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Discussion on Pneumonia type bacteria...not responding to antibiotics

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Anne Guillory
New Member
Username: jugg

Post Number: 1
Registered: 11-2008
Posted on Saturday, Nov 22, 2008 - 3:42 pm:   Edit PostPrint Post

I have a horse who coughs ONLY when initially moving faster than a walk when warming him up under saddle. The last scope/culture said he still had a pneumonia type bacteria and showed minor mucus in his throat.

Now some background: He started coughing last spring. Vet told me he thought it was probably just allergies...gave me some ventipulmin. Didn't seem to help. Alley problems creep in...get worse. I finally take him to another vet about the cough. That vet finally scopes him but doesn't pull a culture. He puts him on a round of SMZ's. Cough becomes less frequent (meaning he'd cough like every other ride) but is still there. Same vet says to give him another round of antibiotics....this time Baytril. Cough seems to come back as bad as it was originally. Finally, another vet says, "Lets do a tracheal wash, culture, scope and see what we are dealing with!" OK!!! Culture comes back with 2 different bacteria...one was the pneumonia type bacteria and the other I can't remember but vet says, "He's definitely bled on you and that's why he has this infection." Vet keeps him for 2 wks and give him 10 days of SMZ's, Gentimicin (sp?), and 10 hyperbaric chamber treatments. CHA CHING$$$$$$ Tells me to take him home and give him 10 more days of SMZ's and then try to ride and see what we've got. Horse now only coughs about every 3 or 4th ride. I demand another culture and scope. This time we've only got the pneumonia bacteria and the scope is the best it's been....meaning very little mucus....but still some puddled in his throat (versus the river he had initially flowing down there!!) We decide to give him a round of Naxel since it is supposed to work on the pneumonia bacteria. Rode him 5 days in a row...no cough. On the sixth day he coughed 1 lite cough. On the seventh day he coughed 2 hard coughs.

Where do I go from here? He's been on PulmonEZ topdress daily. He's turned out to pasture at night and kept inside a stall during the day only if I'm working him that day. Is this pneumonia bacteria from allergies? He's been boosted with a Flu/Rhino shot when all these treatments started. I had him for a year before the cough thing started. It started once I began competing on him(he is used for barrel racing)and making fast runs. Forgot to also mention that vet had me try him on Tri-hist granules and they did not make the cough go away, either. We have been fighting this for about 5 months now....I am about to give up!!!! Need help now!!!!!!
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Rachelle E. Morris
Member
Username: rtrotter

Post Number: 89
Registered: 4-2008
Posted on Saturday, Nov 22, 2008 - 9:32 pm:   Edit PostPrint Post

Anne,

Are you sure the vet said pneumonia or something else like pseudomonas( almost sounds like pneumonia, but needs a different treatment).

The reason I think this is because I had a horse that had pseudomonas bacteria in his knee, found upon culturing the day after I bought him out of a horse sale in Delaware. The horse was on a similar regiment as yours with the same types of antibiotics as well as flushing the knee joint with antibiotics. The only antibiotic that this particular bacteria strain was sensitive to was chloraphenicol. With everything else he would get partially better and then relapse. The chloraphenicol was used as a last resort, but it did work. The knee cultured clean, unfortunately for this horse there was so much damage done to the knee joint from the months before the problem was diagnosed ( previous owners) that he had to be euthanized because he could not be kept pain free without large daily doses of bute and dexamethazone. Without the drugs twice a day he was three legged lame within hours. I attempted to wean him off the dex, but I would get to a certain level and his pain returned. I did not think it was fair to him to make him continue in this mode, so I made the heart wrenching decision to put him down.

