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Discussion on Vet confused about heart sound, help | |
Author | Message |
Member: quatro |
Posted on Sunday, Feb 3, 2008 - 10:07 pm: Dr. O, as you know we have limited horse vets in our area, so the vet I had out tonight, basically said he had never heard a heart sound like Dusty had.We just lost our dog of 14 years on Thursday, so did not need more sadness. Anyhow, I will try to be brief, and hope you can send me in a direction Dusty is our 20+ (no idea of how old) Buckskin. I have written to you on him over the years on weight problems, and diarrhea. We have figured that the diarrhea basically is from the alfalfa, and he has on and off bouts of diarrhea. He has had the runs in the last month, but lately pretty mushy, but formed. AS of yesterday, he was neighing for food, eating and pooping normal for him. Today my worker fed him and said he was at the gate, when she put his watered down senior feed in, and started to eat. I went out 1 1/2 hours later and he was laying down. He never lays down, and if he does he jumps up. He is a very spooky horse, having been abused and beaten before I got him. 8 years ago. I walked him around, gave him oral banamine, and finally put him on the trailer. They always poop on the trailer. 20 minutes later, he pooped a normal poop. When we walked he pawed the snow and grazed the dead grass.. I put him back in the stall, he showed interest in the alfalfa I gave him, nuzzled and ate some, but when I returned he was back down. WE had a hard time getting him up. Called the vet again, advised to give him more banamine. 1/2 hours later he was back down in his stall, did not want to get up. Got him up and walked him. No signs of colic like side kicking, rolling etc. Just laying his head down on his side closing his eyes, just tired out. Finally convinced the vet to come, I am sure he was watching the super bowl. He examined him, and said his gut sounds were hyper, so lots of noise, more than what is normal, but not really colicy like. Respiration was normal. But his heart sounded like nothing he had ever heard before. I listened and the best way I could describe it was a "thump followed by a slow vibrating hiss" then repeating He said it was not an arrythmia, nor leaky valve sound, never heard it before. He had a very weird symptom, gelding with recurring erection all day. I worried about blocked urethrea, bean something. So he said he would sedate him a little, 400 lb. worth of rompum 1/2 dose. Well he wavered and went down. HE did not expect that, although I did since he wanted to lay down without the rompum.???? DUH! Anyhow, no bean or blocked urethea. Basically he was baffled, gave him some "horse version of morphine, forget the name, banimine injection, and some bute? He has been sleeping ever since. He pretty much was the on call vet and said he did not know what was up, call him in the morning. Is he dying or what? I just lost my Sage girl, on Thursday or 14 years. No diffinitive answer from this guy. I will check on him, all nite I am sure, but he did not think it was a colic and all, so did not want me walk him around. Is this a sound in the heart that you know of? Thanks, I hope I hear from someone soon. suz |
Member: ekaufman |
Posted on Sunday, Feb 3, 2008 - 10:30 pm: Oh Susan, trouble comes in waves.What were the vitals on this guy? Temp? Gas colics can present like this-- hypermotile gut sounds w/o impaction. But so can a lot of things. He's an older horse, so a number of the symptoms may be red herrings. I would remove feed if you haven't already. If it is a colic, he needs time to come around. Not all colics thrash or roll-- depends a lot on the horse and the type of pain. I hope he comes around overnight. SOunds like he has a lot of pain relief, which should help him. Let us know what happens. |
Member: scooter |
Posted on Monday, Feb 4, 2008 - 5:15 am: Susan, When Hank gas colics he acts just like that...including the erection. That is how I usually know he doesn't feel well. Don't know about the heart sounds, hopefully it is as simple as a mild gas colic. You never know with the seniors. Keeping fingers crossed for you. |
Moderator: DrO |
Posted on Monday, Feb 4, 2008 - 6:42 am: Hello Susan,Sorry to hear about your problems. There is not enough information in your post to know what is going on for sure nor how serious it is. Elizabeth is right, knowing the pre and post treatment vital signs gives important indications of how serious this is, see Diseases of Horses » First Aid » Taking Temperature, Pulse, and Respiration. Your description sounds like a heart murmur but since you say that is not the cause I really cannot guess what else it might be. How is the horse doing this morning? DrO |
