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  Discussion on Is it strangles? Please help. Thank you.
Author Message
Member:
Sunny66

Posted on Sunday, Jul 2, 2006 - 12:09 am:

Hi Dr. O,

I know I’m not supposed to do this, but someone I know is just at her wits end. If you see anything the vets are missing it would be greatly appreciated. This is a two or three year old arab cross.

April 26 her horse was diagnosed with “the worst case of strangles he’s seen. Starting to colic. Off she went to the hospital.

Over the weekend, he colicked (repeatedly), colitis set in due to antibiotics, he was sloughing great big huge chunks of his colon, termination of the antibiotics caused a return of the fever and his face began to swell with more abcesses.

It has been a weekend of hell and several times we wondered if he was going to make it. After his return to hospital on Tuesday for evaluation/admittance, they confirmed through a myriad of various and expensive tests that he had the following issues: colic, antibiotic induced colitis, strangles, AND ulcers to boot.

There were forty some odd days they fought it at the hospital with several types of antibiotics that all had to be discontinued due to colitis before he eventually seemed to fight it off.

THEN TODAY

He was DrOoling and his jaw was swollen, after getting some dental work done – two caps I think…

“Now I'm really worried but I'm keeping it together. I call the vet who then tells me that yes, he'll be DrOoling for maybe another day or two. He was a little thrown when I told him that the swelling had increased rather than decreased, but said that too could happen. When I told him about the fever, he got really quiet and informed me that this is treading new water for him. He believes it is possible that the temp is up due to his tooth issue but doubtful. The fever was very "suspicious". He also mentioned that the vets were still scratching their heads over his first visit and that when it comes to this horse, the textbook is out the window. They will be consulting this evening and we'll see where to go from here.

Is it strangles that he was never really over? Could he have had a tooth problem in conjunction with some sort of a secondary infection less than a month after coming home from being ill with strangles? I'm kicking myself that I didn't pull a blood panel last night. I said I was going to and I didn't because we were so OVERJOYED at finding the cause of the problem and having it be so minor. I suppose whether we pulled the blood last night or Monday it is what it is. A couple of days won't matter one way or another.

Has anyone had any type of experience with anything of this nature? Do you know of a horse that appeared to recover but couldn't get over an infection? Anything at all would help at this point. He is eating--he never really stopped eating when he was so ill before--he doesn't appear to be in respiratory distress. So we're not in total panic mode yet. Ever the optimist I suppose. I'm off to start hotpacking his face when he finishes dinner, but I am open to suggestions.

Is it strangles, is it not? If it is, do we try antibiotics again, or not? Let him fight it on his own or rush back to the hospital? Now that we have fever again, it's back to the banamine...which caused his ulcers.....which caused the colic. I feel like I am on a horrible merry go round I can't get off of.

I don't know that this IS strangles, if it's not why the fever? I feel like a complete and utter failure.

If you know of anyone that has had any type of experience with this, I'd appreciate any information. My hands are literally tied until we get through the next couple of days and figure out if it is strangles.

This post is a mixture of quotes from the owner.

Again, I'm sorry, but I'll ask her to join your site!
New Member:
Acolori

Posted on Sunday, Jul 2, 2006 - 1:32 am:

I hope this isn't termed as "interrupting" Aileen's discussion thread, but the horse in question is my horse. Aileen referred me to this site in the hopes that there would be some suggestion or answers that can help me.

We keep three horses here on our property. A yearling, a two-year old, and the three-year old in question. The yearling developed a significant fever and slight cough the late part of March. The vet asked us to keep an especially sharp eye for swelling in his under his jaw. No abcesses or other symptoms occurred and the yearling recovered within a week or two. Shortly after that, the two-year old developed a small abcess under his jaw with no other symptoms. Not even fever. Vet thinks more than likely strangles, but third horse has already been exposed so isolation is no help. The three-year old was the only one that had been vaccinated against strangles so we were in a wait and watch situation.

The three-year old a short time later developed the high fever, some coughs and snots, and his submandibular area began to swell. We were almost expecting that. What we were not expecting was to get up two days later to find him foaming at the mouth in respiratory distress. He was rushed to UC Davis with an extremely high white count and fibrinogen in excess of a thousand. They suspected bastard strangles. They also perfomed a tracheotomy in order to help him breathe. They did x-rays and ultrasound and were unable to locate any internal abcesses. The vets felt antibiotics were essential and started him several different types which all caused him to break with severe colitis. The last antibiotic caused such severe colitis he began sloughing off pieces of his colon. The next forty some odd days were spent with him trying different antibiotics and having to terminate them due to his intolerance, him rallying, then new abcesses forming, rallying again, and new abcesses. His guttural pouches were abcessed, submandibular abcesses, abcesses forward of those under his tongue, and eventually up onto his lips on one side and on top of his nasal cavity on the same side. You could see the progression the abcesses were making almost in a straight line. The one on his nasal cavity was the last one to form.

