Seemingly suppressed immune system in one month old? Update #50

[Dressage_Diva333]

Hello everyone :)

I'm hoping for some advice, as I'm not sure where to go from here.

I have a one month old filly, who lives at my trainer's house. She is in turnout 24/7. We were a bit worried about her as birth, as she seemed to be breathing heavily. For about the first week, she would aspirate milk here and there as well (yikes, I know.. but she was showing no signs of pnuemonia). There have been no signs of lethargy. The filly still breaths heavier than any of my other foals. She runs, plays, and acts essentially like a normal foal. It's a little hard for me to say 100%, being as that I can't keep a close eye on her all the time, as I do with my other foals. My trainer is experianced with foals though. Her IGG levels were >800 at about 20 hours old.

She did get a tube of Rejuvenaide, as she was born with very slightly contracted tendons. However, they seemed to be getting a little worse as she aged. The Rejuvenaide helped that ;) She got her last dose on Saturday night. My trainer says that she had some mucous today, and was breathing more congested, as well as coughing a few times. Apparently, she was much better when on the Rejuvenaide, so I'm debating starting her on it again. Can it hurt?

She overall just seems to have a somewhat weakened immune system. With the breathing, mucous, and coughing.... it just doesn't seem like she is "normal". Normally, those would be red flags. However, she's acting fine. I will take action immediatly the minute she starts to act "off". Is there anything I can do to help this? Suggestions? Experiances? I am really hoping to keep this filly as a show horse, so I'm rather stressed about her. She was started on Naxcel at one day of age as a precautionary measure. The filly was a very strong foal, got up and nursed quickly. Foaling was extremly easy, and quick.

She is fairly isolated where she lives, mare was vaccinated prior to foaling, and healthy throughout the entire pregnancy. The mare was dewormed within an hour after foaling as well.

I'm going to get her looked at this week, just to ease my worries.... but would love some thoughts on this.

[Equilibrium]

In all honesty, I would have her checked out by the vet and her lungs at least listened to if not ultra sounded. I try, as much as anybody, to never have the vet around for minor things, but when it concerns the lungs I never hesitate. It may be nothing or it could be something that if taken care of now won't have lasting effects.

Terri

[tuckawayfarm]

I agree and I wouldn't wait until she is "off". I have seen foals with Rhodococcus running around and playing normally, showing just a cough. Something like that, if not caught early, can cause irreparable damage.

I keep mine on Rejuvenaide until weaning. It's a great product, but does nothing for her lungs.

Jingles for your filly!

[MrWinston]

Immediately! Foals are so delicate and can go down hill soooooo fast.

[Lesley Feakins]

I wouldn't wait either...have her checked out.

[Quinn]

Quite frankly, I wouldn't wait either. These babies crash so quickly. Fingers are crossed for yours.

http://community.webshots.com/user/ballyduff

[Laurierace]

I want to echo what everyone else is saying. Get her examined now before its too late. I keep all my foals on foal aide or rejuvenade whichever I can get easier until they are eating the foal's first reliably. Definitely start that back up again but be careful she doesn't aspirate that as well.

[can't re-]

With the breathing, mucous, and coughing.... it just doesn't seem like she is "normal".
I agree, get her looked at ASAP.

[Cindy's Warmbloods]

I agree, don't wait! Get he looked at immediately. By the time you notice signs of her going downhill it may well be too late! Could she possibly have a cleft palate? Not sure if it would affect breathing but might the aspirating milk. However, if she has been aspirating milk I would be very worried about some infection (pneumonia) possibly going on in her lungs.

[pintopiaffe]

Was she checked for cleft pallate (sp, sorry) at birth?

That's exactly what it sounds like. And yes, worth a call TODAY as cleft pallatte can lead to pneumonia quickly...

[Tornado Run Farm]

Like others here, I don't mess around when it comes to foals NQR. Call the vet and see if she can come out yesterday. ;)

Mega jingles for your filly!

