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  Discussion on Mini with URI
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Member:
dwfaith

Posted on Tuesday, Nov 30, 2010 - 3:56 pm:

Hello Dr O.
I occasionally take and foster rescues from a local group who attend the Kill Auctions in the area. Three weeks ago I was asked to pick up a mini from one such sale. She was very, very sick when I got there. The front of her chest, lower legs, muzzle and flanks were matted with dry snot and the volume of purulent discharge from her eyes and nose was startling. I took her immediately to a vet. I saw NO JOY in taking her to the farm and opening up a whole new growth medium within our herds.

She is approx 4, vaccination history unknown, local of origin unknown. 32 inches and I'm guessing about 275 lbs, definitely a 5 on the 1 to 5 scale with fat pads on hips, shoulders, and no signs of ribs. Her feet, though not showing any founder rings, are malformed. She has a cresty neck and a dry, brittle coat, no shine and large patches missing, but we can't tell if from skin disease or just the rigors of being in a kill auction barn for an unknown period of time. I'll test her for EMS when this is resolved.

Her vitals were Temp 104, Resp 36 laboured with rhonchi, Pulse 46 RRR. No lacerations, swelling, or gross injury. Lethargic, with dull mentation, but still moved willingly. Normal proprioception with no sign of lameness or ataxia. Showed no interest in grain but was willing to mouth coastal. (She appears to not know what grain is). Excellent bowel sounds. Normal feces with concentrated urine. She does not appear gravid, but we know she had been penned with stallions.

The vet started her on Gentamicin, followed up with Penicillin, and now she has completed a course of Doxycycline. Afebrile now but absolutely no resolution of her eye scum or nasal discharge; both which continue to be purulent. Her incipient pneumonia has resolved. No swelling, rupture, or drainage from any lymphatic tissues - so no Strangles DX.

I asked the vet this morning, (20 days into this) if he had run any cultures on her discharge or checked her WBC and he indicated no, he was just treating on symptoms (...grrrr). I also asked if he had wormed her and he indicated not yet. We both agree we need to get her well before vaccinating her for anything. We redrew a Coggins as the one from the sale has a rubber stamp quality about it. That was negative.

He is not my primary vet, but the best you can do in a pinch...Ok so now what do I do with her? Grab her up and take her to my REAL vet, a two hour trip in an open trailer with the temp DrOpping or is there something else I could be doing for her? Do you think she is still contagious? Could I take her home and just treat there? I see no Allergic Rhinitis in this, obviously she is still cooking some bacteria, but I don't know what to treat with next and I'm just not getting any good indications from the vet he has a plan. Meanwhile the vet bill is mounting....
Member:
dwfaith

Posted on Tuesday, Nov 30, 2010 - 4:03 pm:

Oh sorry, need to add, he did scope her pouches and they were normal.
Moderator:
DrO

Posted on Tuesday, Nov 30, 2010 - 6:12 pm:

I do not like transporting respiratory infections unless absolutely necessary and can not tell you if she is contagious or not but the prolonged recovery may be do to poor immunity or just the problem of dealing with multiple problems at one time. I don't think we can let Strangles out since you started treating with penicillin and it may have lessened the severity of the symptoms. This is unlikely to be an allergic disease.

Since you describe a upper respiratory infection that remains unresolved after a course of two different antibiotic regimens I like your idea of culturing and getting a sensitivity. This should be done after being off all antibiotic for 72 hours.

By all means go ahead and get a fecal and go ahead and deworm. Be sure the diet is first class and you supplement vitamins at this time.
DrO
Member:
hpyhaulr

Posted on Thursday, Jan 20, 2011 - 8:37 am:

diane,
how is this munchkin doing now???
Member:
dwfaith

Posted on Thursday, Jan 20, 2011 - 6:09 pm:

Hi Cindy, About the same. She has now undergone treatment with another round of nuprin, steroid shots (allergies) and a horsie version of Albuterol. As long as she is on a medication, she is relatively symptom free, but within two days of coming off whatever is the latest round, she is sick again. She has given whatever she has to her mini pasture mate and though he responded to the last round of medications, he now has a cough that reminds me of a two year old with croup. This boy is our rescue mini who was DX with EMS and thyroid issues. He is clipped and so regulating his temp has been a challenge since here in Texas we'll have highs in the 70s and lows that evening in the 30s with wind chills in the 20s. If the weather would just stay an even temp, I don't even care if it is in the 30s, at least we could keep him comfortably blanketed.

