#1 Abdominal Pain, Colic Signs Perform Whole Horse Exam™ (WHE) Assess Color of Mucous Membranes Assess Demeanor or Attitude Assess Gut or Intestinal Sounds Assess Manure Assess Capillary Refill Time (CRT) by examining Gums Give Intramuscular (IM) Injection Give Oral Medication Sand Sediment Test…
— Read on horsesidevetguide.com/Common+Horse+Emergencies+and+the+Skills+You+Need+to+Help
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.
Today Chance had swelling of his back right fetlock. He had a fever around 104 and didn’t eat his feed. His eyes were dull and he was lethargic. He wasn’t limping but was walking slower than normal (he usually runs to the paddock or back to the barn). I decided, due to the Lymphingitis flare up on his back right leg, I would give him a shot of 5 mls (or 5 cc) of Banamine and wrap his leg. Once the medication set in, I would bring him in to give him a bath (it was 80 degrees today). So, that is what I did. By the time he was back at the barn he was covered in sweat. I cold hosed him and drenched the wrap in cool water and let him roam around the barn.
Thankfully, the vet was able to meet me at her veterinary practice so that I could pick up Baytril and more Banamine. Since Chance just had Lyme Disease (and had finished his medication less than a week ago), we are not 100% if this is a Lyme reaction or something else. The plan is to administer 25 cc of Baytril either orally, in his feed, or via IV for 6 days and Banamine 10 mls (or a 1000 lbs) twice a day for 3 days. The vet suggested that I do 5 cc of Banamine if his fever remains between 101-103 degrees and 10 cc if his fever is 103 degrees or above. During this time I will begin Prevacox- one 1/4 of a tablet once a day. After 3 days, I will discontinue the Banamine and continue the Prevacox. If his fevers are not down in two days, I will continue the Baytril but start the doxycycline as it maybe a Lyme disease symptom.
While researching Lyme Disease, I found that many people do two+ months of doxycycline instead of 30 days to ensure the disease has been erraticated completely. However, since Chance had shown such improvement after 30 days, I decided to not do another month. Maybe I should have…
However, Chance had similar symptoms when we found a small laceration in the DDFT tendon of his back left hind- swelling, Lymphingitis, fever, lethargy, no appetite, etc. If he does have an issue with his tendon I will most likely do another round of Stem Cell treatments which proved to be helpful last time. Thankfully I stored his stem cells in a Stem Cell Bank (via Vet-Stem) and can easily have them shipped.
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
During my horse’s recent Lymphingitis flare-up, the vet advised that we run labs to test for Lyme and EPM due to his presenting symptoms (hind weakness, twisting his back leg at the walk/walking sideways I refer to it as- “Chance’s swagger”). As I noted previously, Chance’s Lyme test revealed that he was at the beginning stages of an acute infection…yay for the labs at Cornell University for their amazing ability to give you more than a positive or negative!
A little history before getting to the EPM Tilter results.
About 2ish years ago, Chance was diagnosed with EPM (and one of the reasons opossums and I are not friends since they host the disease as do a few other culprits). Chance immediately began EPM treatment- he received Protazil in his feed for one month. After hours of research I chose Protazil, although extremely expensive (if you order from http://www.drfosterandsmith.com they sometimes have promotions where you receive store credit for every $100.00 you spend…they did when I ordered and I got a “free” dog bed that my dogs adore), due to the decreased likelihood of Chance experiencing a “Treatment Crisis” (worsening of symptoms) and the ease of administration (other brands require the drug being administered 1 hour before eating or an hour after and so on). Typically, EPM treatment is done for 30 days and, depending on the residual symptoms, some may require subsequent treatments. While Chance’s symptoms improved, I wanted to ensure that we annihilated the disease and did another round of treatment but this time with Marquis. At the end of two months, Chance’s ataxia was gone!
Fast forward to September 2016…Chance, just having a Lymphingitis flare-up, has been tested for Lyme and EPM. Lyme came back positive. And….so did the EPM test..well, kind of. Wonderful. (See why I loathe opossums?)
