Liver problem, what is it?

Sugarplum Furry

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Brief summary.

Arab, aged 20.
Started losing a bit of weight Sept 2012.
Weight loss accelerated Oct 2012.
Vet visit Nov. Bloods taken, liver problem indicated. GGT 650.
Scan and biopsy. Biopsy showed liver damage but no sign of it on scan.
Full body scan showed no abnormalities.
Steroids prescribed, horse has been on 400mg a day.
Still losing weight and has muscle wastage.
Now starting to lose large chunks of coat.

He's been tested for liver fluke..negative....ragwort poisoning...negative..virus...negative.
Tim Brazil (you may have heard of him) did the scans and biopsy, he's stumped, as is my own vet. Vet came and took bloods again yesterday and I should get the results later today but it's all a mystery at the moment and meanwhile my poor boy is looking worse by the week, he honestly looks like a half starved Egyptian carriage horse, so pitiful. He's on two feeds a day of D and H Over 16, Dengie with oil, sugar beet, grass pencils, Copra meal and milk thistle plus ad lib hay. Rugged to eyeballs. Seems bright enough in himself, eating up well. Help! Anyone with experience of anything like it? Even if it's not good I need to know. I'm not going to let him go on like this and I'll do the right thing if he continues to keep going downhill, hard though it is...
 

flintfootfilly

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What is his GLDH level? That tends to shoot up when there's an insult to the liver, but come back down fairly quickly (within a month or two) once the insult is removed, so that might give you an indication whether the cause of the liver damage is ongoing or whether it's historical and you've got chronic liver problems.

One of my gang was confirmed with liver fluke (poo sample tested by David Sutton at Glasgow university, who has an interest in liver fluke in horses). They only found 1 fluke egg in 3 grams of poo, so it would be very easy to get a false negative result for such a low level of egg-shedding. Apparently horses tend to shed way fewer fluke eggs than sheep or cattle. From memory, I think sheep can be in the order of thousands of fluke eggs per gram, and cattle into a hundred or so eggs per gram, so with horses it really is much more tricky to find the eggs. I mention that because maybe if you are running out of other options, and your horse is going downhill, is it worth your vet having a word with David Sutton and seeing whether it's worth trying treating for liver fluke anyway (product not licensed for horses)? I was reluctant to treat for fluke until we had a positive fluke result, but I guess it all depends how desperate you are to make a difference, and whether other options are running out.

Have you checked forage/feeds to make sure you are not feeding toxic levels of anything like selenium or copper? What is his diet..... what weights etc of hay/grass/haylage, balancer, vits/mins anything else?

Hope he improves.

Sarah
 

flintfootfilly

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Just had a quick look at D&H's 16 Plus on their website. I can't really work out whether it has all the vits/mins a horse needs. I suspect not, though, from the short list of ingredients on the analysis. So personally I would ring either Teresa Hollands at D&H or Nicola Tyler at Topspec as good nutritionists and see what they'd suggest dietwise.

S
 

Pasha

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My Arab Gelding, 16, suddenly lost weight in Sept/Oct too and I had the vet out in November to run bloods which showed significant liver disease: AST 632, GGT 207 + Neutropenia. We also tested him for PPID (Cushings) as he was diagnosed with EMS in Jan 2011 and that came back positive at 60.2.

Vet started him on Pergolide/Prascend and I spoke to D&H and put him on Staypower Cubes (he was already having Alfalfa but we reduced this, Speedi Beet and D&H Ultimate Balancer).

4 weeks later bloods revealved the Pergolide was working as ACTH was down to 37.9 but not normal so we have upped his Pergolide to 2mg/day. Liver disease had not improved though: AST 636, GGT 211 and GLDH 104.

My vet decided not to biopsy and scan as he wouldnt give him steroids 1) due to his history of lami and 2) as although skinny and lethargic, he has been bright and shiny and looks well.

So vet put him on a 10-day course of antibiotics and protexin, plus Hepatosyl. I stopped the Staypower cubes after a week of the antibiotics and Hepatosyl as he put on weight and have just had him on Alfalfa, Speedi Beet, Ultimate Balancer and loads of Haylage (which I had tested to be sure it was ok).

We are now in week 3, he finished his antibiotics on Christmas Day and the vet is coming back out on the 11th to run bloods, but he looks and feels back to normal :) I took him on a little hack last Sunday and he was bucking and leaping so clearly feeling ok... most amazing thing is that all of his topline has come back without any work as he has been pretty much rested since his diagnosis!

Has your vet tested for PPID (Cushings)? Apparently liver disease is common with it and if it were the case with your horse, it would need treating in order for the liver to recover.
 

Pasha

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He's on two feeds a day of D and H Over 16, Dengie with oil, sugar beet, grass pencils, Copra meal and milk thistle plus ad lib hay.
Give D&H a call as Dr Hollands is very helpful!

For liver disease you should be feeding low oil, low protein so you need to cut out the Dengie with oil and Copra meal im afraid.

