Can I pick your brains, please?

S

Shilasdair

Patting her thylacine
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Hi all
I'm trying to work out what to do with my 5yr horse for the future, and would like your thoughts/suggestions. First though, I have to give you a brief history of her illness.

3yr old - developed chronic urticaria in response to something, which remained winter and summer (although worse in summer) for 2 years.

Fast forward to this spring, aged 5yr old, she was found colicking, had surgery for Ileo-focal eosinophilic enteritis, which seems to be allergy related. During the colic, she had no urticaria until they took her out to eat grass, then she had an extreme allergic reaction.
Was put on Atarax antihistamines, and recovered well from the colic, with no signs of urticaria.

3 months on - when she was back out with her friends on restricted grazing, she developed a high temperature, and diarrhoea. She was hospitalised again for 2 weeks, when she was found to be having a systemic allergic reaction, with lesions on lungs, through digestive tract etc. Vets uncertain if lymphomas, or allergic. Decided to try corticosteroids, in increasing doses, for a week, and if no response, she would be PTS.
Given Prednisolone at 1mg/kg, made a speedy recovery, and came home, stayed on dose and was fine for 4 weeks, dose then reduced to 0.75mg/kg (just this week so still observing her). Seems happy and behaving normally.

I have a few questions I'd like your thoughts on;
1. Should I try to maintain her on Prednisolone at the lowest possible dose, or in your experience is this not feasible long term?
2. Should I take her off the Preds, to allow her to become allergic so they can test her for the specific grass/es she is reacting to? This has the danger of serious illness again, and more vet bills - but do you reckon it would work?
3. Would it be possible to manage her off grass entirely (not sure what I'd do re hay?).
4. Would you PTS if she were yours?

Apologies for the novel - understand completely if you can't be a**ed to read it! :D
S :D
 
What a nightmare, PTS is always a very hard decision which I prefer not to do. (maybe I have just been lucky) When one of mine had a really bad colic last month I had her opened up twice even if it looked really bleak, I just could not think of any other option. I think only you can understand if it is best for her as you are with her and see whether she is suffering. Sorry if i can't help any more. Best wishes and good luck
 
1. No experience of long term Preds in horses. In humans, yes but the longest my husband or I have been on it is months not years.
2. I have no idea. I suppose it's worth a try. ??Insurance???
3. This is kind of leading on from 2. really but having recently been shown how little "canadian hay" and no other grass some racing yards give I'd have thought so.
4. How much do you love her - ie it would cause you great pain to pts?
How much do you value her future - ie is she going to be special either in performance or function or to you?
How much hassle with feeding can you cope with?
How long will your insurance - if you have any - pay? Will they cough up if you pts now but not if you give her a try on grass and risk a further serious illness?

Is this your ShireX?

I'm really sorry you are in this situation with such a young horse.:(
 
could you take her off the meds and do a time of NO grass? will she eat straw? is chaff Possible..

Id be thinking that its more a type of grass she is allergic to than ALL grass.. the blood tests i had done on my old gelding they showed up which grasses he was allergic to if that was the case then its manageble fairly easy.

if a horse of mine was allergic to all grass and couldnt also take hay then at such a younge age yes id be considering PTS.
 
My view on allergies and intolerances, and it may be difficult to quantify medically, is that they tend to come to the fore especially at times of stress or when under the weather so if you are to continue with this mare I guess I would be looking at the most stress free existance possible. When you put that with the difficulty in turning her out then it becomes a real challenge but is not impossible if you can find a yard where she can be allowed to mooch around in a school or dirt paddock. The exertion of exercise may mean that she can never do anything more challenging then amble out in walk.

As for long term steroids, obviously not ideal but I don't think you would actually need to stop them to test for allergens, it is antihistamines that mask the mast cells in test, not steroids. You can, of course, give antihistamines all the year round without a break if the budget runs to it, and these may be enough to prevent another attack.

I wish you luck, as a chronic urticaria sufferer I know how painful the condition can be during flare ups.
 
There appears to be some evidence (based on people not horses) that having one allergy/intolerance may well lead to secondary allergies and intolerances. The longer the 'first' allergy goes untreated the more likely this is. There is also some, maily annecdotal evicence (again in people) the GA can precipitate allergies and intollerances, as can some severe and prolonged traumas. On balance I would probably pts, hard as this decision is. As I am sure you are aware prolonged steroid use is not without risk. There is also the possibility that testing will be inconclusive (often is in people) and so trial and error is then the only option, which again is harder in animals than in people.
Best wishes with whatever route you decide to take. Having kept a horse for about 12 years as a field ornament, with sugar and cereal intolerances it is not an easy task.
 
