Summer Sore? Pythiosis? *8/25 UPDATE*

[KrazyTBMare]

So last week, my gelding decided to cut his cheek at the edge of his mandibular jaw bone. While the vet was out stitching the cut, I asked her to look at the oozy spot on his belly.

It had only been there for like 2-3 days and started from bug bites. She said to keep cleaning it as I was (iodine scrub and then spraying it with Alushield to create a barrier) and watch it closely for turning into a summer sore.

Well it was considerably bigger (swollen I guess is a better term) and now is about 1/2-1/4 the size. However, it is still there and it is slowly draining a bright red/syrumy sticky stuff. It doesnt stink and theres nothing yellow or thick about the discharge.

He was on a round of SMZs for the face cut for 1 week.

It had been looking like two crators, small, like where the circular edges were raised and then the middle was concave like a hole. Last night, I flushed both "holes" with hydrogen peroxide (which I know kills good cells but I havent flushed it with it before) and then sprayed it with Granulex and dried it and covered it with the Alushield.

This morning, it is much "flatter", hardly any definition to where the "crators" were though it was still slowly draining.

I took some pics. Honestly, after reading about summer sore and pythiosis, neither of them really fit the bill.

BTW, 8 weeks ago he was DD with Equimax, and then 2 weeks after that DD with Ivermectin, and then yesterday, I DD with Ivermectin again just in case.

The spot is right in the center of his belly, forward of his umbilical (sp) cord spot. Its not squishy. I cannot depress anything out of it. No noduels or hard things coming out of it. No smell. etc

Looking up at the belly before I cleaned it
http://i144.photobucket.com/albums/r186/krazytbmare1/Rex/IMG_9038a.jpg

After cleaning it
http://i144.photobucket.com/albums/r186/krazytbmare1/Rex/IMG_9041a.jpg

And this is the same pic as above but I drew circles on the areas where the larger edge of the "crator" was and the smaller circle is the "hole". NOTE: I have a monojet syrgine with the curved plastic tip to flush with and it only goes in like 2-3mm. IF that.
http://i144.photobucket.com/albums/r186/krazytbmare1/Rex/IMG_9041b.jpg

Any thoughts? I have never dealt with anything like this. So after looking at pictures online, I dont really see any connection. But maybe if this is the early stages of something, hopefully someone will recognize it.

Thanks!

[thatmoody]

It looks like the summer sore (diagnosed via biopsy at Peterson & Smith) that our stallion has in the same spot. They tried to remove it when he had his hernia surgery but it's been VERY resistant to treatment. Ivermectin orally 1 or 2 times a week plus an ivermectin dex cream that we get from the vet has been the most successful, but the only thing that really helps is cooler weather. I HATE those things. Ask your vet about their treatment protocol - some vets treat differently.

[Justmyluck]

My vet treated my guys summer sores by injecting DMSO, Ivermectin, and Dex subcutaneously under the sore. It created a little lump under the skin, that is taking its time going away. Though it is shrinking and the summer sore began healing in about 3 days.

[ksojerio]

It does look like the habronemiasis that my gelding had. My vet debrided the wound, prescribed a course of steroids and I treated it daily with SWAT and fly spray. I gave a dd of ivermectin and will give another ddose in 14 days.

He is healing well.

[KrazyTBMare]

The ivermectin... is it the paste wormer or did you buy the liquid or what?

Tonight it looks much better. It had hardly any drainage and was looking more like it was trying to scab up, which until now, it was just an open sore.

I dried it and put the Granulex on it and then put the Alushield over it. Will see how it looks in the AM.

Anyone else have any experience? Thoughts?

Do any of you who posted have any pics of what your horses had?

[thatmoody]

I can take one, but it's pretty much healed up right now. It's funny (well, not haha funny) but both of our stallions get them, and neither our vet nor I am quite sure why. They are on a regular, aggressive deworming program, and they are pampered like kings, and still the Andalusian has one on his ankle and the Friesian one on his tummy and on his shoulder. Sigh.

