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Discussion on Steroids used for allergic reactions... | |
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Posted on Wednesday, Jan 3, 2001 - 8:29 am: dear dr o,i have an 8yo gelding mule that has skin allergies that i can't figure out at all!! https://albums.photopoint.com/j/AlbumIndex?u=813322&a=7134493 in past years he has come out in very bad bumps all over his neck and chest. these bumps in a few days weep serum and make him too sore to touch. i can remove the scabs made by this serum by the liberal use of straight bath oil to soften them up and picking them off. the skin doesn't show any blood or cuts underneath. i ruled out a change in detergent/shampoo/environment. he has lived in the same pasture area for 4 years now. the bumps usually end around the first week in july and don't reappear. we have done a punch biopsy, skin scrapings, blood tests and put him on medications. the only one that has any effect at all is cortisone. last year the bumps didn't appear 'till august - which was the first time we had hot weather last summer. from march 'till the end of july i had him on 600mg of antihistamine a day and i thought that it worked and took him off it when i thought the risk was over...wrong! btw, he was never out of a fly sheet and the bumps first appear on his barrel... so it isn't a contact or bug allergy. i have had blood work done on him 3 times and have those numbers if it is important for you to see them. the problem is that there aren't any "normal" blood numbers available for mules in any text nor from one of the best mule researchers in the nation - dr tex taylor from texas a & m. my mule normally comes up with a low white cell count as compared to horses but that might just be normal for a mule. he also has been treated successfully for lymes disease - i have those numbers too. i really want to know if there are any studies for skin allergies that i could sign him up for? or if you have any ideas for me to try. |
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Posted on Thursday, Jan 4, 2001 - 6:41 am: I am afraid that sheets do not guarantee it is not a bug allergy. These type allergies will cause a generalized break out no matter where he is bit. I do not know of any studies like you are asking about.The most useful thing to do for these type horses is move them to a different locale, hoping what ever is causing the allergic reaction is not at the new place. In lieu of that and since the summer time pattern is most similar to bug bite allergies, I have prevention and treatment suggestions at: : Equine Diseases: Skin Diseases: Culicoides Hypersensitivity: Sweet & QueensIand Itch. I am a little confused by your post whose title contains the word "steroids" yet your post says "antihistimines". These are two different classes of drugs. DrO |
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Posted on Thursday, Jan 4, 2001 - 7:05 am: dear DrO,sorry about the confusion. my mule has been on steroids, which do work, but the dose and length of time is very high and i get nervous about it. he has also been on antihistamines. i'm not so sure that these work...the jury is still out. i looked at your suggested link and i don't think that my mule's problem is related to sweet itch. he doesn't have any skin sensitivity at all...never itches. he just doesn't want you to touch him when the serum hardens into scab like bumps. as soon as the bumps are softened and picked off he is just fine. i can ride/drive him and put a saddle on an area just debrided of bumps. thank you for your thoughts. |
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Posted on Thursday, Jan 4, 2001 - 12:26 pm: Hi Kathleen! I was surprised to see your pics of John Henry, as I remember when you first started posting about him on (I believe) the Chronicle site. I'm still quite in awe of him! Anyhow, would you mind if I e-mailed you? |
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Posted on Thursday, Jan 4, 2001 - 4:02 pm: Kathleen,It sure sounds like an allergy. The reactions always occur when the weather first starts to get hot. Cortisone helps it. The description sounds a lot like the reaction my mule gets to bug bites. There must be something in the environment that occurs with summer onset that causes the reaction. Mules are very stoic, so even if you saddle him up after treating him, he may just be tolerating it. Have you tried Stop Itch? It's a herbal remedy that some people say works. I've never used it. When you clean the scabs, you could try using a sulfur shampoo that can be obtained through your vet. Nancy |
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Posted on Friday, Jan 5, 2001 - 6:39 am: Kathleen,I agree the crusts are a little odd, but again they do not rule out allergy completely. If the reaction is severe serum exudation could be a secondary consequesnce. When the crusts come off does the hair come off with it? What type corticosteroid (dexamethasone, prednisone, or prednisolone) were you using, dosage, and frequency. DrO |