Member: quatro |
Posted on Monday, Feb 4, 2008 - 12:55 pm: My internet is not working well. Dusty was up last night around 10:30. Shows interest in food, but does not eat. This morning when I went out he was up, offered food, smelled walked away. He was however, shivering, I blanketed him, he later layed down. I gave him 12 cc of banamine orally. I do not know what his temp is as I can not take it alone, he is the horse that had been abused before we got him, so he clenches his tail and butt, when you get near him. Surprisingly the vet did NOT take his temp last night, so I do not know what it is.I let him out with the others so he would walk around some. He walked to food, did not eat, but I did see him drink some water. He was out for about an hour, and then I saw him laying down in the snow, so I brought him back in. I don't know if I should just keep and eye on him, or call and have the vet come out and pay him for a farm call, so that he can tell me, "gee, I never heard a heart sound like that before" Give him some pain shots, and move on.??? He acts just tired and lethargic, not really in pain, just tired. He did chase off the other horses, as he is alpha, when they bugged him, with ears pinned etc. If I have a vet out, what should I tell them to do, seems like that should be their job, but here we go with pig and cow vets! He was a very nice gentlemen, but I was hoping he would research the diagnostics?? Tom asked him when he called if he found out anything on the heartbeat, and he said nope! Frustrated as usual suz |
Member: ekaufman |
Posted on Monday, Feb 4, 2008 - 4:17 pm: Hi Susan,You need to get vitals on this boy. Does he still have gut sounds? Both sides? Up and down? Are you able to monitor for fresh poop? How are his gums? I would be inclined to interpret the lying down as pain. Many horses do not roll or thrash in pain. And bear in mind the heart murmur, if that's what it is, may not be related to the current episode. He may have had that for years. Does he have digital pulses elevated in his feet? Are his feet hot? Is his stance normal? What about his walk? Is there any way you can confine him with water and without food and get some help to check his vitals? This may be a terrible illness, or it may be something that will pass on its own. But there's a middle ground where he needs your help, based on a diagnosis, in order to get through. And unfortunately observing him isn't going to get you the diagnostic info you need fast enough. Maybe print off some of the articles and hand them to your vet. I'm sure this is awful for you, but it sounds like you're going to need to find some creative ways to get some more info.. Good luck! |
Member: ajudson1 |
Posted on Monday, Feb 4, 2008 - 4:37 pm: I know somewhat what you are going through. My "cow & pig" vet has horses but beyond simple every day things isn't much help. (And I can handle the simple stuff myself)Can you call a vet that specializes more in horses even one that isn't real close? They just may have seen something similar recently and have some answers and advice. Or they may be in the area (I've been that lucky a few times) and be willing to stop over. It don't cost anything to get on the bell and yell, for help! Hopefully it's just a viral thing that passes soon. |
Member: shanson |
Posted on Monday, Feb 4, 2008 - 4:39 pm: I don't recall reading your previous posts so you may have already talked about whether you're mobile or not... Do you have access to a trailer you can use to take your guy to a better vet..maybe the vet teaching hospital in Ames? |
Member: quatro |
Posted on Monday, Feb 4, 2008 - 6:51 pm: Well, the vet left his electronic thermometer here, so I found help to get a temp. It is 99.1. He walks slowly, no tripping, he nibbled at some hay this afternoon, He stands around outside and chews, like he is relaxed. When he lays down, he mostly lays in a normal position, occassionally all out. I can't find my stethoscope, but I can feel his heartbeat on his side, that is weird huh? He has gut sounds on both sides, poop is actually normal formed, not much, but he is not eating much either.The best way to describe him is "tired" Gums are pink and returning normal. I have not checked digital pulse. He has been heavey in the past, but his nostrils are not flared. I did call the clinic, and their horse vet is going to come by in the am with the other vet, to retrieve his thermometer, and they will both listen to his heart. And hopefully a plan. He has no temp, the vet said no fluid in lungs, heart did not sound washing machine like noise, he said his respiration