Liver Issues- Huge GGT levels......anyone got time to read??

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Grey Haven

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Sorry for the essay! I know quite a lot of people on here have liver issues and just wanted to post my ongoing nightmare with my pony.

6 year old New Forest x Warmblood. Had him since he was a yearling and I know he had a very poor start in life, weaned too early and big worm burden.

We moved yards in July 2013 - large DIY yard of 23 or so horses, all eating hay from the same source, etc.

December 2013 - my horse gets a bit pulled down, goes off his hay and bucket feed, drops weight and muscle. Vet out for bloods, expecting a virus and comes back with high liver enzymes. Short course of antibiotics and he starts to pick up and eat again. Horse in at night, out in the day with soaked hay.

Put on vet's liver supplement and also started him on Milk Thistle straight away, cut out all feed expect Thunderbrooks Chaff.

Blood tested monthly through to March 2014 when the enzymes were not back to normal ranges so decided to Biopsy.

April 2013 - Biopsy - liver looks normal on scan - biopsy results come back scoring 2 out of 14 so not much going on there. Enzymes still high. Horse turned around for summer (out at night for longer period, in in the day with hay)

Vet out as horse displaying hind limb stiffness, improved it seemed with work and to cut a long story short was tested positive genetically for EPSM in October 2014 (I pushed for test). Started him on the EPSM diet - ALCAR not high oil because of liver issues. Blood tested at that time too just to see how things were going.

Blood tests October 2014 were:

ldh 1215
Potassium 2.5
Alp 208
Ast 406
Ggt 100
Bile acids 8
Ck 419

Horse came in for the winter, on the ALCAR diet, with vitamin E, thunderbrooks chaff, mag ox, milk thistle, normal Vit/Min supplement and soaked hay (from same supplier as all the others on the yard -although they were not having it soaked).

Horse seemed fine in himself, excellent appetite, still a bit stilted in his gait behind and a bit lazy/grumpy under saddle.

March 2015 - had blood test as we had strangles at the yard (he's clear!) and also decided to take liver just to see where we were. Results were disappointing..

Ldh 1542
Alp 318
Ast 642
Gldh 94
Ggt 494
Bile acids 14
Ck 427

Vet has prescribed 10 days on steroids and 4 weeks on antibiotics and we've stopped the EPSM diet just in case. I've started him on Mycosorb and stopped soaking is hay. I've sent our hay for mineral and nutritional analysis as well.

Horse seems bright and alert, eating, drinking and pooing normally - you wouldn't know anything was wrong - no photo sensitivity, no jaundice, nothing!!

I am having a REALLY bad day today as I'm just waiting for tests to come back, the forage analysis, he's having second bloods taken next week.....

Anyone have any ideas - huge double of whatever you're drinking if you get to the end of this!!
 
I can't help but hope katpt sees the post as she will be interested having recently had an epsm diagnosis on hers who has had high liver enzymes for a while.
 
It might be interesting for you guys to compare at least, I think she was waiting for results post the diet change and I think there is some pondering on whether the epsm is why the liver is struggling.
 
Grey Haven said:
Sorry for the essay! I know quite a lot of people on here have liver issues and just wanted to post my ongoing nightmare with my pony.

6 year old New Forest x Warmblood. Had him since he was a yearling and I know he had a very poor start in life, weaned too early and big worm burden.

We moved yards in July 2013 - large DIY yard of 23 or so horses, all eating hay from the same source, etc.

December 2013 - my horse gets a bit pulled down, goes off his hay and bucket feed, drops weight and muscle. Vet out for bloods, expecting a virus and comes back with high liver enzymes. Short course of antibiotics and he starts to pick up and eat again. Horse in at night, out in the day with soaked hay.

Put on vet's liver supplement and also started him on Milk Thistle straight away, cut out all feed expect Thunderbrooks Chaff.

Blood tested monthly through to March 2014 when the enzymes were not back to normal ranges so decided to Biopsy.

April 2013 - Biopsy - liver looks normal on scan - biopsy results come back scoring 2 out of 14 so not much going on there. Enzymes still high. Horse turned around for summer (out at night for longer period, in in the day with hay)

Vet out as horse displaying hind limb stiffness, improved it seemed with work and to cut a long story short was tested positive genetically for EPSM in October 2014 (I pushed for test). Started him on the EPSM diet - ALCAR not high oil because of liver issues. Blood tested at that time too just to see how things were going.