Chance’s EPM test #2 on 8/30/16 (the 1st one was 2ish years ago) showed the following:
“Combined SAG 2,3,4 Tilter on serum= 1:2000”
So, what does this mean?
The test revealed that Chance had “positive, specific antibodies” detected in the blood work. This means that he had EXPOSURE to S. Neurona, a causative agent of EPM. Serum tilters range from <1:250 (negative) to >1:4000 (high positive). S. Neurona (SarcoFluor) is one of two protozoa found in EPM infected horses, the other protazoa is N. Hughesil (NeoFluor). S. Neurona is most frequently seen, whereas N. Hughesil is not as common.
The vet ran another EPM test to confirm the findings in the 8/30/16 test. The results showed that Chance had “Combined SAG 2,3,4 Tilter on serum= 1:1000. Again, Chance showed EPM protozoa in the positive-ish range.
I initially had not seen the results but was told by the vet that he was EPM negative. So when I asked for the test results to be emailed to me and saw the numbers I sort of freaked out…I emailed the vet to ask for clarification. She explained,
“The EPM test shows that he was exposed to the organism in the first test we did which is why we did a follow-up test. Since his exposure level dropped from 1:2000 to 1:1000 this shows that he does not have the disease. There is no good one time test for EPM once they are exposed which is why we had to do the repeat to compare the two.”
While this explanation offered me comfort, I was confused…why does he have any protozoa in his blood if he doesn’t have EPM?
I spoke to another vet and she explained it in a bit more detail…I am hoping I am summarizing what she said correctly..
When a horse tests positive for EPM they either have an active disease or they may not. However, when the test does from 1:2000 down to 1:1000 this typically means that the horse’s immune system is working correctly to fight the disease off- active or not. EPM testing typically provides you with a % of the chance your horse has an active EPM infection, or at least if you send it to Cornell University. For instance, lets say a horse gets the results back and it shows that they are “positive” or have been exposed to S. Neurona (one of the two EPM protozoa)…their results are 1:647. This means that, after doing a bunch of adding and multiplying that this vet kindly did for me, the horse has a 60-70% chance of having ACTIVE EPM. Meaning, he most likely would be symptomatic (ie: behavioral changes, ataxia, weight loss, difficulty eating, changes in soundness, and a bunch of other neurological symptoms).
My hunch is that Chance’s immune system was boosted because I started him on Transfer Factor (amazing stuff… more information can be found in some of my older posts) again as soon as his results came back positive for Lyme.
Here are the 3 EPM tilters that were run on Chance (oldest to most recent) along with his Lyme test results:
OZONE THERAPY – HISTORY, PHYSIOLOGY, INDICATIONS, RESULTS
Judith M. Shoemaker, DVM 305 Nottingham Road Nottingham, PA 19362
717-529-0526 Fax 717-529-0776
Ozone therapy has been utilized and heavily studied for more than a century. Its effects are proven, consistent, safe and without side effects. Why is it not more universal in its use? Many of you have come with some trepidation about infusing a gas into a vessel because you are concerned about emboli, or have some dreadful fear about ozone’s toxicity since we frequently hear about the unhealthy ozone levels in the atmosphere. These fears do not apply to properly administered medical ozone, and the potential benefits of ozone therapy are profound and without associated detrimental effects.
Oxygen, in its several forms, cycles through the atmosphere and life processes just as water does. Ozone is produced in the upper atmosphere when UV light strikes the oxygen rising from plants, plankton, and algae in our forests and seas. It then falls back through the atmosphere, as it is heavier than air, combining with pollutants and water, cleaning the air and forming peroxides that benefit plants. Ultraviolet light breaking down pollutants and nitrous oxides also can produce ozone at the ground level, which is the eye and lung irritant in smog.
