Raised liver enzymes - expected recovery time?

[BuzzyBea]

To cut a very long story short our ISH has had colic on and off for the last 18 months. I have done everything possible to improve things for him but decided to get a new vet out to him when it happened again a fortnight ago. We agreed that he should take bloods just to rule any other issues out and results came back that his liver enzyme level was high.
We agreed to give him anti-biotics for 10 days and to add milk thistle and legaphyton to his daily feed. Vet also suggested that he not be ridden for 2 weeks.
We are on day 12 now and no more colic and he seems to be more comfortable and brighter in himself. My daughter plans to take him on a gentle hack at the weekend.
The vet will re-do bloods once the supplements have had a chance to start doing some good.
My real question is that assuming he is on the road to recovery how long is he likely to be before he starts to be able to get back to jumping at the level he was at previously? I have heard from a friend that it can be years before they are fully back to the same performance levels. This being the case I would rather him come back into work slowly and find my daughter another horse to compete for the time being.

 

[BeingKate]

Sorry to hear he has been poorly I think length of time would depend on how shrunken the liver is. However I can offer you the following advice on feeding if that helps... unfortunately colic and liver problems can have contradictory problems in terms of feed but really hope this is of some use to you

Under no circumstances feed oil as an energy/calorie source. This is because it is the liver that processes oil and the idea is you need to allow the liver to "rest" as much as possible - a feed high in oil will make it work harder. This is also one of the few circumstances where you need to avoid high levels of protein too as the liver is what breaks the protein down.

Usually I don't advocate the use of cereals, however if your horse is losing condition or is lethargic, the best you can feed is maize, which you can buy from most feed stores. the reason for suggesting Maize over other cereals is because it's high in calories, but low in protein and does not contain a large amount of natural oils. This is the best energy/calorie source for a horse with liver damage. If he's had colic, introduce this very slowly and only feed a small qty.

Feed along side a low oil, low protein chaff such as Hi Fi. Because this won't contain much in the way of nutrition, a broad spectrum vitamin/mineral supplement would be beneficial too - Equivite Original is a good one as again it isn't an all-singing all dancing one high in protein or oil, it simply does what it says and provides a balanced diet. If you need to make the feed more palatable, a small amount of speedibeet as a top dressing can help.

Would also suggest hay instead of haylage.

 

[BuzzyBea]

Fingers crossed that I am sorted feed wise because as you say what I was feeding initially was for a horse with colic and have therefore had to change things around to make things more easily digestible, smaller and more frequent. I have taken oil and alfalfa out and reintroduced hifi, along with continuing beet. Supplement wise I think we are there!!

He is already on hay

 

[BeingKate]

Ahh that's great well done fingers crossed for you bloomin' horses...

 

[Montyforever]

My mare had exactly the same issues, taken a bit of time but within a year she was back to normal. Only fed milk thistle, recent blood tests showed her liver is functioning normally

 

[BuzzyBea]

My mare had exactly the same issues, taken a bit of time but within a year she was back to normal. Only fed milk thistle, recent blood tests showed her liver is functioning normally

That's reassuring. Did she have issues with colic too? Have they re-occurred since? Were you just able to do light work during that year? Just wondering about whether I should rest him totally for an extended period of time and find something else for my daughter to work with in the meantime?

 

[Montyforever]

That's reassuring. Did she have issues with colic too? Have they re-occurred since? Were you just able to do light work during that year? Just wondering about whether I should rest him totally for an extended period of time and find something else for my daughter to work with in the meantime?

Yep,wasn't picked up until she went into the clinic with an impaction and an odd set of symptoms. Vet suspected peritonitis at first. She had a few times where she looked colicky again after she got home, lots of late night walking round the school and stress.
If my YO hadn't of lived on site i would have been sleeping in the stable! But no more big problems after the first time.

She had about a month off after,more because of the impaction than the liver at first but she was really scatty and unpredictable until her liver settled so had she been a ridden horse (she's not ridden but kept fit with inhand work/lunging) would definitely have caused problems.
Took a while to get her weight back up too so gradually brought her back into work so could increase feed slowly.

She doesn't *need* to be in work so took it at her pace.

Blood tests two weeks after the initial ones showed they hadn't dropped, a month after that they had started to fall so vet told me to play it by ear and watch for symptoms. She was recently retested because she was showing some symptoms again but its Cushings and her liver is fine now

 

[BuzzyBea]

Thanks Montyforever that's really interesting. Our vet has suggested leaving re-testing until about 4 -6 weeks after the initial bloods to ensure that the milk thistle and legaphyton have had a good chance to get working. I think until that time we will just take him on hacks in walk.
It would be amazing to think that we have found the cause of his colic after all this time and assuming the liver is improving that we can get him back to his old self again.

 

[Montyforever]

Thanks Montyforever that's really interesting. Our vet has suggested leaving re-testing until about 4 -6 weeks after the initial bloods to ensure that the milk thistle and legaphyton have had a good chance to get working. I think until that time we will just take him on hacks in walk.
It would be amazing to think that we have found the cause of his colic after all this time and assuming the liver is improving that we can get him back to his old self again.

Sounds sensible Mystis were very high initially so vets wanted to check it wasn't just a spike/machine error hence retesting quite quickly.

Im sure you will, Mystis been back out showing this year, out on long "hacks" inhand and been fitter than she's ever been before happier too, liver problems were there a long time before the colic in hindsight!

 

[BuzzyBea]

Thanks for giving me confidence!! Would be lovely to see him regaining the performance that he had before all of this started. As you say I think that he has had it for at least 18 months and think that what I thought was plain and simple colic was all as a result of liver problems

 

[BBP]

What were his readings? A year and a half ago we got all 4 here tested after losing a pony out if the blue to acute liver failure. All 4 had raised enzymes, one with elevated bile acids too. Mine had an easy summer after his first results, just bumbling around doing easy stuff. Late august 2013 his results rocketed, GGT at 800 (normal is 50). We thought the hay cut in the wet summer of 2012 might contain micotoxins that might be poisoning them, switched to 2013 cut hay and results started to drop. My pony was never symptomatic and by November (as always happens when the weather gets colder) he was bouncing out of his skin. So I upped his work to protect him from himself, figured his mental health was just as important. He has been on a full workload (for a leisure horse) for at least 10months now, XC, sj, schooling and hacking and shows no ill effects at all. His reading in June this year were double his April results but his results from a week ago are almost back to normal.

I plan to blood test him every 3 months, he gets milk thistle with his balancer which I intend to keep feeding. Throughout the last year, if he has any days when he just doesn't feel up for it then I just take the pressure off, play in hand or just put him away, just in case it's liver related and he isn't feeling well. But he's such a bouncy little chap those days are rare! I hope yours resolves soon.