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My 22 year old gelding has been suffering from inflammatory

 
Dan C., DVM's Avatar
  • Answered by:Dan C., DVM
  • Horse Veterinarian
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Customer Question

My 22 year old gelding has been suffering from inflammatory bowel disease since Feb. Cause unknown. Symptoms are diarrheoa, chronic scouring and considerable weight loss. I am injecting him with 3mls Dexone-5 each day which improves the diarrhoea problem a bit. He is now being fussy about what he'll eat and will only eat a little, then loses interest. I am desperate for advise to help him recover from this life threatening illness. Thank you, XXXXX XXXXX Owner.

 

Optional Information:
Pet's Gender: Male
Pet's Age: >12
Type of Animal: Horse
Name of Animal: Diesel

Already Tried:
Dexone-5 injections; bio-sponge; variations of horse feeds and probiotics.

Submitted: 930 days and 8 hours ago.
Category: Horse Management
Value: NZ$90
Status: CLOSED
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Expert:  Dan C., DVM replied 930 days and 1 hours ago.

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Dan C., DVM :

Greetings!

Dan C., DVM :

Sorry to hear about your gelding. Can you tell me how his condition was diagnosed?

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Expert:  Dan C., DVM replied 930 days and 1 hours ago.

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Expert:  Dan C., DVM replied 930 days and 1 hours ago.

Hi, sorry I missed you on the chat.

So again, how was his condition diagnosed?

What does his current diet consist of?

Has bloodwork been done by your vet?


Looking forward to your reply!

Customer replied 929 days and 22 hours ago.

Hi Dan, Thank you for responding.

My local vet came to see Diesel late March. (As soon as I noticed the scouring.) He injected him with Vit.B and Stanazol. He took blood and faecal sample. Results were "... not absorbing protein and no worm count," respectively. He explained it was inflammatory bowel disease. He gave me Codeine tablets and Bio Sponge powder to add to his food and a 5 day course of Dexone-5 to inject at 5mls a day. Diesel responded very well to this. But a few days after treatment stops he starts scouring again. Treatment resumes. Diesel gets better. Treatment stops. Diesel starts scouring. Hence the now daily dose of Dexone-5 for the past two months, but his manure is still too loose. My vet can't do any more.

 

Diesel used to eat very well, but for the past couple of months he only eats a very small amount at a time and walks away. I am been feeding him lucerne hage with a little soaked sugar beet pellets, high protein meal of grains with added molasses, vitamins, minerals & salt. (It's called Asian Mix from Takanini Feeds.) I am mixng in about 25mls of Bio Sponge as well. Plus 2 tablespoons of liquid brewers yeast from the local boutique brewery. As of yesterday he was happier eating just the lucerne hage on it's own. But he does love organic gluten free pizza bases! and, of course, carrots and apples. He is grazing and has access to meadow hay, but only nibbles on it and prefers grass.

 

I really appreciate your thoughts and advice.

Thank you, Bunty

 

 

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Expert:  Dan C., DVM replied 929 days and 18 hours ago.

Hi Bunty, and thanks for getting back to me.

Thanks for the extra information, and again, I'm sorry about Diesel's condition. I know how frustrating your situation is.

Inflammatory bowel disease (IBD) is a term that can cover a broad range of illnesses, but it's the reason for the inflammation to the intestine that is the major question. A majority of IBD's are caused by food allergies, so the allergic response in the horse is high, resulting in the inflammation. The reason that the steroids work is the fact that they inhibit the immune system, resulting in a decreased allergic response. You may know that there is allergy testing available for the horse, and you might consider discussing this with your vet.

Something equally important is to be sure that IBD is truly diagnosed. Fortunately, the diagnostic procedure can be done in your barn, and consists of your vet obtaining a small sample of the intestinal lining via a rectal exam. This procedure is called a "mucosal pinch biopsy" and is an excellent diagnostic tool when looking at intestinal problems. If your vet has not yet done this, I'd strongly recommend discussing the possibility. There are other important intestinal problems that should be ruled out in Diesel's case, an important one being a cancerous condition (hate to bring it up, but it's not uncommon in the horse) that can show itself with the same clinical signs. The biopsy reveals what types of cells are present in the lining (where absorption occurs), and what state those cells are in. I will always include this as part of my workup for chronic diarrhea, etc. Treatments can vary as well, depending on the type of problem, and that is also another reason for the biopsy procedure.

