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  Discussion on Administering SMZ with oil
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Member:
9193

Posted on Friday, Feb 4, 2005 - 7:01 pm:

Our horse Justin, has recovered from a fractured right lower tooth in October. Three days ago,I noticed our horse had a slightly snotty right nostril. Didn't think much of it, cleaned it out and went riding. Next day, noticed same thing, cleaned it out, made an mental note to keep eye on horse in event that the weather changes might be triggering a cold. Horse is eating well, temperature 100, eyes bright, attitude alert.
Third day, get to barn and right nostril noticeably dripping thick, white discharge. Had our trainer look at discharge and she identified it as pus. I applied warm towels to his right face which allowed the discharge to freely flow.
His temp was still 100 degrees and he is eating his meals completely. There is no noticeable facial swelling, he takes the bit readily, there is no head tossing from tenderness or any thing out of the ordinary except the right nostril discharge.

I called my vet who prescribed a course of SMZ and said to continue the hot packs. He will see him on Tuesday. (Four days from now.)

I have found that adding a tablespoon of corn oil to the dissolved tablets prevents the clumping of the meds in the syringe. Is there any contraindication to mix the SMZ with the oil? Will the oil prevent the absorption of the SMZ in my horse's system?

After reading the article on the overuse of antibiotics, I will admit to a wonderment of whether I should question the administration of SMZ without an exam by the vet. I am not sure if Justin has a sinusitis, an abcess, an infected tooth or what. Is SMZ an appropriate antibiotic to administer with the description of these signs and symptoms?

Appreciate your thoughts,
Debra
Member:
9193

Posted on Saturday, Feb 5, 2005 - 1:23 am:

Oops.. I want to rephrase my last question in my initial post. It sounds like I am questioning my vet and that is not my intention..

What I meant to ask was when a horse presents with a drainage from the nose without any other signs of illness,(fever, cough, depressed appetite) how long could you consider letting the horse fight the problem on their own before going to the next step of administering antibiotics?

Thank you,
Debra
Moderator:
DrO

Posted on Saturday, Feb 5, 2005 - 8:21 am:

The fact that it is a lower tooth makes it unlikely to be the cause of the snotty nose. An acute onset of a remarkable bacterial sinusitis sounds like a good indication for the use of antibiotics. That is the 100 dollar question: what is causing the problem as a primary unilateral bacterial sinusitis is pretty rare. Usually these are secondary to some other problem.

I don't know about the vegtable oil. I find by just adding a little more water and shaking good before admin I avoid the clumping problem. I have noticed different brands seem to need different amounts of water. Recently I had a brand that took about 50 mls of water for 12 tablets.
DrO
Member:
Eoeo

Posted on Saturday, Feb 5, 2005 - 9:22 am:

I use an inexpensive small electric coffee grinder to grind up bute pills, smzs, just about any of them into a powder before mixing in applesauce or you could use water and suck it up into an old bute paste syringe. Works pretty slick. EO
Member:
9193

Posted on Saturday, Feb 5, 2005 - 11:00 pm:

This stuff coming out of his nose has now taken on a more thick yellow consistency different from the white stuff that first came out. He has had four hot pack treatments (30 minutes at a time) and that procedure seems to be soothing to him and certainly promotes the drainage. He has had four doses of the SMZ.

One of the barn folks reminded me that we had a batch of bad hay in September that was loaded with small foxtail type heads. I remember picking a handful out of Justins lower gum and a few under his tongue. The barn owner got rid of it pronto, but could it be possible that one of these little foxtail things has worked its way from an upper gum area into a sinus cavity and caused this problem four months later? If so, could this be a chronic problem or do the little foxtails decompose and somehow exit the body(sinus) in the drainage material?

Of course, some other barn boarders are concerned that he has something contagious. I am being careful to wash my hands with soap and water after dealing with his nose drainage and not run around petting the other horses, but it would seem to me that if he is not running a fever, coughing or acting sick then he is fighting an insult only to his immune system and not spreading it to other horses. Is my reasoning on the right track?

Thank you for your time,
Debra

Member:
Gintx

Posted on Saturday, Feb 5, 2005 - 11:14 pm:

Sure sounds a lot like the symptoms one of our geldings had about 7 years ago. He was diagnosed with Strangles.

Good luck with your horse. Hope he gets better soon. Let us know!
Moderator:
DrO

Posted on Sunday, Feb 6, 2005 - 8:51 am:

I will bet Ginger, if your horse had Strangles, your horse had a fever and the discharge did not come from just one nostril. Debra, I think the foxtail scenerio UNlikely and you can point out that without a fever he is unlikely to have a contagious disease, but not impossible unfortunately.
DrO
Member:
9193

Posted on Sunday, Feb 6, 2005 - 4:43 pm:

Your point is understood Dr O. When my kids were little and I helped out at their school, whenever I saw kids with icky noses, I was dubious to the claim that the kids were not contagious. If different colored stuff is coming out of your nose, best to keep it to yourself...