The ivermectin cream is one that the vet mixed for us - it's ivermectin and dex for the itching. Swat is important too as the flies will make these things bigger. I am very interested in the injection route and will ask the vet about that tomorrow - I didn't want to go the oral steroid route but that might be a good idea. They can be resistant to treatment (both of our guys had them long before we got them, and apparently they have resistant ones because we've been fighting these things all summer).

[Roan]

Never knew what those were. My mare gets something similar starting in the spring, but they never got to that point (blood wise).

I just kept it clean and covered with with Alushield and in about a week it goes away. Hasn't been back since . . .early May?

Do they itch? My girls says it's itchy and she wants me to scratch that spot when it shows up.

Eileen

[ksojerio]

[QUOTE=KrazyTBMare;4293832]The ivermectin... is it the paste wormer or did you buy the liquid or what?

I used paste wormer.

[KrazyTBMare]

Thanks for that info.

It is even smaller today and NO drainage. It is forming a scab. There is still an area where there was probably some of the "liquid" that crusted up so Im going to remove that to make sure everything has drained and keep it up. Ill also put some of the paste wormer on it just in case.

Poor baby - its his first summer in Florida. I dont think PA has anything on us and our bugs. Poor thing.

[thatmoody]

Florida is just a horrible place :D. Seriously, we have sub-tropical diseases here that they don't get anywhere else in the US, and it's a horsekeeper's nightmare. Ah well, in the winter when we're riding and everyone else is shivering we can gloat...I was born in Maine but we came down here when I was 5 (in the 60's) so I've lived here all my life. I've seen years of summer sores and leeches and horrid parasitic infestations (bots anyone?).

Oh, and both of ours looked a lot better today. Keeping my fingers crossed because it seems that I'll just get them sealed up and they'll itch them right open again! The vet is coming out next week and she promised to take a look at them.

[TallyTaz]

My horse had one summer sores pop up on his girth area last year. He was at a boarding barn and my trainer called to tell me about this weird lump that came up on his side. It grew pretty quickly and had the vet out immediately who did a biopsy. The first results came back as a spider bite, but my vet sent a second biopsy because he did not believe that to be the right answer. Sure enough, it was concluded to be a summer sore so he made a mixture of liquid ivermectin and DMSO. Every day, twice a day, we would clean the sore with Nolvasan, apply the mixture of ivermectin and DMSO, then cover with Aluspray while it was still open, and then swat when the skin started growing back. Unfortunately, you can still see where the sore was, the hair hasn't grown back, but it does not seem to bother him anymore. Here are some before pics, not sure if I have any after, but I can take some if you'd like to see.


*These were taken after the biopsy was performed, so it looks worse than it actually was when left alone.
http://i296.photobucket.com/albums/mm169/TallyTaz/sales_113.jpg
http://i296.photobucket.com/albums/mm169/TallyTaz/sales_110.jpg

[nextyear]

I have a brood mare that had the same look in the same area right after she foaled in May, it cleared up but then started to get a growth that increased in size very fast. Vet took it off and biopsy came back as a sarcoid. Treating with X-terra now.

[jaimebaker]

My horses get them every year. They are from flies. Very easy to tell when you look underneath there and there's a hoard of flies there (BEFORE you get to bleeding stage). I keep them sprayed heavily in those areas. I might slap some Nolvasan on them if they get bad, but if I keep up on the spraying they don't get that far.


At least, that's what it looks like to me. FWIW

[KrazyTBMare]

Well it was looking SO much better.

Tonight while cleaning it, I noticed something granular looking in the center of the little hole.

Unfortunately, I knew what it was. It is a kunker from pythiosis. It looks like a piece of spikey coral. Its actually hardened fungal filament *sp* and necrotic tissue. The fungus actually eats the tissue and muscle and that is what the drainage is - not pus but liquid muscle/tissue. :o

I am calling Peterson & Smith first thing in the AM. My boss is leaving for Hawaii Monday for 2 weeks so I have 2 weeks off. I work 1/2 day on Friday. I am hoping it can wait until Friday afternoon.

