Liver biopsy

Joined
6 December 2018
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4
Please help,

I noticed very subtle changes in my 10 year old pony a few weeks ago. Picky with hay, quiet, water intake down opening bowels once over night.

I had the vet out within two days of these symptoms he said on the outside she seemed well but did bloods as I stated she was not herself.

Her liver enzymes were raised I cannot remember exactly what the figures were but she was in the red but not high in the red is how he put it.

She was given steroids, antibiotics, liver tonic and treated for liver fluke.

3 weeks later two bloods were within normal 2 still raised but had come down from where they were.

She had a liver biopsy yesterday, the vet said her lungs were large and had she had breathing problems which she never has , he also said her liver was small which he was concerned about however, the outer edges of the liver were fine and what he could see looked ok ..

I have to wait until next week for the results but he mentioned a small liver could suggest long term ragwort poisoning!!!!

I’ve contacted her previous owner who is on the ball with ragwort so since 2013 she’s not been in contact, prior to her having my horse she lived on a dairy farm and apparently their land management would have been or should have been good.

I’ve had her 18 months and she’s been great until now.

My questions are if anyone is able to help

1. If it is ragwort then when ingested how long does it take for symptoms to show ?

2. If it is ragwort then would her liver edges look normal?

3. Is it possible for her large lungs to have hidden some of her liver ?

4. Would her liver enzymes have come down if it were ragwort?

I’ve contacted professor knotty as I found his email on here but he’s not replied yet.

To throw another thing into the mix she was sharing a field with another horse who also had raised liver enzymes back in the summer, he was very unwell but his symptoms were not picked up as quick.

It wasn’t really known what it was but it seems a coincidence that two young horses have developed these problems, if it wasn’t for the fact the vet stated she had a small liver then I’d be thinking is it the same as what the other horse had. Sheep do go into this field from time to time and it’s ex dairy land .. I’m thinking possibly liver fluke ??

Any thoughts experiences or suggestions on what to do would be gratefully received as I’m so worried.

At present she’s bright eyed, eating , drinking and looks ok.
 

oldie48

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Is there any chance she might have found it in her hay TBH i don't think many horses will eat ragwort when it's growing (if that is what has happened) but they will eat it when it's been cut and dried. Does the other horse that had raised liver enzymes share the same source of hay? I'm not sure if this helps or not but one of our ponies had the same symptoms and bloods showed raised liver enzymes, he was treated for Fluke but we never really got to the bottom of what was wrong, he just got better but it took a little while for his bloods to get back to normal. Good luck, I hope your mare stays OK.
 

Pinkvboots

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Is there any chance she might have found it in her hay TBH i don't think many horses will eat ragwort when it's growing (if that is what has happened) but they will eat it when it's been cut and dried. Does the other horse that had raised liver enzymes share the same source of hay? I'm not sure if this helps or not but one of our ponies had the same symptoms and bloods showed raised liver enzymes, he was treated for Fluke but we never really got to the bottom of what was wrong, he just got better but it took a little while for his bloods to get back to normal. Good luck, I hope your mare stays OK.
This definitely and I am sure I read a story of a horse on a different forum some years back having liver damage, and the conclusion there was that it was the grazing the horse was on as the horse was moved to a different yard and everything went back to normal, I can't remember the full story it was on Arabian lines you may still be able to find it, just to add there was no visible ragwort or other poisonous plants in the field.
 

pippixox

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Although biopsies can be useful, my vet says often they show more clearly the extent of damage, and they can only speculate the cause. But I think certain markers and levels suggest if it is old damage or if they are currently in contact with a toxin.

On a positive: the liver is very resilient and they can cope with surprisingly little.
My friend loaned a pony for her daughters and he started to just act a bit ‘off’ as if he had a virus. They found liver damage and the bloods suggested it may be from previous ragwort poisoning (I couldn’t tell you that exactly they found that suggested it, but they did know it loved on poor grazing a while ago) but 5 years later despite bad damage he is fine with just supplement.

However, my pony is an unlucky one who is sadly being PTS next week after diagnosis in May this year. He was only blood tested as he was suddenly photosensitive. No other signs. Then did then get a bit jaundice. But the biopsy showed severe fibrosis, suggesting it had been damaged for a while. We did high dose of steroids and a fibrosis drug colchicine and for 6 weeks we tried different forage and grazing just encase (although no other horses showed symptoms and he’s been there for years and I tested my others we no issue. Made no difference to his bloods) but his bloods were not improving and vet now records he is a very rare case of lymphoma causing liver damage as recent bloods showed abnormal white blood cells. This is unusual, my vet has treated 50 roughly and only PTS 2 I think.

