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  Discussion on Mare with stroke?
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Member:
sass

Posted on Friday, Jan 21, 2011 - 3:43 pm:

I came out to the barn on Sunday morning to find my 25 year old mare walking sideways. She had come into the barn fine the night before but came out of her stall in the morning with her right hind not steady at all. Her stall was a mess (it's always very neat). The vet came out and felt her over, watched her walk and then did two different tests - made her walk in a straight line while he held her tail to the side; made her walk in a tight circle around him. On the tail test, he said she had absolutely no resistance to him on the right side. She's not lame on the right side, she can use her leg, but her left hind leg is now turned out, almost as if it's propping up her hind end, so the vet said it's her right hind end that's the problem (this is confusing to me). So when she walks, it's like she's doing a sidepass, her right hind is 'in' by about a foot and she also has the front of her turned in, too (for balance?). The vet gave her an iv shot of dex and 5 days worth of dex pills. He said it was a 'cerebral vascular event' and there was nothing that could be done; that she might get better but it was highly doubtful and she might stay the same or she might deteriorate. She seemed fine otherwise - eating ok, alert, was out milling with the other horses. Now it's 6 days later; we finished the dex and there's not really been a change. I've noticed that her front right leg shakes a lot now, while she's just standing. (i'm not sure if she was doing that on Sunday) She does a lot of circles in the field, which worries me (she just about rotates in a circle in her good direction, over and over). Also, this a.m. she went off her feed, but she was more than willing to eat a different type of grain (her tastes suddenly changed??). I called a different vet in the practice to ask for a second opinion, he offered the same advice, but said i could test for EPM though it was highly unlikely that she had that. I agree, it seems too sudden to be EPM, but could it be anything else? Is there anything else i can do, anything i can test for? thanks.
Member:
kpaint

Posted on Friday, Jan 21, 2011 - 7:29 pm:

Wow Gayle, so sorry to read about your mare. I have nothing to offer but best wishes for a recovery. :-(
Member:
scooter

Posted on Friday, Jan 21, 2011 - 7:37 pm:

Seems like I just read something very similar to this...was it on here? Where ever it was time seemed to help the horse and it went back to close to normal.

Hope things turn out well for your girl, sounds terrible to watch. I wonder if bute or banamine would help... for inflammation?
Member:
mrose

Posted on Friday, Jan 21, 2011 - 7:43 pm:

Hi Gayle. If this was my mare, I'd test just to rule out EPM. Then, I'd work out some kind of physical therapy for the horse. Maybe a vet, chiro, message therapist, or human PT could give you some suggestions. I did this with a mare we had who was partially paralized from a kick to the head (which we saw.) I did message and hand walked her trying to do everything I could think of to work and strengthen the "off" side. She never became totally "normal" but she did greatly improve to the point she could run in the pastures with the other horses and eat without DrOpping all her food as she chewed. Maybe she would have improved with time anyway, but I felt my treatments helped.
Member:
vickiann

Posted on Friday, Jan 21, 2011 - 8:15 pm:

A friend of mine had a mare with similar symptoms but even a little worse in that her eye on the one side was compromised and rather static.

The Vet prescribed a whole lot of drugs and the mare eventually recovered quite nicely.

Banamine was one of the drugs and also stuff for brain swelling.

I seem to recall some bags of fluids but don't know what all was in there.

My friend also had to put lubricants into the one eye since it was not producing tears on that side.

She also gave good supportive care nutritionally and kept the mare hydrated.

The mare had an unexplained poll injury, which truly was not evident unless a professional looked very hard to discover it and found a small bit of swelling there.

In time my friend was instructed to walk the mare a certain amount of time each day.

While the mare's prognosis had been guarded, she recovered well and had a much better outcome than the veterinarian had dared to hope for.

Good luck to you for a good outcome.
Moderator:
DrO

Posted on Saturday, Jan 22, 2011 - 5:27 pm:

Hello Gayle,
I am sorry to hear about your horse, I usually find thoracic spinal cord disease in older horses has a guarded prognosis but until a untreatable cause found there may be hope.

