Equine Weight Loss

Re: Equine Weight Loss

Wren — Thu, 09 Jun 2011 11:01:38 GMT

I replied to this already, but my answer seems to have disappeared.I agree with all the above about parasitism.

A peritoneal tap could be an idea. Probably non-diagnostic if the cause is parasitic but I've picked up a couple of abdominal tumours this way that were seeding across the abdomen or shedding cells. Quick, cheap and easy! Approx. only 25% of equine abdominal tumours are palpable per rectum - I had a splenic tumour the size of a football in a TB that was definitely non-palpable (got this one on peritoneal fluid cytology though). Worth a go? Just make sure you use a lab that's experienced with equine cytology.

Re: Equine Weight Loss

Tim Cheyne — Wed, 08 Jun 2011 19:28:56 GMT

[quote user="Victoria Tannahill"]

[/quote]

Never mind, Victoria, it was worth trying, perhaps this one will be an exception. Anyway, your horse has certainly got this forum buzzing. I look forward to hearing more of it.

Tim.

Re: Equine Weight Loss

Victoria Tannahill — Wed, 08 Jun 2011 17:47:16 GMT

Tim - I haven't come across a single microchipped horse yet in Cyprus but I'll definitely run the scanner over it next time I'm at the yard! Most of the horses here are bred on island and die on island - it is so expensive to get new onto/off island that few people bother. Although I suppose the racing scene may do more of this but it is mainly up around Nicosia (the capital city) and not down where we are. Unfortunately the horse doesn't have a fancy name either so we couldn't track it that way.....

Richard - thanks for your advice. I haven't heard of such a 'belt and braces' approach to worming before but it definitely makes sense to ensure maximum success.

I'll keep everybody posted over the next few weeks as to how the case develops. Fingers-crossed for a good outcome!

Re: Equine Weight Loss

Richard Stephenson — Tue, 07 Jun 2011 21:41:29 GMT

Victoria,

Yes I understand that the Prednisolone is used to control the massive inflammatory reaction in the gut wall caused by the emergence of the encysted L3s and the inflammatory reaction caused by killing them with the Moxidectin. Sometimes effective worming causes colic or severe diarrhoea (if there was a large worm burden present) so I would always use Prednisolone in the situation you describe rather than run the risk of making matters worse.

Although there is no reported resistance to moxidectin as yet it is wise in these situations to mop up any remaining red worms with a panacur guard. I generally don't do it the other way around as I think that fenbendazole resistance is relatively common.

Yours,

Re: Equine Weight Loss

Tim Cheyne — Tue, 07 Jun 2011 20:20:03 GMT

You certainly appear to have covered the common possibilities, Victoria.

Now, about its past history, it is a TB and was racing at one time. I wonder whether it was micro-chipped? It might have retired before the chipping became mandatory or it might have been running on unofficial tracks but if you can find a chip number we could perhaps trace its origins. It is unlikely to help with the present diagnosis but it could add another piece to the jigsaw. BTW, does it have a fancy name that might have been registered in the past, or is it just 'Dobbin'?

If it has been chipped properly, and you have a scanner, you should find the chip in the nuchal ligament, high up near the crest. Chips that are not inserted properly tend to migrate and can be the very devil to find. Let us know if you do find an ID.

Tim.

Re: Equine Weight Loss

Victoria Tannahill — Tue, 07 Jun 2011 18:21:50 GMT

Hello everybody! Thank you so much for all of your suggestions and help. In answer to some of your queries:

The management of this horse prior to its present owner is unfortunately unknown - the owner before this one only had it for a month but it was in good body condition when it was bought. I asked the owner today if she knew anything further though and she's quite sure the horse hasn't raced for a few yrs.

We rasped its teeth almost 4 wks ago now - it had quite obvious lingual and buccal ulceration but this healed up nicely before the weight loss & colic episode started and the horse has been eating readily ever since it arrived on the yard. There's NAD on rectal, the faeces are now back to normal & moist, and the mucous membranes are also moist.

I'm not sure if grass sickness is around in Cyprus - I certainly haven't heard of any cases but I couldn't rule it out.

So.....

