Liver issues

[Mockingbird]

So to cut a long story as short as I can. We have a new horse purchased at start of July, passed a 5 stage vetting start of July horse has been amazing exactly as described and more.

She was delivered 10 days after vetting in a poorer condition than when we tried her covered in hives. Fast forward three months, she appears to be thriving put weight on, hives cleared up and muscle and top line improved.

Silly sod managed to choke her self on some hay and vet decided to take some bloods to check for infection after tubing her. Thankfully no infection but AST and GGT came back very high - GGT was over 900 and AST is over 500. All other levels on the standard blood count were normal.

The lovely but very newly qualified vet jumped to biopsies and imaging (which sent me into panic mode as we’d lost our old horse earlier this year to a really rare blood cancer of the spleen)

we have done a poo fluke test which was negative. However I’ve requested a blood test when we repeat her liver bloods on 4 weeks time. I’ve not really been given any advice apart from keep doing what I’m doing and give her a liver tonic.

Now this horse is a good doer and I have put her on milk thistle, fast fibre very small amount and L94 based on my own research online. She is only 6 so just want to do my best for her but think biopsies are very invasive for not telling is very much?

I am not sure if our vet will allow me to treat for fluke if the blood test comes back positive as she said it’s an anti body test and doesn’t tell us that she has them

The horse is totally well in her self and grown into herself - although we bought her from a dealer she was only sold from the breeder last November.

How long does it take GGT to rise? - could it be that it’s been high and is coming down? Daughter is gutted and very worried after how we lost our old horse at 15 very suddenly.

Nothing in her paddocks that she shouldn’t be eating, she was in a paddock with very little grass to try and keep on top of her weight along with an increased exercise regieme if 4/5 sessions a week compared to the 2 that she had at the dealers?

Vet said she’s not clinically unwell And to continue as normal so we have but I’ve cut back her schooling / exercise

 

[shortstuff99]

Definitely worth looking into iron levels and putting the horse on a low iron diet. Mine all had the same and vet was wanting biopsies. Said to check for high iron, vet said unlikely to find in blood but came back really high! Since being on a low iron diet they've all come down and looking fab!

 

[Mockingbird]

Definitely worth looking into iron levels and putting the horse on a low iron diet. Mine all had the same and vet was wanting biopsies. Said to check for high iron, vet said unlikely to find in blood but came back really high! Since being on a low iron diet they've all come down and looking fab!

I did ask about her iron levels after seeing a post somewhere (maybe here) and she said they were normal. She’s looking great just hoping it’s a hang up from the dealers?

 

[Hormonal Filly]

That is a high figure for GGT.
I would test another horse on the premises to confirm if it’s just her affected (if so, could be damage from previous home) or others are also affected.

Speaking from experience, my mare was similar to yours and we couldn’t improve her on supplements so tested another and bang, he also had liver damage as well as every other horse on the yard.

We suspect the grazing or hay was causing it, YO not interested so we all left and horses returned to full health. With the liver you don’t tend to see problems until it’s too late, one of these ponies had liver failure and was still competing at 80!

 

[nutjob]

Years ago I had a pony with very serious liver issues, he had clinical symptoms before he was diagnosed so it was probably close to being too late. However, he did recover and lived another 8 years before having a heart attack at age 27. I was not able to find out what caused it, he was kept at home and his companion at the time was OK and all subsequent horses have been. A liver tonic made a dramatic difference and his blood tests were much improved a few weeks later. Biopsy was mentioned but I couldn't see what I would do differently whatever the result was. I started feeding the small bale haylage to try to get weight back on him and have more control of what he was eating.

It's difficult on a yard if all the other horses belong to other people but it's definitely worth getting as many tested as possible to see if there's a common factor between those affected and those not.

 

[criso]

My horse had issues as did some others on the yard. At least one was as high as yours and none had any long term effects.

Very experienced vet advised supplementation and follow up testing. It was also him that said other horses should be tested after the first horse showed signs so the request didn't come from a livery.

RVC gave me their own liver tonic, can't remember all the ingredients but milk thistle and vitamin e were two key ones.

I did have a biopsy eventually just before the insurance ran out but it just ruled out things and didn't provide answers.

 

[Mockingbird]

Anyone have any idea if takes for GGT to rise? She arrived 20th of July and blood tests were done 30th of September as I say her overall condition and appearance has improved significantly.

 

[nutjob]

Do you have a blood sample stored that you could test from the initial vetting? That will tell you if the horse arrived with a liver issue and is improving or if she was OK when you got her and this has come about at your current yard.

 

[SEL]

A few years back I had a fairly routine blood test on my pssm mare expecting her muscles enzymes to be up - she was grumpy. AST and GGT were both up but CK normal. One of the other liver markers was up a bit too. She'd had bloods 5 months before with no raised liver markers.

Underground water source turned out to be my issue. Took ages for GGT to come back to normal even with a yard move. Vets did mutter about biopsies etc but I couldn't see that would help. Milk thistle and vitamin E for us.

 

[Mockingbird]

Do you have a blood sample stored that you could test from the initial vetting? That will tell you if the horse arrived with a liver issue and is improving or if she was OK when you got her and this has come about at your current yard.

I don’t but maybe the vet who did it has kept it stored? Would it not have degraded a bit by now?

 

[nutjob]

I don’t but maybe the vet who did it has kept it stored? Would it not have degraded a bit by now?

