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  Discussion on Pemphigus in 21 year old stallion
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Posted on Friday, Feb 25, 2000 - 4:46 pm:

My vet was as perplexed as I was when my previously healthy 21 year old stallion suddenly went off his feed and exhibited signs of mild colic. The next day, I found my horse covered with what looked like hives on his hind legs, chest, and insides of the front legs. The hives crusted over and I followed the prescribed treatment of washing and scrubbing with betadine. The third day, with my horse refusing all feed concentrates and also refusing his alfalfa ration, only eating his orchard grass mix hay, I was very concerned. I looked into his mouth and AAAACHK!!! I saw three sores in his mouth. They were small sores, looking like broken blisters. I (being a well broken in horse owner) immediately decided it was "the worst" and called the vet to say my horse looked like he had Vesicular Stomatitis. Never mind that I live in Missouri where there had been no reported cases of Vesicular Stomatitis. The vet saw my horse immediately, and took samples of all his bodily fluids, saying this was NOT Vesicular Stomatitis. He said, most likely this is an auto-immune disease. I immediately wished he could have said something simple like VS that would just require me to quarantine the whole farm. Autoimmune diseases terrify me. When I asked the vet what an autoimmune disease might be, he mumbled "Pemphigus, but that's not really common...let's wait to get test results." Waiting to hear is difficult. This horse means the world to me. So... I came here to look up more information. So far, what I've read hasn't given me much reason to prefer this over Vesicular Stomatitis!!!

One week into the onset of symptoms, my horse has refused feed concentrates of any sort. For the first few days he would eat his alfalfa (processed dehydrated stuff)but now will only eat the grass hay. It seems that the original outbreak of "hives" that broke open and had the hair fall off has not gained any new bumps. I have scrubbed all the bumps and keep them sprayed with Betadine. No new mouth sores have joined the original three which I found on his gums. His tongue and gums are overly red in general. The horse is listless, exhibiting none of his normal "flare" or stallion behavior of arching his neck and flagging his tail. He has always been a wonderful animal to handle, but now he is just way too quiet and subdued.

One other thing my vet said to me is that if he has ulcers on his gums, it may be that he has ulcers on the inside (meaning maybe esophegus, other parts of digestive tract). If he has not improved significantly by Wednesday, we will take him to be "scoped", but it is an hour trip and he seems to be unable to adapt to much stress right now.

Like so many other people who post here, I'm feeling a bit overwhelmed today. We have gone for years with no significant problems with our horses, and this year has been numbing! We also have a gelding with HUGE infected sinus that is going to be "scoped" on Wednesday... and a yearling who tried to rip his hind leg off on our supposedly safe oak rail fencing... sigh... and a 26 year old stallion who has an enlarged thyroid. We lost our first horse ever this year, a three month old colt with epilepsy. I suppose after those uneventful 30 years that preceded this one we should have been prepared to pay a toll . For today, I'd like to concentrate on the issues of my 21 year old stallion with skin and gum lesions.

Any suggestions or insights would surely be deeply appreciated. I just can't bear the thought of losing him at such a young age.

Nina

Posted on Saturday, Feb 26, 2000 - 7:15 am:

Hello Nina,
Yes it deos sound like your horse has had a hypersensitivity (allergic) reaction to SOMETHING. It may not be himself however. You can see reactions like this with dermatophillus, contact allergins, liver disease, some viral diseases, and frequently they go unexplained.

Having the hives break open to sores suggest dermatophillus that was preceeded by a allergic reaction to the organism but without actually looking at the lesions I am way out on a limb here.

The ongoing depressions worries me more than anything else and it is difficult to recommend treatment. A lot of times severe allergic reactions will have some characteristics that suggest infection. The most effective treatment for this type of allergic reaction is steroids but if infection is present the steroid may potentiate it. It is a decision for your vet: If the predominant sympotomolgy seems allergic, steroids with antibiotics to cover your rear would make sense, if infection predominates specific and pallative treatment needs to be catered to the type infection.
DrO

Posted on Saturday, Feb 26, 2000 - 8:35 am:

Hi Nina,
Just want to say I am so sorry for all of your horse troubles. It's horrible when they all seem to happen at once! My horses, so far, have remained out of serious harms way. But within one year I lost every other animal I loved! Which included a Rotty, a Fila, 3 cats and a 4 ft iguana. I loved them all dearly and am still trying to regroup from the tragedies.
Best of luck with your dear stallion.
~barbara

Posted on Saturday, Feb 26, 2000 - 12:14 pm:

Hi Nina. I have a goat who has diagnosed pemphigus. In addition to the sores that she got, she also had difficulty moving around--like severe arthritis. The vet had to get a skin sample of one of the lesions, then send it to a lab for diagnosis. The lab found that it was either pemphigus or a zinc deficiency (!?!) Since I have two other goats who are symptom free, he thought it was pemphigus. Initially, I gave her dexamethadone injections. She hated getting shots!!! I then started giving her the injectable liquid on sweet feed. This works. She gobbles in right up. The goat weighs about 80--90 pounds and got 3cc's daily, then every other day, every three days and finally discontinued treatment. I have had to repeat this sequence three times in the past year. I don't know what the ultimate prognosis is, but this, at least, buys her some time. There are sites that offer information on pemphigus--just search on any of the search engines. I would strongly recommend that your vet actually send a skin sample to the lab so you can know if it is pemphigus or something else. Good luck to you and your horse.