Here is an article about it from thehorse.com

Pythiosis

Called swamp cancer, kunkers, Gulf Coast fungus, Florida horse leeches, bursatti, or phycomycosis, equine pythiosis is a subcutaneous (beneath the skin surface) inflammation caused by a fungal organism (Pythium insidiosum) that becomes encysted in damaged skin. It affects animals and people in tropical and subtropical climates and is occasionally seen in the southeastern part of the United States. In horses, spores of the organism probably enter through a lesion in the skin, says Hubert. The spores might be present in a warm water environment such as a swamp or muddy pasture, and they stick to damaged skin or animal hair. The lesions usually occur on the lower legs, lower abdomen or chest, or on the face if the horse is grazing swampy areas. This can be a problem in hurricane areas.

The resulting inflammation appears as a large, fast-growing ulceration characterized by lumps, pus, and raw tissue, and it can be very itchy. The lesions often contain coral-like accumulations of fungus filaments and necrotic inflammatory cells. These clumps are called kunkers. Diagnosis might be difficult.

"It looks a lot like proud flesh, sarcoid, or even a summer sore (inflammation caused by migrating larvae of a parasitic worm), or may be mistaken for certain types of fungal lesions. But the pythiosis lesion grows very fast," says Hubert.

Diagnosis can be made by culturing the kunkers or observing the fungal filaments within them (under a microscope). "Your vet can take a sample of the abnormal tissue and send it to a lab that is equipped to evaluate this type of organism, such as our lab at LSU, where Dr. Amy Grooters (DVM, Dipl. ACVIM), associate professor of veterinary clinical sciences, would try to culture the organism. The earlier it can be recognized and treated, the better,"
he says.

"We recommend a combination of immunotherapy and surgery," says Hubert. "A vaccine has been developed by Leonel Mendoza, PhD, a professor of clinical laboratory science/medical technology at Michigan State University. It's experimental, and a veterinarian must get a USDA permit on a case-by-case basis to use it."

The horse should be vaccinated as soon as diagnosis is made to reduce the size of the lesion so surgical removal is easier and possibly more successful. "When you cut it with a scalpel, you can't see how far the organism has gone into the tissues, so you make a calculated guess of how much to remove," he says. Then the remaining tissue bed is treated with a laser (photoablation) to kill any fungal filaments that might have infiltrated the surrounding tissues. Prognosis is guarded, since the lesion has usually been there awhile by the time it is diagnosed and treated."

In experimental work with the vaccine, Mendoza found that response to immunotherapy is best (cure rate 100%) in horses with lesions that had been present for 15 days or less when treatment begins. No cures were obtained, however, in horses where the lesions had been present for more than two months, says Hubert.

So please wish us luck. I know I am self diagnosing but after speaking to my friend whos neighbors horse had the SAME exact thing and they were misdiagnosed for 2 months and finally kicked it, I am feeling confident this is what it is.

[sublimequine]

Whoa, never heard of that! Jingles for your boy. Keep us updated, and at least you caught it early. :)

[desilu]

oh no - I hope it's not what it is but if it is, i hope that you have caught it early enough for a successful treatment. Good luck.....got my fingers crossed for you.

[fourmares]

You might try getting some Spot on type fly stuff and apply about an oz of it around the wound, but not on the broken skin. Seems to really work on my donkey.

[thatmoody]

Have you ever been over there? I love those people :). Even though they gave me bad news once (and good news with the stallion) they are still my favorite vets hands down.

I hope that it's not this - like I said, I hate Florida...leeches is not terribly common, either. Best of luck with it.

[KrazyTBMare]

I havent been to P & S before but I know quite a few people who have and love them. Also I use Craig Roberts who was the chief of sports meds there some years back. Lately Ive been going to EMCO just because I found out they took care credit but I just realized P & S takes it too. WHEW because it looks like it can go up to like $1200 or more.

After talking to my friends friend whos mare had pythiosis, everything I am describing is exactly like it. Its very unique - as in the kunkers, the look, the discharge, etc.

I am just going to make it a 2 for 1 special and take Layla down with him and get her hocks done while Im down there. And if he does indeed have it and needs surgery, Im going to have them look at his OCD lesion and if they feel he needs the surgery, then might as well go ahead and do it while hes knocked out.