was fine. Dusty could be 28-30 years old. I honestly don't know. I have had him 11 years, and he was supposed to be 13 ish, but we think we were swindled. He is an old branded ranch horse, with windpuffs, a big chunk missing from his rump ????, and a scar on his nose from someone leaving a halter on forever. He had a very rough life before coming to be spoiled rotten here. You could not even touch him or farrier him when I got him. When do they just get old and their heart just does not keep up? Could it be something that simple. I just went into major debt with losing my poor Sage. It is snowing, and a trip to my other horse vet is 2 1/2 hours. I don't think he could take the trip standing that long. We are also in the midst of snow and ice storm, so that is out for now. I wish they could give me some good drugs to get through all this stress of animal care I am going to give him another dose of banamine at 10:30 ish, he had 12 cc at 3pm, to help him through the nite, and hope for something tomorrow. suz |
Member: quatro |
Posted on Monday, Feb 4, 2008 - 8:52 pm: I don't know if i did this right but i counted his heart beats for 30 seconds it was 22, so I quess that is 44, another thing, We did catch a opposum in the barn yesterday. He has been around here for several weeks, never saw him in the barn however. Could this be early epm signs? I will read the article on epm right now. Have never seen any poop of any kind in their hay, I check it always before I feed.Will check on him in a few minutes. thanks sue |
Moderator: DrO |
Posted on Tuesday, Feb 5, 2008 - 7:07 am: How about the respiratory rate Susan is it remaining normal? How does he respond to the flunixin (Banamine)? With a normal heart rate and pink gums with normal refill depression from heart disease seems unlikely. But I will be interested to hear in the judgement of the veterinarians. There is a "special language" used to describe heart sounds that includes loudness, when in the cycle they occur, how long they occur, and overall characteristics. Ask them to describe it to you and if you will write down exactly their description we can review it.DrO |
Member: quatro |
Posted on Tuesday, Feb 5, 2008 - 6:44 pm: Thanks Dr. O, The 2 vets came to see Dusty today. He was actually up this am, still not interested in food, but up! I could no longer feel his heart thumping in the palm of my hand. The horse vet described what he heard in his heart as "blood entering one of the chambers and swirling around like in a drain before it emptied out" He felt this was an incidental discovery, not really the problem, probably an old age issue. Under the swirling noise, he felt that he had a "very strong" heart beat. Lungs were clear, respiration normal, temp 99.1, no dehydration.I had described to him how he usually has very loose stool, sometimes diarrhea, off and on. The last few stool I have seen have been hard and round, unusual for him. He also stated that he has had numerous calls in the last few weeks, especially with older horses, with similar symptoms lasting 2-6 days. We have had sub-zero (-22) with -45 windchills here. He feels that the horses are not drinking enough water in the sub zero temps, causing mild impactions, with pain. He did not think it warranted tubing him. He does not drink much normally, and I do believe his consumption has been down, now that I think of it. He said to wean him off the banamine, and try to get him to drink more, add a cup of bran to his feed when he gets back on his feed. On a Great Note! He is not 100% better, but definatelly not worse. He has nibbled at hay, not layed down all day, I caught him drinking 2 x outside today, and this pm when I fed the other horses their grain, I offered him alfalfa cubes that I had soaked for an hour in hot water, they were very wet and mushy. He put his head in the bowl, and every so slowly is eating as we speak. I will give him another 12 cc of banamine tonight, keep him blanketed and say my prayers. I am sure you don't have the sub zero's to deal with, but does this make sense to you? Any other suggestions? suz suz |
Member: ekaufman |
Posted on Tuesday, Feb 5, 2008 - 6:52 pm: Hi Suzanne,If I even suspect impaction, I take them off food completely. It really isn't helping him to encourage him to pile food behind an impaction until it clears completely. If they didn't tube him, did they recommend electrolytes? It's hard to make a horse drink more (though you can lead them to it, as the saying goes). Why do they want him off banamine if he's still painful? Dr. O's article talks about care for impacted horses..... Good luck. |
Member: scooter |
