This is an archived Horseadvice.com Discussion. The parent article and menus are available on the navigation menu below:
HorseAdvice.com » Diseases of Horses » Fever of Unknown Origin »
  Discussion on Need advice concerning fibrinogen level
Author Message
Member:
Sondra

Posted on Wednesday, Nov 30, 2005 - 11:16 am:

Hello Dr. O:
My 2 year old has been showing a high fibrinogen level in his blood since returning from a clinic for gas colic care. I don't have a base line on this 2-year old - but after his colic improved, and he came home from the clinic, he showed a fever of unknown origin (104), a slight nasal discharge, and Fibrinogen 780.

His temperature gradually normalized over a couple of weeks (and it's been normal now for a full week); his manure is normal, eating normal, no clinical signs of distress. White blood cell and protein counts within normal range.

But the fibrinogen - which gradually DrOpped to 400 from the 780 - was tested again yesterday and instead of a further decline, it is up again, to 471. (We did not test this time for WBC again).

I've been advised that this almost certainly indicates an internal abscess. Do you agree?

Separately, I also wonder if the inflammation it indicates could be caused by an allergy? (he's eating alfalfa which I suspect originally caused his gas colic because his hay was switched too quickly from a blander hay).

If you have any comments on this continuing mystery of fibrinogen and what it might indicate (abscess, allergy, and I also wonder Erlichia or Lyme?) I would be most grateful. He may be sent to a clinic for diagnostics.
Member:
Sondra

Posted on Thursday, Dec 1, 2005 - 8:57 am:

A related question: would you be inclined to treat the horse with smz's for a period of time before sending him for diagnostics (ultrasound, etc.)? The thought being a less expensive attempt, to see if the fibrinogen decreases after a course of antibiotics even though we don't know why it's still elevated. Or should I be worried about a sensitive gut based on his recent medical issues? Finally, should I assume a margin for error in fibrinogen tests? From 400 and 471? The thing is, the horse's fibrinogen has been high for a while now - but he shows absolutely no other clinical signs of illness, just the blood!

Sincere thanks for your time.
Moderator:
DrO

Posted on Thursday, Dec 1, 2005 - 8:58 am:

What it does indicate is an ongoing chronic inflammatory process and though possible not necessarily an internal abscess. I do not associate this with common allergies.

471 is just a little bit of rise, are there any other lab abnormalities or symptoms of disease presently? If not, and the decision is to be made by your vet, I am uncertain I would treat a small rise in fibrinogen but would recheck in a couple of weeks. A continued trend upward would have me evaluating further for the causes in a similar manner to what you read in the article on Unknown Fevers. For more on signs seen with internal abscesses see, Equine Diseases » Skin Diseases » Swellings / Localized Infection / Abscesses » Pigeon Fever, Dryland Strangles, & Distemper.
DrO
Member:
Sondra

Posted on Thursday, Dec 1, 2005 - 9:10 am:

Thank you, I have read the articles and they are very informative. I agree we need to look for other abnormalities in the blood along with (yet another!) fibrinogen re-check in the near future.

I thought I should mention one other thing. These might/might not be related but I know how tangential info can be important when you least expect it.

This two year old, at yesterday's examination, had some increased fluid in his digital flexor sheaths, behind the pasterns in both front legs. I thought that was odd. He's turned out 14 hours a day (at night actually) so he's not standing around in a stall all the time. He WAS however recently started under saddle. Walk trot for 10 minutes 3x/week. Can't imagine why he would have this.

The vet also found some slight sensitivity when feeling his lymph nodes, which were easily felt. Nothing extreme, but noted.
Moderator:
DrO

Posted on Friday, Dec 2, 2005 - 7:04 am:

Hmmmm if it is truly just the sheaths that are swollen, it is not related. If the horse is stocking up with general edema it is probably not related if there is no fever or heart abnormalities on auscultation. Does Ehrlicia cause a fibrinogen rise, maybe, for more see Equine Diseases » Cardiovascular, Blood, and Immune System » Equine Granulocytic Ehrlichiosis.
DrO
Home Page | Top of Page | Join Us!
Horseadvice.com is a BBB Accredited Business. Click for the BBB Business Review of this Horse Training in Stokesdale NC