You might want to ask your vet about the chloraphenicol. The only downside was that it is given orally 3 times a day. My schedule was 6am, 2pm and 10 pm. and I do not remember how many days I gave it, but I know it was for quite some time.
Rachelle
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Anne Guillory
New Member
Username: jugg

Post Number: 2
Registered: 11-2008
Posted on Saturday, Nov 22, 2008 - 10:01 pm:   Edit PostPrint Post

Rachelle-

I wish I had a copy of the culture lab report...but yes...the name was somehting somethingpneumonia. LOL and he told me it was called that because it is a bacteria that can cause pneumonia.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 21813
Registered: 1-1997
Posted on Sunday, Nov 23, 2008 - 9:57 am:   Edit PostPrint Post

Welcome Anne,
Having the lab report would help us and could change everything I advise here but without it these are my thoughts.

First let's be clear: it is normal to find bacteria in a TTW. The trachea is not sterile and often pathogens are found in horses who are exhibiting no disease. On tissues where bacteria regularly congregate infection becomes more complicated than the mere presence of bacteria. I attended a lecture last year that found you can culture MERSA (the super staph you hear so mush about) from most veterinarian's nostrils and the more antibiotics the vet handles the more likely MERSA will be found on him.

So here we are with a horse with chronic cough when exercised but otherwise shows no other sign of disease that you describe. By far the most common disease that presents this way would be chronic lower airway inflammation caused by a allergy to the common mold spores found in hay and barns. None of the treatments you have described are effective at treating this problem. I recommend you start with a overview of the problem with Diseases of Horses » Respiratory System » Chronic Cough Without Fever. But if your horse is otherwise healthy, and before you spend another penny on hyperbaric oxygen treatments, I strongly suggest you and your veterinarian consider the management and treatment options presented in Diseases of Horses » Respiratory System » Heaves & Chronic Obstructive Pulmonary Disease. Remember that for horses that have developed this allergic pneumonia that a few minutes exposure to barn air can sensitize the lungs for 21 days.
DrO
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hayley clark
New Member
Username: hayley

Post Number: 5
Registered: 7-2008
Posted on Sunday, Nov 23, 2008 - 9:59 am:   Edit PostPrint Post

Your horses symptoms sound very similar to that my horse had this summer. I had only recently purchased the horse so really did not know what on earth was happening. The horse became more and more exercise intolerent and with the odd cough. The bottom line on that was a high 6/9 inflamation reading from the lab after a lung wash as well as bacterial infection. After futile attempts at trying to knock the infection down first on penicillin then some other antibiotic and then finally Baytril - the latter which bought the grade of inflamation down to 3 after repeated lung washes throughout but there was still high count of bacteria it was to then decided to give a course of steroid inhalers which enabled the inflamation as well as the infection to be dealt with with another course of baytril. It was not clear whether the inflamation was feeding the infection or vis verca. Anyway that bought the score down to 1 which the vet said was acceptable level and the lab report stated no sign of inflamation or infection and indeed the horse was much better. The bottom line is though he does still cough once or twice on exertion in a ride usually the first trot. the vet thinks that this is acceptable provided his respiratory rate has not increased so pointing to an esculation again. The vet whilst to me seemed to take a while to come to this conclusion confirms my horse has COPD (probaby took his time because his colleague didnt pick it up on a purchase vetting!)and this had flared up in May probably due to the pollen. It is quite common I now understand for the inflammation of the lungs to then be suseptible to infection as well. THe horse will therefore always have underlying respiratory issues but with diligent care re no hay straw etc and steroid inhaler when a bad session insues then that is the way forward I am given to understand. Possibly then your horse may have underlying allergy issues too?
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Anne Guillory
New Member
Username: jugg

Post Number: 3
Registered: 11-2008
Posted on Sunday, Nov 23, 2008 - 10:19 am:   Edit PostPrint Post

My gelding has no other signs of illness....no fever, runny nose, etc. My vet DID tell me that it was normal for horses to have this bacteria in them and that I should not neccesarily worry about this one. The other bacteria that we got rid of was supposedly from him bleeding.

