Any experience of low albumin in blood / conditioning feed recommendations / WWYD (no doubt will end up being long!)

[TPO]

Basically I don't know what's going on and please talk me off the ledge

Further to this thread https://forums.horseandhound.co.uk/...itis-autoimmune-disease.829556/#post-15235386 I'm no further forward.

This will be long, I have no idea how to be concise and condense it so apologies in advance.

Firstly I posted a thread about moving vet practices (https://forums.horseandhound.co.uk/...actice-feeling-very-bad.828092/#post-15180554), BIG mistake. It feels like something is very wrong with my horse and I miss my amazing vet so much. He was so thorough and actually cared/was driven to get a resolution. I did crack and message him, he gave me some advice, that I already found online, and I did ask about going back to him. I came to my senses and retracted the request because the reasons for leaving were still valid and with the horse being "actively" ill there was more chance of my needing OOH calls and ending up in the same situations that caused me to leave. Still very stressful!

I moved to a highly recommended equine practice and really thought I was getting a whole team as good as "my" vet, rather than just have one of him. As you'll read I feel that I haven't had any answers, options, solutions, plans, nadda. I've literally just transferred to a mix practice who from the start have said they are not horse experts, due to the number of equine practices in the area, but will do first opinion and are happy to refer me to wherever I want to go.

So, what's happened is...

Towards the end of winter (probably what should have been the start of spring if the weather complied) Chip stopped tucking into hay in the field, wasn't finishing his dinner and was barely touching his hay when stabled overnight. At that time of year he does prefer a nibble at any growing grass over hay but it was unusual not to finish his bucket feed. His teeth were last done by usual EDT Oct 22. Mum's horse needed a vet check up for 6mths from a removal so I booked my horse in to get looked at just to tick it off the list. I didn't for one minute think it was teeth related.

The vet found diastema and big periodontal pockets, this was Friday14 April. She advised feeding him haylage which I duly bought. He wasn't interested in it at all which was unusual as haylage is a real treat. It was bagged "proper" haylage so no quality concerns.

Horse was referred to Equine Dental Clinic and was treated Wednesday 19 April. The gaps were widened between 308/09 and 408/09, pockets were thoroughly cleaned and packed with antiseptic sponges and a soft putty covering. Instructions were no forage, grass only and hay replacer feeds only. To be seen again at the end of the grazing season to check how things were looking before going into winter when forage would be needed. I was given 5-7 days of danolin (need to double check), to give one a day (1/2 twice a day) just in case he was sore.

At this point it was still very wet and cold so no grass had grown in the rested summer paddocks so I was a tad worried. He spent nights on the paddocks and mornings in the big field with the others after they'd cleaned up their overnight hay. At this point they went to living out 24/7 since Chip couldn't have hay when in. He started dropping more weight, he picked at grass but wasn't that interested. He was eating bucket feeds of Spillers Senior Mash initally but then went off that and wouldn't eat anything out of a bucket.

From Friday 21 April Chip's head started coming up in swollen lumps. Predominantly in his cheeks but not in alignment to where the work on his cheek teeth happened. His grass/salivary glands were also very enlarged.- It's normal for them to go up for a couple of days when the grass starts growing but that's it. They have been up, to differing degrees, since Friday 21 April to the present day. There has been maybe 3 days that they haven't been present. If they aren't there am they will be there pm and vice versa. There is no obvious pattern or trigger.

I called the vet as I concerned that danolin was due to finish and his head was swollen and he was off food/eating. She told me to stop danolin as planned, see how he goes and offer hay if he'll eat that. I wasn't happy with that answer so called the dental vet; he said extend the danolin because Chip absolutely shouldn't be left in pain and to try different feeds because he's not to get hay and that haylage would be the worse thing for his teeth.

Things didn't improve staying on the danolin. Salivary glands were up constantly and his whole head would swell; mainly his cheeks but also his chin/jaw to the point there was zero definition from bottom lip to his throat. He was losing a lot of weight and looking worse than what triggered my concern initially.

Dental vet called the vet after I spoke to him and she agreed to come out Thursday 27 April because dental vet was away to a seminar overseas. Vet came out and reported finding buccal ulcers on the cheeks opposite the widened gaps. The putty was out one side but the gums looked like they were healing, it was still in the other side but once removed she found an infection and inflamed gum. She said she didn't know what course of action to take and ended up flushing out the gap/pockets then packing them with manuka honey and recovering with putty. I was given a 10 day course of doxycycline (probably spelt that wrong) antibiotics and 2 bute a day.

