Blood tests - thoughts on what this could indicate?

056775

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My horse had a change of diet (going from 2 large feeds a day to just hi-fibre cubes) and also worked (Equest Pramox) over the same weekend just over two weeks ago.

Rode on the Monday - all ok, come Tuesday morning had large sweat patch to the lower flack and highlysensitive to touch around the area.

Vet came same day and gave 3 days worth of Danilon

Came back out Friday to scan the area (at this point though we had broken a rib), scan showed nothing out of the ordinary (spleen and large and small gut checked) - horse still very sensitive to the touch

Took bloods and readings that cause most concern are the following

RBC - 5.97 (6.1-10)
LDH 407 (81-206)

However these are also out of normal range

PCV 28 (30-42)
HCT 27.5 (30-42)
ALB 28 (29-44)
ALP 114 (117-451)
Bile Acid 0.0 (3-9)
GGT 32 (11-31)
GLOB 30 (31-42)
Glucose 6.9 (2.8-5.5)
iMg 0.68 (0.9-1.9)


He is going to Breadstone tomorrow for 2nd set of bloods, scope and further scans

Is 100% happy, content and usual self except to the touch of that area.

Any one with any thoughts on the levels - would be very interested to hear.

To note he is still sensitive to the touch of the area but no where near as bad and bloods were taken after sedation
 
Good on you for getting a copy of the full blood report. Well worth doing, and well worth keeping records of all bloods for future reference. I've had to look at a lot of my ponies' blood reports in trying to get to the bottom of muscle and subsequently liver problems but I don't have any formal training in analysing them.

I don't understand why you've put that RBC (red blood cells) are causing most concern - they are only marginally low, and can vary quite a lot depending on the activity of the horse. Is it that the vet expected higher for the type of horse you have? Mine are Dales ponies, and they always have low RBCs unless they are stressed and leaping about when the blood's taken! Apparently it's common in native types to have low red cells.

The LDH is interesting. LDH is a sign of muscle damage and/or liver damage. Looking at other muscle or liver indicators gives an idea of which it is.

GGT is a key liver enzyme, but it is only marginally high so I wouldn't put too much weight on that. Bile acids are a liver function indicator - I'd worry more if that was high, but to be honest I don't know what it means to have it so low (I've not come across that with my gang). I'm guessing ALP is alkaline phosphate, and if so it's another liver indicator. I've only had that high when there's been significant liver problems. Never had it low, and that is only marginal so I wouldn't be worrying about that (rightly or wrongly).

You don't mention the other two muscle enzymes: CK and AST. CK only indicates muscle damage, whereas AST indicates liver and/or muscle damage. Worth knowing what those are.

If they didn't test CK, then it's worth them doing it! That's the only enzyme which is totally specific to muscle problems, so would give an idea of if there are/were muscle problems (eg tying up or a scaled down version of it).

I've no idea what iMg is - never had that done on my gang.

Did they test GLDH too. Another liver indicator, but one which tends to shoot up when damage happens, and quickly returns to normal whereas GGT can take months to come back to normal.

Sorry, don't know if that's really any help.

Muscle enzyme levels can be affected by exercise, stress, transport etc. It takes 5 hours for CK to reach peak levels after exercise, so if you are travelling your horse to somewhere for the bloods to be taken, then I'd definitely ask for the bloods to be taken soon after arrival to reduce that effect (although of course that might mean that red blood cells etc might be higher because of the exertion of travelling, but personally I'd rather get a clearer reflection of other enzymes and accept that red blood cells might not be a true baseline).

Patchy sweating can be associated with tying-up (ie muscle damage), but then I guess it might also indicate other things (but I don't know what).

Hope you get to the bottom of things.

Sarah
 
Thank you so much Sarah

I have no such idea why just those two things were flagged up as areas of concern (by Vet)

Bloods taken after 5 days rest

Hes a 5 YO WB

CK is 189 (102-397) and AST is 313 (169-348)

GLDH was not tested

All so confusing, sure they will get to the bottom of it just was hoping to have an understanding of possible prognosis.....

Thank you again for your time
 
Hmmmmmm, doesn't really seem to narrow it down any further.....

Have you googled for reactions to pramox - I have no idea on this, but it's reasonable to think that food/fibre takes a couple of days to go through the whole of the gut system, so I guess it's possible that the pramox might have taken a couple of days to reach somewhere in the gut where it may have caused some kind of problem? Might not be any mileage in that, but probably worth reading up on, in case anyone else has come across similar. It's certainly interesting that it happened so soon after worming.

Otherwise, and these are total guesses, is there any chance he's been stung/bitten/in contact with anything that might have kind of burned his skin on his flank and caused the discomfort? Even just a kick or something causing bruising?

Sorry, I'm out of ideas!

Sarah
 
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