Heres a continuation of yesterday’s story - A strangles vaccine reaction

So what happened next? The horse spiked a fever, the very next day; oh and not just a little 103, no it went big, spiking to 105-106 degrees! OK so now I am thinking this horse has an infection most likely shipping fever. The immune system is stressed the horse had been trailered several hours, it is in a new place, new bacteria, new viruses that it has never been exposed to, so great after all this horse has been through it now has shipping fever.

Well the Banamine knocked the fever right out and we continued giving the horse iv fluids (a treatment for the tying up); the horse’s temperature was back to normal within a couple of hours. The horse feels better and starts eating. So we put the horse on antibiotics as a preventative, and yes for all my holisic followers we were doing other things such as probiotics, immune support and Rapid Response. In fact the owners and myself feel that the horse benefitted the most from Rapid Response out of anything that we tried (again hindsite is 20/20 and considering the makeup of this product it makes sense that the horse received the best results from using it).

Well after some more bloodwork we noticed that the white blood cells (WBC’s) were still normal and the red blood cells (RBC’s) were getting lower (anemia). So this horse ’s disease is now an anemia and a fever that comes and goes. We needed more diagnostics, so in going with the possibility of shipping fever we needed radiographs of the chest to determine if we were indeed dealing with a lung infection and possibly abscesses as the fever was coming and going and the WBC’s were remaining at a normal level. So we sent the horse to another friends place that had the facility to take such a radiograph (x-ray), luckily this is a small horse so it is possible to shoot an xray. Well fortunately for the horse, but unfortunately for diagnosis, the chest films were OK. Blood work done by this veterinarian showed that the liver enzymes were elevated. It concerned him more than me. He was thinking liver infection (hepatitis), but I was thinking the horse just tied up a few days ago and has been sick for almost two weeks now, the liver enzymes are going to be elevated. After a couple days of more fluids in our friends facility and a change in antibiotics the horse was brought home, looking no better with not very many answers as to what this horse had, the next step was a liver biopsy to rule out the hepatitis.

Well that is when I put my thinking cap on…so what do we have here…the biggest sign is the anemia all the other things going on with this horse are symptoms, so lets start with the anemia. The differential diagnosis (what disease cause anemia in horses) are stomach ulcers, chronic infection, Equine Infectious Anemia (Coggins test), cancer such as lymphoma, and immune mediated. Stomach ulcers - too quick of an onset for this horse and most of the time the horse does not have a fever, but still possible. Chronic Infection - this horse was extremely healthy and very strong just prior to coming to Illinois and the WBC are normal, which in chronic infection could happen, but not likely. Equine Infectious Anemia (EIA) - Coggins test taken last month was negative but this does not mean that the horse could not have contracted the disease since then, and all the symptoms fit - intermitten fever, anemia, none responsive to antibiotics - Uh-OH could it be my first time ever seeing a postive Coggins test??? Unfortunately we would have to wait 45 days to do another test to see if it was postive or not and this horse may be dead before then. Then again the only edema (swelling) seen was in the head and usually horses with EIA have edema along there belly. So we are not sure but it is fitting the best so far. Cancer (Lymphoma) - no other signs, this horse was extremely healthy two weeks before, and it is only 4 years old, again posible but not likely. So it must be immune mediated - we need to do a Coombs test. If it is postive we have our answer, if not back to the drawing board.

After this discussion I told the owners that I was out of answers you need to consult with an internal medicine specialist at a university. SO they did, they contacted the University of Illinois and talked with one of the internal medicine doctors there, who thought the EIA did fit the entire disease process but so did immune mediated disease, so he suggested continue supportive treatment and do a Coombs test.

Well the Coombs test turned out to be negative! The story continues tomorrow and you will not believe the one simple question that solved this riddle asked by yet another doctor.

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