So think about discussing the possibility with your vet, and hopefully you'll be a step closer in getting Diesel (and yourself) some relief!

I trust I've been of some help, and please let me know if you have any further questions.

Thanks, XXXXX XXXXX luck and keep me posted if you have the time.

-Dan

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Expert:  Dan C., DVM replied 929 days and 17 hours ago.

Did you have any further questions?

Thanks again,

-Dan

Customer replied 929 days and 17 hours ago.

Hi Dan, Good to receive your comments. Interesting. Thank you.

 

I had asked my vet what could be the cause and he led me to think that diagnostic procedures are very costly, practically impossible and that we needed to treat the problem first and foremost. Possible allergies weren't mentioned, just inflammation. Only in July, when he came back to treat Diesel and I questioned him again, did he say that there could be a tumour or cancer problem. That there was no way of finding out, other than surgery.

 

So because Diesel improved with steroid treatment, would that rule out cancer? And would it clearly indicate an allergy? Can horses suddenly suffer an allergic condition?

 

I own my own 10acre property where I live. Diesel has been grazing happily & healthily here with the same two other horses for the past 6 years. No one has had a problem. The other two horses have lived here for nearly 17years. Last summer was very dry. I was giving them meadow hay previously cut from my own pasture. I later noticed Diesel had lost weight, but the other two were fine. ( My other horse is almost 28yrs and he is 100%. The other younger standardbred mare is fat!) I moved them into fresh pasture where there was a lot of long grasses. Diesel hadn't left the property for at least a year. So is it possible that Diesel could have suddenly developed an allergy of some sort, under these circumstances?

 

I look forward to your answers, Dan. Thank you very much.

Bunty

 

 

 

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Expert:  Dan C., DVM replied 929 days and 16 hours ago.

Hi Bunty:

Appreciate your questions.

Although not always possible, it's best to know exactly what it is that you're treating, however in many instances we end up treating only the clinical signs due to lack of diagnostics, tight budget, etc. The mucosal biopsy is not a "surgery", per se, but a standing procedure done with the horse under mild sedation. The arm is inserted into the rectum, as in a normal rectal exam, however a small, opened, red topped blood tube is taken in as well. It only requires a small pinch of the rectal lining against the edge of the tube to obtain an appropriate biopsy. It's a very safe procedure with very little bleeding, and the horse is normally back to his usual activity within an hour or so. I charge $75.00 to perform the procedure, and the lab fees for processing and reading the results is normally around $80-120.00, depending on the vet's lab of choice. It may be that your vet isn't familiar with the biopsy procedure, but it is a commonly used tool and I'm sure that she or he could receive appropriate instruction to get the job done.

To answer your additional question, cancers are often treated with steroids as well, as they can slow the cancer's progress. Your description of Diesel's history would be a reason for me to want to look a bit further. Although allergies can and do appear suddenly, unfortunately, cancer can as well and often presents itself with the clinical signs that Diesel is experiencing.

I think it would be worth your time to consider getting a biopsy. Is there a University teaching hospital near you? This can be done as a haul-in procedure as well.

Again, I hope I've answered your questions. Best of all to both of you.

-Dan

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Expert:  Dan C., DVM replied 929 days and 1 hours ago.

Hi Bunty:

Any further questions?

-Dan

Customer replied 928 days and 23 hours ago.

Hi Dan,

 

Thank you for your detailed reply. Although I don't know what a "haul-in procedure" is, I shall make enquiries with the University.

