Buscopan / liver fluke nightmare!

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MrsART

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Just over 3 weeks ago I found Harri, my 8yr old Welsh section D in a real state in his stable. Looked like colic, which had brought on laminitis, so called the vet. Saturday morning & my usual vet wasn't on duty. Another vet from the practice duly arrived and agreed with what I suspected. He gave an intravenous injection of buscopan for the colic, which took several attempts, & left some bute for the laminitis.
I didn't think he'd picked up as he should, and didn't really improve much until he'd had some bute.
Next day Harri went down hill quite quickly, temperature of over 40, and his neck started to swell - and so began my nightmare of the last few weeks!

Waiting for the vet.
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The start of the swelling.
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The vet came out again twice that day as his temperature wouldn't come down, more injections, painkillers, antibiotics. He still looked uncomfortable with his guts too, but agreed would see how he was in the morning when my usual vet was back on. His temp was down the next morning, but his neck was worse and he was still tucked up & uncomfotable in his belly. By lunch time his temp was back up & when my vet finally got to see him that afternoon we agreed he should go into their care.

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He was there for 5 days. His bloods showed he had hepatitis, and it was most probably caused by liver fluke! Liver scan also showed areas of scarring,backing up the fluke theory. Once he had dose for fluke he started to improve in his belly, and 5 days of antibiotics finally got on top of the temperature, but his neck just continued to get worse. The swelling spread right down his chest and into his legs.

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It was solid and bless him he could barely move his head to eat or drink.
When I went to collect him he had rubbed himself sore on the front of his neck, he was so tightly swollen.

The sore
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Fat chest & legs.
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Looking bright, but a bit of weight loss!
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Then the sore started to get worse.
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Started to look like the injection site was going to abcess too...
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The injection site didn't burst outwardly but started to drain down through the open wound, which it is still doing.
Think I have been mopping up stinky puss for a good 10 days now. Joy.

Nearly 3 weeks after the initial injection
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He is currently on oral antibiotics and the injection site still hasn't burst, although it did look like it was going to over the weekend. Been using Manuka honey on the wound which does seem to be helping, but still a lot of hard damaged tissue in his neck for his body to sort out. All from a routine colic injection. The vets have said they will see him better. I certainly will not be paying for anything to do with the neck disaster, which is apparently 'just one of those unfortunate things that can happen with injections.'
And then there will be his feet to sort out next as there are some definite changes to his soles. Hopefully he might be right by spring.
I will however be worming all my ponies for liver fluke from now on!
 
Eeek poor you!
Seems at least ponio is picking up, I didn't think there was a wormer for liver fluke yet? Are you on cattle or sheep pasture?

Nice the vets have said no charge tho
 
Sounds horrendous, good to see he's on the mend. We are on the west coast of Scotland an area known for fluke in sheep/cattle but I don't think it is taken seriously enough in horses. Where abouts are you, any idea where he might have picked it up? Westgate do a fluke count for me along with a normal egg count and they did find a couple of fluke eggs a few years ago so I keep a close eye. Hope your boy continues to improve.
 
We're in Cumbria, and fluke has been very bad here last couple of years. Our land is very wet & surrounded by sheep & cattle grazing. I was given triclabenzadole @15ml/100kg for my other ponies. Was also told that worm counts don't really show up fluke?
 
The fluke eggs aren't picked up in the standard egg count test but Westgate say they use a different solution to look for fluke eggs so it has to be tested separately. I think there is also an ELISA blood test that can be used for fluke, similar in principle to the one used for tapeworm, but that's obviously more expensive.
 
Sorry, should probably have warned about the pics!

The wound is looking much improved today. Manuka honey is magic!

29th Oct
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compared to 4 days ago:
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why on earth do you think you shouldn't pay for a complication of your horses illness but the vets should? It is parituclarly the case with fluke that immunosuppression happens and infection is more common, even a sterile technique can lead to this. So I don't really understand why you think it's their fault!
In saying that, it is nasty and I hope he improves soon.
 
I understood that this was the result of the buscopan leaking because the vet lost the vein at least 3 times whilst injecting.
When I questioned my vet, I said that I wasn't happy paying for something that had caused this much damage. I was told that they would take him back in & get him better for me, but he thought he would get better quicker at home, which I agreed with. I was told that they would see me right, and not to venture down a legal path, (which I had no intention of doing anyway) as it wouldn't get me anywhere.
I have a couple of friends who are vets and they have all aimed blame at how the injection was given. You are only other who has mentioned the link between fluke & immunosuppression, the other being my own vet.
It's a pretty dramatic thing to go through, and of course I'm angry and upset that it has happened. Knee jerk reaction is why should I pay for all this pain & suffering if it was caused by a badly given injection - which as it turned out wasn't even needed as it wasn't colic. I was wondering if it would be worth talking to the pharmaceutical company, after all they have done all the research on the safety of their products to get them licensed, and I'm sure that they are not meant to do this!
The reason I have posted this story is because I'd never heard of anything like this before and I am keen to hear of any other experiences people have had, and the outcomes. The wound will hopefully be nearly gone in another month, but I think that the laminitis will take considerably longer to sort. I will no doubt be paying for that complication for the foreseeable future.
 
