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

Jeni the dragon

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I really hope they can find you some answers.
If it's the Dick vet he's at and I can help in any way, please holler! I'm about 5 minutes away from there.
 
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TheMule

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Thanks for the replies.

Chip is tucked up at hospital and being starved. His stomach is enlarged so an attempt to see if it empties and reduces to a normal size or if that inability is the issue.

He's had a scan and bloods. Mind gone blank but there's a thickening in the gut on the "connector" of the stomach to the hind gut. It's on the tip of my tongue but I can't type it out.

Bloods showed albumin dropped to 20.5 but almost everything else, including white count, is normal/healthy. One enzyme is out of whack but its linked to gastro issues so makes sense.

Depending on what his stomach does tomorrow am the plan is to rescan then scope, do belly tap and there was talk of retrieving tissue from the thickening to test.

I think because there's so much visually and in the history it's a case of trying to narrow it down. None of it ties into the facial swellings and how they're behaving or the swollen salivary glands but one thing at a time.

The two vets in charge of him were absolutely amazing. They listened to everything and believed me! They let me stay and talked through every step and explained everything on th4 screen, their plan going forward etc. They managed to get results of the bloods back after 5 and came back to tell me them as I was leaving. They're going to call tomorrow am and again after the procedures. They had a bunch of students too and they were amazing. I've been there a few times and witnessed some concerning interactions between students and horses. One final year student asked me when my horse had last vomited during one visit. But this group were great, so good with Chip and so polite and helpful.

Sorry to hear about your horse @abbijay. How upsetting and stressful. I'm glad he's OK now and what a miracle worker you are getting him through all that. Th4 vets were very on it and they don't seem to be leaning that way but I made them aware of the dosing I was told to give that weren't on his records.

Thanks @doodle. I might need you for the return leg, my usual guy is booked up tomorrow. Although from the sounds of it I think Chip might be having a weekend stay.

I think this is a record for how short a time my salary has remained in my account on payday!

Well done for getting him in, and I hope you get some answers tomorrow. Good luck
 

spoo

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Low alb means he’s losing protein. If his kidney function is ok, it’s not through the kidneys. So he’s losing it somewhere. If he’s got diarrhoea, most likely he’s losing it via his guts. Very common symptom of IBD. Steroids are the fix for this. So he’d have to come of NSAID’s he if hasn’t already.

Neoplasia could also be option, but speak to your vet to see if you can trial treatment for IBD first.

Good luck. Whatever happens, it sounds like you’re doing your best by him.
 

saddlesore

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Low alb means he’s losing protein. If his kidney function is ok, it’s not through the kidneys. So he’s losing it somewhere. If he’s got diarrhoea, most likely he’s losing it via his guts. Very common symptom of IBD. Steroids are the fix for this. So he’d have to come of NSAID’s he if hasn’t already.

Neoplasia could also be option, but speak to your vet to see if you can trial treatment for IBD first.

Good luck. Whatever happens, it sounds like you’re doing your best by him.

OP this happened to my friends horse recently. Her protein/albumin levels were VERY low and she had lots of random swellings, including her face. She also had chronic runs (can’t spell the d word ) and was losing huge amounts of weight. She was admitted to the vet school and they have diagnosed ‘IBD’. She’s doing much better now so I hope you get a positive outcome too x
 

TPO

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Thank you for the replies, best wishes, PMs and messages off here.

When Chip was scanned yesterday the wall of his ileum (the name I forgot) was >1cm. A healthy wall is <4mm.

They starved him overnight and rescanned at midnight. His stomach was reducing at this point.

He was scanned again this morning and the stomach had emptied. So there is delayed gastric emptying.

As the stomach was empty they could scope him. They managed to scope the first part of the small intestine. The surface was irregular and abnormal with ulceration. They managed to take 4 or 5 samples from different areas to biopsy.

They are starting him on a course of oral Steroids for the inflammation.

They are reintroducing feed and monitoring/scanning.

The biopsy results won't be available until Tuesday and that will tell them more.

