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  Discussion on 8 year old mare with Strangles for 3 months, getting worse
Author Message
New Member:
annyb

Posted on Wednesday, Jun 24, 2009 - 1:21 pm:

Hello..we just took on a Tennessee Walker mare 1 week ago who has had strangles for almost 3 months. She has received no vet care til last week. VERY thin, multiple sores under jaw, one above right eye. Since we got her here, she has had Naxcel 20cc once a day X 4 days, and 2 EquiStim IM injections 4 days apart. Some days are better than others. Eating Equine senior and alfalfa hay (until today). Soaking sores under jaw twice a day with hot water and epsom salts. Sores are draining thick yellow mucoid discharge. New ulcers still erupting. Today labored breathing, lying down, lethargic and getting worse. Resp Rate 44/ Temp 103.8. Given 1 gm of Bute this am. Any suggestions?????
Member:
tamarag

Posted on Wednesday, Jun 24, 2009 - 1:43 pm:

Wow..it was kind of you to take this on. I seem to take things on like this without know.

I will let Dr O tell you what is best. I am dealing with a new mare with a nasty virus also.

Tami
Moderator:
DrO

Posted on Wednesday, Jun 24, 2009 - 2:35 pm:

Hello Annyb,
Sorry to hear you are having such a tough case. Your first step should be a reexamination by your veterinarian today to try and determine the source of the fever. This may or may not be related to the past strangles infection and possibly internal Strangles abscesses should be considered. EquiStim or Naxcel can cause fever and should be considered.

In general penicillin is the drug of choice for strep including Strangles but does not penetrate well once abscesses are formed. For more on this, treatment for Strangles in general and proper treatment of Bastard Strangles in particular see the article on Strangles associated with this discussion. You will find articles on Naxcel and Immunstimulants at Treatments and Medications for Horses ยป Antibiotics and Antimicrobials
DrO
New Member:
annyb

Posted on Wednesday, Jun 24, 2009 - 4:31 pm:

Thank you for your post Dr.O....also Tami. I read the article you mentioned before I posted....I will re-read it and check the other sources you mentioned. Why would a horse continue to have outbreaks (ulcers) for 3 months?
Anny
Moderator:
DrO

Posted on Thursday, Jun 25, 2009 - 8:10 am:

When you say ulcer I presume you mean abscess?

Immune deficiency? A series of unrelated infections that have all been blamed on Strangles?

These would seem most likely to me.
DrO
New Member:
annyb

Posted on Thursday, Jun 25, 2009 - 2:00 pm:

Hi DrO...I cannot get a vet to come out and do not have a trailer. I've tried to borrow one but when they hear she has strangles, refuse. Her temp is 105 and she is straining to breathe. I think she is quite dehydrated. she tries to urinate and nothing comes out. She is lethargic and weak and refuses water (nibbles at hay). I do have someone who will DrOp her off at the vet later this afternoon. Any suggestions as to how to get her thru the day? Thanks so much. We are in a resource poor area of NM. Anny
Member:
tamarag

Posted on Thursday, Jun 25, 2009 - 2:23 pm:

Oh wow. When did you give her Bute last? I would give her two doses NOW if it has been 24 hours. I would also, get her some place that you can soak her feet. Or spraying with cold water to get the fever down. I am so very sorry....but those things should help a little to get the fever down. I would NOT spray her body...just legs and feet.

Maybe mix up some sugar water and give her it in small amounts with a spray bottle.

I can't believe the vet won't come out. You are going to lose this girl if you don't get help.


Smokey had a really high fever with Pigeon fever and soaking her feet helped a lot!!!!
Member:
scooter

Posted on Thursday, Jun 25, 2009 - 2:52 pm:

I would be careful with bute or banamine if she is dehydrated. The best thing at this point would be to try to get her hydrated somehow until a vet can see her.

Have you tried flavored water, apple juice, kool aid, molasses? Some people have good results with this. Water poured over a little grain? Syringing electrolytes and water, won't be near enough but may help some until the vet can get her hydrated.

Dehydration could be causing the fever.

Prayers are with you and your horse
Member:
tamarag

Posted on Thursday, Jun 25, 2009 - 3:08 pm:

Diane

I didn't realize that with the Bute. My vet had me give a double dose on a mare that was 106. May I ask why you would be concerned giving it is she is dehydrated??? I wouldn't want to give wrong advice....
Member:
scooter

Posted on Thursday, Jun 25, 2009 - 3:36 pm:

Tami, I believe it is much harder on the kidneys.

I know when my mare was dehydrated I was told by the vet not to give banamine or bute until she was rehydrated. She had quit urinating too, he was afraid it may cause renal failure.

DrO. can ans. this better, maybe small doses are ok short term. I'm not sure.