They normally keep frozen for 6 months. It's usually kept to determine if the horse has been drugged in order to pass the vetting rather than for other issues but I think it's worth contacting the vet and asking if you would get a valid result for liver enzymes from that sample.

 

[BBP]

Are your GGT and AST numbers definitely the right way round? How are the bile acids doing? I don’t tend to panic unless those start shooting up but a GGT of 900 would worry me, and I think you are right to rest her personally.

My youngster was tested in August, GGT over 300, in Sept they were over 500. AST nearly 900. I had been feeding hepalyte (milk thistle, vitamin e and something else I think), plus extra vitamin E. Vet suggested to blood test 2 -3 weekly to see whether they had spiked or still rising. He said if they kept rising we could trial a course of steroids to try to halt fibrosis, or a biopsy would help inform if it was ragwort or iron toxicity related. At that point I completely changed my forage to another supplier. It timed with the torrential rain so he was off grass and on all weather turnout with his new hay supply. I also added mycosorb to his feeds. Blood test 3 weeks later showed he was back to GGT of under 400 and bile back to normal. So now I plan to retest every 4 weeks, as he is now on winter grazing that inevitably has some spores on it.

 

[SEL]

Mycosorb - I also added that. In fact I'm about to order some for all of mine after littlest cob had some issues with AST on winter grass last year.

 

[Mockingbird]

They normally keep frozen for 6 months. It's usually kept to determine if the horse has been drugged in order to pass the vetting rather than for other issues but I think it's worth contacting the vet and asking if you would get a valid result for liver enzymes from that sample.

Just spoken to the vet who did the vetting and the red blood cells would be too
Degraded

 

[Mockingbird]

Are your GGT and AST numbers definitely the right way round? How are the bile acids doing? I don’t tend to panic unless those start shooting up but a GGT of 900 would worry me, and I think you are right to rest her personally.

My youngster was tested in August, GGT over 300, in Sept they were over 500. AST nearly 900. I had been feeding hepalyte (milk thistle, vitamin e and something else I think), plus extra vitamin E. Vet suggested to blood test 2 -3 weekly to see whether they had spiked or still rising. He said if they kept rising we could trial a course of steroids to try to halt fibrosis, or a biopsy would help inform if it was ragwort or iron toxicity related. At that point I completely changed my forage to another supplier. It timed with the torrential rain so he was off grass and on all weather turnout with his new hay supply. I also added mycosorb to his feeds. Blood test 3 weeks later showed he was back to GGT of under 400 and bile back to normal. So now I plan to retest every 4 weeks, as he is now on winter grazing that inevitably has some spores on it.

They never checked bile acids as it was a routine blood test to check for infection after a choke incident.

 

[Mockingbird]

Are your GGT and AST numbers definitely the right way round? How are the bile acids doing? I don’t tend to panic unless those start shooting up but a GGT of 900 would worry me, and I think you are right to rest her personally.

My youngster was tested in August, GGT over 300, in Sept they were over 500. AST nearly 900. I had been feeding hepalyte (milk thistle, vitamin e and something else I think), plus extra vitamin E. Vet suggested to blood test 2 -3 weekly to see whether they had spiked or still rising. He said if they kept rising we could trial a course of steroids to try to halt fibrosis, or a biopsy would help inform if it was ragwort or iron toxicity related. At that point I completely changed my forage to another supplier. It timed with the torrential rain so he was off grass and on all weather turnout with his new hay supply. I also added mycosorb to his feeds. Blood test 3 weeks later showed he was back to GGT of under 400 and bile back to normal. So now I plan to retest every 4 weeks, as he is now on winter grazing that inevitably has some spores on it.

I’ve seen a few on the Facebook liver damage group over 900 but yeah my GGT is 927 and AST 652 all other bloods normal on a normal blood count.

 

[BBP]

I’ve seen a few on the Facebook liver damage group over 900 but yeah my GGT is 927 and AST 652 all other bloods normal on a normal blood count.

I think at 900 I would be retesting every 2 weeks to see if they are going up or down. I’d be looking to get the bile acids tested asap to know where you stand on liver function. If they are high (not just slightly out of range but properly high) and the GGT has gone up then I think at over 900 and rising I would look at doing a biopsy, as it might inform as to whether steroids would be beneficial. I think you are right not to panic, a friends horse went from GGT 600 down to 50 in 5 months just through changing forage, but having held a pony as it died of Liver failure it is definitely not something to mess with so I think the bile acids will give you a bit more information.

 

[Mockingbird]

Thanks the blood test was a fortnight ago and the vets seem in no rush to do anything. She managed to hurt her neck leaning over a fence so they wanted to wait until that was fixed. She’s had two weeks off work and two weeks of L94 and milk thistle and myoscorb - unfortunately we had a pre planned holiday abroad booked and They didn’t want to test while we are away. They said 7-10 days wasn’t long enough to get an idea of whether the levels were changing at all and want to retest week beginning 28th of October. I also asked if she needed referred to vet school before we went away and they said no

Yard owner is aware that if she has any concerns while we are away to get vet out again. I think they feel there is no rush as she’s not clinically unwell.

She did get seperate flu and Tetanus jabs a week before this.

 

[BBP]

The neck injury could definitely affect the AST, so I can see their thinking on that one. I always used to work in 4 week blocks for blood tests for liver, it was just my recent vet who recommended 2 weekly when it’s so high. Good luck, let us know how you get on.