Nasal Discharge, any ideas welcome

[be positive]

One of my liveries has a discharge from one nostril only during/ after work, never at any other time, thick yellowy gunk, she has been blood tested several times, been x rayed and scoped with a trach wash, had swabs taken, nothing has really been found to explain what is going on other than a minor infection/ inflammation, she responds well to antibiotics and the discharge stops but returns within a few weeks.

It remains the same even when she is out 24/7 so should not be a dust/ allergic reaction and it is only ever from the one nostril, she never coughs, rarely blows her nose, is normal in her ability to cope with exercise and is very well in herself, she is on haylage when in but was no different on just grass in the summer, the vet is stumped having ruled out teeth, sinus, lungs etc and with it only being one nostril we are running out of ideas so I throw it open for any suggestions that we may not yet have thought of.

 

[samlf]

I'd be interested to know what ideas people come up with too as I have a horse similar - lives out, almost never coughs, teeth have been checked but she has always had a thick (in her case, milk coloured) nasal discharge after exercise.
The vet seemed nonplussed and said it is likely her airways clearing. She is well in every way, so I have not taken it further.

 

[milliepops]

Interesting that it clears up with ABs, but then returns.. this may be a dumb question but could it be some kind of lingering infection that actually needs a longer course of ABs to fully clear?

has it been cultured? heard of some sinus infections that have lingered like this and turned out to be really unusual bacterial infections hence the difficulty in getting rid of them for good.

 

[be positive]

Interesting that it clears up with ABs, but then returns.. this may be a dumb question but could it be some kind of lingering infection that actually needs a longer course of ABs to fully clear?

She has just finished a long course, best part of 3 weeks I think, the discharge shopped almost immediately then returned a few weeks later, I think it is the same thing lingering but we cannot find the source or explain why it is only the one nostril, I had expected something to show when she was scoped but everything seemed fine even her gutteral pouches were shiny clean which would have been the obvious place to brew a long term issue.

 

[milliepops]

Hmmm yeah, cos the other thing that just rung a bell somewhere in the dusty recesses of my brain was Aspergillus which a friend of a friend went through with her horse, think the only symptom to start with was a persistent runny nose but that turned into quite an ordeal. It was well set into the sinuses... horse scoped clean, I think they noticed it on xRay first and then CT. Hopefully not that!

 

[OWLIE185]

If it is always on one side then

 

[be positive]

Hmmm yeah, cos the other thing that just rung a bell somewhere in the dusty recesses of my brain was Aspergillus which a friend of a friend went through with her horse, think the only symptom to start with was a persistent runny nose but that turned into quite an ordeal. It was well set into the sinuses... horse scoped clean, I think they noticed it on xRay first and then CT. Hopefully not that!

That seems to start in the guttural pouches, we went in them with the scope as it was the obvious place to store a nasty infection, xrays showed nothing in the sinuses and nothing sinister has shown on the bloods/ trach wash, my thought is a foreign body that was not picked up on the xrays, we were not really looking for one, they were for the sinus/ teeth, it is the fact it is only on one side that is so unusual.

Just to add this is long standing well over 18 months now with no real change or deterioration, it improves with antibiotics but has not got worse over time.

 

[Casey76]

Sounds very similar in appearance to the sinus infection Pinto had.

He had wacking huge doses of Pulmodex for 3 weeks, and fortunately it cleared up.

However at the time the vet thought it could also be a tooth root abscess - something else to think about perhaps?

 

[Goldenstar]

Fungal infection in the hyoid area ?

 

[Red-1]

OH's Charlie Horse had similar, we had scopes, swabs, X rays, to no avail. The vet was nonplussed, and after about 2 years it simply stopped. Cost us about £500 for investigations in the mean time though!

It never did return.

It was also only ever from the left nostril, horrible yellow gunk, sometimes tinged with blood. Vet was astonished nothing to show on scope.

Hope yours simply stops as well!

 

[be positive]

OH's Charlie Horse had similar, we had scopes, swabs, X rays, to no avail. The vet was nonplussed, and after about 2 years it simply stopped. Cost us about £500 for investigations in the mean time though!

It never did return.

It was also only ever from the left nostril, horrible yellow gunk, sometimes tinged with blood. Vet was astonished nothing to show on scope.

Hope yours simply stops as well!

It sounds similar, the vet expected to see something significant when scoping, the trach wash looked dirty but came back showing nothing of note, we have virtually eliminated every cause and are continuing as normal but as her owner said today if we go out competing and someone sees the discharge they may get rather upset, I know I would question why a horse with gunk coming out of it's nostril was in the collecting ring as it looks as if it may well be infectious, I think we will get something in writing from the vet before we go anywhere in public.

 

[Red-1]

It sounds similar, the vet expected to see something significant when scoping, the trach wash looked dirty but came back showing nothing of note, we have virtually eliminated every cause and are continuing as normal but as her owner said today if we go out competing and someone sees the discharge they may get rather upset, I know I would question why a horse with gunk coming out of it's nostril was in the collecting ring as it looks as if it may well be infectious, I think we will get something in writing from the vet before we go anywhere in public.

