Category Archives: Blood work

Does Your Horse Need Electrolytes?

By. Casie Bazay

It’s summer, aka the sweatiest time of the year. Hooray!

And while sure, there are things to enjoy (like swimming, ice cubes, and air conditioning), outdoor activities such as barn chores and riding often leave us reaching for a Gatorade. But what about our horses? Do they need the equine equivalent of a sports drink full of electrolytes too?

First off, let’s discuss what electrolytes are exactly and a little bit about how they function in the body. Electrolytes are minerals that help to regulate many bodily processes. The main ones include Sodium (Na), Chloride (Cl), Potassium (K), Magnesium (Mg), and Calcium (Ca).

In solid form, electrolytes bond into salts (such as sodium chloride) but when dissolved in water, they break down into individual ions, which carry a positive or negative charge. These charges allow them to conduct electricity and assist in electrochemical processes such as regulating heartbeat and muscle contraction.

But wait, electrolytes do more! They also aid in moving fluids in and out of cells and help the body to absorb nutrients. Without electrolytes, the water your horse drinks cannot be properly retained or utilized by the body.

In short, electrolytes are super important.

Like us, horses lose electrolytes through sweat, urine, and feces. Most of these minerals are replaced when your horse consumes grass, hay, and/or feed, with the exception being sodium and chloride, which should always be supplemented with either a salt block or loose salt.

So let’s get back to the question at hand: do horses need added electrolytes in the summer?

The answer depends on how much they’re sweating. If your horse sweats for a prolonged period of time, either because of high temperatures and/or humidity, intense exercise, or all of the above, electrolyte losses can be high and therefore will need to be supplemented.

This goes for endurance horses and those competing in three-day eventing or possibly long-distance trail riding. Electrolyte supplementation is also a good idea if a horse is being shipped long distance in hot weather and for those with Cushing’s disease who may sweat more just standing in the pasture.

How to feed electrolytes

Electrolytes can generally be supplemented in feed, added to water, or in paste or gel form. After a period of prolonged sweating, it’s recommended that electrolytes be provided for several days to make up for losses. You can even give electrolytes to your horse before a big event if you know he’s likely to be sweating a great deal. Continue to give electrolytes during the event as well.

When looking for an electrolyte supplement, make sure that sodium chloride is first on the list of ingredients, followed by potassium chloride. Many electrolytes are sugar-based and while horses may prefer them, they aren’t as effective.

With that said, it’s not a good idea to over-supplement with electrolytes, especially if your horse isn’t sweating much as they may irritate the digestive tract or even throw your horse’s mineral balance out of whack.

Many horses won’t need electrolytes at all in summer, but if your horse does, remember to supplement wisely! 

What a Difference 3 Weeks Can Make

Tilly came to me from a slaughter auction in Texas after 17-ish years as an Amish workhorse.  She was thin (she still is), sick (upper respiratory infection) had cracked hooves, had never had her teeth floated (they made a horrible grinding and clicking sound when she ate), and apparently had never been clipped or bathed or worn a blanket.  I do not think she had ever even had a treat (she still won’t take an apple or carrot).  

SYMPTOMS:

  • Rumbling gut
  • Cow pie stools
  • Grinding/clicking teeth
  • Cracked hooves
  • Dull coat
  • Underweight
  • Running nose

PROFESSIONALS:

  • Farrier for evaluation and trimming
  • Dentist for power float of teeth
  • Vet for physical, blood work, and fecal

TESTING/RESULTS:

  • CBC: all in normal range aside from her creatinine and protein suggesting dehydration. These values normalized after about 1 week)
  • Fecal: Minimal

FEED:

  • Triple Crown Senior Feed (Low sugars, low starch, high fat)
  • Tons of water with Horse Quencher added
  • Salt block

MEDICATIONS:

  • Exceed injections (2 total a week apart) then SMZ for 2 weeks
  • Banamine
  • Brewer’s Yeast (Stomach)
  • BioSponge (Gut health and to tackle her loose stools)
  • Electrolytes (To help with dehydration)
  • Strongid wormer 

 

 

Top to bottom:

Tilly on her way from Texas

Tilly when she first arrived in Virginia

Her feet upon arrival

Getting her teeth and feet done

Tilly after being clipped and bathed!

