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Discussion on Undiagnosed illness/injury. Is it Lyme Disease?
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New Member:
vieradbs
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Posted on Monday, May 30, 2011 - 3:24 pm:
Hello,
My 5 year old Dutch Warmblood is experiencing a set of symptoms which are baffling my vets and after finding a white tick which left an infected wound on his leg I am starting to believe that it might be Lyme disease. Lyme disease is not a common thing in the UK and I doubt most of the vets have ever seen anything like it, especially as it is hard to diagnose and unspecific in its symptoms.
I know that I am not a vet and therefore aren't qualified to make these assumptions yet the my vet bills are climbing and my horse is getting worse and I don't have any answers as to why. I just want to help him get better because he is an amazing horse with a loving character with buckets of potential (he has olympic breeding) and it is not fair to him to have to go through this, no horse should have to. It has been 7 months without an answer and I am petrified that I might loose him. I will do anything for my horses and I will be so angry if he doesn't make it especially if it would be something which is treatable and was just missed due to my previous vet who, sorry to say it so bluntly but who just couldn't give a shit. If you have any ideas as to what it could be or know stories of horses with similar symptoms please help me.
In November I got a call from the yard owner that there was something wrong with my horse. It was as if he was drunk. He was swaying, leaning against the side of his stable and couldn't lift his head or bend his neck. We took him out of his stable and after walking "drunkenly" for a few minutes he snapped out of it and looked normal. The senior partner from my previous clinic was put on the case. At first he thought he was tied up. But I hadn't ridden him hard the day before. (He was just in the field and then I took him on a short hack.) His urine wasn't brown and the vet did some kind of blood clotting test on the spot which clotted in some way which showed that there was something in his blood. They said to feed him from a height so his neck wouldn't get "stuck" again and took more blood for some tests. The next morning he was in that state again so I walked him in hand again and he was fine. His temperature was slightly elevated. I measured it 3 times a day and it kept fluctuating. After a couple of days the morning episodes stopped and gradually the stiffness in his neck got better and the his temperature was normal. During the period up until christmas my vet did all sorts of blood tests the results of which are attached. I felt like I had to push him to do them. His attitude as a veterinarian was disgraceful and I as any loving horse owner wanted to know what was wrong with my horse. I was also worried whether it was something infectious (I read all sorts of things online. I know you shouldn't do that but what else was I supposed to do when my horse was ill and my vet was useless) He said that they were all negative, some had a higher white blood cell count some indicated something with his liver but none of them were conclusive. He jumped from one thing to another. In the end he said: "he's fine now. whatever it was he got over it. You can ride him again. See what happens." I was petrified that if I would put any pressure on my horse he would have a relapse or god forbid something worse would happen. But I trusted my vet, he was the one with a degree in this stuff not me so I gradually introduced my horse back into work. His attitude was different. He would rear up, nap, suddenly stop dead in his tracks. I thought it was probably excitement from doing something after being on nearly two months of stable rest.
In january till february I was in the hospital with a kidney infection at which time my horse was being let out in a small paddock for about an hour a day. He used to go out in a bigger field with other geldings for the whole day but I thought it was better for him to be under constant supervision in case something happened again. After I got better and went to visit my horse I noticed that my horse was stiff on his right hind and that he constantly rested it. I showed it to the yard owner and asked whether something had happened while I was ill. She said that nothing happened and that he was probably just stiff from the box rest and time that he wasn't being ridden. I slowly brought him back to work and noticed that the stiffness wasn't going away it was getting worse. A dressage trainer recommended that i ride him more down and low in order for him to be able to use his hind legs more and so I did. At the beginning of April and four days of riding him in this fashion his stiffness got much more worse and he was now lame on both hind legs.
I got a new vet out to have a look at him and he said that he was more lame on his right leg and lame on his left because he was straining it from compensation. He also noticed that he had a great deal of muscle loss on the right side of his pelvis and thought that his stifle seemed slightly swollen but nothing too conclusive. He said more box rest and see how he is afterwards. A week later he wasn't better so I decided to have a chiropractor have a look at him before we went ahead with xrays and nerve blocks. She said that he was in a lot of pain and needed a lot of work.
I decided to get the vet out again as his lameness had gotten worse. The vets took him to the clinic did nerve blocks and xrays. They didn't find anything. The new vet is much better than our last one. He says that the source of the problem must be in his pelvis or in that area as they have done his whole lower leg without any success. They would like us to take him to a larger clinic for a bone scan or mri.
I was just wondering whether somebody could help me read my horse's blood results and give me a 3rd opinion before we go and spend thousands of pounds on more tests. Sorry about this long essay but I think a whole history is important. It might not have any connection to the states he was having but it could. Thank you.
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Moderator:
DrO
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Posted on Tuesday, May 31, 2011 - 8:13 am:
Welcome Viera,
It is not at all clear whether the earlier episodes of transient "drunkedness" are weakness, pain, or seizures. All 3 could appear as you describe and, with some causes, can come and go as you describe. Neither do I see any help as to cause in these labs at first view. Right now I have a call to go on and when I return this evening will try to expand my thoughts.
DrO
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Member:
helenw
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Posted on Tuesday, May 31, 2011 - 10:39 am:
Hello Viera,
Oh dear you must be so worried about your poor horse. I would agree with Dr O that the leaning on the stable wall, drunkenness and apparent inability to move his head and neck do sound a bit like a seizure. But seizures can be symptoms of quite a few things and not a disease in their own right. Whereabouts in the UK are you? I can't believe that Lyme Disease is really as rare in horses as we think because surely many of the native pony breeds graze with sheep and I can't believe they don't get infected. I wouldn't be unduly worried about temperature fluctuations unless they were dramatic because I'm sure humans do the same throughout the day quite naturally.