What a dreadful position to be in. Is she a Shirex? We have lost 2 at relatively young ages (6 & 11), I am convinced that the real problem is in-breeding, because of the small gene pool. However I digress, sorry I have only used preds in dogs and cats and unfortunately we have only delayed the inevitable with them, although the animals all had improved quality of life for the duration.
I'm not sure how you would keep the horse if she could not be kept on grass longterm. IME (and I have plenty!) it is very difficult to keep allergies/intolerances at bay, even with anti-histamines or other medication (I have had vaccines to combat various substances).
I don't think you would need to withdraw the steroids to test for allergies - but I could be wrong. I think in your position I would google (if you haven't already done so) to find the most experienced vets in this field and probably look for homeopathic vets as well and pick their brains.
I'm afraid you may well have to be prepared to pts, which is always horrible with a younger horse but it is something I would do, if the animal's quality of life is compromised, as I'm afraid a youngster who cannot be turned out would be.
 
I don't know what you should do but just wanted to add that I maintained a horse with asthma on pred for 3 years before he developed steroid induced laminitis... and that was the beginning of the end...

Don't know if this is a help or a hinderance but apparently it's quite a familiar story in horses that need regular steroids.

Bx
 
Aww, what a crap situation to be in , poor you and poor horsey. From what I can see, you have a young horse with a chronic and increasingly life threatening condition. To even manage it, the treatment has had to increase in strength, but as people have said, steroids are not recommended for long term use. I think if I could afford it, I would try and find out the specific trigger, but as it seems to be allergic, the list could be endless. I hate to say, but with such as poorly horse at such as young age, I would be thinking about PTS- sorry. x
 
Thanks for taking the time to read my lengthy post :D
To answer a few points - she's not insured (indeed would have been excluded as everything is related to the allergy/urticaria which is a 'pre-existing condition' this year).
Secondly, she's 3/4 Tb x Warmblood.
Thirdly, she is turned out with the others at the moment, in a restricted grass paddock, and aside from the Preds, appears exceptionally well, is happy and settled, and not in any pain, so don't worry that she is suffering in any way.
I suppose I am just trying to mentally work out my future options, and plan accordingly. If she reaches another crisis, obviously the decisions may make themselves.
At the moment, I *think* I am going to continue reducing the steroids as directed by the vets, then get her allergy tested to see if she can be 'vaccinated', and also to try to reduce her exposure to the specific allergen.
I just wanted to discuss it with you guys to get a wider range of view/opinions, and you have all helped me.
Any more thoughts welcomed!
S :D
 
This must be heart breaking for you. I have a livery with a grass allergy His outbreaks have got progressively worse and occur at different times of the year with periods of remission in between The vet treated severe outbreaks with cortisone injections which seemed to give symptomatic relief for several days.

He was also blood tested for allergies and the results came back showing him to be severely allergic to five types of grass pollen including timothy and rye grass. The only grass tested for that came back negative was alfalfa. He was kept in on an alfalfa diet with sugar beet and started fortnightly de sensitising injections. These have appeared to work well and he seemed much happier although this could be attributed to the fact he was able to work again – he has always been a busy character, much happier when doing something.

This summer he has been back out at grass with no obvious problems and has also slowly returned to a normal diet including some haylage. He had his last injection at the start of July and until a few days ago seemed fine. Unfortunately he came in a few days ago with a swollen jaw and throat and one or two urticaria type lumps. He has had a cortisone injection to relieve this and we are now waiting for a second batch of de sensitising injections.

Obviously if you can get her allergy tested you will be in a better position to see if you can adapt her diet to suit. I understand the de sensitising injections work better on some horses than others and some certainly require more than one course of them but in our case they do seem to have made a difference. Good luck!
 
Sounds a really difficult situation, so hard to deal with when it is such a youngster and she feels we. I knew a pony who had severe sweetitch and many other allergies (many years ago, can't recall exact details). He was seen and treated (successfully) by Chris Day http://www.alternativevet.org/ thought it might be worth a look.
 
Its such a shame to be in that kind of position and even more so because she is just a youngster. I kind of know your pain as I have a 7 year old who is going through a tough time with health issues in his guts.

If I had your horse I would keep her on the preds and reduce the dose down to see what would be the least amount you could give her and then I would see about getting an allergy test done.

My horse is on long term preds and we are still reducing the quantity down but had to go back up as he went down hill after a while on the reduced dose. So I reckon it was done too quick and the issue must be due to something he is eating.

Hope all goes well and you manage to get a fine balance to keep her confortable :D
 
When you start running out of conventional approaches, maybe the 'alternative' route might be able to offer something? That's what I'd be looking at, and the de-sensitizing procedure.

A friend's horse was at a yard and suddenly, from nowhere, developed urticaria like you have never seen. The horse was given antihistamines and the 'attacks' reduced in their severity.

I wish you all the best with this one - and a positive outcome.
 
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