Thanks for the jingles. I need them!

The friend whos mare had it had a wound the size of a softball and once it was cut out, it was the size of a platter and extremely close to the stomach wall. She had been dealing with it and having it misdiagnosed for over 3-4 weeks though. Rex's is no where near that size but she said it healed extremely quickly and theres barely a scar. So heres hoping!

[thatmoody]

They have a great sports medicine department - I feel very lucky to have them available to us. They were absolutely wonderful when our stallion had to have hernia surgery - tell them you have talked to Jorrit's person - he has quite a following there - he was a barn favorite as he was there for quite a while. Even the guy who cleans the stalls came up to tell us how much he loved him - he's a Friesian and is just so lovely to be around. They had a TB stallion in at the same time for colic surgery and he was SUCH a pisser - had to have 2 people in there to change his belly bandage (when stallions have ab surgery they often have to have a belly wrap because they masturbate and mess up the incision) because he'd bite. But not Jor Jor - he'd lean against you while you changed his bandages :). So I think he was just the favorite by comparison, but still...And then when I got the bad news about Elli they were so nice to me.

[twofatponies]

Horrors. That sounds revolting. Big jingles!!!!

[KrazyTBMare]

I will def pass on the hello from Jorrit.

I feel so bad even though supposidly it doesnt hurt, it just itches. I cleaned it again and its just dripping... ugh. So I spent 30 mins just currying him as he LOVES to be groomed and snuggled. Hes SUCH a good baby horse.

[gypsymare]

Wow... I'm glad I wasn't in Florida long enough to encounter anything like that!!

[KrazyTBMare]

So I am on vaca but I wanted to update:

I took the baby horse down to Peterson and Smith last Tuesday. They kept him over night and surgically removed the sore Wednesday morning. Luckily I was able to go back down Wednesday and bring him home.

They are running a histology report and it should be back this week on exactly what it is.

He has to wear an elastic band around his belly holding gauze on the site for a week and then I can start hosing it and placing SWAT.

It was obviously draining a LOT when it first was done. When I got him home, the shavings in the trailer looked like a rat had been killed in there.

I went ahead and changed the bandage that night because it was totally saturated. And bless his heart, he has elasticon holding the gauze and if you have never used it, trust me, it sticks like a bandaid but 103450683 times worse and it pulls the hair.

But he stood in his stall and let me pull it all off and rebandage. There was a large blood blot looking area in front of the incision and I really wanted to pop it but I wasnt 100% sure that was what it was. So I just covered it with gauze and rewrapped him. I had to go to the store and when I came back, he had laid down in his stall (poor thing was tired) and the sack had burst and it looked like a small animal had been slaughtered in there - blood was everywhere. But it was just from the blood clot bursting. It had coagulated and then the leaking filled it like a balloon.

So my girlfriend has been changing it for me every 3 days per the vet and my boarder and step dad are keeping close watch on it and after the clot bursting, it has very minimal drainage. Hes SO good about changing the bandage though.

Everything is healing well and we took part of the round pen panels and placed them off the corner of the barn back to the fence so he has a little 15x15 area to walk around outside during the day off of his stall.

Thankfully it wasnt as expensive as I thought it was going to be. I walked out of there with an overnight stay, surgery, bandaging, histology, hock injections with HA (for my mare), a 7 vial box of Adequan, and a 500ct Robaxin bottle for under $1600. I thought it was going to be much more.

Anyways, baby horse is doing well for now. I am very interested to see what the histology report says about what it was exactly.

But I do have to plug Peterson and Smith. It was my first time there and they were wonderful. The facility is very nice and up to date and the Drs are great. I thought it was very well run though I hope I dont have to see them down there for a long time!

