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JOY CAILLOUETTE
New Member
Username: Acepal
Post Number: 1
Registered: 2-2005
| | Posted on Tuesday, Feb 15, 2005 - 9:20 am: |   |
My 20 year old Arabian has a history of spring respiratory problems since I acquired him in 1998. He has always responded well to antihistamine and herbal cough remedies, but this year the usual regime did not abate the cough and congestion, there was no nasal discharge. Our vet (very good general practitioner) auscultated his lungs, upper airway and chest and suspects CHD. There is no peripheral edema nor arterial pulse abnormality. He responded to IM lasix with largely resolved fluid accumulation in 3.5 days. Some crackling in terminal avioli can still be heard. Cough is resolved except after rolling. He continues on oral diuretic bid. What other diagnostic steps would be prudent? Any advice on conditioning regime for return to work after almost a month off? He's bored, I'm worried. Help? |
Robert N. Oglesby DVM
Moderator
Username: Dro
Post Number: 12085
Registered: 1-1997
| | Posted on Tuesday, Feb 15, 2005 - 6:15 pm: | |
Joy,
Your history and the clinical signs you list are also consistant with early heaves which is poorly responsive to antihistimines and diuretics, Equine Diseases >> Respiratory System >> Heaves & Chronic Obstructive Pulmonary Disease.
If CHD is highest on the list because of findings not in your post (what did the heart sound like on auscultation?) I would have the horse referred for a electrocardiogram and cardiac ultrasonography these should well define the disease.
DrO |
JOY CAILLOUETTE
Member
Username: Acepal
Post Number: 2
Registered: 2-2005
| | Posted on Sunday, Feb 27, 2005 - 10:21 am: | |
Update - Pancho finished his oral diuretics on 02/22 with an AM dose. His lungs, upper airways, and chest were clear to auscultation. By 02/25 AM some congestion was audible in his upper airways after light exertion (walking alongside me on level ground for 5 minutes), no cough noted, no adventitious sounds in lungs or chest. This morning his congestion was noted while at rest, no adventitious sounds elsewhere.
I am taking him back to our GP tomorrow to address these symptoms. I would like to take him for a complete cardiac work-up in order to find the source of the trouble, as Dr O suggests. I know cardiologist at Leesburg VA has retired - any suggestions on where I could get a good evaluation in the southeast? Travel to PA would be difficult, but not impossible if needed. |
Robert N. Oglesby DVM
Moderator
Username: Dro
Post Number: 12185
Registered: 1-1997
| | Posted on Sunday, Feb 27, 2005 - 9:58 pm: | |
It would suprise me if VA Tech does not have someone who can at least get the diagnostics done even if the information must be emailed to a specialist. This is done a lot with cardiac information. If this does not work have your vet contact NC State or PA depending who is closer.
DrO |
JOY CAILLOUETTE
Member
Username: Acepal
Post Number: 3
Registered: 2-2005
| | Posted on Monday, Feb 28, 2005 - 2:43 pm: | |
Thanks for your thoughts, I really appreciate hearing your opinions. My vet agrees that it's probably COPD/heaves. Now the question is whether there is cardiac damage. Pancho Earle and I leave for UT Vet Hospital (Knoxville, TN) on Sunday. His EKG and echocardiagram are scheduled for Monday 10am.
Pancho Earle lost consciousness briefly at the vet's today {very scarey even though he hopped right back up & seems to feel ok now (post lasix & steroid). Dr. B (our vet GP) says it was just the combination of stress and low O2 - sort of like when members of a wedding party pass out during the ceremony.
}}My goal for the work-up is a prognosis so I know what adjustments need to be made for the rest of his life. Any suggestions on other testing? Do they draw cardiac enzymes on a horse? Do other horse people go through this? I'd LOVE to hear from somebody who has been down this road with a pleasure horse. |
Robert N. Oglesby DVM
Moderator
Username: Dro
Post Number: 12202
Registered: 1-1997
| | Posted on Tuesday, Mar 1, 2005 - 7:42 am: | |
Let us know what they find Joy and is your vet continuing glucorticoids for the heaves? Let their exam and workup determine the next step. You can check for heart muscle enzymes but I don't know if they will find it indicated.
DrO |
JOY CAILLOUETTE
Member
Username: Acepal
Post Number: 4
Registered: 2-2005
| | Posted on Saturday, Mar 5, 2005 - 9:13 am: | |
PE is home and feels better. The UT vets did a cardiac workup with EKG and echocardiogram as well as a brochial scope and lavage. The verdict is NO HEART DAMAGE (did you hear me sigh in relief?). In fact Dr. Gompf pronounced his heart function "outstanding for his age". The big culprit turns out to be RAO. He is on Ventpulmin orally and will start Combizent and Flovent aerosol therapy as soon as his aeromask arrives. The ventpulmin is on a sliding scale and the aerosols are on a decreasing dose. The costs of the medications is staggering, now I understand the need for health insurance for horses! Still, his value to me is far greater than the cost of this treatment. Dr. Summardahl and company strongly suggest shredded paper bedding. I will continue to wet his hay & I'll be working to reduce his "in the barn" time significantly (he loves his stall) and to find shredded paper bedding. I plan to start your conditioning program with him after one week of aerosol therapy if he is asymptomatic.
I would appreciate any thoughts you might have on any of this. Thanks so much for all your help. |
Robert N. Oglesby DVM
Moderator
Username: Dro
Post Number: 12233
Registered: 1-1997
| | Posted on Sunday, Mar 6, 2005 - 8:57 am: | |
Whether you call it RAO, COPD, or heaves it is all the same and the idea that this requires lots of expensive medications runs counter to my 20 year experience with dozens of cases. I hope they didn't suggest wetting hay and reducing barn time: both have been shown ineffective, the article explains why. Study our article on heaves, as suggested in my first post, for effective management and relatively inexpensive treatments that are at least as effective, and probaby more effective. You should discuss this with the veterinarians who prescribed all this expensive stuff and your regular vet.
DrO |