In relation to FEC - I agree that a FEC probably wouldn't show anything spectacular due to the recent worming but I wonder that if the severe clinical signs seen are due to worms alone, perhaps a FEC may still be high (or at least at the high end of normal?) Just a thought.....!

Also, Richard - please excuse my ignorance, but I am confused as to the rationale behind using the prednisolone? Is this to reduce general GIT inflammation due to encysted larvae death? I know moxidectin will kill the encysted larvae as well as any luminal parasites, so is the Panacur follow up just to catch any stragglers and/or emerging larvae?

Having already ruled out teeth problems, I agree it would be wise to rule out parasitism (so I'll treat it with moxidectin) and to address its diet too (by feeding ad lib hay and a sensible level of concentrates). If I can rule out these common causes of weight loss, I agree that it's probably likely to be something more sinister. In which case, given money is tight and there are no referral clinics on the island for more advanced diagnostics etc, we might not win this one :(

As always - any thoughts/ideas very gratefully received!

Re: Equine Weight Loss

Hannah Wynne Richards — Tue, 07 Jun 2011 17:54:53 GMT

Agree with others, but also try scoping for gastric ulcers

Wynne

Re: Equine Weight Loss

Michael Woodhouse — Tue, 07 Jun 2011 13:57:07 GMT

[quote user="Victoria Tannahill"]the horse had its teeth rasped 3 weeks ago[/quote]

By whom? Have you checked the mouth?

[quote user="Victoria Tannahill"] I can convince myself that it's sclera are jaundiced but can find no other clinical signs.[/quote]

Personally I think equine mucous membranes look more yellow than other species in the normal animal.

[quote user="Victoria Tannahill"]Could the skin tenting be more acute due to the sheer loss of fat from the subcut, thereby making the horse look more dehydrated than it actually is?[/quote]

Where are you observing this effect? I pinch the skin over the eyes, skin tent is unreliable elsewhere. Are the faeces dry? Mucous membranes moist?

Moxidectin and 5 days of Panacur would be my next treatment of choice, assuming YOU have looked in the mouth? (there have been cases of horses rasped so much that they are unable to chew their food properly).

Re: Equine Weight Loss

patrick murphy — Tue, 07 Jun 2011 10:52:22 GMT

after ruling out parasites, colic and weight loss equals neoplasm or grass sickness (sorry but have stupid things like teeth been looked at) or even diet.

Re: Equine Weight Loss

Tim Cheyne — Tue, 07 Jun 2011 07:15:31 GMT

[quote user="Richard Stephenson"]

......small red worms - are your first differential............. - so faecal egg count next to useless..............you need a rule out on the red worms before starting on other treatments. [/quote]

I agree, Richard, and I regard faecal egg counts as next to useless in most situations; to detect the presence of eggs, perhaps, but too much is often placed on the 'significance' of a count.

I would like to know more about the history of the horse prior to purchase. Has it always been in Cyprus or was it at some stage imported from elsewhere? Certain origins could raise the prospect of some nasty conditions featuring in the Diff Diag.

Tim.

Re: Equine Weight Loss

Richard Stephenson — Mon, 06 Jun 2011 21:00:51 GMT

Dear Victoria,

I agree with other comments here - small red worms - are your first differential. Inhibited larvae are NOT affected by ivomectin wormers and it is well know that you can get larval cyathostomiasis after their use due to the emergence of the inhibited L3s which DO NOT PRODUCE EGGS - so faecal egg count next to useless.

Of couse there are many other differentials but you need a rule out on the red worms before starting on other treatments. Give an EQUEST wormer followed by 14 days of prednisolone at 1mg/kg and then repeat worming with Panacur guard. I would get on with treatment straight away whilst doing other tests.

Horses can die of cyathostomes without seeing a single one in the faeces or there being any eggs.

Yours,

Richard Stephenson.

BVMS Cert EP Cert VR MRCVS.

Re: Equine Weight Loss

Julian Earl — Mon, 06 Jun 2011 19:18:52 GMT

What about grass sickness? That was what sprang in to my mind when you ruled out liver abnormalities. Do you get it in Cyprus, and do you get it at this time of year?

