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Dr. Taus
Dr. Taus, Veterinarian
Category: Veterinary
Satisfied Customers: 505
Experience:  Veterinarian with experience in equine and small animal medicine.
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Latest symptom: lesions on fetlock and pasturn, all four legs,

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Latest symptom: lesions on fetlock and pasturn, all four legs, originally only one leg, then spread to other three after 7 days. Pathology reported many eosinophilis and nodular necrobios. However, location is irregular. Horse also became lame on original leg and swelled a good bit. Horse responded positively to dexamatose injection. History of laminitis, celulitis, vasculitis, and blood work shows low lymphocytes. Ultra sound of intestines did not produce findings of thickened wall.
Hi there,

Most horses the age of your mare will develop Cushings, and with the history of laminitis, I fully support your decision to treat her based on her signs.

The low lymphocytes on her bloodwork are a very nonspecific finding. They are part of a "stress leukogram"-- the horse makes increased stress hormones (from Cushings or otherwise being ill), which move the lymphocytes out of the bloodstream and into tissues like lymph nodes where they can't be measured. This could easily just be referrable to her having Cushings.

Good job getting a biopsy of the chronic skin problem. Those findings are consistent with allergic disease. I see biopsy results like that most commonly with horses that are very allergic to insect bites (sweet itch, etc). Their pasture mates may be fine. Additionally, sometimes horses are allergic to specific dust or feed components (this is much harder to control, as the patients are essentially allergic to life as a horse).

I find that hydroxyzine works well in horses that we worry about keeping them on drugs like dexamethasone because of the laminitis risk. It has to be compounded, so this is something to discuss with your vet. If you haven't already tried them, fly boots might help you rule out whether it's insects, bedding, etc that is bothering her.

The nodular necrobiosis on the biopsy involves the skin reacting to the allergy and laying down lots of new collagen (that's why it looks bumpy) and may take longer to go away or may leave the skin bumpy in the long term. The complication we see with these allergies is cellulitis in the area because it itches and bacteria get pushed under the skin during rubbing or scratching.

I hope this is helpful. If so, please rate me positively, and don't hesitate to let me know how I can help further.
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Hi Sam,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Taus