It's rare but it could be cancer in the gut. She used a word starting "nutreo /nutro" but I didn't catch it.

Or looking to be IBD. Which also has a very poor prognosis.

I'm allowed to visit him over the weekend. I have a very horrible feeling that I won't be bringing him home. I just can't believe that this is happening.
 

abbijay

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Thank you for the replies, best wishes, PMs and messages off here.

When Chip was scanned yesterday the wall of his ileum (the name I forgot) was >1cm. A healthy wall is <4mm.

They starved him overnight and rescanned at midnight. His stomach was reducing at this point.

He was scanned again this morning and the stomach had emptied. So there is delayed gastric emptying.

As the stomach was empty they could scope him. They managed to scope the first part of the small intestine. The surface was irregular and abnormal with ulceration. They managed to take 4 or 5 samples from different areas to biopsy.

They are starting him on a course of oral Steroids for the inflammation.

They are reintroducing feed and monitoring/scanning.

The biopsy results won't be available until Tuesday and that will tell them more.

It's rare but it could be cancer in the gut. She used a word starting "nutreo /nutro" but I didn't catch it.

Or looking to be IBD. Which also has a very poor prognosis.

I'm allowed to visit him over the weekend. I have a very horrible feeling that I won't be bringing him home. I just can't believe that this is happening.
So sorry to hear this but try not to focus on the worst case scenario. Twice I have had inpatient stays for the love of my life and resigned myself to him possibly never being in his stable again and both times he fought through it and came home.
Wishing both you and Chip every positive thought and best wishes for the next few days 🤞
 

vetsbestfriend

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Sending you both lots of vibes and hope the oral steroids help him and can kick start a recovery.

My ID x TB was colic prone but also had a bout of IBD confirmed by a biopsy, he was on steroids for a couple of months gradually reducing the number down and eventually down to none. They really did help him.

He also went to horspital 3 times, 1st time for colic surgery and then 2 other times for colic monitoring. Like you I also thought I would not bring him home, but he did. When you go and visit your boy this weekend, give him lots of hugs. If anything like mine, he grabbed hold of my clothing and wouldn't let me go. That broke my heart and I was bawling my eyes out, next time I visited him there I didn't even make it out of reception before the waterworks started. The whole pressure of the pre-horspital period and then the emotion of him being there just came flooding out, literally. Take a friend with you if you can. x
 

Xtra

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I don't have any experience with this to comment but wanted to bring up what you said about a bad track record getting horses back from the clinic etc. I went through this and actually had permission to sent to Glasgow vets as an alternative. In an emergency I sent a mare to my local vet clinic (where I had issues through bad luck)and she is still here 5 years later. So don't over analyse past experience.

Sounds like you have a good team on it now so fingers crossed he can pull through. You deserve some good luck.
 

TPO

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Completely heartbroken for you over here because whether this ends happily or sadly I know how utterly vile this in between bit is and I’m sorry.

Keeping my fingers so crossed for you both on this side of the pond. X

Right back at ya xx
 

palo1

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Thank you for the replies, best wishes, PMs and messages off here.

When Chip was scanned yesterday the wall of his ileum (the name I forgot) was >1cm. A healthy wall is <4mm.

They starved him overnight and rescanned at midnight. His stomach was reducing at this point.

He was scanned again this morning and the stomach had emptied. So there is delayed gastric emptying.

As the stomach was empty they could scope him. They managed to scope the first part of the small intestine. The surface was irregular and abnormal with ulceration. They managed to take 4 or 5 samples from different areas to biopsy.

They are starting him on a course of oral Steroids for the inflammation.

They are reintroducing feed and monitoring/scanning.

The biopsy results won't be available until Tuesday and that will tell them more.

It's rare but it could be cancer in the gut. She used a word starting "nutreo /nutro" but I didn't catch it.

Or looking to be IBD. Which also has a very poor prognosis.

I'm allowed to visit him over the weekend. I have a very horrible feeling that I won't be bringing him home. I just can't believe that this is happening.