I can't remember exact details but I kept in touch with vet because the swellings weren't improving. They hadn't been as bad on 27/04 but still present. On Saturday 29/04 vet said to put Chip up to 3 sachets of bute. She thought it might be a bacterial infection that was resistant to antibiotics. There was a different anti-b that we could try, and it worked on that type of mouth bacteria, but it had detrimental side effects like loss of appetite. Given the rate he was losing weight that wasn't a path I wanted to go down unless absolutely necessary. Dental vet agreed to come out 1 May when he returned from the seminar. Vet also advised to increase bute to 2 2x a day.

Dental vet out 1 May for a check up. He found one small ulcer but no infection. He advised stopping bute asap as it was such a high dose. Also to stop antibiotics as no infection present. He cleaned out the mouth and gaps, repacked them etc.

Round about this time Chip started scouring really badly. He wasn't on any different grazing or feed but it pouring out of him and burning his quarters. His head was still swollen and he was still not interested in a bucket, he'd have a few mouthfuls and walk off. This was buckets of every tempting thing that I could think of from apple juice, grated carrots, his favourite mix and a load of mash samples from various places.

He was on Protexin Gut Balancer at this point too after all the bute and antibiotics.

I felt like I wasn't getting anywhere. His head hadn't been at his worse when either vet was out but I'd sent numerous pictures. I really felt like I wasn't believed and kept being told that this shouldn't be happening, like no $%@! Sherlock. He was standing alone in the field, head down, listless, zero interest in anything or anyone, he was acting really spooky and no one but me could catch him. He was doing weird stretches every so often and grunting and groaning.

I spoke with Dental vet again 24 May because I wasn't getting anywhere. The salivary glands being up and then swelling head didn't tie up with anything else and definitely not the dental work that had been done. He did mention that being head down all the time might be gravity pulling fluid to the head and it not draining because his system wasn't working correctly.

I booked Dental Vet back for another check up on 7 June. My plan was if this was ok to get vet to pull bloods to try and get to the bottom of this. By this point he was listless in the field, not eating and just standing with his heat down. He looked like a toast rack (photo on thread linked at top).

Apparently this is too long so TBC

 

[TPO]

On Sunday 4 June Chip was really out of sorts pm. Standing with his head down and listless. He got put in with the others to see if that would perk him up but it made no difference. I took him out to handgraze the verges and he wasn't even interested in that. His guts had, and still are, been making lots of noise that I put down to them being empty. The he started looking like he was going down but wouldn't go right down. He would buckle at his legs then stand straight back up. He went down in front only and was rubbing his head on the ground.

Obviously called the vet straight away because I didn't have a clue what was going on. Colic was my first thought even although all of the signs were there beyond the attempts to go down. This was about 9pm. The vet said it didn't sound like colic and was unlikely to be that given his empty stomach. I said I didn't know what was going on but he's not been right since April and that he needed to see a vet now. The vet said to syringe in a bute and see how he was after that then call back if he gets worse. Unsurprisingly he did get worse and was very agitated in the stable. He started pawing, looking at this sides, backing into the wall and his stomach noises went up a notch in volume and frequency. I called the vet again and she said she didn't know what she would be able to do but would come out if I wanted her to, emm yes! Vet arrived after 11pm and administered some buscopan and pulled bloods at my request.

It was at this point that she suggested Masseter Myosis, topic of initial thread linked in this post. The more I read up on it (thanks to @stangs for sending me additional information) the less likely it sounded. While vet was out I explained Dental Vet was back in a few days and my plan had been to run bloods after that. My thoughts were perhaps ulcers due to bute and not eating along with stress so perhaps scoping was the way to go dependent on blood results. She said that if it wasn't MM then could look at doing a scope of his throat, because of the swollen glands, and into his stomach.

The buscopan appeared to help and he was much more settled once the vet left.

