Liver Failure or Something Else.

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Amandajm

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My pony, developed sunburn on nose and socks 2 weeks ago, called vet 2 days later as it wsnt clearing with cream and she was looking a bit down, bloods show GGT 600+ and Bile Acid levels at 110... fatal I know, :-( put on anti biotics, ad lib hay, Milk thistle, vit B12 inj one shot and B vit combi tabs, and lactulose,,,,, feeding her fast fibre and hi fi chaf ( only a handful) several times a day, and mix it with a gallon of water to encourage drinking, which she has shyed away from.. but drinks if in food, her face has cleared totally, but legs still a little swollen and still sore with sunburn ( MSM cream advised) , and she has a UV mask on and is inside day time and out at night. It has been 15 days today since onset, and she hasnt taken a turn for the worse yet, she is calling for us when we visit her, and eating hay and feeds very well,, only water is the issue,, or lack of drinking it,,, but I havent been given anything to watch out for as a sign for when she is near the end,, as i was led to beleive she would be gone by now,,, she is urinating, but only small amounts and someting looking rusty coloured, she is not banging her head or walking unsteady or dazed or anything that i would be expecting to see..... I know Box Of Frogs knows a lot about this subject,, but any advice from anyone whould be helpful,, thank you,,
 
I'm not sure I can offer much help and I don't want to upset you but I wondered if you are in a position where you can monitor her 24/7? I ask because my friends lovely pony went from normal to dead in the space of a few hours, and it was not a nice end for the pony, so I wouldn't want to leave one unattended if I knew mine had levels that high (we didn't know it was liver til vet arrived to pts so I don't know what her bloods would have been). We tested the other horses after that and all had raised GGT (mine was at 900 at one point but his bile was normal) and one had raised bile as well but under 40 I think. That one had biopsies and antibiotics. Mine had no treatment other than rest and milk thistle as bile was ok. All of them are now fine (I haven't tested bloods for 2 years now) and mine is on top form. Perhaps get them to rerun bloods to see if you get same results. If you do, and having seen what I saw, I would be tempted to put her to sleep whilst she is still ok. I'm really sorry to say that. Big hugs.
 
Thank you KatPT for your honest reply, She is in a stable right next to the field owners house so someone always there even when we aren't. I have asked for other blood tests. Like you say at least if there is no movement on any of the levels we know where we stand.
 
Have you tried beetroot juice added to her feed for extra fluids and benefits. It's excellent for the liver. Also look at Mycosorb A+, my boys hepatitis was directly linked to toxins. Only when that was under control did we see any improvements. I use Saracens shape up which has added Mycosorb and I buy A+ from progressive Earth on eBay. At his highest his ggt was 500, it took nearly a year but we got there. Good luck op xx
 
She is brighter, eating well and drinking a bit more,, still very selective and preferring drinking sloppy food bucket to water,,, but liquid so Im happy. And urine looking a lot clearer, so at the minute not showing bad signs of needing to be PTS yet. Her socks are still "scabby" and oozing a little serum so been appling cream daily. Just judging dy by day, I was expecting her to be gone days, if not weeks ago, so every day is a bonus
 
We have had the vet come to take some more bloods,,,, and the results are nothing less than Miraculous.... Her Bile Acid level that was 110,,, ( after being told that 100 is most certainly fatal,,,,, ) she now has a bile acid level of 14,,, that is 14,, none of us, not even the vet can believe that she has come back from fatal levels,,,,, Her GGT is 240 from 660,, still some work to do on that but still very encouraging,, and her urea level is still low,, but on the low side of normal,,, so for a pony that was near death not long ago,, she is fighting it like the true Welsh bety that she is.. :-) We are still on a good regime of MILK THISTLE,, ( That I swear is the miracle cure ) REMOUNT, and LACTULOSE and vit B combi tabs on conservative doses as advised by Vet,,, and fast fibre diet, ad lib hay, and a bit of Pegasus and HIFI light chaff as extras when needed .... still monitoring every day for a change in behaviour or ill health and blood taken again in December,, but at the minute we are Over the Moon,, and a few other planets as well XXXX
 