[not again]

Is your filly running a fever?

[Home Again Farm]

Get an ultrasound of her lungs immediately. Waiting for the to be more off than she is now might be waiting for her to crash and be gone. I learned that lesson in 2005. :cry:

[Dutch]

It almost sounds to me like she is deficient in Selenium. This can lead to difficulty swallowing (hence milk running out nose), and suppressed immune system. I would suggest that her blood be tested for selenium levels. If it is low, or low/normal, a couple of shots of selenium/vit E should do the trick.

I had a foal with much the same symptoms a few years ago. Fortunately, my vet suspected that lack of selenium was the cause. Dam was already supplemented with Selenium/Vit E, so it wasn't a dietary issue. For some unknown reason, some horses are unable to properly metabolize selenium when ingested. I think two or three needles did the trick in my foal's case. I can't remember how far apart they were administered. No problems after that.

I hope this is all it is in your foal's case. Good luck!

[not again]

I would worry more about selenium toxicity on the west coast.....but call the vet ASAP in any case. Good luck with your wee one!!!

[talloaks]

You should have that foal looked at by a vet NOW!! When things go down hill, it happens quickly and there is no stopping. Don't put off having a vet see her and chance loosing her.

[Iron Horse Farm]

Was she checked for cleft pallate (sp, sorry) at birth?

That's exactly what it sounds like. And yes, worth a call TODAY as cleft pallatte can lead to pneumonia quickly...

This was my first thought also. This condition can also cause the coughing that you have described too as they fight to keep food from entering their lungs.

[Dressage_Diva333]

Thanks everyone!! The vet is coming this afternoon, I'll let you know what he says!

Now I'm quite worried, as it does sound a bit like it could be a cleft palate from a quick google search I did... She was seen by the vet every evening for the first 5 days of her life. Her lung sounds were fine, heart sounded fine. She is defecating normally, never any signs of discomfort. She *looks* like a healthy foal.

I haven't seen milk running out of her nose, since she was about 5 days old. It seemed to be after excercise. However, there has been mucous on and off since then. She doesn't have a fever right now.

She will be started on Immunall tomorrow, I'm really anxious to see if that helps too :yes:


Just talked to my trainer, and she was coughing a little more this morning. Still no signs of lethargy, she was apparently running and playing this morning.

[YankeeLawyer]

Have the vet check for a subepiglottal cyst ( a cyst in the throat, essentially). A friend's foal had that and presented similar symptoms. I would also test for Rhodococcus to be on the safe side.

[Dressage_Diva333]

Thanks YankeeLawyer :)

I've asked that she be evaluated for a cleft palate, subepiglottal cyst, evalute the possibility of being deficient in Selenium, and for her to be tested for Rhodococcus. In addition to anything else he finds necessary.


Unfortunatly I am not able to be there, but the vet will call me as soon as he has seen her.... thanks again for the help everyone!

[Quinn]

I successfully raised a foal to the age of 20 with a major cleft palate. He however, did have feed and water exit his nose until the day he died. If yours has a palate issue, I doubt it's a large one BUT if fluid has entered the lungs, that "may" be where your problem lies. Mine couldn't be scoped before he was 6 months old to confirm the diagnosis but the symptoms were so obvious with him. Fingers crossed for you and yours.

http://community.webshots.com/user/ballyduff

[Amoroso]

Just a note, if the filly is showing signs of contraction, I've been told by all vets to restrict movement. If this filly is in 24/7 turnout, it could be causing the contraction to get worse.

[Dressage_Diva333]

Okay, vet saw her this afternoon.

Had a fever of 102, but it has been HOT. So that isn't too terribly unusual. She was apparently squirming around quite a bit, so he couldn't get a really good feel inside her mouth. However, from what he could tell, he thinks a cleft palate is unlikely. We should have the blood results back tomorrow, then will go from there. It looks likely that we will ultrasound her chest, at that time, she will be sedated and the possibility of a cleft palate can be explored more extensively. Depending on what the blood says, we might take her to UC Davis to have her scoped... we'll see.