The next day I went out and bought Saracen Re-Leve mix. He inhaled it! Talk about crack for horses. I started with small feeds throughout the day and he couldn't get enough. It then seemed to stimulate his appetite because after a bucket he would pick at grass and hay. I have to say that Lucy the feed advisor at Saracen went above and beyond with advice and suggestions. She also sent out Saracen Recovery samples to help with the effects of his scouring. This was promising and he continued to pick up throughout the week, scouring dried up (still very soft and loose but not liquid), he put on weight and was eating grass and hay. Dental vet okayed hay because the priority was to get him eating and no empty stomach.

The blood results were back Tuesday 6 June. Blood showed low protein and slightly higher white cells according to what the vet told me. After questioning me about my worming programme she said the results pointed towards a parasite infestation. I'm on top of worming/counts so I thought that would be unlikely but agreed for the bloods to go for further testing to double check. The results of that would dictate the way forward but it was looking like worming and steroids. If it wasn't parasite infestation then a belly scan (ultrasound) and belly tap would be next option. She said that because the guts are so big it was unlikely to see anything on a scan. I was told the results would be same day.

Dental vet came and Chip's mouth was healing well. Exactly what he would expect to see and no cause for concern.

I still hadn't heard from vet so I called them Friday 9 June. they called back and said the parasite test was clear, he doesn't have an infestation. As I'd said he'd picked up/ clinical signs had improved (ie was eating) just to leave him a few weeks to see how he went and then retest blood to see if he'd normalised. Vet was then out of the country at a vet conference that I found out via facebook.

On Tuesday 13 June my mum phoned me at work really worried about Chip. Apparently he'd gone down suddenly twice after she turned him out. Prior to going down the first time he'd been standing awkwardly in a lami pose and doing strange stretches. When he went down he was out for the count, mum couldn't rouse him. He also went down in the toilet area of the field and not where any of them ever lie down. He did get back up but was standing awkwardly again and went back down which is when mum phoned me. To explain the seriousness of this, if a horse lost a leg my mum is the type of person to say "give it half an hour before calling the vet because it might grow back", so having her call meant she was very worried. Called vets and left work to meet them at the stables. I arrived before the vet and Chip appeared normal, he was eating hay and standing normally. It had been a hot day, although he'd been in over midday out of the sun, so I gave him some salt water that he drank up. A vet who was doing cover for the practice came out and Chip was clinically normal so there was nothing he could see to explain it or to treat. I bought electrolytes and Saracen Recovery Mash just in case it had been heat related. The very, very, obese cob and mum's other horse were all managed in the same way and they were fine. I'm guessing if it was the heat it was whatever is underlying that caused that reaction?

still too long, tbc...

 

[TPO]

I phoned the office when I was paying my bill (as an aside, I got a £30 premium for a same day visit. I've have many same day visits over the years and never been charged for it. Is this a normal thing and I've just been lucky missing it so far?) and asked for my vet records and blood results. Through google I managed to find out about low protein / albumin but I've not managed to decipher the rest of it. If anyone on here can read blood tests and knows what a healthy result should be I'm happy to email the results over if you'd be happy to translate for me. I also noted from the results that the tests were available same day but clearly my ill horse wasn't a priority to call about.

The lab who did the tests wrote "A moderate to marked hypoalbuminaemia. This may explain odema described. There is also a mild leucocytosis characterised by a mature neutrophilia". The further test for parasites was <20%. A horse >25% should be considered for treatment with moxidectin. He was wormed in winter for encysted red and worm counted 8wks ago. The count was low, rather than <50epg which is his normal, but I didn't worm as so much was going on at the time with him not being well, that's him due another count now.

Through my own research the internet has healthy albumin levels at 25-42g/L. The lab who did the testing has it at 30-42g/L, Chip's result was 22g/L.

Again no guidance was given so me and internet came up with a higher protein diet (Releve & linseed) & milk thistle (liver support). He also gets oily herbs, protexin gut balance and 2wk course of gut sponge (for the scouring).

Low albumin often shows as swelling where gravity pulls eg head (down for grazing), abdomen and sheath. Chip has only had head swellings, none of the other symptoms.

I found a paper/slideshow by Liphook online about low protein in the blood. The low albumin is caused by protein leaking in the blood so the aim is to find out what is causing that. From what I've been able to find the three main reasons are: IBS/IBD, NSAID Toxicosis and Equine Proliferative Enteropathy.

His symptoms aligned with EPE the most but I think if it was that he'd be dead by now.

