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horsemed, Horse Veterinarian
Category: Horse Veterinary
Satisfied Customers: 315
Experience:  Equine veterinarian with 8 years experience working at referral hospitals throughout the country
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I have a 22 year old arabx mare without significant pmhx

Customer Question

I have a 22 year old arabx mare without significant pmhx except for what appears to be sweet itch annually. This year, while experiencing some episodes of sweet itch, she developed significant pitting ventral edema. No fever; no tachycardia; no dyspnea; eating/drinking enthusiastically. Only change was new hay 2 days prior; really nice grass hay, too:) After 1 week, vet confirmed the above r/o apparent cardiac issues. Labs were well WNL except for a slight elevation of GGTP (44). At this time an 8x10 fluid collection appeared behind her left elbow on the lateral chest wall, which is still there 2 weeks later (slightly firmer now but still not hard, contender) with a small collection now on the right side. The ventral edema appears to be totally gone. I have changed over her hay since the vet came out because I really have no clue what else could be the cause of the initial inflammation. Are the anterior/lateral pocket residual ventral edema that escaped and takes longer to disappear. The vet offered to ultrasound the area. Again: no fever, no tachycardia, no tenderness, no change in behavior whatsoever! I live in NJ.
Submitted: 1 year ago.
Category: Horse Veterinary
Customer: replied 1 year ago.
BTW, when I started the new grass hay 2 days prior to the swelling, I had, as usual, weaned onto the new hay using only 1/3 of the new hay mixed with what she had been eating prior.
Customer: replied 1 year ago.
I did give one dose of banamine after first phone call to vet 1 week after swelling appeared without any change. This was 5-7 days prior to blood draw.
Customer: replied 1 year ago.
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Expert:  horsemed replied 1 year ago.

Hello there. I am an internal medicine specialist and I would be happy to help. I am sorry to hear about Mystic's issues. A few possibilities come to mind for her persistent edema.

The first possibility would be edema from the inflammation associated with an allergic reaction. This would be most likely if she still has evidence of sweet itch or hives or other allergic reactions. The inflammation causes inflammation of the blood vessels (vasculitis), causing edema. In this case, the edema readily resolves once the sweet itch resolves, using topical antiinflammatories, shampooing with hydrocortisone or other hypoallergenic shampoo, and systemic antihistamines and/or steroids.

If she is not currently exhibiting any other allergies, at her age, I would unfortunately suspect the possibility of an internal mass such as a tumor, occupying enough space to decrease lymphatic drainage from the area, causing edema. In that case, I would recommend a chest ultrasound with an internal medicine specialist at a nearby referral hospital. They will look for a space occupying mass in that area to try to get you a diagnosis.

I hope this makes sense, please let me know if you have any further questions.

Customer: replied 1 year ago.
I always treat the sweet itch with topical steroids and antibiotic ointment (when abraded from rubbing herself raw). This time I used the spray HC with aloe. I continue the steroids (topical) until inflammation is gone; decreasing the frequency from BID to OD to QOD.
So I have 3 additional questions:
1) Could there be an inflammatory response to either the HC spray or the hay?
2) Being that the ventral edema is no longer present, could the lateral (girth area) swellings (bilaterally and not pitting) be residual, displaced edema from the initial ventral and pitting edema?
3) Could there be any gynecological reason that this occurred. I just found her behavior similar to when she is in-season (very vocal when I approach, maybe a little more frisky).