 

1. If we assume that Diesel has a food allergy:-

a) Do horses become allergic to grass or any of the other green plants amongst the grasses? What are the sorts of things that horses get food allergies from?

b) Could it be the meadow hay? I'll admit that my hay has been shed stored for 2 or 3 years. But horses are fussy eaters and if they don't like it or don't want it, they don't eat it. All the horses had been eating it when the grass was insufficient.

c) What happens with the allergy testing procedure?

d) Once the offending food is removed from their diet do they then quickly recover?

e) In the meantime, is Diesel receiving the appropriate treatment?

f) What would you recommend I feed him that is helpful to his condition and his body can benefit from? ie gain weight as well.

g) Do you think a tablespoon of liquid brewers yeast (living culture) in his feed is good for him? I am just trying to give him Vitamin B and yeast is meant to help the gut.

 

2. If we assume the cause is a cancer:-

a) Is Diesel receiving the appropriate treatment?

b) Is there anything else that I can do?

 

3. What are other possible causes of IBD?

(Diesel was also wormed in early April, even though there was no worm count found at the time.)

 

4. You mentioned treatments can vary. What other treatments should I consider?

 

5. If it isn't IBD - what could it be?

 

Many, many thanks,

Bunty

 

Accepted Answer

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Expert:  Dan C., DVM replied 928 days and 22 hours ago.

Hi Bunty:

A haul-in procedure simply means that you trailer your horse to the facility for the testing.

Yes, horses can have allergies against grasses, etc. I know of one instance where the horse was allergic to many types of pasture grasses, but did fine with oat hay. Also allergies against grains such as corn, barley, etc. There are two types of allergy tests available, one is simply a blood draw followed with the blood being submitted to an allergy testing lab. With that the blood (serum) is analyzed for a reaction/reactive antibodies against many types of individual plants, molds, fungi, etc. Things that are common to your particular location. The other type is known as intra-dermal skin testing, where a small preparation from the possible types of allergens is injected directly under the skin, and resulting skin reaction is analyzed to determine an allergic response. Of the two, I feel that the skin testing is more reliable, but I have seen both types used successfully. The skin testing would need to be done either in a Veterinary teaching hospital or specialty equine clinic setting. I can't recall the costs offhand, as it's been a few years since I've done any of this type of testing. Once the allergens are determined, yes, removal of the allergen is certainly one method of treatment and in most cases resolves the condition. Allergy shots are also used, especially in a situation where the allergen is a constant (types of trees, for example), and the horse develops an immunity to the allergen over a period of a few months.

As far as Diesel's current treatment, steroids are often the appropriate treatment of choice. I often prescribe an oral steroid called prednisolone, and dosages and frequencies can be adjusted depending on the horse's response to treatment. Again, the fact that Diesel is still having problems would suggest that either the dosages/frequencies of his current medication is insufficient, or there is more going on than meets the eye, such as other causes of IBD: microbial parasites (such as giardia that usually can't be seen through a standard fecal analysis), bacterial overgrowth, ulcers, auto-immune disease (where the animal develops an allergy to self) and types of cancer (lymphoma is one of the most common intestinal cancers seen in the horse). Again, that is why performing a biopsy is so important in these types of cases.

Before making diet recommendations, it's best to have a diagnosis, but there are currently multiple products available with high digestible fat content designed for weight gain. Also, rice bran is an excellent fat source. And brewer's yeast wouldn't hurt!

Concerning varying treatments, again it depends on the condition. Along with steroids, often antibiotics are used if deemed necessary. I often prescribe an anti-microbial type of drug called Metronidazole. It has helped in numerous cases of "mystery" diarrheas, but is not something that should be used long term. In cases of cancer, steroids can be used along with chemotherapy drugs that inhibit the cancer's growth. In most intestinal cancer cases we are only talking about prolonging a life, and not curing the condition.

And again, Bunty, much of this can be determined through the findings of the rectal biopsy.................!

-Dan

Expert TypeHorse Veterinarian
Category: Horse Management
Pos. Feedback: 100.0 %
Accepts: 13
Answered: 9/27/2010

Experience: Owner/solo practitioner of a mobile Equine Veterinary practice for 11 years. Accomplished rider.

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