I was wondering if NSAID toxicosis could be an issue. The scouring only started after quite a time on bute culminating on it being 4 a day (even when Vinnie was dying with cellulitis he wasn't prescribed that much and he was much bigger than Chip). I did also wonder if bute and not eating had caused ulcers. However his head and glands were swelling prior to the high dosage and I don't know enough to know if it's the same thing or not.

IBS/IBD is a possibility but I don't understand how/why/what could have triggered it.

As I said above I was in contact with old vet who recommended scanning the stomach for IBS/any thickening and that is the advice I've found online as first port of call. Not sure why vet said it doesn't often return any results or why it wasn't followed through.

Another complication is grass. There is one saved paddock just for Chip that has grass in it still. He was introduced to grass slowly, as would be normal for winter fields to spring fields. Last year he was lame as I had covid and couldn't get there I called the vet. They thought lami because he was short in front but he had no pulses and no reaction to hoof testers. He was treated as a lami and kept in on soaked hay, he was a healthy weight. When I was well enough to visit I found an exit hole for a small abscess, that had been my initial thought when mum described the lameness to me. The vet (not my vet) dismissed that and my vet came out to do glucose/ems/blood tests just in case. The results were all healthy and normal. Back to the present and if Chip is on grass more than 2-3hrs in one go he gets a slight pulse. This isn't normal for him either. He's been on this same grazing for 5yrs now. I raised concerns with current vet but was told he's not a worry because he's so underweight. He now gets on grass either side of the day for 1-2hrs; depending on having no pulses. Grass is probably the best thing for putting condition on him but getting lami is a huge worry given everything else that is also going on undiagnosed.

Over the past week he's stopped finishing his feeds and is losing interest in them. He'll usually eat breakfast fine but isn't interested in lunch and leaves a lot. He hasn't been finishing his dinner either whereas before he was licking the bucket clean and neighing for more. He has put on a bit of weight but nothing like I'd expect for the amount of feed he's getting, even more so considering he was generally a really good doer.


So I've moved practices yet again and have an appointment with the new one. As above they aren't equine specialists. they have his notes and I've spoken to them about what's gone on so whether they'll show up having looked into it or interested I'll have to wait to see but they are happy to refer so I have options if they don't have anything to bring to the table.

Not 100% sure what I'm asking in the post of why I'm posting but it's been 10wks now and I'm slightly deranged with it all.

Am I missing something obvious? Does anyone have any experience of anything mentioned above.

Is there a different way I could be feeding or different feeds to use?

Is there something I need to ask of/to vet or referral clinic that I've missed?

I'm pretty sure the fresh bloods are still going to have low albumin because he's still not right and if that's the only marker from before I can't imagine that's improved by much. I think the first step is those bloods then onto a specialist for scan and possibly scope. Is there anything specific I should/could ask to be tested when bloods are re-reun?

Any better ways to manage him? Currently out 24/7 but in over midday for a few hours and usually, pulse dependent, in the grass paddock for 1-4hrs a day. Due to the heat etc the grass has grown to mid-shin level and is starting to go to seed. It is unfortunately mainly clover with rye. Half of their acreage has been ploughed and re-seeded with a more appropriate mix and their current half will be down in September all going well, but for now it's all I have to work with and hasn't presented an issue before with careful management (usually strip grazing).

I'm on my laptop but I'll try to post pictures from my phone of his swollen head and glands in case that helps illustrate what I mean and makes any difference.

I suspect anyone who's opened this thread is now fast asleep!

 

[TPO]

Here's the photos of him... https://forums.horseandhound.co.uk/threads/masseter-myositis-autoimmune-disease.829556/post-15234391

First one's in the field were when I was concerned about him dropping off and not eating

One in a stable was him recovering from sedatives at the vet's after dental procedure (19 April)

The last two photos were the Sunday night of the OOH vet call for "colic"

 

[Tiddlypom]

I'm sorry that you and Chip are still living a nightmare .

I can only think that referral to a major horsepital might get you some answers. Can you get him to the equine unit at the Royal Dick? You must have shelled out £££s already by now.

 

[Cloball]

Is his liver function ok? a primary hypoalbuminaemia is likely liver related as that is where is it produced. Are the kidneys ok? Protein can be lost through the kidneys and there would be albumin in the urine. Or it could be a symptom of something causing fluid to shift abnormally as you mentioned enteropathy, IBD, sepsis.
Disclaimer: basing the above on human physiology.