To be fair, a painful horse due to liver fluke is going to be impossible to differentiate from colic (for which buscopan is standard) on the first go.
Why did he lose the vein did the horse toss its head?
If your other vet friends have not connected the massive swelling around the neck and fluke and immunosuppression and the subseuqent abscess they're probably not familiar with liver fluke anyway.
Your vets sounds very accomodating.
 
I agree that it did look exactly like colic, and do understand why he was given the injection.
Pony stood like an angel so not sure why he lost the vein. Just kept stopping& drawing down to find no blood, so re-positioned, got blood, continued, stopped drew down, no blood re-positioned and did this at least 3 times.
I don't imagine that my friends are familiar with fluke in horses as I understood that it is pretty rare? I was led to believe the abcesses were a direct result of the buscopan?
You sound like you have a wealth of experience on the matter, I hadn't heard from anyone who has come across anything similar. If indeed this is the norm in these cases then no-one has anything to worry about as it should all be covered by my insurance.
Apart from the laminitis, but that's another story!
 
That looks horrible poor pony. One of my horses had colic a few years ago and was given a jab of bute. He was tossing his head a bit while being jabbed. Two days later he was moving slowly with his neck looking stiff and had a swelling where he had been injected. Some of the bute had gone outside the vein, vet came out and said it would probably become an abscess but luckily it didn't, think we caught it just in time.
My horses have had liverfluke this year. They didn't have raised liver enzymes, they were anemic (sp) though. They were fine until they foaled and then rapidly lost weight over there ribs and couldn't regain it. All but one were treated with fasinex, they all showed slight improvement at ten days after treatment, the one not treated looked worse. That one was then treated and ten days later she too showed slight improvement. All of them were fat with shiny coats until after foaling, if they hadn't had foals i wouldn't of known they had liverfluke. It took six to eight weeks for them to regain the weight after treatment. Ive since treated all my horses for it. The ground is wet here but the haylage was coming from a sheep farm and the farmer himself told me his sheep get liverfluke so my horses probably picked it up from the haylage.
 
rarely diagnosed in horses but not in cows where immunocompromise is a big factor hence why I pointed that out. albeit the injection technique sounds shoddy. how is it looking now?
 
Vet was out again this week to remove a fleshy lump from the wound as it kept poking out when he moved preventing it healing.

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Also scanned his neck & found a pocket of pus under the injection site which has threatened to abscess a couple and then gone down. Vet managed to draw it out with a syringe but there were a few other tiny pockets showing up so another course of antibiotics to help with those.

5 weeks today since the injection:

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The farrier came out last week and thankfully the rotation is nowhere near as bad as we initially feared. He is already much more comfortable walking so hopefully should come sound again sooner rather than later.

4 figure vets bill arrived this morning....
 
Nearly 10 weeks since Harri was first poorly & he has taken a turn for the worse. Had the vet out twice yesterday, his neck is swollen at the initial injection site again and he couldn't get his head down to eat his breakfast. His temp was 38.6, & by the time the vet arrived about an hour later it had shot up to 39.9. First visit was to take bloods & administer intravenous antibiotics & painkiller. Second visit they scanned his neck to see what was in there, but there wasn't any fluid pockets to do anything with, so just more injections and wait for the blood results. Still running a temp this morning, and first bloods are back. Expected a high white cell count, but no. He is anemic though, so just waiting to see what comes back with regard to his liver. Just when I thought he was really on the mend :-(
 
Hi,

So sorry to read what an ordeal you have gone through. I wouldn't feel too bad about your vet paying for the injection site issue, they will most likely claim this back from the pharmaceutical company anyway. Adverse events do happen, especially combined with a non-perfect technique.

My boy was treated for fluke on Wednesday. He's had mild rises in liver enzyme and inflammatory marker levels and just seems quite dull in himself. Did yours need several doses of anthelmintic for fluke 3 weeks apart? Also did your vets mention how quickly this tends to eradicate the fluke at all? I'm desperate to know how quickly mine will start to feel better as am dreading it not being fluke. The other causes are potentially more worrying. I've bought a fluke egg test kit, so we'll see, but they do tend to give false negatives.

I hope your boy continues to improve again!
 
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