Amandajm said:
My pony, developed sunburn on nose and socks 2 weeks ago, called vet 2 days later as it wsnt clearing with cream and she was looking a bit down, bloods show GGT 600+ and Bile Acid levels at 110... fatal I know, :-( put on anti biotics, ad lib hay, Milk thistle, vit B12 inj one shot and B vit combi tabs, and lactulose,,,,, feeding her fast fibre and hi fi chaf ( only a handful) several times a day, and mix it with a gallon of water to encourage drinking, which she has shyed away from.. but drinks if in food, her face has cleared totally, but legs still a little swollen and still sore with sunburn ( MSM cream advised) , and she has a UV mask on and is inside day time and out at night. It has been 15 days today since onset, and she hasnt taken a turn for the worse yet, she is calling for us when we visit her, and eating hay and feeds very well,, only water is the issue,, or lack of drinking it,,, but I havent been given anything to watch out for as a sign for when she is near the end,, as i was led to beleive she would be gone by now,,, she is urinating, but only small amounts and someting looking rusty coloured, she is not banging her head or walking unsteady or dazed or anything that i would be expecting to see..... I know Box Of Frogs knows a lot about this subject,, but any advice from anyone whould be helpful,, thank you,,
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I have been treating Liver issues for the past 6 years

NO FAST FIBRE
hifi or anything with straw, this causes ammonia to build up and give the horse brain fog



I have had all three of mine with high GGT 189 - 164 -176 and a livery just diagnose 102. I also had my late mare into the beginnings of liver failure as she had jaundice.

Dr Teresa Hollands is chief nutritionist with D&H. D&H work hand in glove with Prof Knottenbelt of Liverpool Uni on liver damage in horses. The Prof is a world expert. I wouldn't hesitate to put your horse on a liver-support diet until you know what the most recent blood tests show. If there is any doubt as to whether your horse has an ongoing or serious liver problem then D&H can draw up a tailored diet for your horse. Should things deteriorate, the Prof is always willing to help the individual horse owner.
Legaphyton ( from vets)
milk thistle
yea sac
nettles
other things good for the liver is

dandelion root
licorice
lemon juice

I would go onto haylage - the purple one which is timothy grass as it is better for the liver to have just one grass than a mixture of hay or mixture of grasses in the haylage.


1.. Feed a very low protein diet
2. Diet should be the very highest quality you can afford as this will mean less work for the liver
3. Feed little and often as this is less work for the liver than big blasts even up to 10 small feeds
4. Add Milk Thistle or legaphyton to his feeds to support the liver
5. Add Yea Sac to his feeds to stimulate a flagging appetite and aid hind gut digestion
6. No conditioning feeds or oils EVER as the liver won't be able to break them down
7. Use starches and sugars for energy but with precautions
8. If ragwort poisoning is suspected, the condition may be permanent
9. If ragwort poisoning is suspected, keep the horse out of the sun during spring, summer, autumn
10. Be aware that a poorly functioning liver can bring other problems such as blood not clotting properly, distended abdomen, blood in urine etc etc

Above all diet is a real key into helping the liver repair itself and it can providing you get the cause out the diet or change the diet to consist of forage to aid the liver and easy for the liver to breakdown, thus stopping the disease getting worst.

Both of my horses recently were changed onto haylage and a week after the bloods were taken, they had a biopsy and it showed some signs of the liver to regenerate.

To get her drinking get some low sugar tesco apple juice and put one cup into her water bucket, it is what I had to do for my first mare and my pony who had liver issues 2 years ago.
 
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ILuvCowparsley: what a fantastic post! so much useful information. I shall save this for future reference!

I have no experience of liver failure but what I would like to add is this: all three of my horses have loved to have a bucket of warm water to drink. Found this out by accident as if I went near any of them with warm water they would hassle me to get a drink of it. Don't know if it will work but you never know - worth a try.
 
The trouble is not all of that post fits with current science. I would certainly like to see a recent reference for the oil and protein points.

The OPs regime seems to have worked well anyway.
 
ester said:
The trouble is not all of that post fits with current science. I would certainly like to see a recent reference for the oil and protein points.

The OPs regime seems to have worked well anyway.
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So why did OP ask for help then huh!!!!

Why don't you do yourself a favour and ask your vet about protein and oil on the liver I am sure they will give you facts and figures you seems to desperately want. I am not wasting my time explaining about science whether it is current or not to someone who can never leave a post alone and always wants the writer of the post to give a drawn out document with facts and figures on it.