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Posted on Friday, Jan 5, 2001 - 10:06 am: i just talked to my vet office [because i couldn't remember the type/dosage] and they said that John Henry, my mule, got 30ml of dex in a shot and 10 days of decreasing dosages of prednisone. i remember that he was also on azium after that for days and days and days because the pred didn't work. the azium did work but he had to be on a double dosage [2 packs a day, am & pm] for a week for it to begin to work - then down to a pack a day split into two feedings. this mule is VERY big - 16-2 and 1,400 lbs [on a scale] and mules metabolize meds very quickly so to get continuing coverage they need to be dosed more often.as to the hair coming off... if i am quick and remove the crusts as they appear [daily] then, most of the time, the hair doesn't come off with the crust. if the crusts appear very close together then the hair comes off but it grows back in a matter of days. this seem to be an ongoing problem... i ask everyone i can find if they have any ideas for other treatments. i have used listerine on his skin to see if that stopped the spread - not, anti-fungal shampoos, betadine, and a bath oil and water spray to see if keeping the skin supple will help keep it from getting a possible contact allergy - not! skin problems seem to be the "hole" in this mule. most of the year he is just fine, it is just in spring/summer when he becomes high maintenance! at least the weather is nice and warm! unfortunately this fall at the end of fox hunting he got a wicked bad case of scratches which only responded to a furizan sweat wrap replaced daily but kept on 24 hours a day for about 3 weeks. it lasted this long because by the time i found what worked his scratches were very bad. they never made him lame but it wasn't pretty. thank you for your help. |
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Posted on Friday, Jan 5, 2001 - 8:55 pm: hi jordana,certainly you can e-mail me personally - kathleen@cavalry.com - hi nancy, thanks for the suggestion for stop itch. he doesn't itch at all nor is he uncomfortable once the scabs are removed. i will ask about a sulphur shampoo. i remember i used it on a dog of mine once who developed hot spots. i don't think john henry is a stoic mule i really think he has no discomfort once the scabs are removed. thanks for your ideas... kathleen |
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Posted on Saturday, Jan 6, 2001 - 7:50 am: Now it begins to sound like dermatophillus rather than an allergy (see the article) but this is inconsistent with the steroids being anything but a temporary pallative measure. You need a firm diagnosis rather than having us try to guess from your description. Perhaps a referral to a equine dermatologist or a biopsy might help.DrO |
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Posted on Saturday, Jan 6, 2001 - 8:09 am: i wouls LOVE to get this thing diagnosed!! i had a biopsy done last year and it came back as an allergy. but it wasn't any more specific!i have taken several horses to Cornell Univ vet school for different problems a few times in the past and, on the most part, they weren't able to come to any firm diagnoses. i would love to find an equine derm - that's a good idea and i'll look into it - know anyone in my part of the world [NY]? kathleen |
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Posted on Saturday, Jan 6, 2001 - 12:38 pm: Here is what we need for you to post here Kathleen. Not the interpretation but the actual biopsy findings, we may be able to develop a little better list of possiblities for you. It is important that we know what treatments had been given in the preceeding 30 days however: it could modify the biopsy findings.DrP |
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Posted on Saturday, Jan 6, 2001 - 2:23 pm: the biopsy only said that he had an allergic reaction but couldn't diagnose a cause. unfortunately, this was last summer and i don't remember exactly the treatment at the time. he probably was on pred at that time and then we changed to azium . my vet told me yesterday that he just read a new paper about how some horses don't respond to pred. he thought that jh was one of these equines and we would have to go with azium from the start. the shot of dex didn't work in the beginning either...the symptoms only got worse and worse. i really wrote to you and the list to see if anyone had any similar problems and how they treated them...you know, to get some fresh ideas. since it is the middle of the winter here in the north east and i didn't keep day to day records on the problem the last 4 years i will have to wait and let you know if it reappears next summer.thank you for you thoughts. kathleen |
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Posted on Saturday, Jan 6, 2001 - 3:35 pm: Hi Kathleen - if you search some of the recent newsletters that Dr O posted, the "Dr O's Big Mistake", he talks about that very prednisone thing - apparently all horses don't respond at all to prednisone, but rather to prednisolone, and it's been coincidence when prednisone has alleviated the problem. If you can find that article I think you'll find it quite interesting - I sure did! |
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Posted on Sunday, Jan 7, 2001 - 9:55 am: Hello Kathleen,There is some overstatement of what a biopsy can provide. There is no unique biopsy findings that irrevocable says: this is caused by allergy. There are findings (high eosinophils for instance) that are suggestive, but other primary disease processes can give you allergy like findings. Parasitoses, autoimmune disorders and even bacterial and fungal disease that are long standing can develop allergy like appearances. It should always be understood: biopsy's are as important for what is not there as for what is. DrO |
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