Posted on Tuesday, Feb 5, 2008 - 7:02 pm: Hi susan, I have the same problem with this crazy weather, the horses looked "tucked" up to me like they weren't drinking enough so in an attempt to ward off any problems their Safechoice/alfalfa pellets/ mush has over a gallon of water each feeding a.m and pm. That way I know they are getting at least 2 gallons of water a day and they slurp the stuff right up. Good luck with the old guy |
Member: quatro |
Posted on Tuesday, Feb 5, 2008 - 8:16 pm: Thanks Elizabeth for referring to Dr. O's article, I read the cecal impaction one. He pretty much has kept his self off food since Sunday. He had passed a "Normal for him" mushyier stool this AM. He has been out all day, so don't know if he had another. The wet alfalfa cubes were just barely eaten, but he is trying to eat. Of course the vets did not do a rectal exam? I can only work with what I have here. He is definately not his old self, but I guess I have to be happy with improved, not worse.Questioning if it is a tooth issue, He tried to look in his mouth, but he was just getting way to stressed, did not want to sedate him for this, but if he had an abscess or problem, would you think he would have a fever? The vet said he did not think he was having any circulatory problems, no extremities issue etc. So he does not think the heart has a big play in this. He did not suggest taking him off of his food though. I don't know which way to go. The vets' came out and brought my Sage girls ashes with them, as she was cremated at their clinic, so I am still a bit too emotional to have to deal with this issue as well. thanks suz |
Member: freshman |
Posted on Tuesday, Feb 5, 2008 - 8:18 pm: Unless the horse is very painful, I'd be very conservative with the banamine. An aged horse that may or may not be drinking enough to stay hydrated is at a very high risk for kidney damage. It may be best to give him at least one or more days off the banamine to see what his response is and to give his body a break. If he isn't managable without the banamine on board, then it may be best to get him to an equine hospital to sort out what is going on with him. |
Moderator: DrO |
Posted on Wednesday, Feb 6, 2008 - 7:47 am: Susan, essentially I think they are saying after a good examination they are unable to tell you why your horse feels bad but there do not appear to be any serious issues...at this time. If this is true this is a reasonable approach but without examining the horse I cannot say if this is the approach I would take. If I suspected impaction I would be doing what is in the article.I disagree with freshman's assessment of the benefit vs risk of flunixin in your case. It is true older horses are at increased risk of kidney problems with NSAID use but since the initial risk with a once or even twice a day administration of the recommended dose of flunixin over a weeks time. This increase over the recommended frequency and duration of use is in my opinion worth the benefits of trying to get the horse comfortable and back drinking water. I do question the necessity of giving 12 cc's however. How much is this horse estimated to weigh? Unless this turns around very soon one thing I would recommend doing is run a chem panel and CBD and in that panel looked at kidney function. DrO |
Member: quatro |
Posted on Wednesday, Feb 6, 2008 - 10:40 am: Hi Dr. O, here is where we are this am. Still standing, offered grain, did not even look at it. Had 1 normal size pile of mushy frozen poop. This again, is more normal for him. When I came back to let him out, he had put his nose in the grain, as it was mushed around, but not eaten. Let him out with the others, Went to all 3 hay piles, pushed the hay around, did not eat any that I saw. Busy morning at the kennel. Later, I looked out and he was licking on a brand new salt block I got yesterday, shortly after went over and took a drink of water. 1/2 hour later, he is in the barn in one of the stall, with another pile of wet mushy poop behind him?When he eats he chews it like in slow motion. Do you think I should insist they come out and look at his mouth, like maybe this is a tooth issue??? I can rub all over his jaw, with no pain response, only his normal annoyance for daring to touch his head. He acts interested in food, then turns away? Or should I just take the advice of the vet who came yesterday who said it takes 4-6 days to resolve itself. We are on day 4 now. I wish I had the confidence in my local vets that I have in your opinion! thanks sue |
Member: scooter |