I don't think the rapid onset of symptoms let's EPM out. Is this a common problem in your area? If some of the treatments for EPM are out of your reach I don't see why TMP/SMZ cannot be started. For more on this, other diagnostic rule outs, and nursing care for such a horse see ice.com » Diseases of Horses » Nervous System » Incoordination, Weakness, Spasticity, Tremors » EPM, Equine Protozoal Myeloencephalitis.
DrO
Member:
sass

Posted on Sunday, Jan 30, 2011 - 3:47 pm:

Hi,
My vet is now perplexed. My mare's condition deteriorated once she was off the dex. She got to the point where she had to spin to stay upright every minute or so. (I figured out that the spinning is her way of keeping the right hind from falling down) She could barely eat; she couldn't bend down for hay; she didn't even want to take treats from me; she had no interest in the other horses or anything. She fell down a couple of times and each time i had to coax her to get back up. (fortunately she was able to) However, from her demeanor and lack of interest in things i felt that she had given up. It was even worse at night - my vet feels she uses her vision to keep herself balanced, and in the dark she can't do that (we now keep a light on for her 24/7). I had my vet out again and he gave her an iv shot of dex and put her on 10 dex pills 2x/day for 3 days and then 5 pills 2x/day for 3 days. (currently i'm on my 6th day). We also started her on Marquis until the EPM results came back. He ran bloodwork and it came out normal. He pulled blood for EPM and that came back with a 16% chance of her having EPM, so he thinks it's highly doubtful she has epm. On the dex, she has greatly improved. She's now back to her alert self, she eats just fine, and doesn't have to spin anymore. Her walking has improved greatly; it's like she's just doing a side pass, but due to the snow & ice I've been leaving her in every day and just hand walking her (my vet thinks i should keep her exercising). The front leg shaking has reduced significantly. She can also bend down to eat hay.
The only blood results we have left are for Vitamin E & selenium, but my vet highly doubts they will show anything (apparently EMND is extremely rare for this area).
The vet has ruled out this being caused by trauma, as she's exhibiting no pain and he said her symptoms are 'classic neurological'. He doesn't believe it to be the result of HIV, either, due to my horses being in an isolated herd and lack of other symptoms (such as the urine dribbling).
She's finished with the dex today and i'm worried that in a couple of days she will deteriorate back to the point where we have to put her down. My vet doesn't want to keep her on dex full-time. (he was suggesting maybe prednisone)
Can you suggest anything else to try or test for? Are these cases (with no known cause) truly as hopeless as it's looking like?
Member:
vickiann

Posted on Sunday, Jan 30, 2011 - 5:59 pm:

So sorry that things are not going well for your mare.

Wishing you better days ahead.
Moderator:
DrO

Posted on Monday, Jan 31, 2011 - 8:02 am:

Hello Gayle,
Gayle without a known cause the prognosis is really not known but I find most of these do not respond to treatment. One thing I have wondered about is the possibility that this is some sort of vestibular disease rather than spinal cord disease. It does not change the possible causes very much with the possible exception of inner ear disease for more on this see, HorseAdvice.com » Diseases of Horses » Nervous System » Neurological Conditions Not Covered Above » Cranial Nerve Diseases and be sure to follow the link to Temporohyoid Osteoarthropathy.

I would still consider a course of antibiotic, not all spinal infections are protozoan and Marquis is pretty specific for them and not bacteria. The lack of fever does make it unlikely however.
DrO
New Member:
lmathews

Posted on Tuesday, Apr 15, 2014 - 10:15 pm:

Hello all, I am posting on this 2011 thread because this mare's symptoms are much like my 28 y/o mare's. My vet is using the term "sidewinder," which as summarized in Orsini and Divers is currently just a descriptive synDrOme. The science is still catching up as to the cause. I have wondered about stroke, too.

I will start a new thread specific to sidewinder and my mare's situation. I have reviewed the related neuro articles on the site (thank you Dr. O) and see much discussion of the differential diagnoses my vet has been considering.

Recently reactivated my membership after several years and am happy to be back!

Lisa
Member:
terric

Posted on Friday, Apr 18, 2014 - 10:33 pm:

I recently went through a very traumatic year with my 18 year old mare who was great one day and not the next. Her final diagnosis was TemproHyoidOpathy, (THO) Yikes! One of her symptoms was running in circles, almost running from her head, also very sensitive to anything in her mouth, including feed. The first vet missed it, the second vet thought this might be the problem. This is usually diagnosed by scoping inside the guttural pouch. After two rounds of 30 and 45 days of meds (SMZ and 10. Days of bute) she still had symptoms. With further diagnostics and more scoping we opted for surgery. She had a Stylohyoidectomy and is now doing very well. I am not sure what your girl has going on, but I can tell you that this was very hard to diagnose for us. She is doing great now post surgery. The surgery was very reasonable so it was not too expensive and not too hard for her to recuperate from. Best Wished
New Member:
lmathews

Posted on Sunday, Apr 20, 2014 - 4:24 pm:

Terric, thank you so much for this lead. I am going to run it by my vet. Will post more on a new thread. Thanks!

Lisa
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