It is not your call is it it is for OP, they asked for any help and experience and that is what I gave based on experience over the last few years and currently. having had 3 liver biopsies and numerous call outs and numerous vet bills, nights staying up with the cases. I base mine on experience and original advice from BOF and speaking to Teressa Hoyland Also going to lectures at my vets on a client night based on liver issues.

Also helping 2 current friends horses with liver issues, one of which my experience and advice has led to the horses liver blood test return to normal from a high GGT, including 3 of my own.



My vet explained to me that many types of oil make a liver which is compromised and damaged work harder and to eliminate anything that that can put a strain on the liver. I have gone through liver disease 6 times in the last 2 years and beginnings of liver failure. Current livery has GGT levels of 102.

Also another clients horse has red wee, did you know that is also a sign over a compromised liver, it was me that warned the livery, it was me that told her to get a blood test. I am not blowing a trumpet, I got a thank you and horse now on liver tonic, that is what I did it for as the the livery was unaware of the problem.


Do you know the only time it is permissible to give oil to a liver diseased case and how much and what the symptoms are also which oil????
 
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Amandajm said:
We have had the vet come to take some more bloods,,,, and the results are nothing less than Miraculous.... Her Bile Acid level that was 110,,, ( after being told that 100 is most certainly fatal,,,,, ) she now has a bile acid level of 14,,, that is 14,, none of us, not even the vet can believe that she has come back from fatal levels,,,,, Her GGT is 240 from 660,, still some work to do on that but still very encouraging,, and her urea level is still low,, but on the low side of normal,,, so for a pony that was near death not long ago,, she is fighting it like the true Welsh bety that she is.. :-) We are still on a good regime of MILK THISTLE,, ( That I swear is the miracle cure ) REMOUNT, and LACTULOSE and vit B combi tabs on conservative doses as advised by Vet,,, and fast fibre diet, ad lib hay, and a bit of Pegasus and HIFI light chaff as extras when needed .... still monitoring every day for a change in behaviour or ill health and blood taken again in December,, but at the minute we are Over the Moon,, and a few other planets as well XXXX
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That is brilliant Amanda, lets hope she continues to progress, I would still cut out the Fast Fibre till the liver is back to normal. Give D&H a ring and speak to Teressa Hoyland

Have a read through of some of these OP
http://forum.highlandponyenthusiasts.co.uk/viewthread.php?action=printable&fid=2&tid=38749

here is an old post from BOF
Box_Of_Frogs said:
2 years ago I took on a rescued gypsy cob mare with appalling liver damage from ragwort. Welfare confiscation case. Long story. Vets said pts as she was in such a bad way but a terrific team turned her around. The team was made up of me, my YO who has extensive experience of rescued horses, my local equine vets, Prof Derek Knottenbelt - an absolute saint and the one whose input truly saved Angel, and lastly D&H Head Nutritionist Dr Theresa Holland.

The liver does so many essential things within the body. The ones you need to know about are helping with digestion, filtering toxins out of the blood, and helping the blood clot. If the liver gets an infection then it can recover the function again - not exactly regenerating itself but as close to that as makes no difference. But some poisoning - like ragwort - destroys the liver so that it cannot regenerate. Another thing you need to know about livers is that as long as there is about 25% - 30% remaining liver function, you may not see any signs of liver damage/failure in the horse. It's only when the damage hits 70 - 75% that you start to see the familiar signs. Prof Knottenbelt told me that with over 76% damage, the disease is always fatal. So this means that from the moment symptoms become apparent to the point of no return is a TINY difference. So you need to act very fast.

As your vets and others have told you, you need to put your horse immediately on a very low protein diet. But all animals need some protein, so the protein your horse DOES have must be the highest quality you can afford. This makes the work of the remaining liver easier. Next,
NO conditioning feeds or oils EVER. The liver won't be able to break down the fats.
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All conditioning feeds are high in oils. Next, add Yea Sac, which (a) is a tiny appetite stimulant but more importantly (b) aids hind gut digestion which is compromised in a horse with liver damage. Next add Milk Thistle which has been shown to support the liver in horses AND in people! Dodson & Horrell do a very good quality and reasonably priced dried Milk Thistle. Angel was on Alfalfa (not the added oil one), wet speedibeet, Yea Sac and Milk Thistle. Ad lib haylage in the winter. The final thing to know about damaged livers is that they cannot break chlorophyl down properly. This is what makes plants green. So the compounds circulate in the horse's blood and will attract the sunlight as if he was a great big leaf. So you have to stable liver damaged horse's during the day from about May to September or they can suffer terrible sunburn from acute phototsensitivity. Angel was black and white so suffered very badly on the areas where her skin was white. When she first came to me it looked as if she'd pushed her entire head into a bonfire. Oh, and feeds should be broken down into as little and often as you can manage - that helps the liver too.

