Hepatitis experiences? What causes it? please help

[Martymoo]

Hello,

Has any one got or has had a horse which has suffered with Hepatitis? What treatment did they have and do you know what caused it? My poor boy has chronic hepatitis and the vet does not seem to know what has caused it and the last blood tests it ha got worse not better and is now on steriods

This has been going on since September and I just want him to get better now. He seems perfectly fine it is only the blood tests saying he is ill.

any ideas, advice, experiences I would be very greatfull

 

[Darkly_Dreaming_Dex]

i have posted about my cob with chronic acute hepatitis before but in case you haven't seen it, its below. We still dont know how he caught it as we have our own yard and he doesnt mix with strangers. The other 4 who shared water/feed/hay/rugs/grazing were all absolutely fine. One thought was he tested positive for tapeworms and the burden of them could have been toxic but thats a bit of a wild guess TBH my vet said hepatitis isnt necessarily contagious- its a name for an infected/diseased or inflamed liver. Box Of Frogs on here is fantastically helpful so a PM to her is worth a go


Tuesday 11th May 2010,my vet came to see Dex for suspected ringworm

but he wasnt happy with how his coat looked so wanted to do a blood test- i wasnt too fussed at that time but went along with my vets recommendation..
48 hours later, my vet rang back and i was devastated to learn that his Gama Gt should be max 28 and he has 626 Alkaline something isnt 424 its 1012 plus Dehydrated (??) muscle enzymes/protein levels all wrong . This was followed by a further test (GLDH?) done at the lab to establish which bit of the liver is affected. He told me that some parts can be supported through protein balanced diet and supplements but other parts were irretrievable

Vet was “VERY concerned why it appears to have deteriated so suddenly” especially as we don’t have ragwort filled fields and he has been mine since 2006.

The plan was to run the liver function test, change diet and add supplements ...

He rang me on the Saturday to say that this test was really not good high bile level in his blood indicated 2nd degree liver failure so he was on 4 small low protein feeds a day with milk thistle & sugarbeet-unmolassed for hydration and first thing on 17th May- Monday, he had a liver scan and biopsy.The vet wanted the sample in the lab for that afternoon..

So the vet came to scan/biopsy Dex.When i went to get him in i was almost pleased that Dex took one look at me with a headcollar and marched off in the opposite direction He came back when i rattled his bowl
Put him in the barn with io and Jacob for moral support- picture:

io on left, Dex in middle, Jacob on right.

Dex was sedated, Vet clipped a patch high on his offside flank and the girth groove on near side. He ran the ultrasound over him and the near side looked ok. the offside had a ragged edge like it had been hacked with scissors..blood flow was minimal and the whole of that side was brighter than normal indicating a level of fibrosis
Vet gave him a big jab anaesthetic and OH was a great nurse helping with the biopsy tools Vet made a 1/2" cut and got the worlds biggest needle out- i decided not to watch any further as fainting wouldnt have been helpful Out of the corner of my eye i could see something that looked like scissor handles and looked away quickly Dex was quietly snoring as the vet was just removing the 3rd core sample- OH nipped out the door and Dex threw up his head and barged out the door, mowing down OH and dragging me with the vet desperately trying to stop him. Thankfully he didnt get very far..the giant needle was carefully removed, a further scan to check it hadnt caused any damage in the excitement ( it hadnt thank God!) so 2 staples were put in and we left him to sleep off the rest. 10 mins later Dex was hammering on the stable door demanding to go out

Picture of the biopsy site:
http://gallery.me.com/roger.edmunds#100628/IMG_5238&bgcolor=black

Vet said to wait til we get the results back before we blood test the other horses as it will give an idea what to look for. He didnt think it was liver fluke but tested for it anyway..I got results at the end of the week and it showed that Dexter's liver was rallying all enzymes were lower and the bile in the blood has significantly decreased- thats the good news...the following day i noticed Dex swelling up in his back legs

I rang the vet and he said "keep an eye on him, its probably nothing and i will come tomorrow"

tomorrow came, and his front had swollen too:

Vet took one look and said "******" several times "He has something wrong with his heart" and his breathing and heart rate were abnormal too

There was nothing to indicate a heart problem in the bloods yet he had ventricular tachycardia.heart beat rate of 50 per minute,temperature is 38.5 C, 28 breaths per minute in the heat decreasing to 38C and 16 breaths at night. . So he went off to the clinic 26th May for an ECG, cardio ultrasound, diretics and find an appropiate drug regime. The vet cannot understand, unless its sheer bad luck, how he could develop a heart and liver problem independantly yet they are there. Dex was 5 stage vetted by Peter Scott Dunn himself in 2006 and his heart was fine then so whatever it is has come on fairly suddenly. Dex was full of himself last time i rode- the day before the vet's first visit and hunts for 3-4 hours, 3 times a fortnight over winter without tiring so is usually very fit.

