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Discussion on Scabs all over my horse --- autoimmune????

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Dolores McKee (Dolgeo)
Posted on Saturday, Jul 20, 2002 - 4:56 pm:   Edit PostPrint Post

We have an eight year old appaloosa whom we have had for two years. He has been completely sound and healthy during this period. On April 27 we sent him to a horse trainer. After about two weeks, possibly three, we noticed scabs on his withers and were told it was bug bites. But they were rather thick and hard unlike bug bites. He continued to get worse and began losing weight. We brought Repel-X bug spray out and sprayed him but to no avail. On June 22 we went out to ride him but he was so covered with scabs that it was not possible and we called a vet. She said he had an allergy to bug bites and recommended spraying him twice daily with bug spray. We brought him home and began that regimen. Nothing improved. Also she had given him a steroid shot and some banamine on June 22. After about 10 days and nothing had imporoved, we called another vet who began treating him with penicillin. We soaked the horse with warm water and then the vet sedated him and we scrubbed him with a betadine scrub and used brushes to peel off the scabs. We did this three times. Nothing seemed to be working so the vet dhanged to the antibiotic Naxcel. We were able to administer this three times but he became so afraid of the needle that we could no longer inject him. By this time, our vet had gone out of town for a week. We thought that we had seen some improvement with the naxcel. The vet ordered a blood test and took biopsy samples from four locations. The blood test gave these hi/lo readings: glucose 59, creatinine .9, total bilirubin .7 AST(SGOT) 166, globulin 4.7; CBC hemnoglobin 9.4, hematocrit 26.2, WBC 12.7, RBC 5.64; Differential neutrophils 9906 fibrinogen 600.

I began using a cream that contained tea tree oil and among other ingredients, aloe and cortisone 1%. As the scabs softened with the cream and I could peel them away on his face, if I could rub it in and get the complete scab off, it did not come back at all. The skin remained smooth, no scabs. Underneath the scabs, the skin is a pinkish gray. In his mane and most places on the body, the scabs are very hard, stick hard to the skin, and when they come off, hair comes with.

We took him to another vet who called the lab (in Colorado) who evaluated the biopsies and they told him after having had the samples about four days that it was not a fungus. He told us that they could not tell in that little time whether it was afungus or not that that took about three weeks to culture. However, two days later, he got more results from the lab and they said their tests showed is is an auto immune disorder.

I am perplexed because he had no symptoms of any problems prior to going to the trainer's facility where he was boarded night and day for the period mentioned above. Now he has lost about 150 lbs and is covered everywhere but his muzle with scabs. Can yoiu help us -- we have had so many different opinions from several different vets. Also, is thee some definitive, specific test that would show that it is an autoimmune disease and please let us know how long it is before a fungal culture can be evaluated. Also, thee were no skin scrapings sent, just four cored out skin samples that were about an eighth or sixteenth of an inch thick, just ahead of the areas where the scabbing was worst.

It has not spread to other horses, but I can tell you that a neighbor who had her horse there for training came home with a few spots that they treated with a product called "Microtek" and it cleared up. Also, another friend had a horse there that developed similar scabs (hard, oozy, weepy). I do not know the condition of that horse.

Incidentally, the trainer fed oat hay which we do not, and he was on different water. Also, this horse had never been ridden -- he was sent there for breaking. He was a very strong bucker but a very sensitive and gentle animal. He was ridden hard and heavy every day and was put up wet. We have checked with the trainer and he is unaware of any other horses developing this kind of a problem.

The vet, Joe Grohs, says that there is no effective treatment that will get rid of it. They say that the scabs on his body are a symptom of the disease and the minute you stop treatment it would come back maybe even worse.

I am curious whether an autoimmune disorder would come on so suddenly -- this horse was superbly healthy until about two to three weeks into training. Why did my aplications of tea tree oil/cortisone cream work on him?