There is a short blurb here in this article under contraindications "unresolved deydration"
https://www.horseadvice.com/horse/messages/5/10870.html

I'm not sure about this either, but I would be reading up on the use of Naxcel in the dehydrated horse also.
Member:
mrose

Posted on Thursday, Jun 25, 2009 - 4:01 pm:

I can't believe no one will come with a trailer! don't they sell disinfectant in NM?? Good luck with her.

With people covering with a wet sheet will help lower the body temp. It might be worth a try.
Member:
vickiann

Posted on Thursday, Jun 25, 2009 - 9:28 pm:

When my boy had a very high fever my Veterinarian showed me how to put him on the wash rack and hose and scrape, hose and scrape, hose and scrape and keep that up until he cooled down.

It seems to me that a wet sheet would absorb and also hold heat in and be of no use or worse once it got warm.

I also was instructed to administer Banamine twice daily.

Prior to these instructions the horse had been checked and continued to be monitored by my Veterinarian with me following his instructions.
Member:
mrose

Posted on Thursday, Jun 25, 2009 - 9:58 pm:

The evaporation of the water from the sheet will cause cooling; if the sheet gets warm, you re-wet it. I'm talking about bed sheets, I guess I should have made that more clear.
New Member:
annyb

Posted on Thursday, Jun 25, 2009 - 10:58 pm:

Thanks Everyone for all your comments and suggestions. I finally got Blazee in to the vet around 3:30 and her fever was down to 101 by then (I gave her 1 dose of Bute when I found she was at 105). Her breath was very forced, nostrils flaring, about 60 breaths/min. The vet did blood work: here are the abnl's:
CREA-0.6, ALB 1.8, GLOB 5.7, and really weird: RBC 4.92, HCT 22%, HGB 9.3. WBC'S were NOT elevated. other off labs were: MONO 1.82, EOS 0.09, AND PLT 460. So she is losing blood somehow (not in urine, feces, or wounds)and is quite anemic.
The vet started her on IV fluids and gave her some IV antibiotics (I forget which, sorry). Her lungs were quiet which told him there may be abscesses throughout her abdomen and lungs. He thought it was most likely a case of bastard strangles, although the anemia is odd.

He said there was no x-ray, no MRI, or other diagnostic labs in Las Vegas (New Mexico!) He felt we were unable to pinpoint the cause of her illness without these (there is a high tech equine vet facility south of Albuquerque, but that is about 3 hrs away). He did do a fibrinogen, but it won't be sent out til tomorrow (Fri) and we won't have results til Monday.

We are having to visit the possibly of having to put her down. She is struggling so. But she is just 8 and has a heart of gold. I don't know what to do. I do not have the money for the heroics of fancy diagnosis, and do not know if we could save her if we did know. It seems her prognosis is very poor. The vet was wondering about bone marrow suppression and a possible leukemia.

I'd really appreciate any advice at this point, even though I know it's impossible from a distance. Thanks so much, Anny
Member:
tamarag

Posted on Thursday, Jun 25, 2009 - 11:56 pm:

Anny, As I said....I have walked in your shoes. Not the same illness, but wondering if I would have enough money to help this animal out that trusted me so.

I am going to pray for you. I will also ask many of my friends that love animals to keep this mare in their prayers. I know that God can heal! But sometimes the healing is taking them home where there is no longer and pain or illness.
Moderator:
DrO

Posted on Friday, Jun 26, 2009 - 8:01 am:

Hello Annyb,
I hope things are looking up this morn. Considering this horse has a 3 month history of illness and poor care the anemia should be expected. Chronic illness and poor nutrition both suppress the formation of new RBCs and too a lesser degree increase the rate of destruction. As to the normal RBCs this is often seen in chronic yet severe infections: the body ramps up production early to meet the increase lost due to infection and eventually things even out. The morphology of the WBCs especially the neutrophils is far more telling about what is happening.

To help folks with decision making in bute, vs hydration, vs fever, let's discuss some aspects. In general fevers from infection as opposed to hyperthermia from environmental reasons, should not be treated with cold water. Yes you hear about excessive fevers and brain damage but actually 107 is tolerable for periods (despite what you may read in some sources) and remember the fever is trying to fight infection and is not a bad thing necessarily. Above 107 I would start to think about trying to get it back around 106 but if the horse is not being environmentally stressed I am uncertain even this is called for. I have never seen a infection induced fever above 107 and would suspect environmental problems if I did, like the horse being kept in a hot, humid stall with no circulation.

Concerning dehydration and NSAID us the most important point here is prevention: it is far more important to be sure the horse remains hydrated than to control fever from infection and consider early intervention when a horse has stopped drinking do to illness. NSAIDs may be an important part of keeping a horse hydrated if it allows him to feel better so keeps drinking.