Yes, we had this same worry. I did not get anything in writing, but if anyone had been upset then they would have been welcome to contact my vet. In fact where I had lessons DID do that, and were reassured by the fact that he did not have any "nasties" so we continued lessons.

We did the wash and swab twice!

It was very strange, as he was going really well, and did not feel ill at all!

ETA- some days there was NO discharge. It did not seem conneceted with his work even. Vet wondered if he had bashed his head or something, but there was no bald patch on his skin, and X ays showed nothing.

Personally I suspect a rogue tooth, as I once had one of those myself, that did not show up on X ray.

 

[sallyg]

Fungal sinusitis. My horse had exactly the same history. Had a catheter inserted through his forehead, flushed with 5 litres of iodine every day and loads of antibiotics. Came back shortly after stopping the antibiotics. I work on an intensive care unit and I knew it was fungal by the smell but my vet said fungal was really rare. It gets secondarily infected which is why it improves with antibiotics but doesn't clear. In the end my horse had a second scope, they found a lump of crap and looked at it under the microscope and I was right. The treatment was another catheter inserted through his forehead and flushed with Imaverol which is the stuff they use on ringworm and potassium iodide in his feed for weeks on end, which he hated and had to have a whole mug of molasses to make him eat it. It worked though and he has been fine since.

 

[Rowreach]

What does it smell like?

 

[be positive]

Fungal sinusitis. My horse had exactly the same history. Had a catheter inserted through his forehead, flushed with 5 litres of iodine every day and loads of antibiotics. Came back shortly after stopping the antibiotics. I work on an intensive care unit and I knew it was fungal by the smell but my vet said fungal was really rare. It gets secondarily infected which is why it improves with antibiotics but doesn't clear. In the end my horse had a second scope, they found a lump of crap and looked at it under the microscope and I was right. The treatment was another catheter inserted through his forehead and flushed with Imaverol which is the stuff they use on ringworm and potassium iodide in his feed for weeks on end, which he hated and had to have a whole mug of molasses to make him eat it. It worked though and he has been fine since.

What does it smell like?

No smell, will ask about fungal sinusitis but nothing showed in the sinuses on xrays and they appear normal with no reaction when checked.

Red1 just seen your comment about a rogue tooth that ties in with my feeling that it is a foreign body, or a bit of tooth/ bone somewhere it shouldn't be that is causing an abscess although she shows no signs of being in pain, she also suffers from overactive lymph glands and I think the two are tied together once we can find the cause of the discharge the lymphs will settle down, several vets have been involved and we just go round in circles, told to keep working and monitor her but it is frustrating when you know she is probably never 100% yet happy in her work, she has probably lived with it for so long, purchased with it, that she feels "normal".

 

[Rowreach]

Surely it would smell if it was sinus infection/abscess related?

 

[sallyg]

Erm... gross alert, it smells thrushy, and I don't mean the foot infection that horses get. Sorry. ICU patients are prone to systemic fungal infections because of all the strong antibiotics and being immunocompromised so it is quite common.

 

[Doormouse]

My horse had this but eventually the yellow gunk began to smell (actually stink, made me gag) and he had one rotten tooth and one fractured one next door to each other. His was picked up with an X-ray of his head. Could be a tooth problem, has the horse been X rayed?

 

[Louby]

Something similar happened to a horse I had years ago and it turned out to be a tooth root fracture. It took ages to diagnose, started with discharge from one nostril, which eventually got worse, had tinges of blood in it, then the awful awful smell. ABs would clear it but it would come back, xrays were a bit inconclusive but my vet sent them to Leahurst and then Edinburgh for their opinion and Edinburgh recomended taking the tooth out. It was done under GA via a bone flap, trephines were put in when the discharge came back again, and it kind of went on for years! Horse was 4 when the tooth was removed and 8 when he was finally sorted! Sadly it came back again when he was 14 and he was pts shortly after as for some strange reason there was another infection in the same place that didnt respond to ABS and spread to his bone. Operating again wasnt an option. It was heartbreaking to lose him because of this.

 

[bobble]

I am also having this problem with a new pony. Discharge and a really bad smell one side only. First we tried antibiotics then another lot for a longer length and double dose. It would clear it up then the discharge and smell would come back. Then x rays showed something in the nasal cavity, went to Halifax and found a misaligned tooth and because it had been going on so long food had found its way into the nasal cavity and some of the nasal lining has come away. Had the tooth out and sinus flushed out twice a day for 3 weeks and antibiotics. Bung in jaw to stop food etc going up. Went for check up everything ok and smell etc gone. Bung out everything healed up great . Fast forward 2/3 weeks smell and discharge are back. Cue more vets visits. £2000 later still not gone away completely some days she smells bad and some days she doesn't smell. At the moment vets are happy that she is ok and we are just keeping tabs on it. I am hoping like others it will just clear up eventually.

 

[Casey76]

this popped up on my FB this morning...

https://www.facebook.com/TheEquineDentalClinic/posts/599605076831063