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Elizabeth Sambor
Member
Username: sambor
Post Number: 17
Registered: 6-2003
| | Posted on Monday, Feb 18, 2008 - 2:09 pm: |   |
Dr.O
To make a long story short we had a mare and colt that was released from a hospital (mare was in for chip removal). Colt acquired salmonella infection while being at the hospital. When the horses were released they did not inform us that all cultures were not back yet and two days after getting the horses to the farm we were told the PCR was positive for the colt. We have kept him in isolation (separate farm) and have been doing precautions. This was about 5 months ago, the colt is still having diarrhea. The local vet thought it was due do the fact he was on antibiotics (the hospital had him on them for weeks). We have been culturing him for salmonella intermittently and the last set came back with PCR+. Since he still has diarrhea do we treat? We do not know what to do at this point. This is a clients horse and he wants to sell which we can not do for him till colt is neg and free of loose stools. We do not feel that the hospital did the right thing releasing him prior to neg. culture results but that is neither here or there. I am def. concerned with the diarrhea for months like he has had. Any ideas? |
Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 20103
Registered: 1-1997
| | Posted on Tuesday, Feb 19, 2008 - 6:33 am: | |
Hello Elizabeth,
The decision to treat and to treat with what depends on the assessment of why the diarrhea is ongoing but I can commiserate with you and your veterinarian, this is not always an easily answered question. Is there any indication of malabsorption? This is a important question as this may indicate scarring of the bowel that will not heal, for more on diagnosis see Diseases of Horses » Colic, Diarrhea, GI Tract » Weight Loss in Horses » Malabsorption in Horses.
If there is no malabsorption, the presence of Salmonella is not enough to say if it still is the problem causing diarrhea and even if it is further antibiotic therapy is of questionable benefit. The decision on how to treat depends on the whole clinical picture and if your veterinarians gut feeling that the problem is an upset digestive flora, I would aim my efforts at slowly establishing a simple high fiber diet and returning the flora to normal and one of the best ways I know how to is with a fecal transfaunation. Messy and smelly yes but in a small number of cases can give remarkable results. The article on chronic diarrhea has a description of this and several other suggestions but as long as upset bowel fauna is the diagnosis you should avoid anything that would further upset the fauna, for more see Diseases of Horses » Colic, Diarrhea, GI Tract » Diarrhea in Horses » Diarrhea an Overview.
DrO |
Elizabeth Sambor
Member
Username: sambor
Post Number: 18
Registered: 6-2003
| | Posted on Wednesday, Feb 20, 2008 - 9:22 pm: | |
DrO,
Thanks for your quick response. Not sure of the malabsorption, the colt is a little under weight but not extremely. He has free choice good quality second cut hay but he is not a great eater. He does eat his grain ok, he is on 3 pounds pellets. Should we try him off of the grain?
Not sure about getting him diagnosed either I have no intentions of putting a horse who is actively shedding Salmonella on a trailer to take him somewhere to get a glucose tolerance test done is there any other way to diagnose that would be easier to do with him here at the farm?
I am concerned about him having damage to his bowel. At the hospital he was on long term antibiotics, my concern was when he came to the farm he was still on them and I believe it was a broad spectrum antibiotic. I will try and pull the name up tomorrow but from my understanding that would be the worst kind of antibiotic to be on. Is there a lot of controversy on treatment and that is why a large equine hospital would be treating differently then the recommendations here?
I would believe with the length of time of antibiotic treatment he would not have healthy bacteria left in his bowel. We did try yogurt and Probios we also took manure from healthy horses up to his feeding area, we did not yet try fecal transfaunation. My vet thought by now he would be starting to develop some normal bacteria again and was leaning toward trying to treat the salmonella. Is there a way to check the stool or bowel and know where we stand with his bacteria levels?
Thank you so much for your time, your website is a wonderful benefit to the equine community. |
Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 20111
Registered: 1-1997
| | Posted on Thursday, Feb 21, 2008 - 7:14 am: | |
Thanks for the kudos Elizabeth.
The answer to your question of is there any way to tell if Salmonella is causing the problem the answer is no. Salmonella is isolated from both normal and die If you choose to treat it I would strongly recommend you only do it if you can culture it and get a sensitivity. And use that antibiotic only. If the horse is underweight I would not remove concentrate from the diet for any prolonged period. If you want to discontinue it for a short period to see if it makes a difference you could. We have a long list of recommendations in the diarrhea overview that can be tried to see if one works. Some horses respond to some but not others we don't know why.