Resources for Chronic Loose Stools in Horses

 

BEST Guide to all Things Colitis, Diarrhea, and Intestinal Health

Age-Defying Equines

Diarrhea and Fecal Water Syndrome in Horses

What Comes Out, What Goes In

Practical Biosecurity Tips to Protect Your Horses – The Horse

Learn equine biosecurity basics for the farm, horse show, and breeding shed to protect your horses from infectious diseases.
— Read on thehorse.com/features/practical-biosecurity-tips-to-protect-your-horse/

Fat Little Donkey

I have been desperately trying to get my miniature donkey, Lucky, to drop some lbs.  The thing with Lucky- he literally gained weight overnight.  One day he was a skinny mini and the next he had a potbelly.  I was really concerned that the weight suddenly appeared and had the vet run a heptic panel to ensure he wasn’t experiencing some sort of liver dysfunction.  Sort of like how humans can develop Ascites when they have liver related disease.  Anyways, his blood work came back and all was okay….he was just fat!  

Unlike horses, donkeys develop “fat deposits” around their neck, abdomen, and butt and even once the weight has been lost the deposits stay for life!  


The Dangers of Obesity in Donkeys


 

According to the Scarsdale Vets;

“Obesity increases the risk of developing hyperlipaemia and laminitis, both of which can be fatal. Prevention of obesity is better than cure, because rapid loss of condition in overweight donkeys can trigger hyperlipaemia.

Hyperlipaemia is a condition in which triglycerides (fats) are released into the circulation which can result in organ failure and death unless treated rapidly. The early signs of dullness and reduced appetite can be difficult to detect. Hyperlipaemia can be triggered by anything that causes a reduction in food intake e.g. stress, transport, dental disease.

 

Laminitis is a condition in which there is inflammation in the laminae of the foot that connect the pedal bone to the hoof wall. This can progress to rotation or sinking of the pedal bone within the foot. The cause is not fully understood and many factors are involved but obese animals are more prone to develop the disease.”

Equine Metabolic Syndrome: “Overweight donkeys often develop a fat, crest neck and fat pads around their tail base. When this occurs the donkey can develop a metabolic disease known as ‘Equine Metabolic Syndrome’. This causes insulin resistance and increased levels of blood glucose (blood sugar) in the blood stream. In equids this can lead to recurrent episodes of laminitis or founder. This disease involves inflammation of the white lining or laminar junctions of the feet, extreme foot pain and difficulty walking. In severe cases this can also cause changes in the bone of the foot and hoof wall” (Yarra Ranges Animal Clinic)


How To Help Your Donkey Lose Weight Safely


  1. Use a muzzle
  2. Limit grazing
  3. Ask your vet to do blood work to ensure your donkey is healthy
  4. Have the dentist come out and examine the donkey’s teeth
  5. Engage in an exercise routine

 


Donkey Related Resources and Information


 

donkeyscoring

DonkeyBCS3posterDonkey Body Scoring by Dr_ Judy Marteniuk

Donkey BCScoring

A Guide to Weight Management and Body Score

Care of the Miniature Donkey

Donkey Health and Welfare

Feed_Donkey_Flyer

Misunderstood, Misused, & Misdiagnosed Disease #2: Lyme Disease

I hope you enjoyed reading about Misunderstood, Misused, & Misdiagnosed Disease #1: EPM.  In that post I explained how some horse enthusiasts (trainers, owners, etc) have used this disease to e…

Source: Misunderstood, Misused, & Misdiagnosed Disease #2: Lyme Disease

Immune Booster Leads to Infection?

For the past 6 weeks, my horse has been receiving Ozonetherapy to aid in his chronic back leg related issues- dermatitis (“scratches”), previous DDFT tendon laceration, a history of Lymphingitis, and the residual scar tissue from his DDFT injury.  Due to his age (27), he lacks proper circulation in his hind end which does not help him fight his pastern dermatitis.  


According to the American Academy of Ozonetherapy, Ozonetherapy is described as;

“Ozonotherapy is the use of medical grade ozone, a highly reactive form of pure oxygen, to create a curative response in the body. The body has the potential to renew and regenerate itself. When it becomes sick it is because this potential has been blocked. The reactive properties of ozone stimulate the body to remove many of these impediments thus allowing the body to do what it does best – heal itself.”

“Ozonotherapy has been and continues to be used in European clinics and hospitals for over fifty years. It was even used here in the United States in a limited capacity in the early part of the 20th century. There are professional medical ozonotherapy societies in over ten countries worldwide. Recently, the International Scientific Committee on Ozonotherapy (ISCO3) was formed to help establish standardized scientific principles for ozonotherapy. The president of the AAO, Frank Shallenberger, MD is a founding member of the ISCO3.”

