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Discussion on Can rain rot look like hives?
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Member:
lsweeney
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Posted on Sunday, Nov 12, 2017 - 11:49 am:
21 year old mare. It rained for the first time last week.
Mare is covered from head to toe with hives-like bumps, patches of large edema ( some like large flat pancakes on belly, others as large as an egg above stifle), some bumps have the beginnings of a scab. Our other mare has the classic crusty yellow, oozing beginnings of the rain rot scabs in a few places.
No change in feed or environment.
Thoughts?
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Moderator:
DrO
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Posted on Wednesday, Nov 15, 2017 - 8:44 am:
Hello Laurie,
Rainrot often starts as a circular swelling of the dermis from the inflammation and then as the epidermis and follicular layer separate become the paintbrush crust described in the article. Unlike hives however these are often painful.
DrO
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Member:
lsweeney
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Posted on Wednesday, Nov 15, 2017 - 10:21 am:
Thank you. I came to the conclusion that it is rain rot. After just a day, many of the welts had already started developing crusts. Others were waning. It was interesting how varied the reaction was....and all at once. I got a bucket of water and Betadine and scrubbed all of the spots. Looking much better now.
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Member:
lsweeney
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Posted on Sunday, Nov 19, 2017 - 9:58 pm:
Or maybe not.....
So we still have hives. Pretty good ones with a few on the face now. The egg-size welts in the stifle crease have subsided, and now everything has shifted to the belly with large, hard sections about an inch deep and 5-6 inches square.
We do have rain rot in the picture. A few yellow, crusty scabs in the forelock, some crustiness along the jaw line. Most everything that I had treated a week ago with betadine wash did NOT progress.
I was disturbed that this was not improving, and went over to discuss with our vet. He was concerned that I might have pitted edema on the belly (which could be bad and point to other things) He suggested TMS might be helpful, but would have to see the horse. (I do have tons of TMS laying around.) We also discussed Dexamethasone as a possibility.
This is the horse that went into kidney failure from a treatment of Bute and TMS, so I'm really not excited about diving into antibiotics when I'm not sure of what we are treating.
What I did do was give her a head-to-toe hot bath in betadine and epsom salts. I did give her 9 capsules of benadryl (all I had), which for a 1,500 lb horse was probably a very low dose.
She still isn't running a fever, and appears normal except for the bumps and edema.
I thought she looked slightly better this AM, but when I returned home this evening, she had more welts on her head and neck. The belly edema is hard and not bilateral. - 2 large sections on either side, but not in the same location.
While I was going all over her with my hands, I found a tick fairly high on her neck. I couldn't believe it since I have been all over this horse, and had sprayed her several times with Repel X over the last week. I will say, though, that we were concentrating on the tick areas, like under the elbows, udder, etc. He is not very big, and is a plastic bag now.
I found two ticks on my other mare in the udder area yesterday, even though we were spraying her too. Argh!!! (See my nightmare last year with Anaplasmosis on Christmas day.)
So as I sit here now, I still don't want to do anything because I may have found the cause of the problem, and it may resolve on its own.
If she succumbs to a tick-borne illness, then I believe Doxycycline would be the antibiotic of choice or that fun injectable Tetracycline.
If it is rain rot, then Penicillin would be the best choice - right?
If the allergy symptoms persist, then Dex would be the best option?
Since I also have extensive experience with Pigeon Fever, the early addition of antibiotics might internalize an abscess that might be developing. If you looked at the belly edema, it would be easy to include Pigeon Fever in this discussion - In fact, I was googling belly edema, and found a picture of the same horse from our Pigeon Fever battle on Horseadvice.com. Her picture looks VERY similar to how she looks now.
If it weren't for the hives, I could easily think that this is the road we are headed down.
This is the picture I'm referring to (link below). The arrow is pointing to the pigeon fever abscess location, which is the same location of the egg-size swellings we experienced this time. There is a firmer bump on the inside of the thigh. I'm suspicious that a tick might have DrOpped off of this location. The edema on her belly is identical to what she looks like now.
https://www.horseadvice.com/horse/messages/4/406353.jpg
I'm still not convinced that ticks can't transfer pigeon fever, since both horses had ticks and pigeon fever at the same time.
Is it possible to have multiple tick-borne diseases at the same time?
