Possible Bi-lateral Jugular Phlebitis

meinthejt

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About 5 weeks ago I noticed some swelling in the jugular groove on the left side only while lunging my ~18 y.o. draft cross gelding. Starting at the shoulder with a soft swelling about the size of 1/2 the palm of my hand, it progressed up the jugular as a lumpiness as he worked and is only visible when his neck is flexed and relaxed underneath. At this point there was no sign of a problem on the right side of the neck.

The vet was out two weeks later and was pretty sure that, although my horse has not had any i.v. injections or catheters for more than 2 years, it was probably phlebitis. The vet prescribed aspirin at about 1/3 to 1/2 the normal dose once a day for use as a blood thinner.

There has been no change since starting on the aspirin except that it seems to me that it might have gotten a little worse. Then three days ago while lunging I noticed that I could easily see the jugular on the right side of his neck. Today, it appears similar to (but not as bad as) the left side. I called the vet back and he is coming out day after tomorrow to examine my horse.

Ranger (my horse) is about 18 years old. Very healthy, on a regular and excellent worming program, has not been hospitalized or even sick in the ten years that I have owned him. He has no recent history of illness or even depression. His appetite is good. He typically has a cough in the winter when starting exercise and this may have gotten a little worse in the last few weeks, but he has had nothing but clear thin drainage from his nostrils.

Just in the last week he seems to be reaching down with his head and stretching his neck more than usual while lunging. I am currently grounded due to back problems so his exercise schedule has been limited to lunging 3-4 times a week for about 20 - 30 minutes.

Anyone have any ideas about what I should ask the vet? I don't understand how he could have gotten phlebitis in the first place or why it has started to affect both sides of the jugular. Any ideas out there?
 
I'd doubt a diagnosis of bilateral jugular phlebitis where there's no recent history of IV injections. One-sided phlebitis may occur if for instance an insect bite has caused a local infection which has affected the jugular, but for this to occur on both sides is extremely unlikely. Plus, phlebitic veins tend to be painful, and swelling would persist at rest (IME).

If this is something you've only noticed recently and you are certain the horse hasn't shown this before, depending on what other symptoms the horse is showing, my first suspicion would be a possible cardiac problem.
 
I remember a vet telling me that if you can see the pulse half way up the horse's neck, its heart trouble. I think you need to ask your vet to visit again with this in mind.
 
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