So sorry to hear that it is not straightforward or easy. I very much hope it is not a cancer diagnosis although I understand that IBD has a better prognosis now than it used to be. So bloody grim for you - the waiting and decision making about things is just awful so I hope there is not too much of that and that there is some positive news or a clear way forward early next week.
 

ILuvCowparsely

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Thank you for the replies, best wishes, PMs and messages off here.



Or looking to be IBD. Which also has a very poor prognosis.
No IBD is not necessarily a poor prognoses- my pony was diagnosed with it after continually colicking and lost so much weight her stomach was herring gutted, and body score 4-5. We thought it could be ulcers, so took her to my vets who did a scope which could be either IBD or ulcers, - I was told Andy Durham was going to be at the clinic the following week ( not cheap) but it was too good to miss it. He said IBD. I have kept her to the diet and run anything else by vets who check with him, her diet is as per sheet except for Bailes pre biotic, so u nurse the bacteria there not add new ones like pro biotics. She seems best on shires trickle feed net and much bigger net than she used to so always has food. She still has odemas in front of boobies, and I used to have reg blood test. Now as long as happy i don't do that, and she has a portly tummy now that she never had before.
IBD is manageable with right diet

This might give you hope this is her sheet and she is still with me happy go lucky sassy pony.

ok I will have to copy and paste the discharge sheet.

......................................................................................................................................................................................................................................................................................................
VETS LOGO REMOVED)

XXXXXXXXX…….XXXXXX… Equine

Tel: 0


11th August 2017



“PONIES NAME " my surname – Discharge Instructions​



(pony) came into *********** vets for ultrasound examination of her abdomen with internal medicine specialist Andy Durham MRCVS, from Liphook Equine Hospital.


Today ultrasound examination found thickened small intestine but normal large intestine. This is most likely caused by Inflammatory Bowel Disease (IBD).


The initial plan for xxxx is to simplify her diet. All changes to her diet should be introduced gradually over a 2 week period. xxxx diet should consist of grass (turnout as discussed in her starvation paddock), 'purple' haylage (timothy grass), equivite and a small amount of readigrass (this can be damped down prior to feeding). Also xxxx can have linseed oil, up to a total of 40-50ml per day, this should be introduced slowly and gradually over the next 2 weeks. All other supplements and feeds should be stopped.


xxxx weight (increases or decreases) should be monitored and she should continue to be monitored for signs of colic. xxxx can continue with her normal exercise regime.


xxxxx should be booked in for a repeat blood test in 4 to 6 weeks to review her progress. At this point we will decide if she requires further treatment e.g. steroids.


If you have any concerns with xxxx please do not hesitate to contact the practice on ……………………….





She did not need to have steroids. She can have timothy grass nuts and timothy grass from simple systems, all timothy stuff
 

TPO

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No IBD is not necessarily a poor prognoses- my pony was diagnosed with it after continually colicking and lost so much weight her stomach was herring gutted, and body score 4-5. We thought it could be ulcers, so took her to my vets who did a scope which could be either IBD or ulcers, - I was told Andy Durham was going to be at the clinic the following week ( not cheap) but it was too good to miss it. He said IBD. I have kept her to the diet and run anything else by vets who check with him, her diet is as per sheet except for Bailes pre biotic, so u nurse the bacteria there not add new ones like pro biotics. She seems best on shires trickle feed net and much bigger net than she used to so always has food. She still has odemas in front of boobies, and I used to have reg blood test. Now as long as happy i don't do that, and she has a portly tummy now that she never had before.
IBD is manageable with right diet

This might give you hope this is her sheet and she is still with me happy go lucky sassy pony.

ok I will have to copy and paste the discharge sheet.

......................................................................................................................................................................................................................................................................................................
VETS LOGO REMOVED)

XXXXXXXXX…….XXXXXX… Equine

Tel: 0


11th August 2017



“PONIES NAME " my surname – Discharge Instructions​



(pony) came into *********** vets for ultrasound examination of her abdomen with internal medicine specialist Andy Durham MRCVS, from Liphook Equine Hospital.