After 18 months, Angel's liver function was stable and there was enough left for her to live a careful normal life, with the diet and management as above. She was backed at aged 12 and went to her 1st ever dressage test 5 weeks afterwards and came FIRST! So don't give up on your horse. A final word of advice - loads of tlc and thoughtful nursing will make your horse happy but don't treat him as an invalid and absolutely NO CRYING round him or he will pick up on your vibes and get anxious. As hard as it is, save the tears for away from his stable.

Miracles can happen with liver damaged horses hun, as I hope Angel's story has shown. But this next bit needs to be said too. Symptoms of liver damage include loss of weight, loss of appetite, loss of interest in life, lethargy, drowsiness, sometimes jaundice, and standing in corners pressing the head against a wall. Toxins build up in the brain and begin to cause nerological symptoms. More serious end-stage symptoms can include staggering, blindness, unusual vocalisation, self harm and harm to the owner. Watch your horse well, love him and nurse him with all your heart...but watch for him telling you enough is enough and be brave enough to help him if he needs you to. Remember, better a week too soon than a day too late.

My thoughts are with you hun. PM if you need to xxxxx
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OP This is a picture of reddish urine from a liver diseased horse
681be23b-3d2b-4aff-af23-4adf5f33263d_zps633nonvi.jpg
 
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Wow OP that’s amazing news! What a relief it must be for you. Do you know what caused the problem?

ILuvCowParsely - Can I ask why you’ve had so much experience of this? I’d just like to know about underlying causes, the only one I know of is ragwort.
 
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ILuvCowparsely said:
So why did OP ask for help then huh!!!!

Why don't you do yourself a favour and ask your vet about protein and oil on the liver I am sure they will give you facts and figures you seems to desperately want. I am not wasting my time explaining about science whether it is current or not to someone who can never leave a post alone and always wants the writer of the post to give a drawn out document with facts and figures on it.


It is not your call is it it is for OP, they asked for any help and experience and that is what I gave based on experience over the last few years and currently. having had 3 liver biopsies and numerous call outs and numerous vet bills, nights staying up with the cases. I base mine on experience and original advice from BOF and speaking to Teressa Hoyland Also going to lectures at my vets on a client night based on liver issues.

Also helping 2 current friends horses with liver issues, one of which my experience and advice has led to the horses liver blood test return to normal from a high GGT, including 3 of my own.



My vet explained to me that many types of oil make a liver which is compromised and damaged work harder and to eliminate anything that that can put a strain on the liver. I have gone through liver disease 6 times in the last 2 years and beginnings of liver failure. Current livery has GGT levels of 102.

Also another clients horse has red wee, did you know that is also a sign over a compromised liver, it was me that warned the livery, it was me that told her to get a blood test. I am not blowing a trumpet, I got a thank you and horse now on liver tonic, that is what I did it for as the the livery was unaware of the problem.


Do you know the only time it is permissible to give oil to a liver diseased case and how much and what the symptoms are also which oil????
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Did you not read the update from the OP? That is why I said she has done pretty well!?

I have spoken to my vet and a couple of independent nutritionists/physiologists about the protein/oil thing which is why I was interested where your info was coming from/how recent it was as they were the ones that advised me that it was considered older thinking (box of frogs post is 7 years old). It is a fairly normal thing to do to ask for details about information? In particular when it clashes with other professional sources.
 
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ester said:
Did you not read the update from the OP? That is why I said she has done pretty well!?