Dr Hollands put my boy on Staypower Cubes for the B vitamins and quality of protein as he is very intolerant to sugar and starch. But if your horse isn't they will suggest the most suitable feed for him and the quantity.

The most important thing i was told was to split his meals into as many as 4-6 small portions per day, so only 1/2 kilo of cubes/mix in each meal, so as not to overload the liver. I managed 3 and he is now back to 2 as not having the cubes anymore.

I also give Milk Thistle and Apple Cider Vinegar (which Saracen recommended - I phoned them all lol!)
 

ILuvCowparsely

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Give D&H a call as Dr Hollands is very helpful!

For liver disease you should be feeding low oil, low protein so you need to cut out the Dengie with oil and Copra meal im afraid.

Dr Hollands put my boy on Staypower Cubes for the B vitamins and quality of protein as he is very intolerant to sugar and starch. But if your horse isn't they will suggest the most suitable feed for him and the quantity.

The most important thing i was told was to split his meals into as many as 4-6 small portions per day, so only 1/2 kilo of cubes/mix in each meal, so as not to overload the liver. I managed 3 and he is now back to 2 as not having the cubes anymore.

I also give Milk Thistle and Apple Cider Vinegar (which Saracen recommended - I phoned them all lol!)
^5 this, before you start pumping loads of mix into her , get an ACTUALLY diagnoses. Until you know what it is 100% I would be very reluctant lto change her feed. Treat her for liver disease till then.


I went through it all with Dr Hoyllands who is amazing.
 

Sugarplum Furry

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Thanks all!! Some very helpful stuff which I need to research.

Liver fluke, nope, it's not that, he's been tested for it, even though the test result came back negative the vet gave him and my other three horses a drench as a precautionary measure.The hay, well, all my herd have been eating hay from the same source for the past 3 years, no ill effects on the others. I spoke to the vet about the Dengie with oil, she said if I was sloshing mugs of oil into his feed she'd be concerned, but the Dengie with oil is fine. I can't, and don't want to, make any decisions about his feed until I get the next blood results, this afternoon hopefully. But if I decide to change things I'll definitely give D and H a call, good advice.

Cushings, the initial blood tests showed he's got it 'low grade' Can you get low grade cushings, like laminitis? Forgot to ask the vet yesterday, will mention it to her this afternoon.

Pasha, your horse's symptoms sound so similar. My boy has had a course of antibiotics also but it doesn't seem to have a difference. I'm going to research Hepatosyl, was that from the vets? Glad your horse has recovered by the way, happy days! Such a worry isn't it?
 

foxy1

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Have you had any bloods taken from the others? Even if they appear well their liver enzymes could be raised but they are not outwardly showing symptoms.

I've read a lot about mycotoxins in hay, which is a particular problem this year because of the wet summer.

I do sympathise, it's such a worry. I had to have my yearling colt put to sleep last month who had unexplained liver disease. It's so hard not knowing what caused it.
 

Sugarplum Furry

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Foxy, I'm so sorry to hear about your yearling, that must have been dreadful for you. Thank you, that's a very sensible suggestion about having the others tested, yep, I'll run it past the vet!!
 

Sugarplum Furry

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Cheers OnlythePony, I asked the vet about that yesterday as there was an oak tree in the field at out old yard. She said eating the oak trees leaves or acorns would only have resulted in short term tummy ache and a runny bum, but not liver damage.
 

onlytheponely

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I beg to differ :(
It can kill them as the toxins gradually build up in their system. I very nearly lost one to it a long time ago. They cause kidney and liver damage.
 
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Sugarplum Furry

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Well that's what I was always led to believe, that acorn/oak leaf poisoning was lethal. I'll definately question the vet again about it, I didn't think that was she said was right.
 

Pasha

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Cushings, the initial blood tests showed he's got it 'low grade' Can you get low grade cushings, like laminitis? Forgot to ask the vet yesterday, will mention it to her this afternoon.

Pasha, your horse's symptoms sound so similar. My boy has had a course of antibiotics also but it doesn't seem to have a difference. I'm going to research Hepatosyl, was that from the vets? Glad your horse has recovered by the way, happy days! Such a worry isn't it?
Never heard of 'low grade' Cushings! They either have it or they haven't! I never understood why some vets are reluctant to prescribe Pergolide when it is soo beneficial! Maybe ask your vet what the result was? Anything over 29 is positive! If it is boarderline 28/29/30 I would be looking for a retest to make sure either way.

Yes Hepatosyl is from the vet :)
 

Sugarplum Furry

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Hi, me again. The latest blood test results show my horse's liver is practically back to normal. That's the good news.

The bad news is he's continuing to lose weight and muscle at an alarming rate, and the vets still don't know what's wrong with him. He could go for an exploratory op but we've agreed that he's probably now too weak to go through it, it just wouldn't be fair, so from today he's on a daily injection of an even stronger steroid, and 4 feeds a day plus ad lib haylage and hay. All we can do is wait and see how it goes. What's worrying me too is that his elderly field companion mare has now started to lose weight too, the vet did a blood test on her today to see if there's a connection between his weight loss and hers.