Posted on Wednesday, Feb 6, 2008 - 11:22 am: Hi Susan, I had a post in here a few years ago called colic or teeth problems. My mare acted the same way, except she would eat grain, and had profuse diaharea. She wouldn't eat hay or grass unless I gave her banamine, then she would eat well for awhile, until her next banamine shot.I'm sure your gelding probably doesn't have whatever her problem was, but once Dr.O. saw her blood reports he said she was dehydrated. My vet at the time didn't tell me that!! she was drinking some water on her own...not much tho. I had the vet out to hydrate her IV and that is what turned the whole thing around. She felt better immediately and was a new horse in a few days. She never ran a fever, but did have an elevated heart rate for a day or 2. Could you have a blood test done to check how things are going inside? Just throwing some ideas out...When I suspect a colic, but not sure, I do the carrot (or whatever treat they love) test, if they refuse it Usually it is colic...I know not very scientific, but gives me a starting point. Even Hog Hank will turn up his nose at a carrot when he has a belly ache, tho it isn't glaringly apparent otherwise. Hope your horse is better soon. |
Member: ekaufman |
Posted on Wednesday, Feb 6, 2008 - 2:09 pm: Hi Susan,Well, if poop is coming out, then food must be going in, even if it seems like it's only a very small amount. Wish I could help diagnose this, except to say that if he is licking a salt block, drinking, and pooping on day 4, he seems to be holding his own. Sure hope he continues to improve, and that you get some rest also. |
Member: quatro |
Posted on Wednesday, Feb 6, 2008 - 10:36 pm: I posted something earlier, and it got lost in the cyber space I guess.My questions was whether I should insist on someone looking at Dusty's mouth. Tonight he tried to eat his grain, put his face in the bucket, I hand fed him some apple and a horse treat, he gingerly takes it from my hand and slowly chews it. Also, tonight, he drank about inches of water from his 5 gallon bucket, but there was a quid of hay floating in it. My gut tells me that his teeth or mouth is sore, and that of course would lead to tummy problems. Would anyone else think this? I did not give him any banamine today, as he seemed just lethargic, not really in pain, and he was slowly consuming at least soft hay, the leaffy part of the alfalfa, and had runny poop. Would not the runny poop also be a sign of tooth problems?? thanks |
Moderator: DrO |
Posted on Thursday, Feb 7, 2008 - 9:01 am: Certainly if the horse appears to have trouble chewing Susan, you should have the mouth examined. The runny poop would not be evidence of tooth problems however.DrO |
Member: quatro |
Posted on Thursday, Feb 7, 2008 - 7:24 pm: Dusty had a billion piles of runny poop this am. he ate 1/2 of his mushy breakfast, and was munching on hay. In fact ate a bunch of hay last nite, almost an entire bucket of water.Had the vet out about his teeth, but he was reluctant to sedate him to check it out until, we were sure he was out of the woods. I will schedule a floating next week, when he gets his strength back up. this new vet concurred with the other vets that he had never heard a heart like that. He said it sounded like a thump/then a whirly gig sound, like thump/zzzzzzzzzzzzzzzzzzzzzzzzzzzz. He had never heard of it, but said no other outward heart disease signs, fluid retention in limbs, lungs cough, no other signs. Did not know what it was, probably a murmur of some sort he said. Gave him some probiotics/ no drugs, and tonight he ate all of his grain, drank water, and is munching even grass hay, found some really soft stuff. Feels like we are doing OK, so I will just keep a close eye on him, keep him blanketed. Washed off his poopy tail/butt, keep moving forward. Thanks for all of your help and support suz |
Member: mysi |
Posted on Thursday, Feb 7, 2008 - 10:07 pm: So glad to hear he's improving and eating again! |
Moderator: DrO |
Posted on Friday, Feb 8, 2008 - 6:41 am: A billion piles of runny poop in combination with feeling better: could this be an impaction that has let loose Susan? How big are the piles and does any of the stool have a sticky light colored mucousy membrane associated with it?DrO |
Member: quatro |
