn't clear up by summer to take her in to have surgery to remove infected tissue, which he thought were her lymph nodes in her flank area.


late May '09: Mare is sick, very sick....for 4 days wants to lie down all the time, no colic. Hangs head and off her feed, stool is normal. Was very sick for a week/10 days.

June '09: After all ive been through with this mare i decide to take her in to have surgery done. Vet that was recommended by my Vet is very very highly regarded surgeon and an awesome facility. Discussing my mares history and what all she had been through, i am told that an exploritory surgery will have to be done. Prognosis is good.....i feel that she has a lymph node that is infected in her flank area and that this is the main hub of her infection. Once this abscess/knot closed other knots formed. Hopefully removal of this tissue or lymph node will lead to recovery. Fingers are crossed!!!

June 16th '09: Surgery was done today, did not find any connection between knots/abscesses, no major red flag jumped out showing what was main source of infection or hub of activity. Each abscess was treated and tissue taken from 3 different stages (post rupture, pre rupture and early forming stages).

Any information about what kind of treatment might help my mare would be greatly appreciated. Ive heard many different theories and ideals on treating Strep Equi, with antibiotics or without. I haven't heard of a horse going through anything similar for this long. After nearly $5,500 invested in vet bills prior to todays surgery im not going to quit now. This is an outstanding little mare and i want to do whatever i can to help her beat this.
Thanks for your time and help,
Jon
heelsnhorns@yahoo.com
Moderator:
DrO

Posted on Wednesday, Jun 17, 2009 - 8:48 am:

Hello jon,
A remarkable story.

Before making any recommendations what I would like to see is the biopsy report and the recent surgery's final report. Would it be possible to post it here either as an attachment or can you key it in? The upload attachment button is below the posting window and self explanatory though limited to files smaller than 64k.
DrO
New Member:
horsepwr

Posted on Wednesday, Jun 17, 2009 - 1:15 pm:

Im supposed to get a call tomorrow regarding the biopsy report. if i can i will post any information regarding the surgery report and biopsy findings. Thanks Dr.O!!
Jon
New Member:
horsepwr

Posted on Thursday, Aug 6, 2009 - 1:41 pm:

UPDATE: A few days ago i took my mare back to the vet because she was not improving and the abscesses on her hip/flank were getting worse. She was very lethargic, depressed and sick.
I got a call yesterday from my Vet with news that he was 95% positive that he knew what the problem was, and it was not good news.

See has been diagnosed with Coccidioidomycosis (Valley Fever).
She had signs of a stiff, sore neck so Van palpated her neck and found and area (2nd Vertebrae) that was very sensitive and sore. X-Rays showed a very infected deteriorated vertebrae.
With the lesions/abscesses on her flank/hip and the infected vertebrae things are now making sense and tying together.
I think my mare initially had Strangles/Strep E and eventually contracted Valley Fever due to a depleted immune system. Or possible the lesions/abscesses on her flank area are not connected to the VF and are related to the strangles. Regardless, the prognosis is not good.
With the vertebrae being infected and deteriorating the chances of successful surgery and treatment are slim. This ordeal has been going on for 3+ years (approx. nov-06 to now) and after learning so much about Strep Equi/Strangles and infections i am sad to say that my mare is going to have to be put down.

I have exhausted every avenue and explored every option, trying to get her healthy and back to competing on her. With the severity of the infection it does not look good that she will survive let alone recover to come back to competition.
there is a high probability that the infection is elsewhere, in other bone, and could easily get into her spinal cord.
Id like to give a heads up to anyone that encounters Streptococcus equi/Strangles/Bastard Strangles.

Have a fungal test done, have a complete histopathology done. Have a tissue biopsy done not just a fluid culture or blood tests. Have 2-3 cultures/biopsies done and ask that they test for fungus. Have your vet think outside the box and if you have to push then push for them to network and collaborate with other vets.

Coccidioidomycosis/ valley fever is very very difficult to diagnose. Especially if the horse has Strep symptoms. Im losing a great great great little mare that is going to be sorely missed. I hope the ordeal i went through can help someone, anyone, avoid the same results.

Thanks Dr.O, great site and i appreciate the help.
Jon

If anyone needs and information or has questions about what i experienced with my horse you can email me at prorodeospintowin at yahoo. I have some pictures of the lesions/abscesses that might help with diagnosis.
Member:
anniel

Posted on Thursday, Aug 6, 2009 - 10:02 pm:

Jon, My heart goes out to you and your mare with all you have been through.
I'm so so sorry, Annie
Member:
paul303

Posted on Thursday, Aug 6, 2009 - 11:18 pm:

Oh, no. Such heartache, jon. Wishing you comfort and strength. Thank you so much for the alert.
Member:
frances

Posted on Friday, Aug 7, 2009 - 6:03 am:

What a very sad ending to the long long struggle.

My deepest condolences.
Moderator:
DrO

Posted on Friday, Aug 7, 2009 - 6:58 am:

My deepest condolences Jon.

While not every Strangles case needs biopsy, certainly it should be an early step with any case where there is odd recurrent tumors and abscesses and the caution to look for funguses is important in areas where they occur. If you would like to post images here you can use the attachment button below. It helps to first read Help & Information on Using This Site » Uploading Images and Files Into a Posting. For those interested more in the disease we don't have an article but have more information at Diseases of Horses » Respiratory System » Discussions on Respiratory System not covered by the above » Valley Fever.
DrO
New Member:
horsepwr

Posted on Friday, Aug 7, 2009 - 12:15 pm:

Heres a few pictures of the abscesses/Lesions she had on her flank. This was after the exploratory surgery back in mid june.
Hope this can help anyone in the future.
thanks, Jon









Member:
paul303

Posted on Friday, Aug 7, 2009 - 11:29 pm:

Thank you, jon, because of you...we learn.
Member:
erika

Posted on Saturday, Aug 8, 2009 - 3:44 pm:

Dr. O, I have a friend in NC--actually the breeder of my Silken Windhounds--that had a case similar to what Jon's horse has been through. I told her about this case and what "Dr. O" said, and turns out that you are her vet! Small world!

Jon, I'm sorry the prognosis for your horse is so poor, I will continue to hope for a miracle. So sorry for what you've both been through.
Erika
Member:
vickiann

Posted on Sunday, Aug 9, 2009 - 12:33 pm:

Jon,

I am so sorry to hear about how this has worked out for your mare.

You have been through so much trying to find a better answer for her and I can imagine how difficult it is to have this unhappy ending.

You are very generous in taking the time to share the details of this experience with us so that we all can learn.

Thank you for caring about the other horses out there who may benefit from others having this valuable information.
Member:
canter

Posted on Monday, Aug 10, 2009 - 3:08 pm:

I'm sorry to hear of such a sad prognosis, Jon. Thank you for sharing your information so that others may benefit.
Home Page | Top of Page | Join Us!
Horseadvice.com is a BBB Accredited Business. Click for the BBB Business Review of this Horse Training in Stokesdale NC