It doesn't make sense to make a preemptive antibiotic treatment to prevent a tick-borne illness to take hold - right? (Especially since these antibiotics are prescribed for extended periods of time as I recall.)
Are you with me on the do nothing for right now?
Laurie
(I want to make sure that I procrastinate until Thanksgiving Day to maximize my veterinarian's financial support.)
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Moderator:
DrO
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Posted on Monday, Nov 20, 2017 - 8:03 am:
Hello Laurie,
Most your questions seem rhetorical as they answer themselves pretty well. I think with all the questions and the worsening nature of the problem. you should go ahead and have your veterinarian out to examine the horse to see if a better bead on the infection vs allergic reaction can be made. I like the idea of soothing bathes with warm water to rinse off the soap followed by lots of cold water to lessen the urticaria a sensible approach that has little down side.
DrO
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Member:
lsweeney
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Posted on Saturday, Nov 25, 2017 - 6:30 pm:
Went to the vet on Tuesday. She got a small dose of Dex 5ccs. All of the hives were gone except for the belly edema by Wednesday morning.
Thursday, a couple of hives welts here and there.
Friday, a few more.
Saturday, they are on their way back, with larger welts.
We are up in the high sierras now, where I know that there are no ticks, and she is out of her environment.
The common denominator is hay, but she has been eating the same hay for months now.
:-(
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Member:
lsweeney
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Posted on Saturday, Nov 25, 2017 - 9:19 pm:
Still no fever and no treatment with antibiotics. Oh, and they ran a large animal panel and checked the fibrinogen. Nothing remarkable. The lab results are attached. 
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Member:
lsweeney
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Posted on Saturday, Nov 25, 2017 - 9:20 pm:
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Moderator:
DrO
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Posted on Sunday, Nov 26, 2017 - 11:27 am:
Yes not much help with the labs but the normal physical exam is important. Are they planning on repeating the dex?
DrO
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Member:
lsweeney
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Posted on Sunday, Nov 26, 2017 - 1:24 pm:
They are closed, and I'm up at Lake Tahoe with the horse. (Better to bring her with me while I'm vacationing, rather than rely on relatives feeding while I drill them with details on her condition/symptoms, and teach them how to take a horse's temperature, etc.)
She is about the same this AM.
Pretty good hives, welts and edema, but not significantly worse. I will take some pictures.
No temp, eating, bright.
I brought some benadryl with me, so I thought I would give her some of that. I gave her a gram of Banamine last night. The vet said sometimes you can get some relief with that but she wasn't optimistic given the current history. I didn't see much change, and I believe that I read somewhere in your posts that it would be palliative.
She isn't sprouting rain rot. I found a small patch of crustiness on the top of her head. I have only found it around the forelock and head which is where I didn't wash significantly with betadine last week.
It's been a week now since I took the tick off.
The upside of being where we are is that there are no ticks, and she is in an enclosed pen where I know exactly what she is eating versus her pasture at home.
We are returning home either tomorrow or Tuesday, and based on her state, we might try another dose of Dex.
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Member:
lsweeney
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Posted on Sunday, Dec 3, 2017 - 5:49 pm:
Sorry for going MIA. Had a dog with 106 fever that took precedent over the horse with hives.
Attached is what she looked like after 5 days from the Dex treatment. Pretty much back to the beginning. 
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Member:
lsweeney
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Posted on Sunday, Dec 3, 2017 - 5:54 pm:
Here she is after 3 morning and evening Benadryl treatments of 12 25mg pills. Significantly better.
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Member:
lsweeney
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Posted on Sunday, Dec 3, 2017 - 6:01 pm:
Across the next week, the hives have kind of come and gone while we kept her on the Benadryl. I didn't want to stop until the edema was gone. She has gone about 2 days now without Benadryl, and she still has hives, but not as angry. The edema is 99% resolved. I found a patch of rain rot on her rear-end this AM. Washed it with Betadine and put some antibacterial stuff on it. I'm going back to the rain rot as the overall hives reaction. The tick might also be in there initially, but we are 2 weeks out from the tick bite. She is still normal otherwise.
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Moderator:
DrO
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Posted on Monday, Dec 4, 2017 - 9:49 am:
Thanks for the update Laurie. You can give more diphenhydramine, see HorseAdvice.com » Treatments and Medications for Horses » Anti-inflammatories (NSAID's, Steroids, Arthritis Rx) » Antihistamine Use in Horses .
DrO
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