“Ozonotherapy was introduced into the United States in the early 80’s, and has been increasingly used in recent decades. It has been found useful in various diseases;

  • It activates the immune system in infectious diseases.
  • It improves the cellular utilization of oxygen that reduces ischemia in cardiovascular diseases, and in many of the infirmities of aging.
  • It causes the release of growth factors that stimulate damaged joints and degenerative discs to regenerate.
  • It can dramatically reduce or even eliminate many cases of chronic pain through its action on pain receptors.
  • Published papers have demonstrated its healing effects on interstitial cystitis, chronic hepatitis, herpes infections, dental infections, diabetes, and macular degeneration.”

 

After doing research and speaking to one of my good friends, we determined that Chance’s flare up of Lymphingitis, after almost 3 years of not a single issue, could possibly be caused by his immune system’s response to Ozonetherapy.  Let me explain.

Chance suffers from persistent Pastern dermatitis (“scratches”) since I purchased him in 2000.  I have tried everything- antibiotics, every cream and ointment and spray for scratches, diaper rash ointment, iodine and vaseline mix, Swat, laser treatments, scrubs and shampoos, shaving the area, wrapping the area, light therapy…you name it, I have tried it.  So, when we began Ozonetherapy to help break down the left over scar tissue from his old DDFT injury, I noticed that his scratches were drying up and falling off.  We continued administering the Ozonetherapy once a week for about 6 weeks.  The improvement was dramatic!  

However, one day Chance woke up with severe swelling in his left hind leg and obviously, he had difficulty walking.  He received Prevacox and was stall bound for 24 hours.  The vet was called and she arranged to come out the following day.  The next morning, Chance’s left leg was still huge and he was having trouble putting weight on it.  I did the typical leg treatments- icing, wrapping.  The swelling remained.  I tried to get him out of his stall to cold hose his leg and give him a bath but he would not budge.  He was sweaty and breathing heavily and intermittently shivering.  So, I gave him an alcohol and water sponge bath and continued to ice his back legs.   I sat with him for 4 hours waiting for the vet to arrive.  He had a fever and wasn’t interested in eating and his gut sounds were not as audible.  He was drinking, going to the bathroom, and engaging with me.  I debated giving him Banamine but did not want it to mask anything when the vet did arrive.  

The vet arrived, gave him a shot of Banamine and an antihistamine and confirmed that Chance had a fever of 102 degrees and had Lymphingitis.  There was no visible abrasion, puncture, or lump… I asked the vet to do x-rays to ensure that he did not have a break in his leg.  The x-rays confirmed that there was no break.  The vet suggested a regiment of antibiotics, steroids (I really am against using steroids due to the short-term and long-term side effects but in this case, I would try anything to make sure he was comfortable) , prevacox, and a antacid to protect Chance from stomach related issues from the medications.  It was also advised to continue to cold hose or ice and keep his legs wrapped and Chance stall bound.  

The following day, Chance’s legs were still swollen but his fever had broken.  The vet called to say that the CBC had come back and that his WBC was about 14,00o. She suggested that we stop the steroids and do the antibiotic 2x a day and add in Banamine. I asked her if she could order Baytril (a strong antibiotic that Chance has responded well to in the past) just in case.  And that is what we did.  

Being as Chance had such a strong reaction to whatever it was, I did some thinking, discussing, and researching…first and foremost, why did Chance have such an extreme flare up of Lymphingitis when he was the healthiest he has ever been?  And especially since he had not had a flare up in 3+ years…plus, his scratches were getting better not worse.  The Ozonetherapy boosted his immune system and should provide him with a stronger defense against bacteria, virus’, etc.  So why exactly was he having a flare up?  And that is when it hit me!

In the past when Chance began his regiment of Transfer Factor (an all natural immune booster), he broke out in hives.  The vet had come out and she felt it was due to the Transfer Factor causing his immune system to become “too strong” and so it began fighting without there being anything to fight, thus the hives.  My theory- Chance started the Ozonetherapy and his body began to fight off the scratches by boosting his immune system.  As the treatments continued, his immune system began to attack the scratches tenfold.  This resulted in his Lymphatic system to respond, his WBC to increase, and his body temperature to spike.  Makes sense…but what can I do to ensure this is not going to happen again?  

My friend suggested attacking the antibiotic resistant bacteria by out smarting them…okay, that seems simple enough…we researched the optimal enviroments for the 3 types of bacteria present where Chance’s scratches are (shown in the results of a past skin scape test).  The bacteria – E. Coli, pseudomonas aeruginosa and providencia Rettgeri. The literature stated that PA was commonly found in individuals with diabetes…diabetes…SUGAR!  How much sugar was in Chance’s feed?  I looked and Nutrina Safe Choice Senior feed is low in sugar…so that is not it.  What else can we find out?  The optimal temperature for all three bacteria is around 37 degrees celsius (or 98.6 degrees fahrenheit), with a pH of 7.0, and a wet environment. Okay, so, a pH of 7.0 is a neutral.  Which means if the external enviroment (the hind legs)pH is thrown off, either to an acidic or alkaline pH, the bacteria will not have the optimal enviroment to continue growing and multiplying.  How can I change the pH?  

