Liver disease HELP

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ClaretCarrot

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My 9 year old horse seemed a bit off form so I had bloods taken. The bloods showed raised liver enzymes indicating the liver was under stress. He also had raised ATC (?) levels. I stopped working him due to another injury. The vet advised I gave him legaphyton for one month and retested bloods. His liver enzymes increased again but his ATC levels dropped (I assume due to me stopping work)

I'm baffled as to why he has a liver issue. The vet just keeps saying its probably ragworth. I've had the horse all his life and I always clear the fields of ragworth and dispose of it carefully. The ragworth comes back every year thanks to not so vigilant neighbours but every bit of it is pulled. There's definitely no ragworth in the hay etc. He was in a field with bracken about 18 months ago but as there was such a rapid increase in the liver enzymes over the past month I assume the issue stems from a more recent event. We didn't spray the fields in the past 2 years so it can't be that either.

The vet has suggested legaphyton for another 3 months and retest. Without knowing the cause of it I don't know what to change in his management. He is prone to laminitis so was on a barefoot diet. I'm concerned that the added minerals and the fat in micronized linseed may have overloaded the liver. I've now changed his diet to just beetpulp, a sprinkle of pony nuts and good quality hay.

When he started the micronized linseed I noticed his coat quality deteriorated which came as a big surprise to me. Now in hindsight it was obviously the liver starting to get angry.

I have just wormed him with 5 day panacur. If I worm him for tapeworm next week surely that will rule out the possibility of worms? I also did 5 day panacur in the spring. The vet didn't even mention worms as a possibility but I'm wracking my brains trying to figure this all out.

Any advice or ideas most welcome
 
I'm sure others will be able to give you more info, but I didn't want to read and run!
In my own experience (about 6 years ago with an older mare - she's now 26ish?) liver takes time to repair, the lepaphyton is milk thistle? but you also need a high fibre, low protein diet - we were recommended happy hoof and if we need condition then micronised flaked maize, no oils etc as the liver finds this difficult to break down.
It is also quite common for the vets to prescribe antibiotics incase its infection, I'm surprised they have suggested ragwort if you have not been exposed, it is something confirmed by either scanning or a biopsy, ragwort would be something that you wouldn't probably know about as its only palatable in the dry form. Most common reasons are virus or infection and our vet also suggested that we feed echinacea to help boost the immune system, with the milk thistle being the most important to help with the liver regeneration.

So be patient, if one organ of the body is to be affected at least the liver is the only one that can re-generate!

I'm not sure if box of frogs is still on the forum but she has the best advice? Message me if you want to know more, otherwise good luck!
 
Thank you for taking the time to reply. I'm not really comfortable with waiting as the first month of legaphyton saw an increase in the liver enzymes. I'm terrified of waiting another 3 months feeding legaphyton and finding the liver pretty much failed by then.

The vet advised against a biopsy but he never mentioned a scan. Is it like an ultrasound? There is definitely some sort of immunity issue going on. When I had worm counts in the past this was the only horse with worms despite them all being on the same worming programme
 
There are quite a few threads about this recently - if you do a search you will be able to see what others have been prescribed in terms of medicine/diet/work. FWIW my three came down with the same thing over the summer and they are still not back to normal. We did 3 weeks of antibiotics (twice for one of them) and a biopsy etc which was inconclusive. Its not ragwort though in my case, but some kind of toxin they have ingested. They have changed grazing and hay but I wont really know until they are back to normal range and then see how they go from there.
 
My son's pony was diagnosed with acute hepatitis in June and spent 2 nights in horsespital. We never got to the cause, just either a viral/bacterial infection. She had strong IV antibiotics, ultrasound scan on liver (which showed no permanent damage) and then IM antibiotics afterwards once discharged. She had liver tonic and I now feed her milk thistle. Her bloods taken a few weeks later were coming back down to normal ranges but it was a worrying time.
 
My 5 year old ISH had a cough when I first purchased him and bloods were taken as a precaution. His liver enzymes were v v high most likely caused by a virus. He was then tested again 6 months later and only a slight improvement. Enzymes still v high. He was tested again and still the same result so I had a liver biopsy done, a liver function test and had him scoped. The biopsy showed mild hepatitis and no damage, liver function was normal and no ulcers were detected. He was treated with a liver supplement for dogs and steroids. His last reading was normal. The vet said they are seeing this more and more and ragwort poisoning was seen in some horses but is in the minority, I would suggest you have the biopsy and then take it from there. I am so glad I did. Good luck. x
 
We used hepatosyl, milk thistle and yea sacc when my mare had raised liver enzyme levels - we also out her on a low protein, high fibre diet. It's hard as it takes time for levels to drop so you have to be vigilant (physical signs) and patient. My mare was find but it was worrying.
 
When my horse was diagnosed with liver disease 3 years ago the biopsy showed a type of liver damage that wasn't caused by ragwort, and blood tests showed that he didn't have a virus. His ATCH level was 670 (eeek!!). My vet wouldn't put him on milk thistle as apparently it would cause the liver to regenerate too quickly, instead he prescribed steroids, Prednisol, 90 pills a day to start with, increased to 110 a day after a month, eventually I had to inject my horse every day with steroids and this went on for 10 months.