We bring him home at that point. No more fever. No more abcesses and he seemed to be tolerating the last antibiotic well. The next day he began to colic, sloughing pieces of his colon, and not eating. Back to Davis for a diagnosis of antibiotic induced colitis and colic caused by ulcers from the month and a half of banamine.

He has been home approximately a month since then. He's been doing great, putting on weight, perking up. He's been on Ulcer Guard since. Yesterday, I noticed him DrOoling/foaming at the mouth again. His muzzle is swollen slightly on one side--the opposite side as the last strangles abcesses--and he was suddenly extremely head shy and it was difficult to examine his mouth. No fever. The vet examined him last night and thought his muzzle might be swollen due to a slight ulceration of his mouth by a sharp cap. He popped the cap off and asked me to monitor him over the next couple of days.

Today his face is twice as swollen as it was yesterday and he is still foaming at the mouth. I expected that due to the work that was done on him last night. But he also has a fever of 103 which frightens me. When I called the vet and mentioned the DrOoling and swelling originally, he was worried that the strangles was never really gone and here we go again. He felt much better knowing that he didn't have a fever, but now he does. We're pulling labs on Monday in an attempt to determine what is going on.

Can a horse appear to have recovered from strangles and scope clear only to start with more abcesses weeks later? If this is a continuation of the strangles saga, is there a reasonable expectation that he will ever recover fully? Can popping a cap cause him to spike such a high fever?

I feel completely lost and the thought of another 45 days with him in intensive care leaves me chilled. I don't know what else to do or what other questions to ask.

Is there anything that you could suggest?

Thank you.
Member:
Erika

Posted on Sunday, Jul 2, 2006 - 9:40 am:

Ugh! Strangles is such a mess!

Aileen, you asked if anyone else has seen this. My friends horse is currently undergoing a milder version of what William's horse is experiencing.

The horse was vaccinated when strangles broke out on the farm--so was mine, but she got it anyway. This horse, Bandit, however didn't get it until months after everyone else recovered.

Everything seemed routine, the horse seemed to recover well, and weeks later they noticed his gums were all ulcered, and he was extremely lame on a hind foot that within days swelled grotesquely all the way up to the hock.

Vet did not come out but pronounced it Bastard Strangles.

I wonder if there is a particular strain of strangles that is unusually hard to get rid of? It is usually just annoying and disgusting but these two cases are so much more.

Good luck on recovery, William.
Erika
Member:
Sunny66

Posted on Sunday, Jul 2, 2006 - 9:55 am:

Can you put a picture up? You'll need to reduce it tho. Dr. O can help more if he can see what's going on and if you fill out your profile it gives him some background.

I do hope your boy is feeling better this morning, you have been through so very much.

Don't be disheartened if Dr. O doesn't answer today, it's his day off...but hopefully he'll check in on this.

edited to say thank you to Erika. Your input is much appreciated.
Moderator:
DrO

Posted on Sunday, Jul 2, 2006 - 7:02 pm:

Welcome William,
A day off...? We do tend to travel a lot during the weekends but there are not many days we take off. Taking your questions in order William:

Can a horse appear to have recovered from strangles and scope clear only to start with more abcesses weeks later?

Yes

If this is a continuation of the strangles saga, is there a reasonable expectation that he will ever recover fully?

Yes the prognosis is fair to good.

Can popping a cap cause him to spike such a high fever?

Probably not

Is there anything that you could suggest?

I think you need to be back on bute or flunixin (Banamine) till the fever and swelling reduce and antibiotics. If life threatening complications occur you should consider a short course of steroids. Though we have specific recommendations in the article the problems you have had make me slow to suggest a particular antibiotic. Is there one that culture has shown effective that the horse has tolerated well or you have not tried yet for detailed recommendations on antibiotics and course to therapy see the treatment of bastard strangles in the article.
DrO
Member:
Sunny66

Posted on Sunday, Jul 2, 2006 - 8:16 pm:

Dr. O, you're even more dedicated than I thought... and that is a LOT. Thank you.
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