Vinegar!  An antimicrobial and a 5% acetic acid! And…vinegar is shown to help kill mycobacteria such as drug-resistant tuberculosis and an effective way to clean produce; it is considered the fastest, safest, and more effective than the use of antibacterial soap.  Legend even says that in France during the Black Plague, four thieves were able to rob the homes of those sick with the plague and not become infected.  They were said to have purchased a potion made of garlic soaked in vinegar which protected them.  Variants of the recipe, now called “Four Thieves Vinegar” has continued to be passed down and used for hundreds of years (Hunter, R., 1894).

I went to the store, purchased distilled vinegar and a spray bottle and headed to the farm.  I cleaned his scratches and sprayed the infected areas with vinegar.  I am excited to see whether our hypothesis is correct or not…I will keep you posted!

 


References & Information


Effect of pH on Drug Resistent Bacteriaijs-43-1-174

NIH: Drug Resistant Bacteria

Vinegar

Lymphatic Conditions

Horses Side Vet Guide

What does my horse’s CBC mean?

th

Nutrena SC Senior feed ingredience
The American Academy of Ozonetherapy

Hunter, Robert (1894). The Encyclopaedic Dictionary. Toronto: T.J. Ford. ISBN 0-665-85186-3.

 

I Loathe Ticks! 

Your horse comes in from being outside and is barely able to move.  His legs are swollen, he has a fever, is sensitive to the touch, and has a loss of appetite.  He has chills- intermittently shaking.  He wont touch his hay, his eyes are dull, and he looks depressed and tired.  You call the vet and they run hundreds of dollars worth of tests- CBC, x-ray his legs to ensure there is no fracture; they diagnose him with Lymphingitis.  You begin a course of antibiotics.  You cold hose.  You give him Banamine.  Your wrap his legs while he is on stall rest. A week later, the swelling has subsided, his fever has dissipated, and his appetite is back.

You get a text saying that your horse “ran away” when he had been let out earlier that day.  But when you get to the barn, you notice when he turns he looks like his hind end is falling out from under him..remember when you were little and someone would kick into the back of your knees and your legs would buckle?  That is what it looks like.  So you watch him.  You are holding your breath, hoping he is just weak from stall rest.  You decide, based on the vet’s recommendation, to let him stay outside for the evening.  You take extra measures- leaving his stall open, with the light on, wrapping his legs, etc- and go home.  Every time your mind goes to “what if..”, you reassure yourself that your horse is going to be okay and that you’re following the vet’s advice and after all, your horse had been running around earlier that day.

The next morning your horse comes inside and it takes him an hour to walk from the paddock to his stall.  All four legs are swollen.  He has a fever (101.5).  He is covered in sweat.  He won’t touch his food.  He has scrapes all over his body and looks like he fell.  You call the vet- again- and they come out to look at him.  They note his back sensitivity, his fever, the swelling at his joints (especially the front).  They note that his Lymphingitis seems to have come back.  The vet draws blood to check for Lyme.  They start him on SMZs and Prevacox.  You once again wrap his legs, ice his joints, give him a sponge bath with alcohol and cool water to bring down his fever.  You brush him, change his water, put extra fans directed at his stall.  You put down extra shavings.  And you watch him.

A few days go by and you get a call saying that your horse has tested positive for Lyme…and while your heart sinks, you are also relieved that there is an explanation for your horse’s recent symptoms. You plan to begin antibiotics and pretty much not breathe for the next 30+ days while your horse is pumped with antibiotics.  You pray that he doesn’t colic.  You pray that you have caught Lymes in time.  You pray that the damage is reversible.  You research everything you can on the disease.  And you sit and wait….

