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  Discussion on I have a 3y/o with EHM, EHV-1 neurological form...wondering?
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New Member:
Dblcreek

Posted on Tuesday, Jun 21, 2005 - 12:02 pm:

Hi, Im new here, but have found the most information in one spot about this type of EHV-1. I had a gelding brought to our farm almost three weeks ago for evaluation(we sell horses on consignment periodically)but before they get here have to have proof and verification of vaccinations and current coggins, all of which he had. I liked the horse so much I went ahead and bought him. Hes a kentucky mountain singlefoot, a if that matters, but I liked that he was different from other gaited horses around here. All new horses go into the seperate paddock/barn(a good 500 ft from any other horses, for a min of 2 weeks....which thank goodness, helped in this instance from a major outbreak. He did have a clear, watery nasal discharge, but I didnt find that particulary unusual for being hauled on an open stock trail from KY to NC. I gave him some PPG, for 3 days, then the discharge turned to the thicker yellow/green mess, so I started him on Naxel. After 3 more days, didnt seem to touch it. Noticed some swelling in his sheath and just between his front legs, at his chest. but thought it was just from him standing in the same place. Vet said to keep on Naxel(20cc) but to also give IM Banamine with the shots for 2 more days. Did so, and he seemed to be gettting better. Started eating some, and really drinking alot. He didnt walk around much though. Vet said to stay on the naxel another two days as it was probably working. Friday, after his naxel shot(about 2 hours after) he started to colic really badly. He went down, and I gave him 10cc banamine IV, and called the vet to come over, it was about 8pm then. It took a good 20-30 minutes for the banamine to even shown any signs of working. Finally though, after several attempts, he managed to get up and I walked him around the yard. He was somewhat stiff in his hind legs, but I didnt think anything much of it. Vet came and performed a rectal exam, his bowels were fine, and had normal gut sounds. Went from a temp I took just before colic of 104.6 down to a 102.2 when he stood up after the banamine, and then at 101.8 when the vet came. He turned him in circles and said he was showing signs of hind limb atexia. He also said his lungs were very very congested and full of mucus...probably why his heart rate was up in the 70's instead of half that. He drew blood and called me about an hour later to say his WBC was up, and he more than likely had EHV-1, and with his atexia, probably the neurological form. Went on to tell me there was a farm a few miles down the road that recently had a young mare with this also, but her hind legs(both) were completly paralyzed(she sat like a dog, couldnt get up) when they found her. They took her to the vets and she died 2 days later on her own...another case at a farm several miles away in the next county a month or so ago in an older mare, showed the same signs and the owners had her put down. My vet said teh best chance would be for me to take him to his clinic. I did this last saturday. Since then, Ive been trying to find out as much as I can about this form of the virus. The successes, what worked, didnt, etc. Not finding a whole lot either. Sat his symptoms didnt progress, but his heart rate was back down to mid thirties, and his lungs sounded much better. Sun AM he loss his tail tone(it was limp) and he lost the use of his sphincter muscle. Still no swelling in his legs though, but sun evening when asked to walk his right leg didnt work correctly, showing signs of progressing paralysis. He has had him on DMSO IV, Aclyvoir(than goodness the guy at the other farm that had the mare that died gave it to us) and hes also on banamine and has been tubing him with water(although he does drink some) he will lay down, but could still get up and shift around some. His upper palate of his mouth is really swollen, but he has good color in his gums and is urinating freely. Yesterday, Mon AM, vet said since the signs seemed to be getting work we might consider euthinasia. I visited him at the clinic about 2 yesterday. Stayed there. Whicle I was there, somehow he regained most of the use of his tail(would respond to a fly and able to lift and swish it, even though he still held it a little sideways) and he had his first bowel movement since friday(which was great). This Am vet said he is able to use his right leg again, its still weak, but not shakey and hes using it to pivot and pick up instead of dragging it. Im wondering though, is this a sign that the drugs are helping relieve the vasculitis, and that hes on the road to recovery? How much longer would he have to stay at the vets...its rather expensive! And when would we know that we are pretty much on the right track? Can it regress after showing signs of recovery? What about any thing else at the farm, if he does get well enough to come home, how long should I keep him seperate...and will he be able to shed the virus later on to others? Thanks a bunch...I just havent seen many info on horses that have recovered, and what time frame(to stay at the vets) or any regression after showing recovery. Any help would be appreciated. So sorry for his life story up there!
Moderator:
DrO

Posted on Wednesday, Jun 22, 2005 - 9:03 am:

No it sounds like real improvement to me but even it is just the vasculitis to the degree that this was contributing to the clinical signs that is good that it is better. The clinical course is variable Ralena so we cannot predict when he can come home but as soon as you are able to administer all the appropriate care and he is stable to ride he could come home.

There is very little you can do but give good nursing care (see article for more) and even the very expensive acyclovir is of uncertain use at this stage of the disease though some have thought they see a clinical response. You watch for signs of improvement and it is good that at the very least he has stabilized. Regression of the ataxia or recurrence following recovery is not documented even though the horse will remain latently infected. You are not out of the woods for some of the complications however and so the nursing care remains important.

Later shedding is certainly possible as we don't think the virus ever completely is eradicated but it is very likely all your horses have already contracted EHV-1 in the past, recovered, and are latently infected also. We do not know why some horses develop the neuro form. There is a vaccine out there that is showing some early signs of efficacy, see the article for more on this.
DrO
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