Concerning malabsorption diagnosis (I think you meant to say xylose?) the article referenced above has some recommendations of things that can be done at the farm.
What differences in recommendations for care with our article did you note your horse receiving at the hospital? It has been well noted that human hospitals are guilty of the over use of antibiotics and veterinary hospitals are no better. But that is not the same as did this occur with your horse, there are indications described in the article where antibiotics should be used.
DrO |
Elizabeth Sambor
Member
Username: sambor
Post Number: 19
Registered: 6-2003
| | Posted on Thursday, Feb 21, 2008 - 9:58 am: | |
DrO,
Would you try the fecal transfaunation at this point? How long is normal to reculture the bowel months? Years? We have also thought of adding beet pulp to his diet since he is not a great hay eater do you think that is reasonable for a 6 month old colt.
Sorry for changing terms on you the test described in the article is the equivalent of the human glucose tolerance test since I am a RN it was the term that came to mind.
The hospital in question I have had some good experiences with but I have a sour taste from this one for the following reasons. They did not run sensitivities and the colt was there for I believe over 6 weeks. They just treated with a general antibiotic. They never tested the mare but told us the colt got it from the mare who must have been a chronic carrier (we tested her multiple times since coming to the farm once during weaning and she tested neg. every time PCR neg also). I know that just like a hospital they did not want to have it appear that the colt acquired it there. They released the colt after 3 cultures not 5 and sent him home before the final culture result was back. They called me 2 days after the colt came home and told me he was positive. The vet then apologized to me and said she did not realize the colt was coming to my farm. We have a large public barn if my husband and I were not medical professionals and did not know how to do proper isolation precautions and understand salmonella we could have spread salmonella to other horses and people. Also I did not understand some of the treatment on the mare. She had severe ulcers and was underweight. The treated with ulcergaurd but had her on 20 pounds of grain per day. My understanding is you can create ulcers by high amounts of concetrates. When the mare came to the farm we slowly cut her down to 10 then 8 pounds of grain gave her free choice second cut hay and later added alfalfa and she gained weight beautifully. We kept her on the ulcergaurd of course and she has recovered fully. The other clinic I consulted was a little puzzled over all of the above also. I guess I am just a little frustrated with having to deal with the whole situation, sorry for venting. |
Elizabeth Sambor
Member
Username: sambor
Post Number: 20
Registered: 6-2003
| | Posted on Thursday, Feb 21, 2008 - 9:57 pm: | |
DrO,
The antibiotic that they had the colt on was Naxcel. |
Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 20116
Registered: 1-1997
| | Posted on Friday, Feb 22, 2008 - 6:59 am: | |
The decision to use any particular treatment must be based on an examination Elizabeth. In general if I believed the cause was upset flora and it did not turn around quick, yes I would give it a try. I have had antibiotic induced diarrheas turn around with it. The problem of upset flora is not well studied so I don't have any "normal" turn around times following antibiotic administration. Some horses are never bothered by antibiotics others develop chronic problems, we really don't understand this problem very well at all.
As long as the protein and vitamin deficiency and calcium/phosphorus imbalances are addressed beet pulp can be used in growing horses. For ways to address this problem see, Horse Care » Equine Nutrition, Horse Feeds, Feeding » Beet Pulp.
DrO |
Elizabeth Sambor
Member
Username: sambor
Post Number: 21
Registered: 6-2003
| | Posted on Friday, Feb 22, 2008 - 9:00 am: | |
Hi,
Thanks again for you time. I guess there is no clear cut answers to this colts problems. I have a question about horses being Chronic carriers of Salmonella. Some articles say horses are not chronic carriers and some say they are. Which is it? One Vet told me only extreme stress would make a horse shed (like hospitalization) others said any stress. Makes me wonder if this colt should ever be introduced into a herd once he tests neg. or do you have to continue testing if you think the colt is in a stressful situation? |
dieliz
Member
Username: dsibley
Post Number: 100
Registered: 11-2005
| | Posted on Saturday, Feb 23, 2008 - 8:28 am: | |
Just a question, Elizabeth: did the colt ever run a temp? Is he running a fever at all now? It is my very humble layman's understanding that if a horse has diarrhea they might test mildly positive as the bacteria is shedding at a higher level due to the increased 'activity'. Doctor O, can you clarify this?