We got to the clinic, wired him up and Dex's ECG is fast but the wave pattern is normal Ultrasound showed his heart has a touch of scelerosis on the left side but "nothing of clinical significance" so he has a good heart but still doesn't solve the mystery of the swelling :

^^ you can see the white pads where the ECG was attached.

He had a steroid injection- i was freaking out at that as he had bad laminits when i purchased him and it took a long time to nurse him back to health He was also put on 50 furesamide tablets a day, this was accompanied by 68 steroid tablets a day AND Heptosyl tablets AND Liver Active liquid supplement plus Kossolian Blood Salts for the dehydration..Thank god he is such a piggy cob and shovelled down his food no matter how many tablets were stirred in

Within 2 days he looked much better- i had to put factor 50 sunblock on his sores to stop the burning:

Here he is in August with OH:

We missed the BSHA championships he had qualified for as a LW cob but the vet said i could bring him back into work and if all ok then he would be allowed to start hunting.

We managed to get 5 days autumn hunting in , missed the Nov 2010 opening meet but went upto the central vale Tuesday where he joyfully pulled my arms out for two hours and then complained at being taken home so early

Even carted me over a rather big rail for a 14.3 cob!http://www.evespics.co.uk/2010 even...undhill, Kimblewick 9.11.10/HTML/img_7518.htm

Deepest, heartfelt gratitude to Thames Valley Equine for ALL their outstanding efforts to save his life Things will never be normal but they are manageable..

 

[Box_Of_Frogs]

Hi Martymoo, sorry to hear your boy is ill. What caused the vet to take bloods to diagnose hepatitis? You say he's fine except for the blood test results but there must have been some reason you had bloods taken in the first place. Next thing to think about is that your horse may look fine but he isn't, especially if the condition is worsening. Hepatitis is inflammation of the liver and can be caused by many things including liver flukes, viral infection or ragwort poisoning. Often the only way to be certain what the cause is is to take a biopsy. Something to bear in mind (linked to what made you take bloods in the 1st place) is that a horse can have a staggering 70%+ of it's liver damaged or destroyed without it having many visible effects. So by the time an owner notices suspicious symptoms, the damage can be enormous. Ragwort poisoning is, sadly, a common cause of liver damage in horses. It is cumulative so your horse may have eaten ragwort years ago and something may have happened recently to tip him over into hepatitis. With ragwort poisoning, the liver cannot regenerate so you need to support the horse through his diet for the rest of his life. With other causes, the liver can regenerate it's function given time.

While your vets work out how to help your horse, you need to immediately make changes to support his liver. The following is straight from Prof Knottenbelt and D&H head nutritionist and worked for my rescued mare who was a day away from euthanasia for ragwort poisoning (she's now well and happy and full of attitude!): Start a very low protein diet, but all animals need SOME protein so what protein you DO feed must be the highest quality you can afford. This gives the liver less work to do. Then add Milk Thistle (D&H do a dried tub of very high quality) because it has been shown to support the liver. Then get Yea Sac - liver damaged horses often struggle to absorb nutrients in the hind gut - Yea Sac helps this as well as being a very mild appetite stimulant and liver damaged horses often lose their appetite. Feed little and often, which again means less work for the liver. In bright sunshine, you will need to stable your horse as damaged livers cannot break down the chlorophyl in the grass they eat so it circulates in the body and attracts sunlight to the skin.