He's absolutely fine now thank goodness. It was a mystery to the vets, eventually they came to the conclusion that the liver damage had been caused by a mycotoxin in the grass, which in turn had been caused by a very wet and warm summer.
 
Sorry haven't had time to read all of this, so somebody else may have already given this advice.

My old horse had liver problems and I fed him milk thistle (capsuls from holland and barret) I just emptied a few in to his feed morning and night and after just a few days he was so much better (wee clear and no longer stinky)
 
I'll try to find time to write a proper response later but just briefly, my horse has had fluctuating liver enzyme levels for the last 18months. I'll try to dig out the numbers later but his GGT hit more than 700. We thought perhaps the hay cut in 2012 after the flooding of the fields had developed micro toxins that were poisoning them (we had one for of acute liver failure, then tested the other 4 and they all had high levels). A change of hay brought improvements but it only now that my horse is nearly back to normal. That said, after several months of light work after initial diagnosis, he has then been on a full workload for the last year. If I get on one day and he feels at all out of sorts I give him the benefit of the doubt and get off again. But he has never shown symptoms and is always fit bubbly shiny and full of beans.
 
He's absolutely fine now thank goodness. It was a mystery to the vets, eventually they came to the conclusion that the liver damage had been caused by a mycotoxin in the grass, which in turn had been caused by a very wet and warm summer.
Click to expand...

Interesting that your vet thought the same as us, mycotoxins in damp grass/hay cut from flooded fields.
Luckily my pony has had no treatment but my friends had raised bile acids and had multiple biopsies, steroids and antibiotics.
 
Loads of informative replies, thanks a million. The hay he had been eating up until the end of the summer when he was first tested would have been 2013 hay which was a warm relatively dry summer and great hay. If it is micro toxins in his grazing can I do anything about it? Does it just go by itself?
It's quite possible all the other horses have raised liver enzymes too but they are all retired field ornaments. I only noticed the subtle symptoms on my one riding horse and got him tested.

What is the normal and the alarming ranges for liver enzymes?
Thanks in advance
 
Hi, my mare had severe hepatitis for over 2 years and eventually went into liver failure, she had two biopsies, got treated for liver fluke, we did the 120 prednisole a day, we tried herbal stuff, we tried antibiotics, we tried all sorts.. and then they said we should withdraw treatment as she wasn't getting better. I ended up moving yards as a last ditch attempt and within 8 weeks her liver had started to recover - she only has about 1/3 of a liver but has now had normal bloods with no treatment for over a year - general consensus no one knows why it happened but most people assume there was something in the soil after a couple of very wet summers and winters and very clay soil that she was allergic to and it was killing her. at her worst her AST was 894 (should be less than 420), her GGT 492 (should be less than 49), her GLDH over 400 (it should be less than 11!) and her LDH was 1472 (should be less than 956), her Bile acids went over 30 and they should have been less than 14.. and despite being told I had months left with her she survived and a year later we are competing again and she is better than ever.

Happy to PM for more info but i literally tried everything. I put her on happy hoof as a laminitic diet is not dissimilar to a hepatic one. Hepatosyl is very good, i would recommend a blood tonic to increase Vit C levels and i ended up buying Vit E from a health food shop and giving her that which seemed to help.

Anyway i am rambling now - feel free to ask any questions, after 2 years of it i have researched everything and become quite a liver nerd!
 
Thanks switchthehorse. Unfortunately moving yards isnt an option, I keep my horses at home and I've invested a huge amount of money to make it "perfect" for my horses, leaving no spare money to put him on livery somewhere. I obviously didn't think the soil/grass would be slowly killing them. He's been on a strict laminitis/barefoot diet the past few years so I don't know where I'm going wrong with that.

Should I get the new hay tested to make sure there's no micro toxins in it, and assume that it was the old hay that caused the issue? And if it's the grass what can I do apart from selling my house which I'm not prepared to do (yet!)
 
My vet said there were hundreds of mycotoxins and it would cost me a fortune to test for all of them. It's frightening to think the soil or grass might be poisoning them but like you I couldn't move him, they live by my house and we have had either liver problems or grass sickness all around so don't know a safe place to go.

Bile acids seem to be an indicator of whether liver function is impaired. Mine never had those raised but his enzymes were huge indicating he was fighting some sort of assault on the liver. If it wasn't improving I would look to move him to see if any effect. Having looked after my friends little pony as she died of liver failure it was horrendous and I'd try what I had to to stop it. What sort if levels is yours showing?
 
Trying to find the paper on the research but there possibly is a link to low copper levels and liver function in rhinos (I know they are not horses but they do graze and are in the uk!) Got the vets out tomorrow so will be discussing this with them.
Hopefully there'll be some research conducted shortly on liver disease in horses, I only know as my horse is one of the subjects!
 
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