There is no doubt almost any drug becomes significantly more toxic in the dehydrated animal and none more so than NSAIDs do to it's concentration and clearance by the kidneys. It use must be carefully considered under these possible conditions. So what do you do when a horse is dehydrated, no chance for fluid replacement therapy, and a dose of NSAIDs might get him drinking again? That would be a clinical judgement made on a case by case basis and with continued dehydration and no drinking would never consider more than one dose. I would say that I would prefer flunixin over phenylbute if I had it as experimental renal toxicity is more often reported in horses at lower dose rates for less time.

Annyb what is the treatment plan for your horse today.
DrO
Member:
annyb

Posted on Friday, Jun 26, 2009 - 9:03 am:

DrO, thanks for your response. As per treatment plan for today, I do not know. The vet will only be there once in the morning. He did not know of any further diagnostics and was a bit apprehensive giving her IV fluids with her anemia. It's reassuring to hear your assessment of her labs. The only further piece we are waiting on is the fibrinogen, and that will be monday. I remember in your article that it was time sensitive, so I'm not sure how this will affect it. The vet said it will be spun and kept cold and should be ok.

They do not open til 9am Mountain time today. We spoke yesterday afternoon and the plan then was for 24 hrs of IV therapy.

Do you have any suggestions? Do you think she could pull through with long term antibiotic use? Do you think she can pull through at all?
What are the chances of her being chronically ill? I know it's hard not seeing her, but a 2nd opinion is greatly appreciated! Annyb
Member:
dres

Posted on Friday, Jun 26, 2009 - 9:54 am:

I will not be much help here as i don't remember the antibiotic that was given.. but had a girl friend that had a mare that had pigeon fever for ever.. 6 months.. she looked like death walking.. ended up the infection had internalized... she went on a heavy duty drug / expensive as well and for a long period.. The mare had a lovely foal this spring.. she is thriving..
good luck..

On the first day God created horses, on the second day he painted them with spots.
Member:
annyb

Posted on Friday, Jun 26, 2009 - 11:23 am:

Blazee died during the night. So sad, so sad. I know she's more comfortable and it makes clear just how sick she was.

Thanks to all of you for you advice and support. I just joined this service for Blazee and think it is a wonderful site. Anny
Member:
vickiann

Posted on Friday, Jun 26, 2009 - 11:25 am:

That's a long time to be sick, but perhaps she will begin to improve more steadily now with better care since you have the horse.

With serious illness there certainly can be discouraging ups and downs.

One of mine was extremely anemic, very sick and kept erupting in sores and swelling last fall. Every few hours it seemed like it was something else and for a while others had grave doubts that he would survive without having some complication develop that would do him in, but he recovered and is back to work happily.

It took from August 24 until about Nov. 10 for him to be back to feeling consistently good enough to go back out on the trails.

Hang in there and just take it as it comes and try not to get discouraged by daily developments.
Member:
mrose

Posted on Friday, Jun 26, 2009 - 11:42 am:

I'm so sorry. At least you were able to give her a fighting chance and some loving care, which is much more than she had before.
Member:
ajudson1

Posted on Friday, Jun 26, 2009 - 11:47 am:

I am sorry to hear she didn't make it.

(((Hugs)))
Member:
pattyb

Posted on Friday, Jun 26, 2009 - 11:56 am:

Oh Annyb.....I am soooo sorry.

Like Sara says, you gave her a fighting chance and I have no doubts that she knew you were trying to help her. If she had to go, at least she went in the hands of someone who was caring for her...............

Member:
canter

Posted on Friday, Jun 26, 2009 - 12:53 pm:

My condolences, Anny. Sounds like you did your best to give her loving care.
Member:
paardex

Posted on Friday, Jun 26, 2009 - 2:26 pm:

I am so sorry to hear this outcome.I do agree with the others: you gave her a chance and she didn't die alone and without care!
Jos
Member:
vickiann

Posted on Friday, Jun 26, 2009 - 3:46 pm:

I am very sorry to hear of this sad outcome about which you were apparently posting as I was posting my last comment.

One thing that I've learned in life is that there are worse things than death, and perhaps the mare has been spared further misery.

She was lucky to have your compassionate help as she neared the end of her life on earth.
Member:
leslie1

Posted on Friday, Jun 26, 2009 - 9:00 pm:

(((HUGS))))
L
Moderator:
DrO

Posted on Saturday, Jun 27, 2009 - 9:06 am:

My condolences Abbyb,
I have often found folks get some help from knowing what happened you might consider a necropsy. I suspect you will find advanced and ruptured internal abscesses.
DrO
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