To that end, we are not turning him out into the common turn outs to graze, but rather hand walking him around to let him munch where other horses haven't been and are unlikely to go. My daughter and I have been careful to wash our hands often with soap and water after handling him. His temp is still 100 and the drainage this morning has thinned out to a yellow serous drainage. I added a 16 gallon bucket to his stall to encourage him to drink as much as he can to prevent dehydration from the SMZ and to hopefully keep the drainage thinned out so it can drain easier.. He looks and acts perky, he just has this stuff coming out of his nose.. Vet is coming on Tuesday, so I'll be curious to hear what he thinks might be going on..

Thank you for your time,
Debra

Moderator:
DrO

Posted on Monday, Feb 7, 2005 - 6:54 am:

If this is improving he may do little more than look at the local lymph nodes and percuss the sinuses, othewise endoscopy and radiographs are the typical.
DrO
PS sorry about the mixed up message earlier you would think by 9am I would have enough coffee to get it right at least by the second edit.
New Member:
Rein

Posted on Monday, Feb 7, 2005 - 8:18 pm:

Debra,

Is there a rotton smell to the discharge? Also, does it drain more when he gets running around?

I've had a few horses with gutteral pouch(spelling?). I can't say I've seen yellow, but usally a clear and/or whiteish color. Sorry to say that this requires surgury.

Good luck,
Michelle

Member:
9193

Posted on Tuesday, Feb 8, 2005 - 3:57 pm:

My vet examined Justin this AM and feels he has a sinusitis in one of the two cavities above his right nostril and below the eye.(Right nostril was draining moderate amount of thick yellow drainage.) Percussion of the sinuses did not reveal any audible difference and horse did not react as if in pain. We are having a dental clinic scheduled for this Friday, so my vet wants to do a thorough exam of his mouth under standing sedation to use the bright lights and dental picks to see if there could be any peridontal disease or communication to the sinus cavity. He also drew blood to do a CBC and check the white count to rule out any systemic presence of infection.

In the meantime, continue with the TMP/SMZ 16 tabs twice daily, continue hot packs to promote drainage, continue to monitor hydration and temp,
and try to manipulate his head to get stuff to drain from one cavity to the other and out his nose. (Using a carrot to encourage him to lift his head in different levels and contortions works the best..) Also taking him out and letting him roll gets stuff draining too. We can ride him in a considerate manner,(WTC) but not to the point of heavy huffing and puffing and exertional sweating

Next steps would be radiographs, change of antibiotics and possible flushing of sinuses, but that is only if he does not respond to this continued course of treatment for the next couple of weeks. My vet feels this will be unlikely, but needed to give me all the options and possiblilities. I am comfortable with our current course of treatment.

Michelle, there has not been nor is there a smell to the discharge. My vet said if there was a gutteral pouch infection there would be drainage from both nostrils because of the location of the pouches at the back of the throat that communicate with the nostril passage. Thank you for forwarding that suggestion. I was wondering about those pouches too..

Dr O. Is there a diagram of the horse's sinus cavities somewhere in the archives of HA? Does anyone have a website they know of that would show a good anatomy of the horses head and related structures?

Thank you all for your consideration and good wishes. I have been appreciative of the suggestions and wonderments. Will keep you posted as to our progress in the next few weeks.

Smiles,
Debra
Moderator:
DrO

Posted on Wednesday, Feb 9, 2005 - 6:51 am:

No we don't have a picture of the sinuses and we should Debra, I will see if I can get something by next week.
DrO
Moderator:
DrO

Posted on Saturday, Feb 19, 2005 - 4:50 pm:

Debra check out References » Equine Illustrations » Head and Mouth » Paranasal Sinuses of the Horse » The Paranasal Sinuses of the Horse. I hope this makes the anatomy clearer.
DrO
New Member:
dwongmd

Posted on Saturday, Mar 21, 2009 - 11:42 am:

would someone be kind enough to give me step by step directions on how to do a nasal flush via nasal passage w/o drilling hole through skull? or is this just not effective. i've been all over the internet looking for instructions and cannot find anything but very vague references to how to do this? thank you
Moderator:
DrO

Posted on Monday, Mar 23, 2009 - 6:40 am:

Welcome DFW,
What area in the nasal region are you trying to flush and what you trying to flush it with or in short, "what disease are you trying to treat?".

It sounds like you may be dealing with a upper respiratory infection and perhaps the best place to start is Diseases of Horses » Respiratory System » Nasal Discharge in the Horse. If after reading the article you still have questions be sure to start a new discussion. The button for this is at the bottom of the article page under the list of already existing discussions.
DrO
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