 

[TPO]

I'm sorry that you and Chip are still living a nightmare .

I can only think that referral to a major horsepital might get you some answers. Can you get him to the equine unit at the Royal Dick? You must have shelled out £££s already by now.

Yes, that's on my list and a referral only vet has bought and set up in the farm behind, as the crow flies, my parents so I have options.

Yip, he couldn't have timed it better to coincide with moving house and now having a ridiculous mortgage!

As an aside when vet was on about cheek muscle biopsies (under GA according to what I've read about MM) and going off on tangents. I did say then that it's not a bottomless pit of money. I'm not spending thousands to pursue an uncurable/unmanageable condition and to end up at the same place. I chose not to insure because I want to make decisions based on what's right and not what's excluded or has to be done within 12mths etc. I want to be free to make horse-centric decisions. I have beyond vet fees that insurance cover in savings (or had!) and have access to a lot more in credit should it be needed. I don't know if it's my farmer/agricultural heritage but I'm quite black and white that the horse and it's quality of life at every stage comes beyond my want to keep them for my sake.

That discussion was during the sunday night call out. The dental vet was out 3 days later and said "vet told me that money is an issue so I'll try not to do too much". I corrected him that money wasn't an issue but pouring it away on random whims was, that Chip was to get anything that he needed. I was so angry. That wasn't at all what I said and my words were taken completely out of context and almost twisted. When vet called with blood results and said about belly scan and tap I got the "I know you're concerned about money so the costs are X & Y for those procedures". I said again then money ISN'T and issue and he'll get what he needs but if he's chronically ill I'll not putting him through loads of invasive tests to end up being PTS if the writing is already on the wall. I pay all my bills immediately, and always have, and never squabbled over anything so I was mightily unimpressed with that as well. Sorry, spiralled a bit there!

 

[TPO]

Is his liver function ok? a primary hypoalbuminaemia is likely liver related as that is where is it produced. Are the kidneys ok? Protein can be lost through the kidneys and there would be albumin in the urine. Or it could be a symptom of something causing fluid to shift abnormally as you mentioned enteropathy, IBD, sepsis.
Disclaimer: basing the above on human physiology.

I don't know. Vet didn't mention liver or kidney to me. Through my googling I've seen links to liver issues/damage/failure and suggestions to feed Milk Thistle, which I do anyway but I've upped the dosage.

I haven't figured out how to decipher the rest of the blood results. I focused on understanding albumin and the labs notes. So there might be something in the rest of it that I can't see for looking at. I'll definitely be asking new vet to explain them.

His urine was darker on the day of the collapses but was clear by the end of the day (salt water, recovery mash and electrolytes were all administered during the remainder of the day and night). I do check his urine as he goes every night when he comes in for dinner before being turned back out (he's helpful like that) and it's been clear to slightly darker (but not orange/brown/red) yellow.

But thanks, I'll definitely ask new vet/referral vet about liver and kidneys.

 

[doodle]

I am in the same rough area and would be interested in what vets are causing the issue. A friend has recently moved vets so I would suggest them and also wonder about the dental vet as i have had mixed issues with who I am thinking of.

I think I would be taking him to
Glasgow or Edinburgh and get them to start from the beginning and try and work it out.

 

[TPO]

I am in the same rough area and would be interested in what vets are causing the issue. A friend has recently moved vets so I would suggest them and also wonder about the dental vet as i have had mixed issues with who I am thinking of.

I think I would be taking him to
Glasgow or Edinburgh and get them to start from the beginning and try and work it out.

In case I didn't make it clear I am very happy with dental vet. He's gone above and beyond at every turn and taken time out to help when it's really not dental related.

 

[TheMule]

You need a referral to an internal medicine specialist.
My vet was straight on the phone to one of the country's leading specialist when my mule lost a huge amount of weight, started scouring and her bloods came back funky. They had a list of different things to try and very sadly hers turned out to be cancer, which rapidly progressed and she was PTS quite soon after we'd tried a few different things which didnt work.

 

[Michen]

Omg nothing to add but so sorry, this sounds horrendous for you both. Really hope you get some answers.

 

[Ample Prosecco]

Nothing useful to offer but I agree hospital sounds the best option. What a nightmare for you

 

[TPO]

You need a referral to an internal medicine specialist.
My vet was straight on the phone to one of the country's leading specialist when my mule lost a huge amount of weight, started scouring and her bloods came back funky. They had a list of different things to try and very sadly hers turned out to be cancer, which rapidly progressed and she was PTS quite soon after we'd tried a few different things which didnt work.