I have spoken to my vet and a couple of independent nutritionists/physiologists about the protein/oil thing which is why I was interested where your info was coming from/how recent it was as they were the ones that advised me that it was considered older thinking (box of frogs post is 7 years old). It is a fairly normal thing to do to ask for details about information? In particular when it clashes with other professional sources.
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I have already said who Is looking over my horses treatment past and present if you care to read my post again. I will not jeopardise my horses care listening to things that have already been told not to give my horses, specially when 3 of the recent horses have all got normal liver function again.
I replied to OP with what I have don't successfully and the tailored diets for liver horses, now if you want to go pour oil into a liver diseased horse go ahead, but me I am sticking to what I know has worked and 3 horses are back to normal. I must stop clicking on view thread on ignored people

Now if you care to Contact D&H Teressa Hoylland she will give you an update on oils fed to a liver diseased horse *smacks hand*
 
I really don't see why there is apparently such an issue with me asking politely whether there was an additional reference for your information that could be read? That is totally standard practice when discussing things like this? all you needed to say was no, that was the instructions given to me by Teressa Hoylland, I don't see why it is ever a waste of time to 'explain science'? It is important to me because the information that I garnered just last year when it became very important to me suggested differently, and that a certain amount of good quality protein is helpful for liver repair. I wasn't asking just for the fun of it. I would have been genuinely interested to read anything and see how it stacked up to what I had been told, because I am always open to change my management of the issue.

Nowhere have I suggested you jeopardise treatment your horse care, I merely asked a question based on my own experience and conversations about feeding a horse with a liver problem myself and felt it appropriate for the OP, and other members of the board, to mention that that without further qualification the information was potentially out of date as these things can move quite quickly.

Frankly if all you are going to do is rant at my polite requests for information or having received different information from experts different to yours I'd rather you didn't read my posts either!
 
ester said:
The trouble is not all of that post fits with current science. I would certainly like to see a recent reference for the oil and protein points.

The OPs regime seems to have worked well anyway.
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You are wasting your time. Her posts are normally plagurised, so if you put the first line or so into google it will bring up the original.

ILLCP why do you have so many horses with liver issues?
 
Well Dr. Holland isn't at D+H anymore anyway, she works for surrey uni. She did at least do an interesting PhD (hoofy) thought.
Can't see any particular interest/publications on liver nutrition though so I guess I will stick with my current regime.

But yes, it's a shame that the proper posters cannot be attributed to their postings all the time when the quote function works just fine. I guess that is why people get ranty at you when you ask for a bit more info.
 
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Leo Walker said:
You are wasting your time. Her posts are normally plagurised, so if you put the first line or so into google it will bring up the original.

ILLCP why do you have so many horses with liver issues?
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NO YOU WONT.


Actually no the wording is from my BHS training experience.

What I wrote down here is my notes I made and experience I had and newer things during the last 5 years what I been told to do by my vet, I also went to along lectures at my vets practice with many others in my area. I am BHS trained over 36 years and experience throughout my training first hand thank you very much.

No one knows why the liver enzymes were high, the vets think it is a virus going round as many horses in the area were(are) suffering from livery issues or we have had dodgy hay as now they are on haylage their liver's are improving as I have said in many many liver threads..


I have dealt with liver issue horses since 1981 so I don't need to copy anything. It is all here in the old fashion pen and paper before computers were invented something you will not know about.
 
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Amandajm said:
My pony, developed sunburn on nose and socks 2 weeks ago, called vet 2 days later as it wsnt clearing with cream and she was looking a bit down, bloods show GGT 600+ and Bile Acid levels at 110... fatal I know, :-( put on anti biotics, ad lib hay, Milk thistle, vit B12 inj one shot and B vit combi tabs, and lactulose,,,,, feeding her fast fibre and hi fi chaf ( only a handful) several times a day, and mix it with a gallon of water to encourage drinking, which she has shyed away from.. but drinks if in food, her face has cleared totally, but legs still a little swollen and still sore with sunburn ( MSM cream advised) , and she has a UV mask on and is inside day time and out at night. It has been 15 days today since onset, and she hasnt taken a turn for the worse yet, she is calling for us when we visit her, and eating hay and feeds very well,, only water is the issue,, or lack of drinking it,,, but I havent been given anything to watch out for as a sign for when she is near the end,, as i was led to beleive she would be gone by now,,, she is urinating, but only small amounts and someting looking rusty coloured, she is not banging her head or walking unsteady or dazed or anything that i would be expecting to see..... I know Box Of Frogs knows a lot about this subject,, but any advice from anyone whould be helpful,, thank you,,
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Op how is the pony doing now, any update??
 
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