I sent this mesage once but I think I was disconnected and didn't
send. The scabs are literally all over except on his muzzle by his nose and
the front of his neck and an area on each side of the neck. His legs are
just covered as is his barrel where they appear to run together. Many hard,
large knots of scab in his mane but they are discreet scabs. On his rump,
the scabs are larger but discreet. On his belly and inside his back legs,
after the scabs were softened with soaking and a shampoo, the scabs/hair
just appeared to slide off. On his face, forehead I removed the scabs and
rubbed in the cream. Hair hasn't grown back but I only did this on Monday.
On Monday, his face was smooth where I had removed the entire scab and
rubbed in the cream. Yes, it hurts to pull them off so we hafve to soften
them. By the way, the name of the equine leave-on wash is Teaclenz by
Healing Tree Products of McMinnville, Oregon and the cream is Tzon healing
cream. I don't think the vet is currently giving him anything but bute and
baths to make him comfortable. Wehn we gave him naxcel, it seemed to
improve him. Also, in the areas on his flank where scabs were removed and
the leave-on shampoo applied, the skin remained healthy pink with no scabe,
although there was a lighjt, yellow crusty, thin bit of stuff there but it
appeared to be going away. He is staying at the vets now so I don't know
what is happening. I have heard of a treatment with chapparell which is
apparently an immune system stimulator/homeopathic remedy. I can't bear to
let this horse go until nd unless I have exhausted every possibility. The
vet said that instead of his immune system attacking the lesions, it is
attacking the skin. If we got rid of the lesions, mightn't it stop
attacking the skin? He mentioned some treatment called gold salts and is
investigating that. Thanks for your prompt answer and we are waiting to
hear.


i cant think of anymore info ... maybe a pic will be forthcoming.
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Robert N. Oglesby DVM (Dro)
Posted on Sunday, Jul 21, 2002 - 3:31 pm:   Edit PostPrint Post

Yes an autoimmune order could come on this quickly and the reason the corticosteroid would help is that it slows down the overly aggresive immune system. However there are many diseases that would look better with this treatment.

I would be interested in a picture and the lab results that showed it was an immune disorder and it sounds like a very bad case of dermatophillus. The article associated with this forum covers the two most common forms of autoimmune disease, the diagnosis and treatment but you should also review the article on dermatophillus.
DrO
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Dolores McKee (Dolgeo)
Posted on Sunday, Jul 21, 2002 - 4:42 pm:   Edit PostPrint Post

Thanks, Dr. O, for your reply. We will get the results of the lab tests for you tomorrow and I will also send you the blood test results in full. The vet is apparently trying to get ahold of gold salts but I will get the complete lab results on the biopsies and the blood test and send them to you tomorrow. Also will let you know what the vet is starting as a course of treatment. We will be bringing Harley home tomorrow to continue treatments at home under the supervision of our previous vet. We will get a picture of Harley and the lesions and transmit them to you tomorrow as well. Thanks so much for your reply.
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Dolores McKee (Dolgeo)
Posted on Sunday, Jul 21, 2002 - 7:52 pm:   Edit PostPrint Post

I came across the title of an article by George LW, White SL. "Autoimmune skin disease of large animals" in Vet Clin North Am Large Anim Pract 1984 Mar; 6(1): 79-86 but I couldn't get the article to come up. I would like to read it --it was under Equine Medications, Aphabetical Listing, Depo Medrol:Prednisolone. I know prednisone isn't effective in horses but what, specifically, is the difference between prednisone and prednisolone?
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Robert N. Oglesby DVM (Dro)
Posted on Monday, Jul 22, 2002 - 6:46 am:   Edit PostPrint Post

The title is all we have and it is put there as a reference for those with access to that publication. I am afraid I do not have a copy.

Prednisolone is the active form of the medication. Prednisone is the inactive form that requires the liver to convert it to prednisolone. Apparently horses either do not absorb the prednisone or the liver does not convert it to prednisolone.
DrO
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Dolores McKee (Dolgeo)
Posted on Tuesday, Jul 23, 2002 - 12:28 am:   Edit PostPrint Post

Dr. O, the results of the lab tests haven't come in the mail yet (our vet spoke with the lab by phone) so our vet is asking them to fax them to him tomorrow so that I can get them to you tomorow. Also, Harley won't come home until tomorrow so I will get the pictures. The vet where he is staying has started him on azium??? or something like that and is giving him medicated baths. He hasn't found the gold salts yet -- if this is the treatment followed, do you know where we can get the gold salts? Also, I was concerned that if you looked at the lab results and thought it might not be PF, wouldn't it be dangerous to use an immune suppressant like the prednisolone if it were some sort of infection or fungus instead?
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Robert N. Oglesby DVM (Dro)
Posted on Tuesday, Jul 23, 2002 - 4:21 am:   Edit PostPrint Post

Azium is dexamethasone another type of corticosteroid. If there is a infection present the use of the corticosteroid would not be logical however it is unknown if it would be dangerous and/or prevent any treatment from working.