Thank you. Sorry again for your loss.

I'll be sure to ask for an internal medicine specialist.

If its not too intrusive how funky were her bloods?

ETA the scouring has stopped now ans he's off the Gut Sponge supplement.

 

[TheMule]

Thank you. Sorry again for your loss.

I'll be sure to ask for an internal medicine specialist.

If its not too intrusive how funky were her bloods?

ETA the scouring has stopped now ans he's off the Gut Sponge supplement.

Very- she had hyperlipidemia so her liver was going into emergency starvation mode. The weight dropped off her incredibly fast and her diarrhea didn’t respond to probiotics.

 

[ycbm]

I can't help TPO but I don't want to read and run. I hope you get an answer to this worrying situation some time soon.
.

 

[TPO]

Very- she had hyperlipidemia so her liver was going into emergency starvation mode. The weight dropped off her incredibly fast and her diarrhea didn’t respond to probiotics.

The vet didn't even record the scouring in his notes let alone prescribe probiotics.

Rightly or wrongly everything that's I've given him is off my own googling attempts at research

 

[southerncomfort]

I'm so sorry TPO, you must be beside yourself with worry. The worry must be compounded by the lack of equine vets in your area.

My only suggestion is to video any worrying behaviour so you can show the vet. I'm sure sometimes vets think we're just being neurotic/paranoid, so it's good to show them proof.

I'd been telling my vets for months that my old girl wasn't right, but it wasn't until I showed them a video of her fitting that they understood.

I really hope you get some sort of a diagnosis and a treatment plan very soon. X

 

[scats]

I’m so sorry to hear Chip still isn’t right.
My first thought, when you described the symptoms was liver. I lost one to liver disease and a few of the symptoms sound very similar.

I think I would push for a referral and get him into a hospital asap.

Thinking of you, it must be horrendously worrying xx

 

[ILuvCowparsely]

Basically I don't know what's going on and please talk me off the ledge

Further to this thread https://forums.horseandhound.co.uk/...itis-autoimmune-disease.829556/#post-15235386 I'm no further forward.

This will be long, I have no idea how to be concise and condense it so apologies in advance.

Firstly I posted a thread about moving vet practices (https://forums.horseandhound.co.uk/...actice-feeling-very-bad.828092/#post-15180554), BIG mistake. It feels like something is very wrong with my horse and I miss my amazing vet so much. He was so thorough and actually cared/was driven to get a resolution. I did crack and message him, he gave me some advice, that I already found online, and I did ask about going back to him. I came to my senses and retracted the request because the reasons for leaving were still valid and with the horse being "actively" ill there was more chance of my needing OOH calls and ending up in the same situations that caused me to leave. Still very stressful!

I moved to a highly recommended equine practice and really thought I was getting a whole team as good as "my" vet, rather than just have one of him. As you'll read I feel that I haven't had any answers, options, solutions, plans, nadda. I've literally just transferred to a mix practice who from the start have said they are not horse experts, due to the number of equine practices in the area, but will do first opinion and are happy to refer me to wherever I want to go.

So, what's happened is...

Towards the end of winter (probably what should have been the start of spring if the weather complied) Chip stopped tucking into hay in the field, wasn't finishing his dinner and was barely touching his hay when stabled overnight. At that time of year he does prefer a nibble at any growing grass over hay but it was unusual not to finish his bucket feed. His teeth were last done by usual EDT Oct 22. Mum's horse needed a vet check up for 6mths from a removal so I booked my horse in to get looked at just to tick it off the list. I didn't for one minute think it was teeth related.

The vet found diastema and big periodontal pockets, this was Friday14 April. She advised feeding him haylage which I duly bought. He wasn't interested in it at all which was unusual as haylage is a real treat. It was bagged "proper" haylage so no quality concerns.

Horse was referred to Equine Dental Clinic and was treated Wednesday 19 April. The gaps were widened between 308/09 and 408/09, pockets were thoroughly cleaned and packed with antiseptic sponges and a soft putty covering. Instructions were no forage, grass only and hay replacer feeds only. To be seen again at the end of the grazing season to check how things were looking before going into winter when forage would be needed. I was given 5-7 days of danolin (need to double check), to give one a day (1/2 twice a day) just in case he was sore.