Today ultrasound examination found thickened small intestine but normal large intestine. This is most likely caused by Inflammatory Bowel Disease (IBD).


The initial plan for xxxx is to simplify her diet. All changes to her diet should be introduced gradually over a 2 week period. xxxx diet should consist of grass (turnout as discussed in her starvation paddock), 'purple' haylage (timothy grass), equivite and a small amount of readigrass (this can be damped down prior to feeding). Also xxxx can have linseed oil, up to a total of 40-50ml per day, this should be introduced slowly and gradually over the next 2 weeks. All other supplements and feeds should be stopped.


xxxx weight (increases or decreases) should be monitored and she should continue to be monitored for signs of colic. xxxx can continue with her normal exercise regime.


xxxxx should be booked in for a repeat blood test in 4 to 6 weeks to review her progress. At this point we will decide if she requires further treatment e.g. steroids.


If you have any concerns with xxxx please do not hesitate to contact the practice on ……………………….





She did not need to have steroids. She can have timothy grass nuts and timothy grass from simple systems, all timothy stuff

Thank you for replying. I hope ots the same for Chip and I can bring him home.

He's already been started on steroids. I'm going to meet thr vet at 10am tomorrow during visiting hour so hopefully they'll have more information after another 24hrs. The key seems to be the biopsy results for a diagnosis.

He hasn't had any swelling or fluid build up anywhere other than his head (whole head and localised lumps at various times and changes daily) and his salivary glands have been up, to varying degrees, close to constantly.
 

BronsonNutter

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I'm glad they have found something and that he is now on the right treatment. IBD sounds like a terrifying diagnosis but there is a whole sliding scale of severity; to my memory we have more successfully managed cases (some on no medication whatsoever, living normal horse lives, although some have had to remain on specialist diets and/or steroids) than those PTS where I work. In Chip's case it sounds like he is obviously a tough cookie, and its been going on for a while, which is likely better than an acute onset case. Fingers crossed! He is in good hands.
 

ycbm

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I'm sorry it wasn't better news TPO, but let's hope for IBD. I drag hunted along with a horse who had an IBD diagnosis from Leahurst and was sent home for a short retirement and expected death. The owner found a way to keep him going. I'm sorry I can't tell you what it was, apart from that I know ryegrass was completely banned from his diet in any form, but I'm hoping you have a similar tale to tell in a few years time.
.
 

Kunoichi73

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Didn't want to read and run so just stopped in to say sorry this is happening and sending positive vibes to you and Chip.
 
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J&S

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Here's hoping for the very best outcome for your horse and yourself. Such a lot of worry over such a long time must be very waring. Take care.
 
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TPO

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Visiting hour today.

He was out in the paddock when I arrived. They've been reintroducing feed and monitoring his gastric emptying ability. I was told that his stomach isn't beyond his 13th rib anymore and that this is a good thing.

In between sun showers (that's why some photos are dull and he looks over it) he got a groom and a scratch. His preference was to stuff his face and I was more than happy about that!

His facial swellings and salivary glands were gone/down. He did a normal (ish) 💩 while I was there, too. It consisted of actual poo balls! Small things.

He's put on weight too so I'm hoping that's a good, and permanent, thing.

They told me previously that the thickening of the ileum is stopping him getting any goodness from any feed and that's why he's dropped so much weight. The delayed gastric emptying is why he stopped/stops eating because he'll feel full.

He was in the paddock for approx 1.5hrs and went back to an empty stable to be monitored. He's getting controlled feeds.

Everything 🤞 thanks again for the help and support

P.S. my work built the building in the background, Large Animal Research and Imaging Facility. Was weird being back and seeing it weathered and in use.
 

Tiddlypom

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Thanks for the update. Bless him, he looks pretty amazing considering what he's been through. Tired and a bit skinny, but that shine on his coat!

Those explanations for his weight loss and inappetence make so much sense. 🤞🤞that they can control his symptoms and he remains comfortable.
 
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