Re: Equine Weight Loss

Evelyn Barbour-Hill — Mon, 06 Jun 2011 19:12:36 GMT

Sorry if it's a silly question, but have you done a rectal exam? Any lumps or bumps inside?

Re: Equine Weight Loss

Tim Cheyne — Mon, 06 Jun 2011 19:02:44 GMT

Re-reading your initial post and the mention of colic, could this be a 'bastard strangles'? I am not sure how you could confirm the diagnose though at this stage, other than at autopsy.

Tim.

Re: Equine Weight Loss

Evelyn Barbour-Hill — Mon, 06 Jun 2011 18:54:57 GMT

[quote user="Victoria Tannahill"]

I won't rule out redworm though - I suppose a FEC wouldn't go amiss even if we haven't seen any evidence of worms in the faeces which I would probably expect if they were the cause of such marked weight loss?

[/quote]

It wouldn't go amiss of course, but you wouldn't expect to see much of a faecal egg count because the illness is due to the accumulated and still accumulating damage caused by larval helminths; and that one ivermectin dose will have knocked back the numbers of adults in the gut.

Do you know anything about the management before it was acquired by the present owner?

If you have to go for empirical treatment, 5 days of Panacur Guard would be my suggestion.

Re: Equine Weight Loss

Tim Cheyne — Mon, 06 Jun 2011 18:45:11 GMT

[quote user="Evelyn Barbour-Hill"]

The fact it had an ivermectin dose does not rule that out at all.

[/quote]

No, it certainly doesn't but, having been given so recently, it could make a faecal egg count difficult to interpret (not that I am a fan of them; the results can be skewed by so many factors). However, if redworms were still an active cause of the signs I feel sure that the actual worms would be seen in the faeces. The trouble is that you probably do not know the history of the horse before it was obtained six weeks ago. Are you dealing with the effects of previous damage, perhaps? Ulcers are quite common in racehorses but are often asymptomatic. (There was a good article about them recently in the BVA 'In Practice') A bit late for omeprazole though by the sound of it. Does the horse want to eat readily and is it getting suitable food in small meals several times a day? You can be sure that you have covered the three main causes of equine weight loss, malnutrition, parasitism, dentition. To go from there leads into a veritable jungle of noxious diseases and conditions, cancer, TB, ragwort poisoning, bacterial infection of mesenteric nodes, etc. Good luck! I hope that you can give us a progress report.

Tim.

Re: Equine Weight Loss

Victoria Tannahill — Mon, 06 Jun 2011 18:20:04 GMT

Sorry - I should probably have mentioned it's in Cyprus! But it's not a military horse - it was retired from racing and has now found itself on a riding club-type yard (where money is tight!) that we provide veterinary cover for.

All advice is great - thank you!

Re: Equine Weight Loss

Evelyn Barbour-Hill — Mon, 06 Jun 2011 18:02:48 GMT

Sorry, I've just looked at your profile - I hope you don't feel I'm trying to teach my granny to suck eggs.

Is this horse in Cyprus or the UK? In this part of the UK I'd put my money on redworm damage - but never rule out cancer.

[quote user="Victoria Tannahill"]my gut instinct[/quote]

Re: Equine Weight Loss

Evelyn Barbour-Hill — Mon, 06 Jun 2011 17:40:30 GMT

I'm no equine specialist but redworm is what springs instantly to mind. The fact it had an ivermectin dose does not rule that out at all. Get a full blood profile done by someone like Beaufort Cottage Labs including protein electrophoresis.

Re: Equine Weight Loss

Tim Cheyne — Mon, 06 Jun 2011 16:22:31 GMT

Resting PCV/HCT alone is not a very reliable indicator in the horse because of the reservoir of blood in the spleen. It needs to be considered in relation to other constituents to calculate MCV, MCH, MCHC, and then in comparison to a series of samples. I quite often see race-fit horses with a resting (early morning) PCV of around 33% although others can be around 45%. If there has been blood loss the PCV might have been pushed up to a reasonably normal figure by the dehydration, thoroughly confusing the picture. You mention ivermectin otherwise I would suggest intestinal parasites as the first suspect. How about a faecal sample and a blood film? Sorry I cannot be more helpful.

Tim.