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  Discussion on Mild case of narcolepsy
Author Message
Member:
Spruss

Posted on Tuesday, Jun 13, 2006 - 8:33 am:

Hi Dr. O,

I wrote you sometime back regarding my 22 year old appendix QH mare who sustained an MCL tear of the stifle and now has some arthritic changes and a moderate effusion. That problem is chronic, but stable at this time.

My new concern is that I believe she has a mild case of narcolepsy as her clinical picture closely matches your description of the disorder in your article. Although I have never witnessed her falling, there have been a couple of occasions where I thought she would and had to startle her to prevent her from doing so. I am wondering if this could worsen her stifle problem if she where to fall.

She most commonly has an issue in her stall or on cross-ties. My concern is that she could really hurt herself in her stall if she were to fall so my intention is to get her free roam between a paddock and a stall to lessen the chance of this. What would your advice be regarding the narcolepsy and the stifle issue? Also I am wondering if there is an increased incidence in dementia or other organic brain diseases in horses who suffer from narcolepsy?
Moderator:
DrO

Posted on Thursday, Jun 15, 2006 - 9:47 am:

Yes, I think a fall could cause further damage to the weakened tissues of the stifle Sherese. If it is in your budget you could consider the use of imipramine as described in the article. With narcolepsy there usually is no progressive brain disorder.
DrO
Member:
Spruss

Posted on Thursday, Jun 15, 2006 - 11:44 pm:

Dr. O,

Given my mare's narcolepsy is very mild with 1 or 2 occurrences every few months, do you think the risk of using imipramine outweights the benefit? I know TCA's have some side effects in humans that limit their use. Have SSRI's been researched in horses? Would TCA or SSRI therapy help with some of her chronic pain issues associated with the stifle even though her pain may not be neuropathic?

Sherese
Member:
Christos

Posted on Friday, Jun 16, 2006 - 5:51 am:

Sherese, think of narcolepsy as a claustrophobic reflex caused by very restrictive tack. This is not a definition, but a good idea to have in mind in order to prevent it.
It can be easily induced (in horses that are predisposed to fainting) by a tight girth, side reins, a curb bit, or, untacked, just feeding them in a corner.
Try tightening the girth very gradually while the horse walks slowly, not using strong bits and sidereins, not working her in a frame (even if she offers it easily) and not feeding her in a corner, and I think you'll never see her falling asleep again.
It is interesting (and a bit sad) to note that all (3) horses I knew who were fainting were very sweet, soft, cooperative characters. Not sleepy or slow, one was a 6yo TB stallion, but very mellow, sweet, soft characters who would die to please you.
Moderator:
DrO

Posted on Friday, Jun 16, 2006 - 11:38 am:

Using both the term "selective serotonin reuptake inhibitor" or one of the more common SSRI's "paroxetine" I cannot find any direct research in horses for this type or related disorder. There is just one reference to a trial in a weaving horse.

The judgement of whether the risk's outweigh the benefits really depends on the details I don't have Sherese. You suggest this is not much of a problem so it sounds like maybe it is not worth the cost/time/risks. As Christos suggests many cases are associated with specific events so perhaps managing around them is a better choice.
DrO
Member:
Spruss

Posted on Friday, Jun 16, 2006 - 2:43 pm:

Thanks for the info, Dr. O. I like the conservative approach far better.
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