If there is any chance this is a primary infection and not autoimmune I think it makes the most sense to pursue treatment of the infection.
DrO
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Dolores McKee (Dolgeo)
Posted on Saturday, Jul 27, 2002 - 4:09 pm:   Edit PostPrint Post

Dr. O, just got Harley home yesterday. I didn't take pics because the scabs are drying out, going away, and new hair growing back. I got partial lab results as follows but the transcribed complete case results aren't available to us yet. Will have my vet call about them. Also, he was at the veterinary hospital for ten days and I have a schedule re his daily treatment as follows. I am a little concerned about the daily dexamethasone after rereading your comments to Julianne Pedersen 9/28/99 re the effects of daily use of the drug.

Lab results from Colorado Veterinary Diagnostic Laboratories(there is probably a lot of unnecessary data that I am including but since I don't know what's important/not, will leave that to you):

Page 1: TS fungal culture Multiple isolates: 3+ 28
TS Fungal culture candida guilliermondii 3+

TS fungal culture fusarium sp.
TS fungal culture pigmented yeast -- will try to identify

Comment Code Comment Narrative:

Fungal results pending

Special Notes: bacteria isolated - acinetobacter sp. 3+ Pseudomonas fluorescens 3+ Bacillus sp. 3+

Page 2: TS fungal culture candida guilliermondii 3+ 28

Fungal results pending

(and then special notes as above)

Page 3: Diagnosis: pemphigus folliaceus

"Complete case results will be sent after transcription is complete"

Daily in-hospital regimen:

"7/16: phenylbutazone 1 GM tabs

7/17: phenylbutazone 1 gm tabs
dormosedan 10 gm/ml
torbutrol inject 10 mg/ml
Malaseb thera shampoo
Malaseb spray DVM

7/18: Phenylbutazone 1 gm tabs
phenylbutazone 1 gm tabs

7/19: dexamethasone 2 mg/ml

7/20: phenylbutazone 1 gm tabs

7/21: phenylbutazone 1 gm tabs
dexamethasone 2 mg/ml

7/22: phenylbutazone 1 gm tabs
dexamethasone 2 mg/ml

7/23: malaseb spray dvm
dexamethasone 2 mg/ml

7/24: dexmethasone 4 mg/ml tab (dexamethasone tablets listed above are special order for Harley for use in hospital and use at home

7/25: nothing indicated

7/26: start "gold salts" injection. Dose is intramuscular and first two doses are small test doses of 20mg (0.4ml) given one week apart. Then if all is well, Harley is to get 1 mg/kg (this equals about 400mg or 8ml of the 50mg/ml solution) weekly. The lag phase for positive response is reported to be 6 weeks to 3 months.

Relative to the dexamethasone tablets, the dose is 900M daily (22.5 of the 4 mg tablets) by mouth. If Harley responds well, we hope to reduce the dose to every other to every third day and perhaps even a lighter dose of the dexamethasone. Once in remission, gold therapy should be once per month and lowest possible dose of the dexamethasone. A complete blood count and urinalysis is recommended on a weekly basis to monitor for some of the many side effects of the medications as previously discussed." (end of vet treatment narrative)

Harley is eating/drinking well and is quite alert. Still very much underweight but we're hoping increased appetite due to medications will help that. Will take back to vet for next "gold salts" injection and are giving him his dexamethasone at home.

What do you think at this point or can you tell anything without the transcription of the lab results?
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Robert N. Oglesby DVM (Dro)
Posted on Sunday, Jul 28, 2002 - 11:25 am:   Edit PostPrint Post

What I really was interested in was the histopath description of the lesions found in the skin, this would be the basis of the diagnosis Pemphigus. But of equal interest was that dermatophilus was not found and most of the organisms are "opportunistic" and not primary. They seem quite confident of the diagnosis. The dangers of long term steroid use are explained carefully in the article Overviews of Steroid Use but in a primary autoimune disease the risks are usually worth taking and 90mg daily seems a reasonably agressive place to start.

I am delighted the horse is getting better. Keep us informed as to the progress.
DrO
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Dolores McKee (Dolgeo)
Posted on Thursday, Aug 8, 2002 - 10:07 pm:   Edit PostPrint Post

Dr O: Finally got some more faxed stuff from U Colorado but I am not sure it is everything you wanted. Here goes:

"History: Skin lesion progressed to over 90% of body.

Diagnosis: Pemphigus foliaceous.

Remarks: Histologic features are consistent with pemphigus foliaceous. Diagnosis was reviewed and confirmed by Dr. Schultheiss.