Medical ozone, used to disinfect and treat disease, has been around for over 150 years. Used to treat infections, wounds, and multiple diseases, ozone’s effectiveness has been well documented. Ozone has been used to disinfect drinking water since before the turn of the last century. A text on medical ozone therapy was published by Dr. Charles J. Kenworth in 1885! The best technology for producing ozone gas was designed and built by Nikola Tesla in the 1920’s. Heads of leading medical institutions in the U.S. contributed to a 1929 book “Ozone and Its Therapeutic Actions” describing the treatment of 114 diseases using ozone.
In 1933, the AMA began its systematic suppression of all modalities of treatment that did not complement its liaison with the emerging pharmacologic and diagnostic industries. Ozone therapy, along with many other useful therapies, were methodically eliminated from the educational process and exposure to the public in the U.S.
Less suppression has occurred in Europe and other countries, especially in Russia. Today in Germany, and other countries, ozone therapy is commonplace. Over 7000 doctors in Germany use it daily. In fact, in Germany, ozone generators are in ambulances for treatment of stroke victims. The incidence of permanent paralysis in these patients is much less than that in similar patients where ozone is not used.
Ozone generators are relatively simple and inexpensive. The equipment used to handle ozone is readily available but needs to be relatively non-reactive. Glass, Teflon, Kynar, silicon, and gold are completely non-reactive. Equipment made of other substances can contaminate the ozone or just deteriorate rapidly using up the ozone and becoming nonfunctional.
Generators use several technologies to produce ozone
- UV lamp – makes small amounts of ozone and is unreliable in making accurate concentrations. They burn out easily.
- Corona discharge – dual dielectric sealed systems produce ozone but also lots of heat which is both destructive to ozone and to the machine.
- Cold plasma generators – which produce ozone using low level current passed in 2 tubes of a noble gas between which an electrostatic plasma field forms that ionizes the oxygen.Ozone concentration is measured in u/ml or gms/L of oxygen, 5% or 70 u/ml is usually the maximum concentration used in clinical medical applications. High concentrations will damage red cells and inhibit growth of healthy cells.Dosage and frequency protocols vary widely. Initial high dose treatments may “jumpstart” the immune system followed by lower doses. Those who are fearful have been “starting slow and going low” with dosage and still have good results. Concentration must be carefully controlled with accurate flow rates, requiring pediatric regulators for the needed slow flow rates to produce high concentrations. Therefore, home made machines and lesser quality nonmedical devices are not appropriate.
Ozone poteniates free radical scavenging substances and systems in the body, inducing the production of superoxide dismutase, catalase, and glutathione peroxidase. If ozone administration causes any respiratory irritation from out-gassing through the lungs, a bolus dose of 1 to 5 grams of vitamin C can be given and will eliminate any coughing instantly.
Oxygen/ozone mixtures cannot cause emboli when injected at reasonable rates as they dissolve and diffuse very quickly in body fluids, unlike air (predominantly nitrogen) which is what forms emboli and causes the bends or decompression disease.
The physiologic actions of ozone are many, the simplest of which is to provide sufficient oxygen to allow complete oxidation of sugars and other fuels to produce sufficient and efficient energy and to “burn clean” to CO2, water, and inert end products. If not enough oxygen is available, then incomplete oxidation occurs, producing carbon monoxide, lactic acid, and partially oxidized toxins that inhibit further oxygen metabolism and “clog the system”, tying up hemoglobin, water, and the mechanisms for function and elimination.
Administration can be through any route with modifications:
- Direct IV infusion – Ozone slowly administered into a major vessel.
- Major auto-hemotherapy – Anticoagulated blood is mixed with ozone and is infused into a vessel.
- Rectal/vaginal insufflation – Humidified ozone is administered by catheter.
- Minor autohemotherapy – Blood mixed with ozone is injected intramuscularly.
- Limb or body bagging – Body or parts are bathed in humidified ozone.
- Ozonated water – Dissolves easily in water to be used topically or consumed.
- Ozone in Saline or LRS – Can be used topically or given IV or SQ.
- Intra-articular administration – For joint healing and prolotherapy.
- Prolo/Sclerotherapy – Very good, less painful than other agents.
- Acupuncture – With ozone, more effective than B12.
