Category Archives: Lyme Disease

The Perfect storm

So, I wish I did not have to start this process again…but unfortunately, I do. Once again I have a senior horse with a variety of acute and chronic conditions that all hit at the same time. Right now I am trying to make her comfortable while also trying to figure out what is what and how to best respond.

Three months ago Tilly was tested for EPM due to muscle wasting and weight loss.The first time she was in the lower end of an active infection. We started a compounded medicine for 1 month and her numbers decreased. We decided to do another round as she responded well to the first round. However, the numbers remained the same. We also tested her for Lyme which showed a chronic and an active infection but the numbers were in the high normal range and the vet felt that it was not treatment worthy at the time.

Last month Tilly began “crab walking” out of the blue. Called the vet. They came out. Her ataxia was bilateral- both her left and right hind- whereas EPM tends to be unilateral. Further, her presentation was not suggestive of Lyme.

We started steroids (dexamethasone oral power) for 5 days with Banamine, tapering as we went, and she seemed to recover. The consensus was it was an acute attack that may have occurred given she is a senior with a history of being an Amish workhorse and perhaps, she pulled something in her neck.

Treatment was complete and another week went by and again, she showed some ataxia. This time less severe. The vet felt that since she responded well to the first round of steroids that it was not EPM-related as you would not see improvement. Further, if it were Lyme related the presentation would be more consistent. Again, a round of Dex and improved quickly. The next week we had her neck x-rayed and there were some arthritic changes. However, she was running around and moving well so the vet felt injections in her neck would not be necessary at that time.

Seventy two hours later, she had some trouble getting up but eventually succeeded. The next morning my sweet girl was spinning, crab walking, and falling over. It was absolutely terrible to see. I immediately gave her 10cc IV Banamine and she calmed down and stopped spinning. The vet came out and administered Dex IV and thought that due to her inflammatory bowel disease we should try Dex IM to ensure absorption. We also decided to pull blood to test for Cushings as she seemed to lose weight overnight and was not shedding out well. The next day she was lame on her right front. Panicked I called the vet fearing that if she did have Cushings, she was trying to founder due to the steroid use. Thankfully, the vet came out, did a nerve block on her right front (this helps to see if the horse has laminitis as they will improve once blocked) and checked for pulses (if a horse has laminitis typically they will have pulses in their hooves) and Tilly did not have any. So, the vet did not feel we were dealing with founder. However, the lameness presented a major challenge due to her still being ataxic on the hind end. The vet did cortisone injections into her neck hoping to help with inflammation due to arthritis. Tilly did great and suddenly, began freaking out. Spinning, knocking into the doors, etc. The vet explained that the injections likely added more pressure on her spinal cord causing her to react. Again, once the vet was able to safely administer Banamine and some Dorm, she calmed and laid down for the first time in over a week for a good 45 minutes. We decided to make sure she was able to get back up. Although she had some trouble, after a couple tries, she was able to do so. Her breathing was heavy, wheezy, almost like she was having a panic attack and hyperventilating. A few minutes later, her breathing returned to normal.

Tilly’s Cushing’s text level was about 100 pg/mL (it should be about 30 pg/mL during mid-November to mid-July) meaning, she does have Cushings. The vet decided to wean her off of the steroid as to not increase the risk of Laminitis even more but also to give neck injections time to work (5-7 days). We also immediately began Prescend (2 tabs) a day to treat her Cushings.

We are on day 5 since the 3rd ataxic episode and day 3 post neck injection and she is still lame on her right front along with ataxic on her hind end. However, she is still eating, engaging, and is bright and alert. She does not seemed distressed or in pain thankfully. Due to Tilly not showing much improvement (even though it can take 5-7 days to see improvements from the neck injections) I decided to start her on a non-compounded EPM medication, Protazil. According to the vet, Protazil should not cause any harm whether her symptoms are EMP related or not. I also began 10cc of Vitamin E oil. Tilly was previously on pelleted Vitamin E but due to her inflammatory bowel disorder, she may struggle to absorb the pelleted form of the supplement. Further, there are a number of studies showing the benefits of Vitamin E and the connection between Vitamin E and ataxia.

On a positive note, since starting Prescend for her Cushings, I have noticed that she is drinking less water. Increased water intake is a symptom of unmanaged Cushings. I am hopeful that means the medication has started to work at regulating her hormones. We are now at a wait and see point. I continue to try to make her comfortable. Tons of bedding in her huge foaling stall, hay everywhere, fans on, doors open. She has been a trooper. My hope is that she recovers from this and enjoy whatever time she has left and fights this as she has so many other things- the reason she was given the name, Ottilie.

RESOURCES

https://www.horseillustrated.com/horse-health-equine-cushings-disease-24321

https://www.horseillustrated.com/horse-experts-horse-vet-advice-cushings-disease-diet

https://cvm.msu.edu/vdl/laboratory-sections/endocrinology/equine-endocrine-testing

https://www.horseillustrated.com/horse-experts-horse-vet-advice-cushings-horse-treats

https://resources.integricare.ca/blog/cushings-disease-in-horses

https://equine-vets.com/health/l/laminitis-is-one-of-the-most-common-causes-of-lameness-in-horses-and-ponies/

Testing for Equine Cushing’s Disease

Spotting Lameness: The Game Plan

Spotting Lameness: The Game Plan
— Read on horsenetwork.com/2018/10/spotting-lameness-game-plan/

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

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

Fall Fever

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.