[goeslikestink]

t had been looking like two crators, small, like where the circular edges were raised and then the middle was concave like a hole. Last night, I flushed both "holes" with hydrogen peroxide (which I know kills good cells but I havent flushed it with it before) and then sprayed it with Granulex and dried it and covered it with the Alushield.

i wouldnt use hydrogen peroxide on a cut or sore on the body as you will make it worse
i would wash with petherdine then use any nappy rash cream as its soothing or an anti botic cream

[Lori T]

I have been fighting a habronema on my draftx for 2 years now on his ankle (it is all on our website under Tucker's blog, www.calypsofarmeventers.com). He has severe allergies and develops small sores on his legs from being allergic to grass. They usually heal in a day or 2, but this one turned into the habronema.
The first biopsy showed nothing, though my regular vet said it was a habronema. A 2nd biopsy, sent to the lab we use at work (I work for a vet dermatology center) diagnosed the habronema. I also had been concerned it was pythiosis. The derm vet I work for said it was highly unlikely since I am not in a swampy area (though after the monsoons we have been having this summer, I sure feel like it :( )
I have chosen not to have it removed due to the location. It doesn't affect his soundness and I don't want to chance any complications.
Once I had the habronema diagnosis, we changed treatment and for the past year I have had it 95% cleared (it was the size of a tennis ball) and manageable. I use a solution of:
30cc Dex
10cc Ivermectin
and mix in DMSO and Fura ointment
I apply twice daily and keep it covered with a fly boot.
It was doing really good until about a month ago when all my micromanagement of Tucker literally came undone in one night..he came in one morning just all eaten up, sores everywhere and the habronema re-opened and bleeding. As one poster said, Florida is just a sucky place to be, especially for horses!

[cllane1]

Krazy TB,

If you need more Robaxin, PM me.I have an unopened bottle from when my gelding was diagnosed with fibrotic myopathy last year. Jingles for your boy!

[KrazyTBMare]

Lori, Ive been following your website and thought about it being habronema as well. I just got off the phone with the P & S vet and she just got the report back - they didnt see any signs of parasites or anything like that and said there was a lot of granulation tissue and dermatitis etc - basically she said it was habronema and that I need to dose once a week for 4 wks with Ivermectin and then get a topical mix of ivermectin and a steroid to place topically.

I had just double dosed him with Ivermectin 2 weeks before taking him down and she said that probably helped a lot with why they didnt see any parasites in the biopsy.

I am going to get the report and everything mailed to me to get more specifics but I just wanted to update.

BTW Lori, when I was looking at your site, I saw you had an opening for boarding, so I refered Michelle to your website. Im glad that worked out and she loves it there.
I have been fighting a habronema on my draftx for 2 years now on his ankle (it is all on our website under Tucker's blog, www.calypsofarmeventers.com). He has severe allergies and develops small sores on his legs from being allergic to grass. They usually heal in a day or 2, but this one turned into the habronema.
The first biopsy showed nothing, though my regular vet said it was a habronema. A 2nd biopsy, sent to the lab we use at work (I work for a vet dermatology center) diagnosed the habronema. I also had been concerned it was pythiosis. The derm vet I work for said it was highly unlikely since I am not in a swampy area (though after the monsoons we have been having this summer, I sure feel like it :( )
I have chosen not to have it removed due to the location. It doesn't affect his soundness and I don't want to chance any complications.
Once I had the habronema diagnosis, we changed treatment and for the past year I have had it 95% cleared (it was the size of a tennis ball) and manageable. I use a solution of:
30cc Dex
10cc Ivermectin
and mix in DMSO and Fura ointment
I apply twice daily and keep it covered with a fly boot.
It was doing really good until about a month ago when all my micromanagement of Tucker literally came undone in one night..he came in one morning just all eaten up, sores everywhere and the habronema re-opened and bleeding. As one poster said, Florida is just a sucky place to be, especially for horses!

[KrazyTBMare]

Another quick update:

I went out to the barn to remove the bandage and hose it.

He is now allowed to have the bandage off, go outside with his buddies, etc. I just have to hose it and place SWAT to keep the bugs off.

I am amazed at how healed it is. Everything is there except the skin. Its bright and pink and very healthy looking. Im thrilled.

Lori - my boy doesnt exhibit any bug allergies, etc. He gets bit by mosqutios and flies and all and he doesnt get the crusties or anything. Since he isnt showing signs of a bug allergy, is it likely this thing is going to come back or what?