Regarding the contracted tendons, they have improved quite a bit with the Rejuvenaide, almost 100% now. The air quality is much higher outside, rather than in the barn. Hence why I've wanted her out in turnout. If they get bad again, then maybe she can start going in during the evening.

[TrueColours]

Jingling that she is okay ...

And I, too, suspect a cleft palate as well. Many years ago I had a colt born with one that had to be euthanized at 4 days of age. I did take him to Guelph to get him scoped and looked at and to be evaluated for surgery and then ended up speaking wth NB, Davis and Colorado about the prognosis as well and we all collectively opted to not go forward with it

His involved all of his soft palate and 4 ridges of his hard palate and none of these hospitals had ever attempted surgical correction on something that extensive before. And by Day 4, he had aspirated enough fluid into his lungs that they felt by morning, pneumonia would have set in and he would not be able to go under the anaesthetic even if I wanted to go for surgical correction

Quinn was a blessing during these very hard 4 days as she recounted her story with her fellow but it sounded like her guys wasnt as extensive as my colt was. If the vet cannot see or feel a cleft palate on your baby, most likely the hard palate is intact and its the soft palate only that is involved

The biggest thing with cleft palate's is the aspiration factor as they nurse and the fact you are fighting pneumonia all the time until they are weaned. Perhaps if it is not extensive, the first thing you will need to do is wean immediately and raise baby as an orphan foal from a bucket. The angle for nursing creates the perfect environment for aspirating liquid whereas the angle for drinking or eating from a hung bucket, doesnt

Good luck with your baby and jingling that everything is okay ...

[Quinn]

TC, I can't believe that's 4 years ago. I remember your heartbreaking struggle with that decision.

http://community.webshots.com/user/ballyduff

[TrueColours]

Actually Quinn it was 2002 - 7 years ago ...

And you were the most wonderful sounding board anyone could have hoped for going through something like this ...

[Dressage_Diva333]

Well, here is an update:

The bloodwork had come back fine on Wednesday morning. She had not worsened, and seemed to be holding steady. Vet didn't put her on antibiotics :mad:

Thursday she had gotten a little worse, then that evening she started to crash... heartrate was up, coughing was BAD, and lethargy was setting in. We elected to take her immediatly to UC Davis. We got her there (BTW, UC Davis was a wonderful NICU!) around 11pm. Got some bloodwork done right away, it was all within normal limits. Temp was 101. Ultrasounded her chest, and although she was squirming, there was some evidence of absesses in her chest.. They were going to do a trachea flush today, as well as radiographing her chest. She is on antibiotics at this time, still in ICU. However, her condition is now "stable". She doesn't have a cleft palate.

I haven't heard anything else since this morning, but I guess no news is good news.... at least she is stable, and hasn't gotten worse. Once she started going downhill, it happened fast. This morning the report was that she's the same, around 12pm, she was stable.

I'm just sick about this, I can't believe it. Something should have been done immediatly, but I hadn't gotten out there to see her myself. My vet just didn't seem too concerned.

[Home Again Farm]

Has it been hot and dry where you are? If so, this sounds like rhodococcus. Or it may be pneumonia brought on by the aspiration. The good news is that either is curable.

They do crash so quickly and some vets seem to think that all sorts of things are nothing to be concerned about. Glad your baby is in good hands. Please keep us posted.

[Dressage_Diva333]

Yes, it's extremly hot, dry, and dusty. Since the mare is a leased mare, she doesn't live at my house.... where I almost always have sprinklers on to help keep the dust down, and keep the babies cool. It has been HOT lately too. There is a little shelter, but it doesn't help a lot with the heat.