Histopathology: Multiple sections of haired skin from the right neck deep, the left shoulder and left neck were examined and found to be morphologically similar. Sections from the right neck are characterized by intercorneal pustules with numerous intralesional acantholytic keratinocytes. In addition, there is intralesional foreign material in the form of naked hair shafts and plant material. Other sections have erosions and ulcerations of the skin's surface and mild to moderate mixed inflammation of the superficial dermis."

The second page is as follows:

TS Fungal culture: multiple isolates:
TS Fungal culture:--candida guilliermondii 3+
TS Fungal culture:--fusarium sp.
TS Fungal culture:--rhodotorula mucilaginosa 3+
TS Fungal culture:--black yeast -- unable to identify"

Harley received 22-1/2 4mg tablets of dexamethasone for the first week home, which was reduced to 15 tablets beginning last Saturday. He received his second "test" injection of the "gold salts" on Saturday. We check him thoroughly three or four times a day and there are no new lesions and all the old ones seem to have healed. He has one remaining area on one hip that looks like a large sore which we are treating with over the counter neosporin. He had two other large sores which have since healed. I understand that animals heal more slowly while on this steroid. He has had a medicated bath (malaseb) once a week while home. He has a monstrous appetite and is getting all the hay he wants plus COB and Millenium Gold supllement. We put him on pasture grass each day but are easing him into it because of the possibility of founder. He finally looks like he may be gaining weight.

Tomorrow he goes back to the vet for his gold salts injection, this time the increased dose, not a test.

Is the transcription from UC what you wanted or should I ask them for any more backup? Does this show that there is a fungus as well? Thanks.
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Robert N. Oglesby DVM (Dro)
Posted on Friday, Aug 9, 2002 - 9:44 am:   Edit PostPrint Post

Most excellent Dolores,
Yes steroids slow healing in healthy horses BUT in horses with autoimmune disease they take a horse from being covered with sores to being able to heal, so in your case they promote healing! The "histopath is a perfect description of P. foliaceous and the fungal infections are secondary invaders living off the damaged tissues. I think you have it pegged.

As you have been told, often this is a life long problem of the horse and may require corticosteroids for the rest of his life. Take some heart that once under control the dosage can be reduced and even alternate day therapy may be instituted with prednisolone. Please come back here ever so oftenand keep us informed on your progress. I will be glad to help in any way possible.
DrO
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Dolores McKee (Dolgeo)
Posted on Thursday, Aug 22, 2002 - 3:33 am:   Edit PostPrint Post

Dr. O,

Have a few questions.

Harley has not started the gold salts injections yet (other than the initial small doses to determine tolerance). The vet was waiting for his supply to come in and he is temporarily out of town. What do gold salts actually do? Are they necessary if he is responding well to the dexamethasone? His dexamethasone is at 15 4mg tablets once daily, this dosage continuing for the second week (which is up Friday). We will know Friday if we are to reduce it further or go to the alternate day therapy. Since the lesions are gone, we aren't giving him the weekly medicated baths anymore.

He hasn't got any lesions and the two large sores on his hips are healing nicely though slowly with continuing daily neosporin ointment. He is slowly gaining weight. He eats huge amounts of hay and alfalfa (to which we add acout a cup of canola oil twice a day, the Millenium Gold supplement, and a large coffee can of cob twice daily (pretty much the same diet he has had since coming home except the oil addition).
One thing that we have noticed that concerns us is that there is a marked swelling just over the eyes. The place above the eye that is usually a little sunken in is sometimes quite puffy. Is this a problem? It was there about three days ago, then appeared to go down, but tonight was markedly puffy again. Let me know as soon as you can so that we can either do something or quit worrying. Thanks so much for being there when I am concerned and need advice!
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Robert N. Oglesby DVM (Dro)
Posted on Thursday, Aug 22, 2002 - 8:27 am:   Edit PostPrint Post

Gold has anti-inflammatory and immune modulating effects. The exact mechanisms for these actions are not well understood but what we do know is gold is taken up by macrophages where it inhibits phagocytosis and may inhibit lysosomal enzyme activity. It also inhibits the release of histamine and prostaglandins. One last documented effect is to suppress the helper T-cells.

I have never used gold salts so I must fall back on the research I have done and gold is usually listed as a fall back for when glucocorticoid therapy fails. I have assumed cost and the high incidence of adverse side effects is the major reason. Veterinary experience with gold is limited. Adverse reactions seen in people include:
  • rashes (common)
  • mucosal ulcers (common)
  • thrombocytopenia, leukopenia, aplastic anemias (rare but serious)
  • kidney disease (rare but serious)
  • Enterocolitis (rare but serious)

Because of the serious nature of these adverse reactions, adequate patient monitoring is essential.