***And I ditto the kudos sent earlier, Dr. O! You have been a huge source of knowledge on this website! Wish you were closer to me so you could be my ponies' personal Doc!!!*** |
Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 20122
Registered: 1-1997
| | Posted on Saturday, Feb 23, 2008 - 10:43 am: | |
Clear cut answers would be the exception but don't let that stop you from trying. More often than not one of the recommended therapies in our article will greatly reduce the diarrhea, we just don't know which one. Try them in the order that makes the most sense to you and your veterinarian, make dietary changes slowly, and give them 2 or 3 weeks to work. Keep a diary.
The problem of silent carriers with intermittent shedding without displaying signs of disease is real but because it appears almost any horse can shed at some times I am not sure what the meaning of this is. A question unanswered is whether the amount of shedding represents a danger and if so under what conditions. And always the species serovar are important concerning pathogenicity.
Concerning when it will be safe to mix this horse with others, if you need strong proof, I wold use the "5 consecutive negative culture rule" but the fact of the matter is that after these horses return to normal they very rarely cause any problems in the home population they are returned to. The fact your horse has ongoing diarrhea does suggest caution however.
DrO |
Elizabeth Sambor
Member
Username: sambor
Post Number: 22
Registered: 6-2003
| | Posted on Saturday, Feb 23, 2008 - 11:42 pm: | |
He did have a temp after coming home from the hospital, does not have one at this time.
My concern is that since he has had diarrhea since he was 7 weeks old that by now he has done permanent damage to his bowel and will never return to normal. |
Vicki Zaneis
Member
Username: vickiann
Post Number: 589
Registered: 3-2005
| | Posted on Sunday, Feb 24, 2008 - 11:35 am: | |
Elizabeth -- A neighbor and I each had a horse come down with salmonellosis after being at a riding clinic for a few days (they were housed in stalls that adjoined where what was on the floor could make make its way to the next stall. I treated aggressively with the indicated antibiotics based on efficacy tests and my Vet. also tubed activated charcoal into my gelding, who was 8 - 9 years old then. My friend had a young filly, and she elected not to aggressively treat but rather simply isolated the horse. It took time for each of us to have our horse test clear, with setbacks in the course of testing. Prior to becoming ill, my guy had already had a runny manure situation, which continued for many more long years. The filly cleared up in that regard. Each of us have other horses, and it was never passed on to any others to the best of our knowledge. I read somewhere that if a large number of horses were randomly tested, a large percentage would come back positive, without any obvious symptoms or problems. The old, young, and infirm are those most apt to be effected. My gelding got severely heat stressed the week he became ill, had stopped sweating and was dehydrated. I had worked him beyond what was sensible by trail riding, team penning and participating in a clinic when the dew point was so high that it made no sense to work a horse. I was new to horses and my friend who knew more said "You can't hurt that big horse," which proved to be very wrong. Over the years, I tried all of the suggested remedies to slow up the diarrhea, which would be bad most summers. He has been great for over a year now, more healthy and happy and sound than ever, which I could attribute partly to finally finding the right diet, fixing his painful feet (stressful) and getting him properly wormed. I think that Dr. O's worming plan, followed to the letter, had the most to do with his now resolved diarrhea condition. Good luck to you. In my experience, the messy butt situation was more time consuming and tiresome than anything. |
Vicki Zaneis
Member
Username: vickiann
Post Number: 590
Registered: 3-2005
| | Posted on Sunday, Feb 24, 2008 - 11:40 am: | |
Last sentence should have indicated that the messy butt was tiresome and time consuming over the years, but that it did not seem to effect the general health of the horse. If you experiment with the various remedies, perhaps something will work for you. For me, some would seem to help temporarily but not be a real cure, until the problem was resolved a little over a year ago, for which I am very thankful. |
horseygran
Member
Username: horsgran
Post Number: 16
Registered: 8-2008
| | Posted on Thursday, Aug 28, 2008 - 6:29 am: | |
I have been told that the product Rotagen for calves works also wonder for foals affected by salmonella and other scours. You can check that natural product in the following link:
http://www.vetpack.co.nz/pages/welcome/products/rotagen-combo.php
I am not promoting it as I don't have any personal interest but thought it is worth considering any available treatment. |