Posted on Saturday, Feb 26, 2000 - 12:16 pm:

Thank you Barbara and Dr. Oglesby for your kind responses. I've spent some time reading other posts in related areas of Horseman's Advisor and I came across something NEW to torture myself with. It seems that I may have given my horse this problem unwittingly. I bought a "natural" product called Bute-Less and gave it to him for his very minor arthritic hock problem. He did begin to manifest these symptoms a couple of days after I began to dose him with the Bute-Less.

The lesions on his skin are drying and scabbed over. I continue with the Betadine scrubs. The three small lesions in his mouth are getting smaller, but he still only wants to eat his grass hay and will also eat the grass on his daily outing. Last night he also ate a BIG mouthful of dirt.

I am to call my vet in a couple of hours for the results of the latest tests. He is a good vet and always looks out for both the interests of the horses and for our human limitations. I think I pushed him pretty hard for a "what if" when he named the autoimmune possibility.

Hopefully we will unravel more of the mystery today. I also wonder whether there is anything to my observation that not all horses handle pain very well. This horse, and his full brother, are both very sensitive and have always sought out a great deal of human comfort and attention. When something seeminly minor affects their health they seem to stress over it more than the other horses. If I spend extra time with them, they don't seem to get as sick. Unfortunately, I had been struck by the latest influenza epidemic and had left the chores to another person who was prompt and fed on schedule, but provided no "extra" attention.

Nina

Posted on Sunday, Feb 27, 2000 - 8:13 am:

Hello Nina,
Don't be too fast to make any particular diagnosis or blame any particular substance. It might close your eyes to other possibilites. Right now collect all the information you can and the Bute-Less temporal correlation is just one piece of this puzzle and possibly a red herring. When you find something that allows the pieces to fall together you got it.
DrO

Posted on Monday, Feb 28, 2000 - 1:16 pm:

I need advice fast. I just got a call from my vet telling me that my stallion is in liver failure. He said it may be time to put him down. I was in shock at the moment of the phone call, and the horse had been extremely lethargic, still with overly pink gums and tongue and refusing all feed except grass and hay over the weekend. I just didn't expect such a swift decision to put him down. I told the vet I'd call him back after I made arrangements for disposal of the body of the horse. Then it struck me that just because he is in liver failure does not mean he has cancer (which is what the vet thought most probable). I raced to read your article on Liver Diseases, and frankly, I'm not sure this horse is at the stage to be put down just yet. He is has been "on his own" with these symptoms for nearly a week now, and while he is losing weight, he has not been recumbent, and even though his water comsumption has been at about half of normal, he has not received IV hydration. I took a close look at his eyes and gums and have to admit I see a slight yellowing...in his eyes it is more of an "off white" look than true yellow. In the gums, which today have lost the dark pink and begin to look more normal, I can see maybe some streaks of yellow. With the horse not in total failure and still eating hay and drinking water, I feel like I can afford to take a couple of days to make this decision. What further tests should I ask for? I have access to taking this horse to the University of Missouri Veterinary School if my vet will schedule it. I'm wondering why he immediately went to the euthanasia mode. I took my horse out to eat grass today and he ate as long as I'd let him. He then ate several carrots (2 lbs to be exact) with relish. When I put him back in his stall, he went to his hay manger and ate his grass hay. Today he perked up and put his head out over the stall door to greet me. Am I denying reality? The skin lesions have dried and no longer seem to itch him. The mouth sore (smaller than my little fingernail) is resolving. I'm not opposed to ending the suffering of the animal if all hope of good quality of life is gone...but I don't want to kill a horse that might recover. I'm terribly confused and distraught.
Nina

Posted on Monday, Feb 28, 2000 - 1:32 pm:

Oh dear, this is terrible for you, I'm not surprised you are feeling confused and distraught. If it were me, I think I would take him to the University of Missouri Veterinary School if it is thought that they could help him and not cause him pain or stress with unnecessary tests. I think you must have a long, long talk with your vet - tell him that he is eating grass, ate 2 lbs of carrots with relish, etc. It is a terrible time and a terrible decision, which only you and your vet can make. My thoughts will be with you.
Alexa

Posted on Tuesday, Feb 29, 2000 - 9:49 am:

I responded in greater detail to this in your new post under Liver Disease. Essentially I concur with Alexa, refer him.
DrO
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