If you can support your lad's liver while the underlying cause is identified, then your horse should have a good chance of recovery. Fingers crossed for you. But a final word: watch out for further deterioration. Serious symptoms include lethargy, loss of appetite, loss of interest in life, jaundice, standing in corners pressing the head against a wall, blindness, staggering, unusual vocalisation, self harm and harm to the owner. This stage is enormously distressing for both owner and horse so keep a careful watch should he get worse and his quality of life becomes too low. Please PM if I've missed anything or if you need any more info. Fingers crossed your lad has just had an infection and will make a full recovery but stay alert xxx

 

[threeponies]

My pony died last year from liver failure, he had a biopsy to determine the cause of his hepatitis but he was ill for so long before showing symptoms that my vet was unable to say what had caused the initial liver insult, beyond saying it was not ragwort poisoning. My other pony who lived with him 24/7, shared stable etc for 14 years had very slightly raised liver enzymes so vet concluded the hepatitis was viral or bacterial. My pony responded well to antibiotics and lactulose, he was absolutely fine at 2pm on the day he died when I gave him his meds, by 8pm he was struggling to breathe and I made the decision to pts as he had gone blind and was pressing his head to the wall (all in space of 2 hours). Hopefully your horse will not have to go through this, my pony hid his symptoms so well that people on my yard said I was wasting my time getting the vet as they couldn't see anything wrong with him, but you always know your own animals. My vet said he had seen horses unable to stand with better liver function than my gelding had, but he was just a wee bit quieter than usual. Good luck with your horse.

 

[hellywelly1]

hey
my 4yo had liver trouble and we still dont know what caused it!
which enzyme is high?
mine was ggt and after 5mths of tlc and milk thistle along side a low protein diet he has come right.
he will always have to have a low protein diet but the vets are hopefull he is have no futher problems.

the support we recieve on here was second to none!

 

[Martymoo]

Thank you every one for your advice. He had a liver biopsy between christmas and new year and this confirmed that is was not ragwort posioning (thank god) and there was no real damage to the Liver.

The first signs were back in July when he was just not right, lethargic and depressed. He seems to struggle breathing after a short period of work and I first thought it was an infection he had the winter before in his lungs had returned but after being scoped that was all clear.
Blood tests shows an elevation in a couple of the enzeymes (not sure which) so he is on a low protein feed, milk thistle, and Vit B and hepatosyl and complete rest. A month later more bloods but this time the results were through the roof even though he seemed much happier, coat back nice and shiny the vet said his results were that of a very ill horse with ragwort posioning So then had the biopsy which confirmed it was not and thought it was just from a virus.
Blood tests again a week ago and no change so he has been put on a month course of steriods to try and shift the 'virus'.
He does seem so well and after reading the post from threeponies I am so scared it might be something horrible
I have read though that a mold in the hay could cause liver damage so been trying to find out about that and all sorts of things. Hopefully it is an infection and will clear up and it looks like I did catch it very early as he is not showing any signs of being ill now

 

[hellywelly1]

Thank you every one for your advice. He had a liver biopsy between christmas and new year and this confirmed that is was not ragwort posioning (thank god) and there was no real damage to the Liver.

The first signs were back in July when he was just not right, lethargic and depressed. He seems to struggle breathing after a short period of work and I first thought it was an infection he had the winter before in his lungs had returned but after being scoped that was all clear.
Blood tests shows an elevation in a couple of the enzeymes (not sure which) so he is on a low protein feed, milk thistle, and Vit B and hepatosyl and complete rest. A month later more bloods but this time the results were through the roof even though he seemed much happier, coat back nice and shiny the vet said his results were that of a very ill horse with ragwort posioning So then had the biopsy which confirmed it was not and thought it was just from a virus.
Blood tests again a week ago and no change so he has been put on a month course of steriods to try and shift the 'virus'.
He does seem so well and after reading the post from threeponies I am so scared it might be something horrible
I have read though that a mold in the hay could cause liver damage so been trying to find out about that and all sorts of things. Hopefully it is an infection and will clear up and it looks like I did catch it very early as he is not showing any signs of being ill now

teddy's enzymes went up with a bang, then suddenly drop all my vet said when they went down is she believed they went up as was detoxing. how true is was i dont know but he's continued to go down and are normal now. have you had a fluke test? we found this hard to get from our vets but as others have said it is possible chin up

 

[Martymoo]

teddy's enzymes went up with a bang, then suddenly drop all my vet said when they went down is she believed they went up as was detoxing. how true is was i dont know but he's continued to go down and are normal now. have you had a fluke test? we found this hard to get from our vets but as others have said it is possible chin up

Hi there,
ah that sounds positive then, fingers crossed. Have not had a fluke test it has not even been suggested but I will ask and see what they say x