- Ozonated olive oil – Ozone is bubbled through oil until the oil is thickened. This will produce ozonides that are not irritating and thus is applied topically even to eyes.
- Inhalation – Ozone that has been bubbled through olive oil and humidified will not irritate respiratory epithelium.
- Subconjunctival injection – For ulcers and keratitis sicca.
- Gingival and tooth apex injection – Can eliminate infection.
- Urinary bladder insufflation – For chronic inflammation.
- Disc protrusions – Prolotherapy, which can be injected at interspinous space and around facets, stabilize joints and accelerate healing.
- Auricular – Can be direct, humidified, or bagged with a homemade device made from IV bags and tubing (á la Margo Roman).As an anticancer, antiviral, antibacterial, and ant fungal agent, ozone is unsurpassed, especially since there are no appreciable side effects.Oxygen deficit is key to the development and progression of all disease processes. Dr. Otto Warburg’s work, confirmed by others, shows that this deficit and subsequent toxin buildup is the fundamental cause of all degenerative disease, especially cancers.
Antioxidants help the body to protect itself from excessive oxidative damage caused by multiple free radicals, many of which are inactivated by ozone. The support of free radical scavenging systems is important but only oxygen can improve the deficit that makes cells vulnerable to oxidative damage in the first place. Long-term ozone therapy can be augmented by supplementation with antioxidants, but normally they should not be administered within 4 to 12 hours of ozone therapies.
Ozone produces the same effects as exercise, which produces significantly more free radical oxygen than can be administered in any ozone treatment. Ozone equals ”exercise in a syringe” without doing joint damage.
Ozone potentiates more complete oxidation, helps to maintain more normal body temperature and increases the effects of most hormones, vitamins, herbs, homeopathics, and drugs. Concurrent ozone administration reduces the amount of chemotherapeutic drugs needed to achieve effect by 1⁄4 to 3⁄4. It complements chelation therapies and frequently improves the affect and sense of well being in patients.
Continued therapy will allow Herring’s Law to manifest “Healing from inside to outside, top to bottom, front to rear, and in reverse chronological order of the insults to the body.” Healing crises, however, may occur. Ozone therapy facilitates the rapid resolution of these crises.
2005 Judith M. Shoemaker, DVM
A common and potentially hazardous infection that can be helped with combining antibiotics, cold hosing, and exercise.
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…
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My old guy has always had issues with his cervical spine/neck. Throughout the years he has developed arthritis which has caused symptoms which mirror EPM such as; ataxia, difficulty bending, hind end weakness, difficulty going up hills, lethargy, difficulty balancing when foot is lifted, muscle atrophy, sore back…you get the picture.
When his symptoms first came on I had the vet test for EPM. The test was positive. I did my research and found out that about 50% of horses will test positive for EPM but only 1% show actual impairment from the virus. I went ahead and completed two rounds of EPM medication therapy and still his symptoms continued. So, I sought out another vet who practiced eastern and western medicine.
After some chiropractic adjustments and acupuncture she felt that his issues were actually due to the cervical spine and not EPM. The vet also showed me how, when looking at Chance straight on, one of his eyes was lower then the other- a classic sign of cervical and jaw issues. We continued with the chiropractic and acupuncture therapy and have continued for over a year and the change has been remarkable. Along with these therapies, we upped his feed, added supplements, began stretches and different exercises, and had him walking and running up and down hills whenever he was outside. The dentist has also been of great help by floating Chance’s teeth every few months instead of once a year. This helps with the alignment of his teeth because he tends to ware one side of his teeth down more then the other; ultimately straining his jaw and neck.
He has rebuilt the muscle on his hind end, put on around 100 lbs, and is able to do stretches while someone is holding his foot up. He runs when he is outside and is no longer on pain medications (except on the rare occasion).
Here is some useful information on a horse’s back and cervical spine.
Be Prepared for an Equine Emergency
You don’t want to waste time in an equine emergency! The American Association of Equine Practitioners (AAEP) offers these tips to keep you organized and calm in your horse’s time of need.