At this point it was still very wet and cold so no grass had grown in the rested summer paddocks so I was a tad worried. He spent nights on the paddocks and mornings in the big field with the others after they'd cleaned up their overnight hay. At this point they went to living out 24/7 since Chip couldn't have hay when in. He started dropping more weight, he picked at grass but wasn't that interested. He was eating bucket feeds of Spillers Senior Mash initally but then went off that and wouldn't eat anything out of a bucket.

From Friday 21 April Chip's head started coming up in swollen lumps. Predominantly in his cheeks but not in alignment to where the work on his cheek teeth happened. His grass/salivary glands were also very enlarged.- It's normal for them to go up for a couple of days when the grass starts growing but that's it. They have been up, to differing degrees, since Friday 21 April to the present day. There has been maybe 3 days that they haven't been present. If they aren't there am they will be there pm and vice versa. There is no obvious pattern or trigger.

I called the vet as I concerned that danolin was due to finish and his head was swollen and he was off food/eating. She told me to stop danolin as planned, see how he goes and offer hay if he'll eat that. I wasn't happy with that answer so called the dental vet; he said extend the danolin because Chip absolutely shouldn't be left in pain and to try different feeds because he's not to get hay and that haylage would be the worse thing for his teeth.

Things didn't improve staying on the danolin. Salivary glands were up constantly and his whole head would swell; mainly his cheeks but also his chin/jaw to the point there was zero definition from bottom lip to his throat. He was losing a lot of weight and looking worse than what triggered my concern initially.

Dental vet called the vet after I spoke to him and she agreed to come out Thursday 27 April because dental vet was away to a seminar overseas. Vet came out and reported finding buccal ulcers on the cheeks opposite the widened gaps. The putty was out one side but the gums looked like they were healing, it was still in the other side but once removed she found an infection and inflamed gum. She said she didn't know what course of action to take and ended up flushing out the gap/pockets then packing them with manuka honey and recovering with putty. I was given a 10 day course of doxycycline (probably spelt that wrong) antibiotics and 2 bute a day.

I can't remember exact details but I kept in touch with vet because the swellings weren't improving. They hadn't been as bad on 27/04 but still present. On Saturday 29/04 vet said to put Chip up to 3 sachets of bute. She thought it might be a bacterial infection that was resistant to antibiotics. There was a different anti-b that we could try, and it worked on that type of mouth bacteria, but it had detrimental side effects like loss of appetite. Given the rate he was losing weight that wasn't a path I wanted to go down unless absolutely necessary. Dental vet agreed to come out 1 May when he returned from the seminar. Vet also advised to increase bute to 2 2x a day.

Dental vet out 1 May for a check up. He found one small ulcer but no infection. He advised stopping bute asap as it was such a high dose. Also to stop antibiotics as no infection present. He cleaned out the mouth and gaps, repacked them etc.

Round about this time Chip started scouring really badly. He wasn't on any different grazing or feed but it pouring out of him and burning his quarters. His head was still swollen and he was still not interested in a bucket, he'd have a few mouthfuls and walk off. This was buckets of every tempting thing that I could think of from apple juice, grated carrots, his favourite mix and a load of mash samples from various places.

He was on Protexin Gut Balancer at this point too after all the bute and antibiotics.

I felt like I wasn't getting anywhere. His head hadn't been at his worse when either vet was out but I'd sent numerous pictures. I really felt like I wasn't believed and kept being told that this shouldn't be happening, like no $%@! Sherlock. He was standing alone in the field, head down, listless, zero interest in anything or anyone, he was acting really spooky and no one but me could catch him. He was doing weird stretches every so often and grunting and groaning.

I spoke with Dental vet again 24 May because I wasn't getting anywhere. The salivary glands being up and then swelling head didn't tie up with anything else and definitely not the dental work that had been done. He did mention that being head down all the time might be gravity pulling fluid to the head and it not draining because his system wasn't working correctly.

I booked Dental Vet back for another check up on 7 June. My plan was if this was ok to get vet to pull bloods to try and get to the bottom of this. By this point he was listless in the field, not eating and just standing with his heat down. He looked like a toast rack (photo on thread linked at top).

Apparently this is too long so TBC

Yes my pony gets low albumin.