The property where she lives used to be a breeding farm about 10 years ago, now it's a private training facility. My vet doesn't know if there was ever rhodococcus there, but it's definately a possibility. The only thing is that she is about a month young for the "average" age for it to show up. Not that that means anything. I know it sounds bad, but I'm hoping it is rhodococcus... so we can treat it.

This is my dream filly, one that I had hoped to have compete quite a bit in the futures... I honestly just am beating myself up so badly. I should have pushed the antiobiotics.


The good news is that she still wants to nurse, no milk out the nose. They put her on fluids, as a precautionary measure though. Feces are still formed. I believe she is on Amikacin? Anybody else care to chime in with the antibiotics used for rhodococcus foals?


I'm so sick... lesson learned, she should have gone in at the FIRST sign of anything abnormal.

[Quinn]

If I beat myself up each and every time I made a wrong decision, I'd be a mess. Look ahead and know you have a whole community of COTHERS behind you. I'm pulling out my special curb chain to send jingles and big hugs to you.

http://community.webshots.com/user/balllyduff

[TrueColours]

I am SO glad to hear that it isnt a cleft palate! Thats great news. As mentioned - everything else is treatable ...

I have fortunately never had to deal with rhodococcus before so cant tell you much about what antibiotics are the preferred ones, but jingling that all is going to turn out well with your filly

BTW - did you do an IgG on her at birth? Might her levels be down and they need to give her some plasma to help *kick start* her?

Good luck and big {{HUGS}}}

[Dressage_Diva333]

Thanks guys, I really appreciate the report.

So here is the news from this evening:

Definately pnuemonia, not ruling out rhodococcus at this point. The culture will be back Monday I guess (ugh, I thought it would only take a day..). They said she was doing better this evening. The plan of action as of right now, is to leave her there until at least Monday. She needs to be in a temperature controlled environment. They will scope her on Monday as well. I've been really impressed with how worried they are about doing too much that might stress her out. Although they told me that they were 99% sure she didn't have a cleft palate, scoping her will tell us if there is some other abnormality in her throat.


Her IGG levels were >800 at 20 hours old. So she did get adequate antibodies from the colostrum. I wonder if it would do any good to test that again, and consider a plasma transfer? I feel so bad, and right now we're pretty much game to do what it takes to save her... as long as she's on board with it, and doesn't become stressed or shows any signs of getting signifcantly worse.


Once again, I really want to thank everyone for the ongoing support on this website. The knowledge, and experiances shared are absolutly invaluable. I will update as soon as I hear from UC Davis tomorrow morning!

[tuckawayfarm]

I've only dealt with Rhodococcus once and my colt was the same age as your filly. We were really surprised the test came back positive in one so young. My colt was treated with Azithromycin and Rifampin for six weeks. I also kept him on Gastrogard and Saccharomyces Boulardii. He made a full recovery and follow up lung radiographs were clean.

Don't be too hard on yourself. I saw my colt several times a day and he never acted lethargic at all. I noticed a very slight cough and had the vet out immediately only because I had just lost a foal in a totally unrelated accident and was feeling very paranoid.

Thoughts and prayers for you and your filly :)

[Home Again Farm]

Azythromicin and rifampin were used when it hit a friend's farm a couple of years ago. The foals were also on gastrogard. It is possible to have rhodococcus in a 4 week old foal, but not common. The foal must be kept out of the heat until well.

If it is any consolation, I have gone through pneumonia and rhodococcus with a couple of foals. They grew up to be absolutely fine after intensive treatment with good nursing care.

My guess is that the filly either has a congenital condition that caused the aspiration which caused pneumonia, or the property has rhodococcus present and it was not seen until a susceptible foal was there under the right weather conditions (rhodococcus does not effect horses over 6 months of age). In the Ocala area most of the large farms harbor rhodococcus and plasma at birth is a routine treatment to prevent the disease.

Keeps us posted. I am jingling!

[Dutch]

It sounds like your filly is in good hands. I expect the hospital vets will discuss with you about possibly treating her with Gastroguard at some point to counter the effects of antibiotics on her gut.

