polymorphic leucocytosis eosinophillic - or mud fever..!

elizabethshaw

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well, I posted on here a few days ago after our yearling had a very sore, scabby and oozy heel on his one white sock. Although opinion on what it could be was varied, the majority thought it was probably mud fever. Anyway, our vet came over yesterday, took one look, and diagnosed PLE....apparently an autoimmune condition that could be permanent...have googled it but can find very little, so wondered if anyone has heard of it? It still looks like mud fever to me; treatment consists of steroid cream, bute and antibiotics so pretty much the same treatment for mud fever, but management is very different. If it is mud fever I would keep him in, especially as the grass is wet, but vet said ok to turn out as it isn't mud fever...Help!
 
Hmmmmmmmmmmmmmm. You know what they say: common illnesses are the most common. Also known as the zebra theory, ie if you're walking down a country lane in the UK and you hear hoof beats behind you, you would expect to turn round and see a horse, not a zebra. Makes you wonder how your vet reached that diagnosis. I do know that white socks are anecdotally reputed to be more prone to mud fever. Friend of mine had an Arab gelding with 4 white socks and every winter he developed a skin problem that looked exactly like mud fever. His owner treated it exactly as you would mud fever and it always cleared up. With such a wet spell, it does make you wonder......
 
Hmm, well my vet told me years ago that they could only really diagnose mudfever by taking a sample of the scab. I don't know how they would diagnose something more complex without further tests??

At least the treatment is the same - I'd follow your vets advice but not worry about the long, complicated sounding, disease that your horse may or may not have.
 
2 of my horses have been suffering with something similar in the summer and I have put it down to fly/mite bites. I have tried lots of different vet recommended remedies including dermobion, frontline spray, purple spray all to no improvement and unbelievably have cleared it up by using an ivermectin wormer! Someone had suggested this on HHO - Thanks!
 
Yes ,and it doesnt matter whether its a Zebra or a horse if the headcollar fits.
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Hmmmmmmmmmmmmmm. You know what they say: common illnesses are the most common. Also known as the zebra theory, ie if you're walking down a country lane in the UK and you hear hoof beats behind you, you would expect to turn round and see a horse, not a zebra. Makes you wonder how your vet reached that diagnosis. I do know that white socks are anecdotally reputed to be more prone to mud fever. Friend of mine had an Arab gelding with 4 white socks and every winter he developed a skin problem that looked exactly like mud fever. His owner treated it exactly as you would mud fever and it always cleared up. With such a wet spell, it does make you wonder......

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well B.O.F., that is exactly what we wondered - how he could diagnose something without taking blood/skin scrape....
the good news is it is sooo much better today, been keeping him in off the wet grass and now we've got the scabs off it's looking a lot better. Amazing....cannot understand why he came up with that. Maybe it's because they can charge more for stuff with long names....
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Lol HC - you could be right about a rising scale of vet fees linked directly to the length of name of the illness! Anyone looking for an MSc dissertation subject, there could be a paper in this!
 
I don't mean to be funny but - does this exist? Like you I'm sure I've tried to google it but got no-where. The internet is a big place and I'm surprised not to find something.

The words themselves do mean stuff. Polymorphic means "comes in many forms". Leukocytosis means there is an excess number of one particualr type of white blood cell in the blood. Amongst other things it can be indicative of round worm infestation. Eosiniphillic refers to the staining of slides with Eosin - a normal way of detecting white blood cells in a blood sample. Eosiniphillia however is an increase in granulocytes (another type of white blood cell) also indicative of parasitic infection.

I'm not a vet - I'm a parasitologist (someone who studies parasites). To me these three words used like this indicate a) someone who doesn't understand latin gammer but also b) some type of rampant infection or parasitism causing an auto immune like response becuase of an excess of 2 of the 3 types of white blood cell. Although how you would tell that without a blood sample I have no idea.

I know I see things slanted through my professional knowledge but based on this, Hedichocs suggestion of an ivermectin based wormer is probably a good one. Or possibly a quiet word with another vet?

Do let us know...I'm intrigued by this now!
 
