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  Discussion on Strengthen or "adjust" immune system?
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Member:
brandi

Posted on Thursday, Sep 15, 2011 - 2:25 am:

I have agreed to retire a spectacular Friesian to my barn who has been diagnosed with PF and is responding great to treatment with prednisolone. My question is more from a holistic approach. Is there any information on things that can be done to help or strengthen the immune system - to essentially improve it? I am fully on board with the medical treatment options, but I would really like to add to that any options that might help him in an additional way.
I will be having him treated with acupuncture for certain, as soon as he arrives in a few weeks.
He will be traveling from Southern Oregon 8 hours to Northern CA - so any input on best things I can do for the travel would also be greatly appreciated. He is a very seasoned and comfortable traveler but I don't want the trip to be a trigger to a relapse.

Thank you,
Brandi
Moderator:
DrO

Posted on Saturday, Sep 17, 2011 - 11:09 am:

Hello Brandi,
It is important to remember that this disease is caused by a immune system that can be defined as "overactive" as it is attacking the horses skin. Any nonspecific attempt to strengthen the immune system may trigger an attack. I would be slow to recommend this horse be given vaccines unless the disease has a good chance of getting hold of the horse as the adjuvants will nonspecifically activate the immune system. In general I would recommend that the horse be given good general nutrition and kept a bit on the lighter side and avoid any experimenting with immune potentiating drugs.
DrO
Member:
brandi

Posted on Wednesday, Nov 30, 2011 - 12:37 am:

Apologies for the delayed thank you, Dr. O, but a big thank you for your valuable info. Your comment about the vaccinations was perfectly timed - the very day I read your response this horse's owner emailed me that she was scheduling his vaccinations in preparation for moving to our ranch (Oregon to California). We discussed - and she noted that he had a mild reaction to previous vaccinations prior to his diagnosis. We were able to decide, after conferring with our vets, to forego them, since he was moving from one closed herd to another.

Now if I'd been as smart before I gave him an Adequan injection (after he sustained a stifle injury)....

24 hours after the Adequan injection, he got hard lumps all over his neck, chest and abdomen. They were grouped - 5 to 8 in a group, varied in size from approx 2 to 5cm across, raised prominently, and hard. I consulted with my vet over the phone, we decided to wait until morning before considering any treatment. He was slightly improved 12 hours later, so no treatment was administered. 12 hours later, he had oozing sores over both eyes, under his chin and on one size of his face, but we didn't know this was going on (we seriously thought he'd gotten into something around the barn). Vet came to see him another 24 hours later when by this time the bumps had worsened - and a few of them had started oozing as well - we started him on prednisolone immediately.

He responded very well, with bumps 30-40% reduced and oozing ceased within 12 hours of the pred. Bumps were gone in another 24 hours. We continued daily pred for 5 days then switched to every other day. By the 3rd dose at every other day, the bumps returned a bit. Back to every day for 5 days and now instead of moving to every other day we've reduced the dose by 25% but sticking with every day, and we'll reduce another 25% in a few more days. So far, so good, but we're only on day 2 of the reduced dose.

Questions:
Are the bumps pemphigus? I assume the oozing is for sure, but am I right? Is the PF secondary to an allergic reaction? I don't understand the connection to allergies, but I think there is one. I am not convinced that the Adequan is really the entire allergic picture since the bumps returned after approx 8 days. What are your thoughts?

I read a previous post about hay allergies, and I am concerned about this but where do I start? He's getting timothy and teff with minimal grazing on mostly bermuda and rye. He was on Oregon-grown orchard-grass before, but I don't like the sugar content of most orchard grasses. He is a Friesian, after all (btw, 15 yo gelding, finally diagnosed with PF by his Oregon Vet via biopsy in spring 2011, after nearly losing him in Dec 2010 from a terrible bout that included fever and progressed to colic, he was in a lot of pain, but made it through, treated initially with Dex, and has been well managed on pred and off pred from July until now).

I also read that you are not a fan of allergy testing (2004 post). Are your thoughts still the same in that regard?

I hope I've given you a decent profile & history, but please let me know if you need more information.
Member:
brandi

Posted on Tuesday, Dec 20, 2011 - 2:28 am:

Dr. O, I would much appreciate hearing from you on the above question. Not sure if it just got overlooked or if it's because it might be considered a new thread, but I look forward to your thoughts.

An update to the above is we are still unable to get him off the pred without the bumps returning and now even on his full dose the bumps are coming back. He sees an allergist/dermatologist tomorrow.

Thank you very much
Moderator:
DrO

Posted on Wednesday, Dec 21, 2011 - 4:37 pm:

Hello Brandi,
Yes I did miss the questions. Taking them in order:
The bumps are hives which are a histamine mediated immune reaction. They are usually part of an allergic reaction to almost anything. They may be associated with a pemphigus complex also.

PF is generally a primary immune reaction to the bodies own antigens. You could say the body has become allergic to itself. Can PF be a secondary reaction to a primary allergic reaction....that question is not well studied.

I too think the Adequan may not be the cause of the allergic reaction.

Yes I still find no evidence that allergy testing is either sensitive or specific.
DrO
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