They want to repeat the scope, but this hasn't been my year for our rescues. Out of the blue, one of our pony mares developed a skin condition that just didn't respond to anything, Penicillin, Fungal washes, steroids, so we did biopsies. Came back Pemphigus Foliaceus, a RARE autoimmune disease with little hope of survivability even after massive amounts of steroids (for life) and the condition is VERY Painful. She was losing hair as if she had rain rot, but it started on her neck and belly and worked its way up. The skin underneath was rotting away in front of our eyes. The meds had NO effect on her whatsoever. The vet and I discussed increasing her to 55 steroid pills a day for two weeks tapering off if the pills had an effect; we'd know in a month if she would respond.

But she was in such pain that I just don't see a good reason to prolong her agony, the treatment is a lifetime regimen, she still needed surgery to repair her stifles, but the high doses of steroids she would have to be on made her a poor surgical risk. Usually the impetus for this condition is cancer somewhere else in the body. The disease presents other problems, muscle wasting, decalcification of the bones, and internal organ atrophy. She can't be bred as it is thought to be inheritable, like Lupus and Rheumatoid Arthritis. At the time I made the decision to put her down, she had no hair on 70% of her body. The blankets were painful for her to wear. Her skin condition made her photosensitive so she couldn't be out in the sun. It's too cold for her to left out at night and she is a nut case in the pasture with a blanket, even a storm shield can survive her antics. I just couldn't see the need to keep her in pain, shut up in the barn away from her pasture mates, so she can run the 80% risk of organ failure in the next year. I decided the only humane thing to do was put her down.

So after all that, the budget is shot and I don't have the funds to get the mini scoped again. So we take each day as it comes and keep an eye on the minis for fevers, lung sounds, appetite (which is typically pony hungry 24/7), manure piles and water consumption. If they take a fever, guess I'll take out a loan.

All these rescues are going to put me in the poor house!
Moderator:
DrO

Posted on Thursday, Jan 20, 2011 - 10:25 pm:

She continues to be febrile Diane?
DrO
Member:
dwfaith

Posted on Friday, Jan 21, 2011 - 5:24 pm:

Good Morning Dr Oglesby

Tinkerbell's temp stays between 99.2 and 101.4. Since her worse temp was 104 something, I'm not too alarmed by this range.

But she continues to have a crusting discharge from her eyes and an intermittent, thick, taupe colored discharge from her nostrils.

But either she feels much better or is just tired of having her temp taken daily as she has become almost impossible to catch. I hate running either one of the minis in their round pen to do any training as it brings on rapid deterioration of their breathing and increases the gelding's cough. So we just play a long, drawn out Ring-Around-The-Rosie to catch her each day. Her stamina is non-existant so she doesn't run long.

We have her on 2 cups Purina's WellSolve Weight Control (can't tell you the weight on that, it doesn't even register on my digital scales, 1/4lbs being the smallest increment), 1/2 scoop Platinum's Performance supplement and 1 1/2 lbs hay a day (soaked). I wonder if she is getting enough nutrition. I haven't had her tested for EMS yet but she presents all the classic physical signs. On her arrival in October she had an extremely cresty neck and was a butterball with terribly deformed hooves. Either her illness or the diet has resulted in a smaller crest and she actually has a discernable flank now. Though it is difficult to ascertain her actual fat distribution under all that mini winter hair growth, she appears to have lost some weight. But does that mean she doesn't have enough protein and fat to resist whatever this is? Having just lost a horse to a sick immune system, I'm now getting paranoid! The vet has cut us off till I can get my bill paid down significantly. Do you think I can wait to get her scoped or should I seek over avenues to get her looked at again? We have 12 horses, 8 are founder/EMS/abuse rescues, high maintenance all. Praise the Lord, OUR horses are all healthy at the moment.
Moderator:
DrO

Posted on Sunday, Jan 23, 2011 - 11:33 am:

Certainly you can wait Diane but the continued nasal discharge suggests that while waiting you should consider administering a wide spectrum antibiotic.
DrO
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