[Dressage_Diva333]

Good news!

The report this morning was better. They are taking her off oxygen, she's bright and alert, and nursing. I guess they are nebulizing her, and she coughed up a ton of mucous after that this morning. The little girl doesn't have a fever, her heartrate is staying more consitent, and her breathing is not nearly as labored.

She is on Gastrogaurd :)


It is very possible that there was Rhodococcus on that property. There hasn't been a foal there for a good 10 years. If all goes well, and the improvements continue, the *plan* is for her to come home on Tuesday, to my house. We are trying to figure out what the best way to do it is though. My barn is extremly open, though it stays pretty cool in there (the breeze goes through it nicely), there's no way to keep it at a somewhat constant temperature. She'll need around the clock care, and I'll put the foaling cameras back up, to watch her more closely.

Our options for when she comes home are;
-Steel hay building, that stays pretty cool. It has a concrete floor (we'd put rubber mats down of course), and can be completly closed up so if were were to put a swamp coolor and fans up there, it would likely stay at a more constant temperature. The other option is the garage. It's insulated, so it might be easier for her to stay cool. However, there is so much crap stored in it right now, it would be a major effort to get it cleaned out. I'll also have the measure the ceiling height, as I'm a little worried about it being a bit low. Although the mare isn't tall, so that might be an option.



The jingles seem to be working, keep them coming!!

[clint]

Many jingles coming your way for your filly.:) The report from UC Davis is such good news. I hope you can get a temperature controlled place all set up for her; that sounds like a bit of a project!

[YankeeLawyer]

Our options for when she comes home are;
-Steel hay building, that stays pretty cool. It has a concrete floor (we'd put rubber mats down of course), and can be completly closed up so if were were to put a swamp coolor and fans up there, it would likely stay at a more constant temperature. The other option is the garage. It's insulated, so it might be easier for her to stay cool. However, there is so much crap stored in it right now, it would be a major effort to get it cleaned out. I'll also have the measure the ceiling height, as I'm a little worried about it being a bit low. Although the mare isn't tall, so that might be an option.


The garage option appeals to me, but only because I always begged my parents to let me have a pony in our garage and the answer was always "no" (I seem to recall a childhood favorite book by Jean Slaughter Doty with a pony in the garage - maybe Summer Pony?). It sounds like either option would work; maybe ask her vet?

[Dressage_Diva333]

Good news! She is set to come home tomorrow evening!

She has improved dramatically with the antibiotics, and hasn't taken any steps backwards since being there. *Knock on wood*

They are STILL waiting on the culture results to be finalized. I guess they are having a specialist look at them? So much for the results being back on Monday. Not looking like Rhodococcus right now though, which is a bit of a relief. They are also not thinking that it was aspiration pneumonia. They did not end up scoping her because they were waiting on the culture results and did not want to stress her further unless necessary.

Apparently she is back to her firey self though, she was turned out for the first time yesterday and was bouncing all over the place. Same today. She hasn't had a fever in 5 days now, and everything seems to be improving. Lets hope it stays that way.

I'll post with the culture results when I finally get them!

[VirginiaBred]

Ask them about Lawsonia. Similar symptoms. I've had several with Rhodococcus and it's no fun. Both Lawsonia & Rhodococcus require keeping the baby in with fans. Limited turnout and only when it's coolest.

Keep us posted and good luck.

[Dressage_Diva333]

Thanks ViriginaBred, I'll definatly ask them about that!

Yep, she will be kept under a ton of fans, we're limiting the potential dust as much as possible, and turnout only for a little bit in a small area in the evenings when it's cool.

Would you reccomond straw or shavings? They have her on shavings down at Davis, though I can't say I've ever seen a horse on straw there anyways.

[VirginiaBred]

Shavings.

We used Blue Ridge Equine Clinic and they also used shavings.