So, I'm guessing that now I need to learn how to manage him as an allergic horse?? I did soak down his hay with water this morning and I'm planning on giving the stall walls and roof a good cleaning. Currently have them bedded with shavings.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 21818
Registered: 1-1997
Posted on Sunday, Nov 23, 2008 - 5:50 pm:   Edit PostPrint Post

Read the article I reference above on COPD carefully. Most find the management steps you have taken not enough to fix the cough.
DrO
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Anne Guillory
New Member
Username: jugg

Post Number: 4
Registered: 11-2008
Posted on Sunday, Nov 23, 2008 - 9:25 pm:   Edit PostPrint Post

So what is the best way to get an accurate diagnosis? Should I just remove him from the barn completely and feed only hay cubes and see if in 21 days he no longer coughs? I have spent over $3000 already in drugs/treatments/etc.

I will call vet tomorrow to get the actual name of the bacteria we still have.

Also, do I need to give him any dex to help him immediately?
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 21830
Registered: 1-1997
Posted on Monday, Nov 24, 2008 - 9:13 am:   Edit PostPrint Post

Currently there is no "test" for COPD and yes I believe aggressively removing contact with mold spores and seeing if you get a response is the best diagnostic technique we have. Of course if some other disease is evident you should pursue that first. Anne I can educate you about COPD, it's diagnosis, treatment, and prognosis but what I cannot do is diagnose and treat your horse. This information is put out as educational so that you and your vet can mull it over and see how it applies to your horse.
DrO
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Anne Guillory
New Member
Username: jugg

Post Number: 5
Registered: 11-2008
Posted on Monday, Nov 24, 2008 - 12:05 pm:   Edit PostPrint Post

LOL...It's just that I'm about to shoot myself. I always get the crappy vet calling me and answering my questions....I'll call and demand to talk to the good vet. I mean....take a look at what has been done to this poor guy!! Wouldn't you be frustrated too?? I'm really frustrated at the vets for just handing meds to me left and right and not getting to the bottom of this by going off of up to date cultures.

Here is a history:


First scope found a river of mucus flowing down Trach and in his pouches. Treated it with a round of SMZ's (10 days) and Ventipulmin.

Still coughed but with improvement (only coughed every few days) so brought him back. Did a gut pouch flush with a penicillin gel. Scope looked better, but still had alot of mucus. Gave him time off...tried to ride again.

Still coughed so did a round of Baytril.

Cough seemed to come back worse....as in EVERYDAY instead of every few days. Good vet says TTW and culture to see if we have allergies or infection. Culture comes back with 2 bacteria. So....10 hyperbaric treatments along with SMZ's for 10 days and 5 days of Gentocin all done together at vet's. Sent me home with 10 more days of SMZ's

Still coughed, but only about every 4th or 5th ride. Vet gave him Flu/Rhino shot, 10 more days of SMZ's along with Equistim Injections for me to give him.

Cough remained the same. Tells me to give him Tri hist because he thinks it's allergies. Didn't seem to change anything at all.

I brought him back and demanded another wash and culture. Culture comes back with only the pnuemonia type bacteria. Scope looked the best it ever had....only one or two small puddles of mucus.

Then he says to do 8 days Naxcel along with every other day of Azium powder.

Rode him 5 days straight with no cough...6th day he coughed 1 time very light....7 th day coughed hard 2 times. Yesterday no cough. blah blah blah.....


Now I'm broke!! LOL

Sorry!! I'm just beyond frustrated and don't want my boy to build up a bunch of scar tissue because of my ignorance on this whole ordeal!!
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 21833
Registered: 1-1997
Posted on Monday, Nov 24, 2008 - 8:17 pm:   Edit PostPrint Post

If putting the horse out on pasture 24/7 plus some cheap dexamethasone fixes this horse's problems I would be a bit put off. But we have not gotten your horse well yet and I still want to see that lab report.
DrO
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Anne Guillory
Member
Username: juggy

Post Number: 6
Registered: 3-2009
Posted on Wednesday, Apr 1, 2009 - 11:45 pm:   Edit PostPrint Post

Dr 0

I found my old post...I now have the lab reports :-) This post goes along with the "Barn Cough" post. Same horse.

Thanks,
Anne
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