The puffyness may be do to fluid retention caused by the steroids in combination with the effects of gravity when the head is down grazing all day. Some horses do this normally. Though this is not a serious side effect should be monitored by your veterinarian with a physical exam and possible lab work up for other possible causes.
DrO
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Dolores McKee
Member
Username: Dolgeo

Post Number: 10
Registered: 7-2002
Posted on Thursday, Jan 30, 2003 - 9:30 pm:   Edit PostPrint Post

I am having dificulty rejoining because my subcription ran out and the machine won't let me fill out a new application using my user name. Help!
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Dolores McKee
Member
Username: Dolgeo

Post Number: 11
Registered: 7-2002
Posted on Thursday, Jan 30, 2003 - 9:51 pm:   Edit PostPrint Post

Dear Dr. O.

I have been having difficulty posting messages but apparently it is now taking my messages. I want to renew my subscription and will try again to renew aftr sending this message if the computer takes it. Anyway, Harley is very sick again.

We went from the original 22 pr day pill regimen of dexamethasone and gold injections (8cc)every two weeks and gradually, two weeks at a time under careful vet supervision, reduced the amount to one 4 mg tablet of the dex twice a day and once a month on the gold salts (4 cc) by the second week in December. Progress was phenomenal. Very healthy, gaining weight, frisky and after about a week on the latter regimen, he crashed, practically overnight. Swollen sheath, soreness in legs, scabs, listless. Immediately called the vet, gave him eight piils twice a day and 8 cc gold salts. Brought him down gradually to thirteen pills a day (am/pm), gold salts injection once a month and he is due again.

There was an immediate an dramatic improvement for about a week and then he crashed again and is worse than he was when he crashed in December. He does not have the swollen sheath, the scabs are gone, but he looks sick, doesn't move around, has lost a tremendous amount of weight, and is extremely sore in his legs back and front. Hooves not hot and pulse not pounding.

The local vet thinks he may be having kidney problems and may be foundering. We have just about given up hope. His appetite is extremely good but he doesn't care much for any kind of grain. We are giving him canola oil but weight continues to drop, and giving him milenium gold twice a day with grain, which he eventually eats.

If there is anything we can do, we will. If in the final analysis there is nothing we can do and must put him down, would it be safe to donate his body for dog food for the mushers or is the disease transmittable to other animals? Can you give us any hope? Please answer as soon as you can because this is an emergency and none of us knows what to do.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 7702
Registered: 1-1997
Posted on Friday, Jan 31, 2003 - 4:31 am:   Edit PostPrint Post

Hello Delores,
Your post does not tell me what might be wrong with your horse, I am afraid. He needs a good physical exam and complete laboratory work up and from there a problem list can be generated.

Founder will need to be diagnosed from the physical exam findings, laboratory work (to rule out similar looking diseases) and possible radiographs. Kidney disease is ruled out on laboratory work. We have articles on both of these diseases where you can read about diagnosis and treatment.

If the veterinarian is still not sure what the cause of the problem is you need a referral to someone who can figure this out. I know this seems tedious right now, but you have a very complicated situation. You have a horse with a permanant autoimmune disorder and receiving medications that are potentially toxic or at least may lead to other problems. This will require a cool head to figure out.

I wish I could give you more but take it a step at a time and if you feel euthanasia is your most humane alternative, make it knowing you have really worked hard to make this guy well. This disease is not transmitable but with the gold salts in his body I am not sure he would be considered suitable.
DrO
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Dolores McKee
Member
Username: Dolgeo

Post Number: 12
Registered: 7-2002
Posted on Saturday, Feb 1, 2003 - 6:55 pm:   Edit PostPrint Post

Dr. O., Thanks for responding. We had a vet out yesterday (Friday) to draw blood to find out what we can. We should hear back Monday or Tuesday. A very sad time for us, so thanks for your words letting us know you understand how hard we have worked.
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Dolores McKee
Member
Username: Dolgeo

Post Number: 13
Registered: 7-2002
Posted on Thursday, Feb 6, 2003 - 10:10 am:   Edit PostPrint Post

Dr. O.,

Sent this last night but apparently it didn't post. Got th lab results and will post the abnormals only unless you want the whole thing.