Below are resources on Lyme Disease in horses- treatments, symptoms, the course of the disease, and the prognosis.

epm-diagram

Lyme Disease in Horses | TheHorse.com

Lyme Disease, testing and treatment considerations | Best Horse Practices

Microsoft Word – Lyme Multiplex testing for horses at Cornell_2-12-14 –

Lyme_Disease_Multiplex_Testing_for_Horses.pdf

Recommended Equine Professionals and Services

 True North Equine Vets  www.truenorthequinevets.com   540-364-9111

Genesis Farriers: Dave Giza www.genesisfarriers.com   571-921-5822

Ken Pankow  www.horsedentistvirginia.com  540-675-3815

Full Circle Equine www.fullcircleequine.com  540-937-1754

Farriers Depot:  (Farrier related supplies) www.farriersdepot.com 352-840-0106

StemVet (Stem cell acquisition and storage) www.vet-stem.com

SmartPak Equine Supplements  www.smartpakequine.com

 

 

 

 

 

   

 

 

 

 

 

 

 

 

 

I have a limp!

Resources on how to diagnose, treat, prevent, and handle lameness in horses

Your Horse Has a Swollen Leg – Why and What To Do | EquiMed – Horse Health Matters

All About the Fetlock

Fetlock Lameness – It’s importance… | The Horse Magazine – Australia’s Leading Equestrian Magazine

Causes of Equine Lameness | EquiMed – Horse Health Matters

 

Common Causes of Lameness in the Fetlock

fetlock lame

 

Equine Podiatry

Medical History


  1. DDFT Lesion on right hind
  2. Cervical Spine Arthritis
  3. Hip discomfort due to past fall

Past Treatments Tried


  1. Stem Cell Injections: Healed the DDFT lesion in right hind until recently the lesion began to reappear
  2. Ozone Therapy: Assists in the healing of tissues
  3. Shock Wave Therapy: Assists in the healing of tissue
  4. Chriopractic adjustments
  5. Acupuncture
  6. Supplements

Initial Consultation


Chance showed decreased movement in his right hip and a audible cracking noise at the suspensory joint.  He has edema of both hind fetlocks, Pastern, and Pastern Dermatitis.  Chance was unshawed on both hinds due to his inability to stand for long periods of time and his decreased mobility.  However, his front adorned clips.

Due to the length of Chance’s front toes and the height of his heels he was unable to evenly distribute his weight (60/40) to his front and hind ends.  This would most likely cause increased tension on the DDFT tendons and corresponding ligaments resulting in an increased likelihood of tendon and ligament related injuries.  The uneven distribution of weight could also inhibit the horse’s range of motion through his hips resulting in his body compensating for this injury and causing ataxia (balance issues), pain, arthritic changes, and cervical spine misalignment.

By shortening the toe of both front feet, the heel will rise allowing a more even distribution of his weight.


Front


IMG_3193

IMG_3196


Final Product: Front


Trimmed feet to corrected to the following specifications:

Foot   Beginning Angle & Toe       Corrected Angles & Toe   Total P.C.

L/F    47 Degrees at  3 7/8 inches   53 Degrees at 3 inches         6 Degrees

R/F    45 Degrees at 3 3/4 inches    54 Degrees at 3 inches         9 Degrees


Hind


20160604_160438


Final Product: Hind


20160609_153622

 Return visit to trim and shoe Chance’s hind feet with #2 OBRHB Wedge shoes.Trimmed hind feet and corrected to the following specifications:

Foot   Beginning Angle & Toe       Corrected Angles & Toe   Total P.C.

L/H   48 Degrees at 3 7/8 inches    54 Degrees at 3 1/4 inches    6 Degrees

R/H  46 Degrees at 4 1/4 inches     55 Degrees at 3 1/4 inches     9 Degrees

Note: Chance needed to be sedated by veterinarian to complete the trim and shoe his hind feet due to preexisting hip and DDFT issues.

Treating Cellulitis in horses

A common and potentially hazardous infection that can be helped with combining antibiotics, cold hosing, and exercise.

EQUINE Ink

Freedom's left knee was very swollen. You can see the scrape on the outside of the knee.

On Monday night I showed up at the barn around 7:00 p.m. to ride once the day cooled off. To my dismay I found that Freedom’s knee was hugely swollen. I had wrapped his legs because he’d felt a bit stocked up the night before and because the swelling had no where to go except the knee, the effect was horrifying. Visualize a grapefruit.

Almost immediately I saw the cause: a scrape less than an inch long. Before I called the vet I scrubbed the wound to make sure it wasn’t a puncture wound (didn’t look like it to me, but a puncture would where a joint is involved can be very serious). Normally I would also shave the area around the cut but I had sent my clipper blades out to be sharpened!  My guess was cellulitis but since it involved a joint I wanted to makes sure I…

View original post 499 more words

Gator Rubs

Chance was not acting like himself near the end of the snow storm.  He seemed lethargic and gloomy…his appetite was good but the light in his eyes was not as strong.

I called the vet and asked her to please come out. She came out that day and ran a CBC along with going some acupuncture and chiropractic adjustments.  The vet also gave Chance B12 (or as our previous vet called “the old man shot”).