Is your horse insured? I would be pushing for a referral to a specialist equine clinic or veterinary teaching unit. The bad behaviour under saddle does sound pain related. I read somewhere that the warmblood breeds are rather more prone to developing joint disease because they grow and develop rather fast. Could your horse have had a fall? The trouble is with horses that they get up to all sorts of stupid things and we only have to turn our backs for a moment for them to get themselves into trouble.
I'm sure one of the magazines (Your Horse I think) ran an article about Lyme Disease only a few months back. That might be worth tracking down.
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Member:
frances
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Posted on Wednesday, Jun 1, 2011 - 12:42 am:
Hi Viera,
Has anyone tried to treat the back pain with antiflammatories? The muscle loss, constant resting of the right hind, stiffness of the right hind, subsequent involvement of the left hind, improvement with hand walking all just sound so similar to my horse's recent lower back pain. (Not however the "drunkeness", nor the possible tick bite).
However DrO will no doubt get back to you soon having digested your blood test results. I do wish you all the best in resolving this.
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New Member:
vieradbs
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Posted on Wednesday, Jun 1, 2011 - 11:07 am:
Hi,
Sorry about not replying sooner I've been organizing vets and clinic visits.
It is possible that he's had a fall. He used to go out all day with other geldings and they play rough. From the first episode he's been in a small paddock on his own in case he did have another episode and now with the lameness he is on strict stable rest. Poor chap.
Unfortunately he is not insured as in between all these injuries and episodes he could never get a clean bill of health for insurance.
The in hand walking did not improve his lameness but it did improve his "drunk" states. After these states he did get a couple of doses of antibiotics (i'm not sure which kind) but he hasn't had any after that. Last week he did get bute for 5 days but it did not seem to make things better.
The clinic has mentioned that it can be neurological or that it can be possible that we are looking at two things happening at once.
I guess the best thing to do is go to the specialist equine clinic and see what they can find. I might have to strip for money after that but at least we can start treating whatever this is.
Thank you for your ideas and help.
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Moderator:
DrO
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Posted on Wednesday, Jun 1, 2011 - 4:21 pm:
Reading the above again I too am inclined to believe that there are two different things going on Viera and since the drunkeness has resolved pursuing the hind limb lameness seems logical. Before they MRI and scan him it would be important to localize the lameness in the leg. For more on this see HorseAdvice.com » Diseases of Horses » Lameness » Localizing Lameness in the Horse.
DrO
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New Member:
vieradbs
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Posted on Thursday, Jun 2, 2011 - 12:27 am:
They have nerve blocked and xrayed every possible place in is leg but nothing has worked.
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Moderator:
DrO
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Posted on Thursday, Jun 2, 2011 - 8:06 am:
You misunderstand what has been done Viera. A negative response to a block gives useful information. Assuming the block is done correctly it means the area being tested is now known not to be the source of lameness. This test is far more reliable that radiographs, scans, and even MRI at identifying pain. Can you list the specific blocks done and on which leg?
DrO
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New Member:
vieradbs
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Posted on Wednesday, Jun 8, 2011 - 4:08 am:
Hello,
I have been waiting for the clinics results before I posted again.
I understand that a negative response nerve block is helpful in indicating that the area block is not the source of pain. I'm sorry I should have chosen my words more wisely. They did his whole leg as far up as they could gradually point by point higher and higher including the stifle on the 3 points. There was a slight improvement in one point of the stifle yet it was only about 50% or less. After xrays had been done of the stifle a small hole was found on the outside cartilage not deep enough to impact the bone in that area. I'm sorry I forgot the name and area but I will find out later today.
That was done at the first clinic after which we got recommended for a bone scan as the improvement after the block hadn't been significant and the xrays didn't show anything more significant either. His leg was xrayed up and down at each nerve blocked point as well.
The bone scan revealed 2 hot spots. 1 only slightly elevated one in his hocks and another in his right stifle (the one that the previous clinic blocked and found the less than 50% improvment). They blocked the stifle again and got the same result. They xrayed again with the same result.
They said that the slight elevation in the hocks is normal for young horses in growth. Is this true?
Yet as the block in the stifle has only come up with a less than 50% response then they would like to block and xray the hocks area and stifle together and see how it goes. All of this has been done before with no improvement in his lameness. But if there is no remarkable improvement then their verdict will be that it is that small dent in the stifle which would be crazy reason as to why my horse is so lame and stiff.
They say we have 2 possibilities: Steroids which I a crazy option as he is only 5 years old and surgery which I believe is a bit drastic especially due to the size of the dent on the stifle.
They said his previous lyme disease tests were borderline. Should I get them done again or am I just being crazy?
Somebody suggested that we do neither of the options the clinic suggested especially as he is so young and give him some muscle and joint supplements and turn him out in a small, hard, flat field for a couple of months and let his body recover from whatever has happened. Especially as he is getting worse not better on stable rest or hand walking both mentally and physically. Thoughts on this option?
I really just want to help him. He is such a beautiful and kind horse and he is family.
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Moderator:
DrO
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Posted on Wednesday, Jun 8, 2011 - 1:59 pm:
Any joint with a growth plate that has not fused can show increased radionucleotide uptake (hot spot). I like the idea of repeating the nerve and joint blocks, even experienced clinicians can sometimes miss a block so the recheck is logical. Did they name the stifle lesion and describe exactly where it is at?
DrO
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