Blood tests October 2014 were:

ldh 1215
Potassium 2.5
Alp 208
Ast 406
Ggt 100
Bile acids 8
Ck 419

Horse came in for the winter, on the ALCAR diet, with vitamin E, thunderbrooks chaff, mag ox, milk thistle, normal Vit/Min supplement and soaked hay (from same supplier as all the others on the yard -although they were not having it soaked).

Horse seemed fine in himself, excellent appetite, still a bit stilted in his gait behind and a bit lazy/grumpy under saddle.

March 2015 - had blood test as we had strangles at the yard (he's clear!) and also decided to take liver just to see where we were. Results were disappointing..

Ldh 1542
Alp 318
Ast 642
Gldh 94
Ggt 494
Bile acids 14
Ck 427

Vet has prescribed 10 days on steroids and 4 weeks on antibiotics and we've stopped the EPSM diet just in case. I've started him on Mycosorb and stopped soaking is hay. I've sent our hay for mineral and nutritional analysis as well.

Horse seems bright and alert, eating, drinking and pooing normally - you wouldn't know anything was wrong - no photo sensitivity, no jaundice, nothing!!

I am having a REALLY bad day today as I'm just waiting for tests to come back, the forage analysis, he's having second bloods taken next week.....

Anyone have any ideas - huge double of whatever you're drinking if you get to the end of this!!
Click to expand...
So sorry

please tell me where you sent your hay to be analyzed - my boy had raised liver but went down - but ponies went up and went on to milk thistle and legaphyton, stopped all oils supplements etc- second bloods some went down some went up. Liver biopsy yesterday and hadve to wait now agonizing all weekend till tues - wed for results.

I want to check our hay out.

So many coming down with liver issues , can't loose this pony - I have lost to much already
 
HGA-12 - I spoke to Forageplus which is where I got the mycosorb from as well as it wouldn't hurt to feed it to him. It's costing me £80 to get the hay analysed for mineral and for nutritional content.

The fact that nearly all the horses at the yard eat hay from this same source is confusing me - also they are all on the same pasture....I'm just assuming maybe there is something in the hay that my boy cannot process very well - perhaps because of his EPSM.

Like you - I've been through far too much with this pony to give up. He's only 6 and we've done nothing!
 
Hi! Yes, I'm liver and EPSM obsessed right now! First thing I'd say is don't panic, my horses results have been way worse than your horses and have come down and gone up plenty of times without him ever being sick or sorry or having a day off. I haven't figured out what's causing it yet, but Ive learned not to get too stressed as it will likely change in 3 months even if you change nothing. Your horses bile looks normal (depending on which vet you use!) which is good as it indicates that although the liver is fighting some sort of assault the liver function isn't impaired. (Friends horse had bile in 30s, infection of bile duct). I made decision that as long as liver function markers were normal I would keep working him as hard or easy as he wanted and wouldn't biopsy.

I did get great results after 4 weeks on ALCAR for AST and CK but they forgot to scan liver enzymes so I've had new bloods done and am waiting on them. Also waiting on vit e and selenium blood results.

Has your horse had any sort of trauma before his blood test? A gallop round the field or injury that could exacerbate the EPSM? Or less exercise and more stabling? The diet only goes so far to helping EPSM, controlled exercise is massively important.

I'll let you know what my liver results are when they come in. Try not to worry too much!
 
Dodson and Horrell do hay and grass analysis too. I had nutrients done in mine last year and am happy he isn't getting too much iron from it (excess iron very bad for liver so worth checking this in their diet). My next stop is mycotoxin analysis but it's so hard to know if you'll get a representative sample.
 
Thanks KatPT - yes he was stabled overnight for quite a while - I'm turning him out for summer on Monday so he'll be in a few hours in the day to rest this massive belly, but out more. I need to start his exercise again as it's hard with two kids having holidays all the time!

I did notice, since I stopped his ALCAR, he's rubbing his bum again which stopped literally days after I started the ALCAR diet. I'm going to wait until Friday when I see my vet for our seconds bloods, but I'm adamant that ALCAR is not a factor in his liver issues and as he was doing better on it I'm keep to get him back on it ASAP!

I'm having mineral analysis done and nutritional analysis on my hay supply - so they will check for iron levels and also selenium levels which of course can also implicate EPSM!
 
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