She contacted me after seeing Chance and informed me that she was diagnosing him with an ulcer and thinks that he may have either slipped on the snow and hurt (bruised) his hip or hurt it while rolling.

I asked about the diagnostics that lead to the ulcer diagnosis.  She explained that with horses there are 7 “acupuncture points”.  When they are all reactive 85% of the time the horse has a gastric ulcer. She also went on to explain that with the lethargy and the change in patterns due to the snow a gastric ulcer would be plausible.   They are apparently common when there are changes in the horse’s routine and fairly easy to cure.   She prescribed “Nux” (give 1 teaspoon until gone) and Ranitidine.

I am suppose to let her know if he stops eating or becomes more lethargic.  She felt that he was not at risk for colic because he is eating well and on a high quality feed.  Fingers crossed.

hc-gastric-ulcers


Resources on Gastric Ulcers and Prescribed Medications



Gastric Ulcers in Horses

Ranitidine

Nux Vomica Herbal Medicine

How To Read Equine (Horse and donkey) Blood Work?

I had the vet run some blood work on Luck and Chance as a precaution, because of the “Panic Grass” in Virginia has been causing liver failure in horses, and because I like to do a full work up every 6-12 months.



Chance’s Blood Work



C 1

C 3


L 2


INTERPRETATION OF RESULTS



Elevated Potassium (6.6 mEq/L):

“Low levels indicate depletion and are often a predisposing factor, along with
dehydration, in fatigue, muscle cramps, colic, synchronous diaphragmatic flutter (“th
umps”), diarrhea and other symptoms of exhausted horse syndrome. Even seemingly normal or high-normal levels may in reality be lower, but appear higher due to concentration secondary to dehydration as measured by total protein and albumin levels.
Therefore, levels at the lower end of the normal range should be evaluated relative to concurrent dehydration” (https://www.quia.com/files/quia/users/medicinehawk/2407-Vet/labs.pdf).

Low Sodium:

“Low levels commonly indicate loss through excessive sweating, or through kidney or intestinal disease. Low levels may also be found in young foals with bladder damage. Increased sodium levels are usually a sign of dehydration” (http://www.minstervets.co.uk).

Low Platelets: 

This was the most worrisome in regards to the potential immediate issues that could ensue because of the low platelet count. 

“The platelets are the third cellular component of blood (along with red and
white blood cells). These cells contain a number of biologically active molecules that are
critical to the blood clotting process. Low levels may indicate a number of disease
processes not necessarily directly related to a bleeding disorder. Chronic or acute blood
loss, immune disease, toxemia, liver, spleen or bone marrow disease, or even critically
reduced or increased body temperatures can also cause low platelets counts. Any
significantly low platelet counts should be further investigated by a veterinarian. High
levels are generally clinically insignificant unless the condition persists, in which case it may be indicative of bone marrow neoplastic disease” (Susan Garlinghouse).

Low Glucose:

“Glucose is the source of the body’s energy. It is measured in suspected cases of equine metabolic syndrome and sometimes in cases of equine Cushing’s disease. Blood glucose may also be measured as part of a glucose tolerance test, assessing small intestinal function” (http://www.minstervets.co.uk).

Chance was tested for Cushing’s Disease within the last year and the test showed that he did NOT have Cushings. 
Elevated CPK (337 U/L):

Levels 2-3x the highest number in range are considered significant according to vetstream.com.  Levels are easily increased due to poor handling techniques as well as lab error.

According to Dr. Christine Woodford and Carla Baumgartner on vipsvet.com, “Elevations of CPK and SGOT are indictors of muscle inflammation–tying-up or rhabdomyolysis. The term “rhabdo” means muscle and “myolysis” means rupture of muscle cells. The CPK and SGOT are very sensitive indicators of skeletal muscle damage, and they rise in concentration proportionally with the amount of damage. A bit of timing is required in order to obtain the most sensitive results; CPK rises (due to its leakage from muscle cells into the blood system) approximately six to eight hours after the onset of muscle inflammation, and SGOT rises after approximately 12-14 hours. The absolute peak of CPK concentration and the time it takes to return to normal are important indicators of the severity of muscle damage and the response to therapy.”

Elevated MCV: Is the average volume of red blood cells.

  • Macrocytosis.
  • Indicates immature RBC in circulation (suggests regenerative anemia).
  • Very rare in the horse, but may observe increasing MCV within normal range as horses increase erythropoiesis.

