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  Discussion on Liver disease 2 yr old Part bred lusitano
Author Message
New Member:
trilogy

Posted on Tuesday, Aug 9, 2011 - 8:02 pm:

Dear Dr

Brief history:

Our two yr old returned from his Winter away from us out at grass with young playmate, and on the way home underwent a complicated castration (cryptorchid), under general anaesthetic March 2011)for six weeks we had several vet visits to remove clots, and ? bulging lining, that had DrOpped through incision, and prevented healing, three weeks of Norodine anti biotics, box rest, and final healing.

End of May he received his second flu and tetanus vaccination.

In June began 24 hour turnout. Throughout this period he has had good appetite, but appeared a little poor behind, attributed to the obvious trauma of his castration.

Mid July I think in hindsight put down to lessening of testosterone in very coltish/sharp youngster, we think he was a little dull, i.e bridled, saddle on, girth and no reaction.

At this same time, he was observed to have a bruise on hiswhite lower lip,which spread, and inatwo weeks period became very thickened,and crusty,

29th July, he was brough in from the field lame, and trying to collapse behind,his legs filled. Vet took bloods:
GGT 677 u/l
TBIL34 umol/l
CK 224 u/l
LDH 1755 u/l
CA:3.21
PLT:174
GLU:1.73

all other reading taken were wihtin normal limits

Since the 29th he has been on hay, and unmolassed sugar beet, vitamin supplement, and 5 day course of Norodine. The photosensitivity on lip has healed (in stable 24/7), his three white legs have broken out ozzed and no scabbed, his gait remains pottery, and very wide behind. His poos have varied fromformed, to cow pat in appearance, and light in colour.

We have scoured the paddock, and found asmallamount of St Johns Wort, and evidence of a pink clover, no ragwort.

He was wormed with a broad spectrum wormer 28th June.

His mother was diagnosed with Leptospirosis Bratislava, which affected her liver when he was 4 weeks old.

Bloods taken today, show no significant change in any of the levels above. He shows no sign of jaundice, and is holding his weight currently, still eating well.

My vet at this time is not thinking about doing aliver biopsy or further investigation, just wait and see approach, which leaves me with many questions:

1. Could there be a link with the castration in March.
2. Could there be a link regarding a potential inherited issue/weakness of the liver.
3. Could there be a link between Proteq flu te
4. Could there be a link between the wormer
5. Am I right in thinking the St Johns Wort is a red herring.
6. How do we identify whether the pink clover is Aslike Clover?Pink Clover is widespread across our grazing and no other of the 50 or so horses have become unwell.
7. If further investigation does not occur, how are we going to prevent it from happening again in the future, as at this point my vet is at a loss as to the cause.

Apologies for the long speel, am very worried having felt like have been here before, and being told liver problems in horses are rare.

I know I cannot expect a miracle answer to all of this, but i think i need to understand what I need to ask of my vet now, who I know to be struggling with some personal issues, which appear to be impacting upon his work a little ..i.e forgetting to write up meds, forgetting to come back to take bloods,

Thankyou; I so look forward to maybe being better informed.

Karen
Moderator:
DrO

Posted on Thursday, Aug 11, 2011 - 8:47 am:

Welcome Mrs Patient,
I would like to see all the lab tests done and what your labs normal values are. With the possible exception of bilirubin it is important to understand liver enzyme levels do not correlate well with the amount of damage done. They can be quite high in some relatively minor conditions and lower in some quite serious conditions.

Having the bilirubin separated out in direct and nondirect can be helpful and bile acids will tell you much about how well your horses liver is functioning.

When anyone asks "Could there be...?" the answer is almost always yes because some fairly exotic and rare problems are always possible. If we assume that your horse is experiencing liver related phototoxicity and taking your questions one at a time:
1) Unlikely
2) Unlikely
3) Unlikely
4) Unlikely
5) Photosensitivity is reported in humans and the human literature describes various effects on inducing liver enzymes. So it is wrong to throw out this possibility.
6) Check out HorseAdvice.com » Diseases of Horses » Colic, Diarrhea, GI Tract » Mouth, Esophagus, and Liver » Plant Poisoning and the Liver: Hepatotoxicty. It has pictures and descriptions.
7) Until a firm diagnosis is it is impossible to say if it might reoccur and under what circumstances. If you assume this is plant related you will have to insure there is no further exposure to the plant.
DrO
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