Posted on Friday, Feb 8, 2008 - 7:50 pm: Dr. O, I think you are right about the impaction letting loose. It was hard to tell what the stool looked like as it was frozen, It is warmer in the barn, but still very cold here.He had mushy (normal for him) piles of poop this am. and he drank almost a whole 5 gallon bucket of water. That is great, that salt lick outside is helping I think. He has one in his stall, mineral block small wall mounted one, but he really likes the big salt block. Tonight he had runny poop in his stall again, just mushed up hay. He ate his normal portion of senior feed, and whinnyed for his hay tonight as well. This really soft grass hay, mixed with some leafy alfalfa seems to be making him happy. The other hay he was eating was pretty coarse grass hay, What is your opinion on the sound of his heart? At his age, should I try to find out what it is? Is there anything that could be done, if it is a murmur of sorts? The 3 vets that listed to them just shook their heads, said they never heard anything like it, and never offered to find out more, just said they are not cardiologists. He is retired, so only walks around his pasture for a job.? |
Member: zarr |
Posted on Friday, Feb 8, 2008 - 8:45 pm: Susan have not posted on this yet as I have no horse experience with horse heart troubles What I do have is experience what you describe is my mothers heart sounds plus tiredness, lack of appetite etc! But mainly the sound it is EXACTLY what hers was and it was a defective valve(aortic).She finally had it replaced but don't know for horses. Altho I remember 2 things very clear: one thing is Dr.DeBakey's red cowboy boots and the second was the swishing sound when he let us listen to her heart. I would think Dusty will set his own pace and his world may get smaller but you will be in and that will be good enough for Dusty! Cindy |
Moderator: DrO |
Posted on Saturday, Feb 9, 2008 - 7:18 am: Susan, Cindy is likely to be right a murmur in a older horse is likely to be a valve problem. To attempt further localization we need a bit more information: during what part of the heart cycle did it occur: does the thump in your post represent the first or the second heart sound? And is the murmur followed by the next heart sound or does the thump-murmur repeat with the same character and somewhere one of the heart sounds lost in the murmur?DrO |
Member: quatro |
Posted on Saturday, Feb 9, 2008 - 11:16 pm: Dr. O, I still have not found my stethoscope. I will try to get this pinned down next week. When I listened to it, you only heard one thump then the zzzzzzzzzz. the other thump was covered over, if that makes any sense. It sounds like"thump-zzzzzzz thump-zzzzzz thump-zzzzzzzzz" Is there meds that he could be on to make sure this does not shorten his days, or just part of old age. I will have to transport him someday to someone who knows what is up, if it is something you think is able to be helped/ short of surgery obviously. thanks We are having another below zero days ahead. I am keeping him blanketed, and his appetite is back. Still has runny poop, but I think that is better than backed up. Drinking really well, especially for him, he hardly drinks normally. thanks suz suz |
Moderator: DrO |
Posted on Tuesday, Feb 12, 2008 - 10:11 am: Appropriate localization of the sound to a particular valve Susan does not tell us why the valve is malfunctioning. Some causes may be treatable, like infectious endocarditis. Diagnosis of a cause usually starts with a ultrasound where some lesions are visualized. When a valve dysfunction is causing clinical signs there are some drugs which can improve heart function but these are expensive and time consuming to institute and partially because of side effects that require frequent monitoring. Currently such treatment is not common place.As common a problem as this is it would make a great article so I will see if I can get one up in the next week or so. DrO |
Member: quatro |
Posted on Tuesday, Feb 12, 2008 - 6:54 pm: Thanks Dr. O, if you would love to come to -16 degrees, with -35 windchills, you are welcome to come out and listen to Dusty HeartDo you think I should be concerned about sedating him to do his teeth? I am sure the reason he went down when the vet sedated him with enough "for a 400 lb horse" was because he was already down. But the one vet is now nervous about sedating him, what is your feeling on this? suz |
Moderator: DrO |
Posted on Wednesday, Feb 13, 2008 - 10:25 am: Susan, this will be a decision that needs to be made by someone who can examine him at the time of sedation. Though I have no experience with it chloral hydrate is supposed to be a good sedative with minimal effects on blood pressure.More commonly used is the inclusion of the narcotic butorphanol with xylazine or detomidine which may decrease the cardiovascular effects (though I can find no work to back it up or refute it). You can read more about this in the Sedative Topic. DrO |
Member: quatro |
Posted on Wednesday, Feb 13, 2008 - 10:24 pm: Thanks Dr. O, I will question them about this when it is time. I think I am going to try to put it off until we get through this nasty cold snap. That could be May the way we are going around here.I will read the article though. suz |