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Discussion on Stones?

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Kim Fotter
Member
Username: Fpony

Post Number: 286
Registered: 9-1999
Posted on Sunday, Jan 25, 2004 - 7:56 am:   Edit PostPrint Post

Hi Dr.O,
Thank goodness for your site where a worried owner can come and get knowledge and information to consider and then to be able to ask questions!

My 10 y/o arab who has EPSM has been having difficulty since late Sept. He has had two minor tie-ups. The first at the end of sept (we thought caused by the increase sugar in the fall grass?) recovered nicely then had another tie up the end of Nov. (thought it was due to the terrible windy and weather conditions making especially nervous-we had a small tree branch fall quite close to us one ride)Since then I have not been able to ride him and have worked him up to 40 min of hand walking and some trotting with hills. The reason I haven't ridden is his back continues to be painful but this is sporatic.

The pain is over the loin area. He will kick out when palpated there and gets very grumpy. then he might be fine on another day. During december he had started circling and swiping at his sides but was easily distracted. (he has done this on other occasions) but then on New Years eve he was in alot of pain kicking at his belly biting at his flanks and wouldn't be distracted. He would eat imbetween kicking and he was drinking. Banamine didn't help, (he was passing manure and never tried to roll, had no fever)by morning I called my vet she told me to give more banamine and Ace. (He had been very nervous for the past month and I had done this combination before when I thought he might tie up as well as giving him this in Nov. when he did tie up.)It was only 2ml of ace orally for the vasodialattion effect I believe more than for calming.

We decided he may have an ulcer so I waited for the gastoguard to arrive. In the mean time he had another colic type episode a week ago. The gastoguard was delivered Tuesday the 20th and my vet took blood to check his kidney's and enzyme levels I thought (I'm not sure everything she checked but she said everything was normal except some elevated liver values which she said was related yto his muscles)Day three on the gastoguad (Friday)he has a fever of 104 from 8am until 11pm. It didn't start going down until 9 that night. My vet asked that I stop the gastoguard until she called the company Monday morning in the rare chance it was a reaction. He started side biting and kicking at his stomch again yesterday but was distacted out of it.

Sorry, this has been so long, I'm concerned about the back and flank pain as well as this horse only urinated once a day. (large volume)Should we be checking his bladder? He also eats alfalfa pellets twice a day (about 8 cups total)with his oil and selenium.We didn't scope his stomach as I would have had to trailer him over an hour to a hosp and he has tied up in the trailer before. At this point I would sedate him to trailer him if it is needed.Any suggestions?Thanks you, Kim
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 9839
Registered: 1-1997
Posted on Sunday, Jan 25, 2004 - 10:30 am:   Edit PostPrint Post

Definately a complicated situation where the cause of the odd behavior remains uncertain: muscle cramping, ulcers, something else? Any time a horse has chronic unexplained abdominal pain he should have his urinary system evaluated for the possibility of disease as should all the possiblities be explored.

I think it is unlikely the Gastroguard was the cause of the fever but removal until the cause of the fever is better known does seem prudent. Actually faster acting, though long term not as sucessful, would be ranitidine for the ulcers, see the ulcer article for more.

Could you tell me which enzymes were run and what their level were?
DrO
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Kim Fotter
Member
Username: Fpony

Post Number: 287
Registered: 9-1999
Posted on Sunday, Jan 25, 2004 - 12:37 pm:   Edit PostPrint Post

I will have to ask her on Monday for more info about the enzymes. He has been diagnosised with EPSM for 2 1/2 years and been on a strict high fat diet ever since. He hadn't tied up for two years but he has had lots of ups and downs. Sept and Nov he had palpatible muscle damage from the episodes but we have never checked enzyme levels. These muscles remain sensative for couple of weeks slowly responding to gentle massage,stretching and mild exercise gradually increased as tolerated. The pain he has over the loin area seems to come and go over a few days period of time.

If I understand the article, blood work won't tell us if there are stones but checking his urine might? Can blood work tell us anything else about his urinary system or do I need a urine sample? I doubt if I could actually catch one! Can one get more info than just intestinal from a rectal exam?
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 9852
Registered: 1-1997
Posted on Monday, Jan 26, 2004 - 8:35 am:   Edit PostPrint Post

Stones from the bladder down are not much of a problem they cause straining to urinate and can be ultrasounded. It is the kidney and ureter stones that are tough. Some small horses or vets with long thin arms may be able to visualize these on US. Some other signs of problems are blood or puss in the urine, so you look for these even though their presence is only suggestive and does not confirm it. For instance cystitis also will give these results.
DrO
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Kim Fotter
Member
Username: Fpony

Post Number: 289
Registered: 9-1999
Posted on Wednesday, Jan 28, 2004 - 9:38 am:   Edit PostPrint Post

Dr. O, I have posted under an old posting of mine in the tying up,rhabdomyolisis and EPSM section. His urine is now yellow and for the first time in 3 1/2 years he actually has urinated while I was only 10 feet away! I'm bringing a container with me at all times maybe I can catch some! The only time he has gone in his stall is when he was confined due to his fever and our sub zero temp and that was after being stalled 20 hours! Kim
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Kim Fotter
Member
Username: Fpony

Post Number: 290
Registered: 9-1999
Posted on Thursday, Jan 29, 2004 - 12:22 pm:   Edit PostPrint Post

oops, I posted under my old post in Lameness: Rehabilitating Injuries to the Tendons and Ligaments: Rehabing muscle damaged from EPSM.
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