glucose 296 hi rang 60-125

creatinine 0.8 lo 1.0-2.2

alkaline phosphatase 348 50-250

chlorid 95 97-108

Under CBC thos clos to abnormal we:

hemoglobin 16.1 11.0-17.0

hmatocrit 46.6 32.0-50.0

MCV 54 34-58

MCH 18.7 12-19

MCHC 18.7 12-19

Under differential:

Neutrophils 9120 Hi 96% 2600-7500

lymphocytes 190 lo 2% 1500-7700

Apetite and attitude good, isn't lying down as much. Getting 2mg bute. On Tuesday gave him 7 pills (4mg) of dexamethsone at night only; Wednesday gave 5 in am, 3 in p.m. Seems like the reduction of the dexamethasone resulted in his being a little stronger. We reduced it because he is just about starving to death. Vet said we could give him some banamine as well. Also said that based on blook work, he may have an infection and is going to bring out some antibiotics today.

Can you tell us anything with thes results?
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Dolores McKee
Member
Username: Dolgeo

Post Number: 14
Registered: 7-2002
Posted on Friday, Feb 7, 2003 - 2:30 am:   Edit PostPrint Post

Dr. O. -- don't know why but seems I am having to post my messages twice. It looks like they post but then when I check, the message isn't there. Will try again on this one.

One of the vets gave us some antibiotic powder called "uniprim" powder for horses, The packet contains 37.5 grams and we gave it to him tonight along with 3 dexamthasone tablets (gave him 5 this morning). He remains on bute; we did not give him the banamine because he looked better, stronger today. Maybe the lowered dosage of steroids is letting him get back a little weight.
Are we doingthe right thing -- the uniprim antibiotic was prescribed because of the high neutrophils, I believe he said. Let us hear soon as you can. Thanks.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 7747
Registered: 1-1997
Posted on Friday, Feb 7, 2003 - 8:12 am:   Edit PostPrint Post

Dolores even with the information you provide I cannot examine the horse and make treatment decisions. This has to be done by the examining veternarian. I can provide information however.

I think the high blod glucose, increased liver enzymes, neutrophilia, and lymphopenia could be do to the steroid administration, it has this effect. More important to help answer the infection question is the cytological features of the neutrophils. The low creatinine indicates his kidneys are fine.

Remember that the skin problems are related to the disease process but the systemic problems may be related to over administration of the gold salts (toxicity), over administration of the dexamethasone (Cushings), or too rapid a decrease in the dexamethasone (Addisons). These possiblities must be always considered when the horse shows systemic signs. We discuss the steroid related problems at Equine Medications and Nutriceuticals Anti-inflammatories, Steroids, and Arthritis Treatment Overview of the Steroidal Anti-inflammatory Drugs. I discuss gold salts above.
DrO
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 7748
Registered: 1-1997
Posted on Friday, Feb 7, 2003 - 8:21 am:   Edit PostPrint Post

Delores we have not received other reports of posting problems and posting to this board over 30 times a day, over the internet like you do, I have not experienced any problems. Be sure you save your post following each posting.
DrO
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Dolores McKee
Member
Username: Dolgeo

Post Number: 16
Registered: 7-2002
Posted on Tuesday, Feb 18, 2003 - 1:50 am:   Edit PostPrint Post

Dr. O.:

Harley has ben diagnosed as having laminitis by our vet. He attributes it to the steroid/gold salts. We have reduced the steroids to thre dexamethasone a day (4mg) for a week and it hasn't brought about any new skin problems. However, he is really sore in front. His weight loss seems to have stabilized. He is also on one and a half grams of bute each day. The vet says the laminitis is in the acute phase and doesn't feel there is much we can do about it given that Harley must have continued steroids. Do you have any suggestions for treating the laminitis? Also, what about the alternate day treatment? We would like to begin the alternate day therapy in hopes it will assist with his weight gain but we are afraid to let him go a day without the steroids because it was such a scare when Harley crashed in December. At what point does one go to alternate day therapy? We have read the articles you mentioned but can you tell us what circumstances allow a person to do the every other day thing?
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 7807
Registered: 1-1997
Posted on Tuesday, Feb 18, 2003 - 4:18 am:   Edit PostPrint Post

First we should note that the steroid induced founder is conjectured and not written in stones. It may be possible to continue to treat the autoimmune disease and the founder. It should be treated like other founders, see Equine Diseases Lameness Foot and Sole Problems Founder & Laminitis for more.

ADT is usually attempted after control of the allergic/inflammatory disease is achieved with daily treatment. The proper dosing of steroids, whether daily or ADT, is always experimental and what dosages and frequency that will be effective is different for every case so must be established by trial and error.
DrO
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