According to Vetstream.com, “Macrocytosis (increased MCV) resulting from release of immature RBC from the bone marrow during regeneration is very rare in the horse therefore the MCV is less useful in the horse than in other species.”

Elevated MCH: Is the average amount of hemoglobin in an individual red blood cell.

  • Hemolysis, if intravascular in nature .
  • Errors can occur during processing

Low RBC:

“You may be inclined to think that red blood cell levels need to drop significantly before they cause a problem for your horse. But the truth is that even low-grade anemia – levels hovering around that 30% range on a PCV – can impact your horse physically and may indicate a health problem. This is especially true for high performance athletes. The greater your horse’s physical condition and demand, the higher on the range of normal her red blood cell counts will typically be. Therefore, a red blood cell level low on the normal range or just below may indicate a concern for a racehorse, for example, where it wouldn’t for that pasture pet.”  See more at: http://www.succeed-equine.com/succeed-blog/2014/02/05/anemia-horses-part-1-just-equine-anemia/#sthash.JJuWN5ob.dpuf


Luck’s blood work



L 1

C 2

Elevated Potassium: Potassium can become elevated for a number of reasons.

According to Vetstream.com,

  • 98% of potassium is intracellular.
  • Changes in serum or plasma potassium levels reflect fluid balance, rate of renal excretion and changes in balance between intra- and extracellular fluid.
  • Hypokalemia increases membrane potential, resulting in hyperpolarization with weakness or paralysis.
  • Hyperkalemia decreases membrane potential with resulting hyperexcitability.
Susan Garlinghouse states that, “High serum levels of potassium during an endurance ride are generally not a concern. These increases often reflect nothing more serious than a delay between blood collection (when potassium is actively sequestered inside cells) and sample measurement (after potassium has had time to “leak” from inside the cells out into the plasma or serum).”  This could also be a result of Luck and Chance running around in the heat when the vet arrived.
Increased [potassium] (hyperkalemia) can occur from;
  • Results can be false due to processing time (ie: if the lab waited too long to process blood sample)
  • Immediately after high intensity exercise.
  • In association with clinical signs in horses with hyperkalemic periodic paraysis (HYPP)    .
  • Bladder rupture (neonate)    .
  • Hypoadrenocorticism  [Pituitary: adenoma]  (rare).
  • Metabolic acidosis.
  • Acute renal failure    .
  • Extensive tissue damage (especially muscle).
  • IV potassium salts, eg potassium benzyl penicillin, potassium chloride    .
  • Phacochromocytoma (rare in the horse).
    Hypokalemia
  • Chronic diarrhea.
  • Diuretic therapy, especially potassium-losing diuretics.
  • Excess bicarbonate/lactate therapy.
  • Chronic liver disease    .
  • Acute renal failure (polyuric phase)    .
  • Recovery from severe trauma.
  • Metabolic/respiratory alkalosis.
  • Prolonged anorexia.
  • Recovery period after high intensity exercise (30-60 min after).
  • Parenteral feeding.

In combination with clinical signs and results of other tests results could signify the following;

Elevated GGTP:

* Donkeys tend to have 3x higher levels then horses.  This means that in stead of the typical equine range being 1-35 U/L a typically donkey’s range would be up to ~105 U/L.  Lucky’s test showed he had 120 U/L which is still elevated but not much.  It took sometime to get Luck from the field when the vet arrived- he ran around non stop.  The excitement and anxiety could be the cause of the elevated levels.

RBC:

Katherine Wilson, DVM, DACVIM, of the Virginia–Maryland Regional College of Veterinary Medicine (See more at: http://equusmagazine.com/article/decode-horses-bloodwork-27122#sthash.sc4J1ISJ.dpuf) explains “RBC count is probably the least helpful information because horses usually don’t have big changes in red blood cell numbers. It is not uncommon for horses to have an RBC count a little lower than normal range, however. The term we use for low RBC is anemia, but unless the count gets very low, a horse doesn’t necessarily need to be treated for that condition. A lot of diseases or any chronic long-term disease can cause mild anemia. Usually if we see mild anemia on the bloodwork and the horse has other issues, the anemia is just an indication that we need to fix/treat another problem.”

Low or Elevated Values

  • Splenic contraction.
  • Polycythemia (rare) .
  • Dehydration.
  • Consider causes of anemia
  • Blood loss    .
  • Hemolysis (i in vivo or artifact).
  • Decreased bone marrow production.
  • Poor technique at sampling.
  • Poor handling and storage of samples.
  • Poor technique in laboratory.