.My pony was diagnosed with IBD 4 years ago, and her albumin was fluctuating from 27 - down to 23, which is too low.

I was told to put her on ready grass, equivite and linseed oil.

With all this warm weather, she stopped liking her food, so cut out the supplements including the oil. the last 2 days she has not want to work, by the shares, who had a hard time making her move. SO without doing bloods I increased her oil back in her diet and she was a little better yesterday, now the pony leaks albumin into the lining and has odemas, so I wont stop it again. it is too dangerous for her.

 

[DabDab]

Oh TPO, I'm so sorry. What a nightmare, poor Chip.

Not exactly the same symptoms because no random swelling (that I can remember anyway, but it was a stressful time), but I had a very similar situation with Arty when she was 3. She dropped weight dramatically, would have mild to moderate colic symptoms at least once a week, was listless and spent hours a day just lay flay out in the field, wouldn't really eat anything, had a swollen stomach despite being a hat rack (at he worst you could clearly see every spinal process without getting particularly close up - proper grim level of skinny), and constant diarrhea.

Like you, I would call the vet out and they would always miss the colic symptoms and she was clinically 'normal' so not a lot to be done. Eventually it was put down to Mycotoxins in a batch of hay she had had, but that was just a strong theory from bloodwork and knowing when it started etc. It took months for her to get better and in that time I was fairly certain that I was going to lose her. There was nothing clinically that they could really do/offered to help at the time so I fed her whatever she would eat and would syringe various concoctions of herbs down her in an attempt to find something that at least eased her symptoms. The most useful thing I found actually was coligone, that did at least ease her stomach issues and made the thing as a whole manageable

So difficult knowing whether to push for hospitalisation of an already stressed horse when there is no obvious course of treatment being offered. I didn't with Arts because quite frankly she was defensive and aggressive whenever she wasn't half comatosed and I don't think they would have willingly had her.

So so sorry you've got this going on with him. Hugs xx

 

[PinkvSantaboots]

I would definitely get him referred to an Equine hospital/specialist I know when Arabi got a bad impaction colic the bloods came back as low white cells no worms were detected so they put him on antibiotics as it can mean an infection somewhere, he needed 2 courses before his bloods were normal.

 

[SEL]

I'm so sorry he's still poorly.

Nothing more to add but I hope your new vet can point you in a better direction.

 

[SEL]

Last time you posted I remember getting on Google and big head disease came up. I didn't think it was a thing in the UK but perhaps its worth a look?

 

[palo1]

So sorry to hear all this trouble @TPO No ideas from me but hope you find someone who can diagnose and help Chip. Timing is golden eh?

 

[The Xmas Furry]

TPO, sorry to read all this, sounds a blooming nightmare scenario for you and for Chip.
I've nothing to offer that hasn't already been mentioned, I think. So all I can do is send hugs xx

 

[PurBee]

Very concerning TPO, you must be so stressed with it all
I just wanted to say i would completely avoid clover and rye grazing with an ill horse. Do you know what clover species it is? If its old cow pasture that can often be sown with alsike clover and that particular type of clover is absolutely a no-no for horses as its toxic.
Other red/white clovers have their issues too, if a healthy horse get a lot to eat fresh, but as i said, for an ill horse potentially with struggling liver and kidney health, the clover and rye attributes which are less than idea cannot be cleared by the body adequately, and can bring additional issues in their own, or complicate another health issue going on. By cutting out ryegrass grazing/hay/haylage aswell as clover, the additional health issues with those forage species can at least be eliminated.

Poor you and Chip. I really hope you get answers soon from switching vets.

 

[CanteringCarrot]

Arg, my post got erased before I could submit it.

I'm sorry that you're going through this.

I did think of Big Head Disease as someone else mentioned, but I'm not sure that it fits.

I suppose if be looking for a specialist and/or going to horspital.

 

[Reacher]

I was wondering how you were both doing. Really sorry he is so poorly. Is he strong enough to be transported to a hospital?

 

[BronsonNutter]

I'd recommend referral for more investigations - starting with an abdominal scan (even though you can't see everything within his abdomen on a scan there will be lots of useful things to see for ruling things in/out in the right hands!) and then further tests as needed.

Has he been on any steroids? How old is he? (Sorry if you've said this and I've missed it)

Hope he's on the mend soon for both your sakes