If you own horses long enough, sooner or later you are likely to confront a medical emergency. From lacerations to colic to foaling difficulties, there are many emergencies that a horse owner may encounter. You must know how to recognize serious problems and respond promptly, taking appropriate action while awaiting the arrival of your veterinarian.
Preparation is vital when confronted with a medical emergency. No matter the situation you may face, mentally rehearse the steps you will take to avoid letting panic take control. Follow these guidelines from the American Association of Equine Practitioners (AAEP) to help you prepare for an equine emergency:
- Keep your veterinarian’s number by each phone, including how the practitioner can be reached after hours.
- Consult with your regular veterinarian regarding a back-up or referring veterinarian’s number in case you cannot reach your regular veterinarian quickly enough.
- Know in advance the most direct route to an equine surgery center in case you need to transport the horse.
- Post the names and phone numbers of nearby friends and neighbors who can assist you in an emergency while you wait for the veterinarian.
- Prepare a first aid kit and store it in a clean, dry, readily accessible place. Make sure that family members and other barn users know where the kit is. Also keep a first aid kit in your horse trailer or towing vehicle, and a pared-down version to carry on the trail.First aid kits can be simple or elaborate. Here is a short list of essential items:
- Cotton roll
- Cling wrap
- Gauze pads, in assorted sizes
- Sharp scissors
- Cup or container
- Rectal thermometer with string and clip attached
- Surgical scrub and antiseptic solution
- Latex gloves
- Saline solution
Many accidents can be prevented by taking the time to evaluate your horse’s environment and removing potential hazards. Mentally rehearse your emergency action plan. In an emergency, time is critical. Don’t be concerned with overreacting or annoying your veterinarian. By acting quickly and promptly, you can minimize the consequences of an injury or illness.
For more information about emergency care, ask your equine veterinarian for the “Emergency Care” brochure, provided by the AAEP in partnership with Bayer Corporation, Animal Health. More information can also be obtained by visiting the AAEP’s horse health web site, www.myHorseMatters.com.
The American Association of Equine Practitioners, headquartered in Lexington, Kentucky, was founded in 1954 as a non-profit organization dedicated to the health and welfare of the horse.
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
After I left the barn, I drove home and went straight to my computer.
What was happening? What are the masses? Scar tissue? Nothing was able to be extracted out of them…How can I get rid of them in order to see behind them?
Again, I stayed up until the sun came out the next morning. I already had two binders full of research and now I had a third.
Research made me believe that C has an infection in the Synovial Tendon Sheath that was being masked by the masses on the outer lining of the SS. The masses could be scar tissue from his MANY past Lymphangitis flare-ups. Perhaps, his immune system was not able to fight last attack and the infection settled in the SS and was walled off. Thus his CBC & WBC were normal and no fluid was extracted from SS masses due to the large size of the scar tissue.
C has a major hx with his RH and “flare-ups” and lameness. I never realized this until I took the time to study his past records from the first 5 years I owned him.
Symptoms are similar to an infection- what if we proceeded as if it were?
Lack of a positive culture does NOT mean that there is not an infection in the sheath!
1. Swelling decreases after being active
2. Fails to extend fetlock
3. Lame- exasperated by flexion
4. Positioning for fetlock flexion
Septic Synovitis: Cartilage degradation ischemia, Fibrin deposition lead to lameness to pannus form and adhesive form
Most common is Staph
Systematic Procaine Penicillin 22000 iU/kg or Sodium Benzyl Penicillin & Gentamicin 6.6 mg/kg for 2-9 days
Then change to oral potentiated sulfonamides 5mg.kg Trimethoprim and 25 mg/kg of Sulphadiazine
Other potassium penicillin w/ Amikacin Cectiofur or Enrofloxacin
IV antibiotics for 7-10 days switch to oral for 2 weeks
Regional limb profusion or placement of impregnated Polymethyylmethacralate or PMMA
I immediately called Vet4 and told him my theory. He said that it was possible and that we should begin treatment asap. He was still out of town so I called Vet3 to order Baytril. Vet3 felt my theory was legit and immediately ordered the antibiotic!