The two others in the herd (they've all lived together, sharing the same hay, feed and grazing for the last 3 years) are youngsters, both are healthy and thriving.

I am SO stressed, I'm convinced I'm going to lose my best boy, I don't think he'll last another month as he's so thin now.
 

ILuvCowparsely

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can you send your boy to the vets so they can run more test??

failing that i would contact Glasgow vets best in country for investigating things other vets cannot find
 

philamena

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How horrible for you, I really feel for you, you must feel sick with it.

I know this probably sounds a bit drastic, but having lost a horse to unexplained liver disease some years ago, I kick myself now for not moving them to somewhere else / the vet's in case it was a toxin she was somehow ingesting from the pasture / hay / water / whatever. Like I said, I know it sounds drastic, but being completely honest that's what I'd do now. I know it'd bring stress etc, but if there's something they're getting into their system from the stuff they're eating or drinking, that's worse than some stress! If you have two of the older horses potentially (and therefore with weaker immune systems) potentially going the same way, I'd act. I kick myself for not doing so now, whether or not it would have been too late for my girl. We'd gone over and over the pasture, including with the vet, and couldn't find anything, but I do know that when I bought my replacement horse she began to display the very very earliest signs of not being right and I instantly moved her (a big deal because it was off our pasture and onto a livery yard) and she completely recovered and never had a repeat.

I'm sorry, I know I sound completely OTT hysterical when really I'm actually very rational I promise!! But at the moment you're worrying constantly about what it could be and whether you're doing the right thing, and the peace of mind / process of elimination by removing them from any possible environmental causes would be worth it in my mind.

I'm also PMing you something. GOod luck, fingers crossed for your buddy. x
 

Sugarplum Furry

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Leviathan there doesn't seem to be any more tests they can run. They could scan him again, but as the vet explained they can only see part of his innards that way, and the last scan showed that would they could see looked normal. I think anything more invasive would finish him off. Cheers for the tip about the Glasgow vets, I'll pass it on to my vet.

Philamena, you must have read my mind! It occured to me only last night that now with two horses being affected it might be something in the soil or the water. The yard itself hadn't been used for horses for 20 years until earlier last year. My friend moved there in the spring with her 3 horses (hers seem OK, but they aren't elderly) and I joined her with mine in the summer. Previous to that the fields were used by a local farmer to graze some cows, he also cut hay off it.

Very good shout, you aren't OTT hysterical at all, it sounds completely rational to me, especially as you had the very same thing happen to your horses..so sorry you lost your girl. Right, so the search is on for somewhere to put the oldies quick smart...and possibly the youngsters too. I wonder where I can get soil analysed, and water?

Off to do a Google search, thanks for you kind replies.
 

flintfootfilly

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My understanding is that forage testing is more appropriate than soil testing (because the forage is what the horse actually eats, so it's the levels of different minerals in there which is important, rather than what's in the soil which may or may not be taken up by the plant).

I have used a company called Sciantec, based at Cawood, Selby for forage analsyis. They have analsed grass, hay and haylage for me as well as checked some feeds to be sure they didn't have toxic levels of anything. I opted for a full mineral test on the forage, and then also tested hard feeds for iron, selenium, copper and zinc. They produce the results pretty quickly (selenium took a bit longer than the other results) and are very helpful.

Sarah
 

Sugarplum Furry

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It just got worse.

I had my mare blood tested yesterday, she's lost weight and she's now showing signs of liver damage as well.

Going to have the youngsters blood tested next week.
 

undertheweather

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I had a horse with a liver malfunction, discovered by blood tests. After a month on milk thistle his liver showed improved function.

What is your routine, what forage/feed are you giving? Where is your forage sourced from? Can you go to the fields where it was cut from and look at hedgerows, speak to father about Hemlock, Ragwort, local people who look over the fields ?

Pesticides/Herbicides?

Look at your paddocks on OS Maps online. Are they at the bottom of a valley? Is there an industrial plant up hill from you that could be leaking something?

I would be worried about the acorns:
http://www.equi-therapy.net/equestrian/equine-veterinary/acorn-poisoning.shtml
 
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Sugarplum Furry

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Ok. Very poorly horse is on 4 feeds a day of D and H 16 Plus, Dengie with oil, speedy beet, Fast Fibre, Copra meal, milk thistle, veg oil, also daily steroid injections, ad lib haylage and hay. His liver function is almost back to normal which is why he can have products with oil as the liver can now cope with it. I moved him and his friends to the new yard at the end of June last year, he was totally healthy, He started dropping off ever so slightly at the end of Sept, through Oct, vet called at the start of Nov (I think) and that's when he was diagnosed with liver damage and started to lose weight rapidly.

I am absolutely convinced it's something in the soil/water/ grazing there. My hay comes from a totally reliable source, they have horses themselves, having been making their own hay for years and their own horses are all fit and healthy.

It's not ragwort poisoning, or liver fluke, or a virus. I've been round the fields, looked closely at all the grazing, plants and the hedgerows and can see absolutely nothing dodgy at all.
 
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