I have an Arab Mare who has 2 white feet. She has just had a bout of "mud fever" even though it is summer. I keep the area clean (if really bad use hibiscrub) but generally just water and apply a barrier cream such as protocon. I can't wait until the winter as it gets a lot worse
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and I struggle to stay on top of it.
 
I agree with Shay, leucocytosis is raised white blood cells. granulocytes, a type of white blood cell,are some times known as polymorphs and are raised in bacterial infections. Eosinphils , another type of wbc are raised in parasitism or allergic conditions.
I cant see how this could be diagnosed with out a a full blood count and differential white cell count.
 
The problem with using somthing like Hibiscrub is that it kills everything on the skin .The skin has a natural "flora" of bacteria,kill these and you create opportunities for more aggressive and unwelcome bacteria.
 
I suspect that the disease you are referring to is "Pastern Leukocytoclastic Vasculitis". This is a disease that mimics the clinical signs of mud fever and is often the cause of mud fever that doesn't get better with standard treatment. Making a concrete diagnosis can be problematic as you need to biopsy early lesions and often a diagnosis is made on clinical signs alone: affected horses are often disproportionally painful to the size of the lesion, and the skin has "islands" of very inflamed skin with a sharp demarcation next to normal skin. The cause is uncertain but there is a relationship to UV light and treatment consist of corticosteroid and covering the lesions to stop UV light reaching the skin.
 
^ Interesting.

I brought a horse in from Canada last year who has a history of extreme immune responses (he's allergic to tetanus jabs, amongst other things). He has had a few small bouts of mud fever over his life but nothing out of the ordinary and always resolved with good care and standard treatment. (To be fair, it's a bit easier to treat in Ontario because the most typical time for mud fever, the fall, is quickly followed by months of snow and cold, which pretty much solves the problem.)

But last fall he got what LOOKED like mud fever initially but then got what amounted to a complication that certainly did not behave like it. He initially had a few lesions around the back of his pasterns - standard stuff - which didn't respond particularly well to treatment but seemed contained. Suddenly he developed what looked to be new lesions on the outsides of his fetlocks, much "flatter" and more open than standard mud fever lesions. Within days the outsides and backs of both hind legs developed what amounted to ulcers - so raw they sometimes bled - with scabbing and hair loss over the entire cannon, fetlock and pastern. Messy.

Every attempt at cutting edge treatment, topical creams and systemic antibiotics, seemed to make things worse. Biopsy was inconclusive as apparently there was nothing on the skin that shouldn't have been there.

Eventually, in despair, we went "old school" with minimal iodine washes when essential and twice daily bandaging with furacin ointment (unheard of here now - we had to get it from Spain). We also put him on a vitamin supplement and an immune boost. He went back on limited turn out to try to address the significant swelling on the theory that even if the pathogen was in the field, we'd be hard pressed to make things worse. Eventually the inflammation calmed down, no new lesions appeared and over the course of months the condition healed up. The skin remained very fragile so he went out in bandages.

The vets pretty much scratched their heads through the whole thing. All anyone could suggest was he had something quite common but his immune system was compromised and unprepared for a UK bug.

The above suggesting really does pique my interest though as I thought it odd the most obvious lesions were on the outside of the fetlocks. I'm now wondering if he started with "regular" mud fever but in fact developed something along the lines of the above. Hmm.

Sorry, pointless contribution to the thread but it's got me wondering as I'm trying to formulate a system to keep the situation from repeating this season.
 
Interesting stuff,Tarr Steps. If you are interested in another "old remedy" that actually has a strong scientific basis behind it,please PM me and I will be glad to discuss it.
 
very interesting replies thanks guys - and Shay especially, as we keep coming back to the fact that any diagnosis is a bit hit or miss without testing first...
thanks Shay, by coincidence he has recently been wormed with ivermectin.
it is better, we have been applying the steroid cream the vet gave us and he has finished the anti bitoic course. no swelling now, and we have picked quite a bit of the scabs off. kept him in and been treating him for mud fever but now, after reading all your posts, am thinking it could be anything....and how the h*ll do we know? So yes, one of the posts suggested a new vet...good idea!!
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