Ultimately it is usually very treatable even if there is some long term damage from ragwort poisoning a while ago.
 
Joined
6 December 2018
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Is there any chance she might have found it in her hay TBH i don't think many horses will eat ragwort when it's growing (if that is what has happened) but they will eat it when it's been cut and dried. Does the other horse that had raised liver enzymes share the same source of hay? I'm not sure if this helps or not but one of our ponies had the same symptoms and bloods showed raised liver enzymes, he was treated for Fluke but we never really got to the bottom of what was wrong, he just got better but it took a little while for his bloods to get back to normal. Good luck, I hope your mare stays OK.
Hi and thank you for your message , yes we do share the same supplier which is very much food for thought !
 
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I had a similar thing with my ISH 6 years old at the time. I called the vet as he was coughing and found liver enzymes to be very high. He had a liver biopsy and was also thinking on ragwort damage. He was diagnosed with mild hepatitis and was treated with steroids and milk thistle. Liver enzymes took over a year to come down but hes now 11 and fully recovered.
 

JanetGeorge

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I understood that ragwort causes a particular type of damage which should be identifiable in the biopsy.
Correct - the biopsy should show if there are the typical microscopic abnormalities caused by ragwort poisoning. But, I have to say that the symptoms to me do NOT sound like ragwort damage - and the fact that treatment has shown an improvement on the bloods also suggests it's not ragwort damage. And the symptoms are very 'mild' and not common to symptoms of hepatic insufficiency (weight loss is most common sign.)

The 'normal' size of horse (or people) organs is pretty variable - if anyone doubts that, look up Secretariat's heart size.

Casper7 - you have a lucky pony because you noticed small signs of unwellness which could be due to at LEAST 20 possible causes when taken together with the improvement in bloods. Your vet seems to have done everything reasonable - and it will have already cost you. You could spend a LOT more money and still not find the 'cause' of the initial sympoms - but I would say chances are good that the treatment has helped and you might never see any more symptoms because the pony is fine. So unless the biopsy gives cause for concern, I would be inclined to put ity down to just one of those things. Remain alert to any new symptoms, perhaps check bloods again in 3 months, but otherwise - stop worrying.
 

BBP

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A few years back, all 5 of our horse show developed high liver enzymes. We had owned 4 of them since they were 3 or 4 and they had never had contact with ragwort in all their time with us (grow our own hay). The fifth probably was exposed to ragwort for a chunk of her life a year or two previously. She went from itchy to photosensitive to death in a couple of days, completely taking us by surprise and causing us to test the rest. Mine had very high GGT (over 900, normal is below 50). The others had lower readings but one had elevated bile. I didn’t do a biopsy as didn’t think it would change anything but friends horse did. Hers had steroids and all sorts, mine just had milk thistle and light work. 6 years later all are fit and well with no sign of liver issues. Mine in particular is in fantastic form.

We believe it was caused by a mycotoxin in the ground/on the grass that particular year. In future I would change the primary forage source, so if they were on pasture I would move to a different one, if mostly hay I would change supplier. Plus milk thistle and whatevee level of work the horse wants (mine was busting out of his skin so couldn’t rest completely!)

A friends horse suffered very high levels this time last year and went this route, moved paddocks, switched hay, rest, milk thistle and 3 months later, having gone up again in the middle, they also went right back to normal.

So I don’t know the answers to your questions, but I do know it’s not always ragwort.
 
Joined
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BBP, that’s what happened to us.
A few of the horses on the yard were under the weather so had bloods taken. They came back with high liver enzymes. Concerned that this might be something affecting others in the yard most of us had our horses blood tested. My girl came back with the highest levels on the yard, even though she wasn’t showing any symptoms.
She was initially left to see if the enzymes reduced on their own, for a while they did, but then spiked again. At this point a biopsy was taken. The biopsy showed some inflammation, and that the cause wasn’t ragwort, but it couldn’t identify what the cause was.
She was put on a course of steroids and after a few months her levels were back to normal.
We have no idea what the cause was, we just know it wasn’t ragwort and all is fine now.
 
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