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  Discussion on Can't get a diagnosis
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New Member:
judgesma

Posted on Wednesday, Jan 18, 2012 - 1:17 pm:

Hi there,

Not sure where to post this exactly, so here goes. I own a 15ish year old Clyde Cross who has been the pinnacle of soundness/health in the three years I've had him. Teeth floated once a year, regular vaccinations, you name it.

Anyways, in early December he was a bit gimpy on his left rear and farrier dug out abcess goo, so I soaked him twice a day for a week and he appeared to be fine.

Over the holidays, he started losing muscle over hind quarters, started quidding his hay and began acting kind of lethargic, and didn't want to lift up his left hind for hoof picking or farrier.

Vet came out the next day and the abcess had ruptured through his coronet band and I soaked again for five more days just to be sure.

He has gone steadily downhill, vet did a three hour exam, drew blood, was up in his mouth for almost an hour, checked for neurological symptoms etc.

It's been two weeks, still no diagnosis, tested for EPM for which I have no results, still waiting on that. His regular blood worked showed mildly elevated liver function, normal white cell and everything else was in the norm.

He's not 100% on his rearend, but I did uncover a horrible case of scratches a few days ago which was causing him to stomp his feet, chew on his legs and just general discomfort signs. I shaved off his feathers and have been scrubbing/treating some pretty good sized sores on his hind legs/heels.

Can a horse that is truly neurological stand on three legs and chew on their hind pastern?

Could it maybe be an ulcer that is causing him to quid his hay, general discomfort?

I'm kind of at a loss here on what else to try and I feel like I need to be asking all the questions of the vet so if anyone has any ideas, I would greatly appreciate it.
Member:
paul303

Posted on Thursday, Jan 19, 2012 - 12:12 am:

Well, I can understand the muscle loss with the confirmation of an abscess in the left rear. The abscess continued to fester, since it popped out in the coronary band after the holidays...so, there's a history of an infection for one month and most likely, much longer. He's got to compensate in the hind end due to the pain. As far as that leg goes, I'd have some x-rays taken to see where you are "abscess wise".

As far as the quidding, they usually can't "quid" unless they have the dentition deformities that enable it. If he's quidding enough to challenge the nutrition he needs to get from the hay, then you might look to one of the "whole" feeds that is pelleted and formulated to replace hay. I'd still keep normal hay feeding available to him, just for his mind. Keep looking for a quidding cause in the mouth, though.

You absolutely have to defeat the scratches. Although they are not uncommon in heavy breeds with feathers, they may indicate that his immune system is not 100%.

Has he run a temperature at any time?
Member:
judgesma

Posted on Thursday, Jan 19, 2012 - 6:42 am:

Thanks!

His temps when I have checked them other than during his abcess have been normal
Moderator:
DrO

Posted on Friday, Jan 20, 2012 - 5:51 pm:

Hello Wendy,
I agree with Lee completely. Until you get that foot infection taken care of it is hard to see if there may be other problems. For more on treating foot abscesses see, HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Hoof » Hoof Abscesses, Bruises, and Gravels. Remember good ventral drainage is the key to a rapid cure.
DrO
Member:
judgesma

Posted on Friday, Jan 20, 2012 - 7:10 pm:

Thanks for the advice.

Unfortunately, his EPM test came back with readings at the second highest level, so my vet says EPM. His neurologicals continue to deteriorate and difficulty eating as well.

I'm just not convinced even with a guarded prognosis that putting him on that EPM medication will reverse the damage that has been done or that he will ever be the same.

I was really hoping for better news. I'm kind of wondering since this appeared to come on so fast if the abcess infection lit off the epm? I guess we'll never really know in the end. Just a big gentle giant who deserved a happy retirement in a big grassy pasture and now I can't give him that....
Member:
paul303

Posted on Saturday, Jan 21, 2012 - 2:14 am:

I live in an area that is heavily populated with possum. There are two horses nearby, that have come through treatment for EPM. 15 is not an old horse. Has your vet given you any reason to think that EPM treatment might not be successful in your horse's case?

I'm sorry you've had such a rough diagnosis, and I wish you all the luck and strength needed to deal with this. There have been past discussions on this site, have you accessed them? Please continue to treat the abscess and scratches agressively, until you decide what to do about the EPM.
Member:
vickiann

Posted on Saturday, Jan 21, 2012 - 5:59 pm:

A bad case of scratches is very painful and debilitating.

Went out of town for a couple of months one time and the person in charge at the barn did not understand about scratches.

When I got back my horse would fall down to his knees if I made him pick his foot up on account of the scratches.

It took me 2 - 3 weeks of diligent care to get him back to normal.

Anyone watching me treat him might have wondered if there was a neurological problem.
Member:
judgesma

Posted on Saturday, Jan 21, 2012 - 6:26 pm:

Thanks.

Getting the scratches under control thankfully.

I think with regard to the EPM prognosis, my vet gave me a very guarded poor prognosis. While we have seen the miracles from the drug, they were also sometimes followed by relapse, or didn't undo the neurological damage, so the horse you have after the treatment is not the same. That's not to say recovery is not possible, but when you add up the cost of the drug, length of treatment, and a iffy chance of recovery, I think in our situation, it's braver to end his life. Yes, 15 isn't old, but he has 10 years of history which I know nothing about. This could be a relapse, could not be. We have two EPM survivors at our barn who were on the medication forever and are about the same as when they were diagnosed, no worse, but not 100%.

I think it's just the frustration and mystery of this damn disease. Just makes the decision that much more difficult with the well, what ifs.

Glad to have a forum like this though to bounce thoughts around and get good feedback. I sincerely appreciate everyone's posts.
Moderator:
DrO

Posted on Saturday, Jan 21, 2012 - 6:46 pm:

Wendy, get the foot infection fixed there is no mystery there and you may be amazed at the improvements in your horse following this. If you and your veterinarian believe you have EPM by all means treat that too but the blood test is not diagnostic. For more on this see HorseAdvice.com » Diseases of Horses » Nervous System » Incoordination, Weakness, Spasticity, Tremors » EPM, Equine Protozoal Myeloencephalitis.
DrO
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