Low Bilirubin:

Heather Smith Thomas of Equus states,  “Another indication of liver health is a pigment called bilirubin, which is formed from the breakdown of red blood cells. Elevated levels can mean unusual loss of red cells or liver dysfunction. However, in horses, unlike other animals, elevated levels of bilirubin often isn’t serious. “This value can increase fairly rapidly when horses go off feed, and this is something that is unique to the horse,” says Wilson. “Often we get phone calls from veterinarians who don’t work on horses much or owners who see the blood work and note that the bilirubin is above normal range and are concerned about liver disease. If the horse is off feed for 24 to 48 hours, that value will increase, but this is just a temporary elevation.”

Elevated Hemoglobin (19 g/dL):

According to vetstream.com, Thoroughbred and other “hot-blooded” horses Hemoglobin range differs from other equine- the thoroughbred range = 11.0-19.0g/l.

Elevated Hematocrit (54 %):

 Elevated levels could be due to;

  • Dehydration.
  • Splenic contraction.
  • Polycythemia .

“A measurement of the relative amount of red blood cells present in a blood
sample. After blood is drawn, a small tube is filled and centrifuged to separate the heavier
blood cells from the lighter white blood cells and the even lighter fluid (plasma or serum)
portion. A higher than normal reading generally indicates dehydration (same number of
cells in less plasma volume) or may be due to splenic contraction secondary to
excitement or the demands of exercise. A low reading may indicate anemia, though not
invariably. Highly fit athletic horses may normally have a slightly lower hematocrit at
rest due to an overall more efficient cardiovascular system. Evaluation of true anemia in
horses requires several blood samples over a 24-hour period” (Susan Garlinghouse, 2000/ http://www.equinedoc.com/PrideProjectInfo.html).

It took sometime to get Luck from the field when the vet arrived- he ran around non stop.  The excitement and anxiety could be the cause of the elevated levels.

Low Sodium:

According to horseprerace.com, “Low levels indicate depletion and are often a predisposing factor, along with dehydration, in fatigue, muscle cramps, colic, synchronous diaphragmatic flutter (“thumps”), diarrhea and other symptoms of exhausted horse syndrome. Even seemingly normal or high-normal levels may in reality be lower, but appear higher due to concentration secondary to dehydration as measured by total protein and albumin levels. Therefore, levels at the lower end of the normal range should be evaluated relative to concurrent dehydration.”



More information on your horse’s blood work

Decoding your horse’s blood work

CBC and Chemistry Profile

A Better Understanding of the Results



The vet suggested that I add water to Luck’s and C’s feed in case their values are due to dehydration. She also explained that some of the values may be a result of running around in the field right before drawing them along with anxiety.  

The anxiety and running around seemed fair but I am hesitant on the dehydration portion.  Yes, I know it is winter and that horses are less likely to drink as much water.  But if it were due to dehydration then the Albumin would be low as well.  But, the blood work revealed that the Albumin was 2.8 (Luck) and 3.2 (Chance).  These values are within the normal range…. that being said, the results could also be due to lab handling especially the Potassium levels.

While speaking with my uncle Jerry (the horse whisperer), he suggested adding a salt block to the horse’s feed.  This will increase the horse’s thirst which will get them  drinking more.  I also added heated water buckets so that the water won’t freeze and in case they are less inclined to drink when the water is cold.

In order to feel comfortable about my horse and donkey being healthy, I will have more blood work done this week to make sure everything is in fact okay.

 

 

A Month Later

Luckily, after about one week of stall rest and hand walking, along with a stronger anti-inflammatory, Chance has begun to show improvements over the last couple weeks of treatment.

Chance has almost completed his first 30 days of EPM treatment and has about a day or so left of the Protazil. He is going to continue his other medications and supplements:

1. SmartPak: senior flex and immune boost
2. Vitamin E
3. MicroLactin (amazing) to help with regrowth of his cells, inflammation, and pain.

As I’m doing research, and trying to come up with a plan of action, once again I am inundated with opinions…medication, exercise, holistic, massage, acupuncture, chiropractic, organic, shoeing, etc.

I know I need to continue therapy, or start a new therapy. But which one do I choose?

Do I go the holistic approach and work with an acupuncturist, chiropractor, massage therapist, and vitamins such as Vita Royals? Do I go organic? Or do I try Marquis? Another month of Protazil? Oraquin-10? Rebalance has been linked to a number of recent deaths in the past handful of months. If I go the organic or holistic approach do I run the risk of the disease progressing? If I go with the medication do I run the risk of yet another “treatment crisis”?

I contacted Vet4 and he suggested doing another round of the Protazil or Marquis.  I decided on trying Marquis and waited for it to arrive.

Chance after a month on Protazil