[Dressage_Diva333]

Darn it! I was just beginning to get my hopes up too :no: She is aspirating milk now, the first time it's been seen since she was 5 days old. Endoscopy exam is tomorrow morning... she's still doing better, lungs are sounding more clear, and coughing is decreasing. She's acting "normal" now in regards to energy.

Will post with endosopy results in the morning :( We are still planning to go get her, she can have 100% around the clock care here. Unless they say that she really needs to stay, I'd like to have her home. I have a bad feeling that we might have to wean her early due to this aspiration.

When it rains, it pours... I'm getting to be well known at UC Davis. In the last three years we've had two fractured jaws on youngsters, a post castration eviscoration that required two emergency surgeries, a puncture wound that had about a 12 inch tract going up the inside of the stifle, MUCH to close to the joint for comfort, and now this. Not to mention the repro work and radiographs on young horses. It's not good when one walks into reception at such a large clinic and is recognized with sympathetic looks :no:

[VirginiaBred]

Prayers for the little one. She's at a great place to be sick. Keep us posted.

[clint]

Having had a seriously damaged weanling at UC Davis last fall, I most definitely concur with Virginia Bred that your filly is at a good place, if one needs to be sick. Many jingles coming from me that she is better and home very soon.

[TrueColours]

I wonder if its a defect in the eosophagus area so that when she tilts her head to nurse, the flap isnt closing properly and some milk is dribbling into her lungs as well??? Lending credibility to doing an early weaning so that she no longer has to tilt her head to eat/drink and aspiration wont be an issue any longer for her

Jingling that all goes well and waiting for the next (positive!) update on her ... :)

[Home Again Farm]

Jingling for something that can be fixed on the scoping.

[Dressage_Diva333]

Thanks for the jingles! It's going to be an exhausting few weeks...

She is home, we picked her up this evening. We put her under our carport, and I can see and here her from my bedroom window. Will put up the foal cams when I have the energy as well.

The endoscopy showed no congenital abnormalities, however, the muscles in her esohpagus are extremly weak. They pulled blood from her and the mare to test for EPM. Although neither of them are showing any symptoms, apparently if the mare contracts in while pregnant, it can cause the paralyzation of these muscles in foal... however, it can be treated successfully. I let her have her last nurse when getting off the trailer, and gosh is she aspirating badly :no: I didn't want to wean her just yet, I don't want to stress her. Every two hours I'll be milking the mare (who, thank God, is being a saint about this) and trying to get her to drink from a bucket. The filly is muzzled, and not happy about it. I will be giving her meds (Amikacin, Naxcel, and Banamine) in her catheter twice a day, she is also on Gastrogaurd. I can turn her out in a small, watered down area in the mornings and evenings when it's cool for 20 minutes. Her energy level is WAY up, she's bouncing all over the stall! I'll put as many fans up as possible tomorrow morning, I just don't have the energy tonight.

UC Davis reccomened "Mares Match", which I'm going to try to order. Apparently not many foals like Foal Lac pellets, but we're gonna try it. She's also eating her Equine Junior very well. I have been having luck milking the mare with a large syringe, so I'm gonna continue with that.

Will keep everyone posted, I didn't know that about EPM....

The filly sure is a different foal then when we took her though, the difference is amazing. The cough is much less deep, and more infrequent. Her breathing is SO improved as well.

[Elfe]

Please ask your vet if you shouldn't use Equioxx instead of Banamine. I have had very bad experience with Banamine used on young horses, kidney failure and right dorsal colitis.
Wishing you all the best.

[Dressage_Diva333]

Well it's been a while, and another post reminded me of this one, so I thought I'd put an update.

This filly is now 5 months old. She doesn't look as healthy as the others right now, but I think she'll catch up. Her energy level is good, right up to par with the other weaners. I haven't heard her cough in over a month. However, when she eats, with her head down of course, there is still that 'roaring' sound. She doesn't cough when eating, or seem to have difficulty swallowing, it's just very noisy. I would say maybe it's gotten a little better, but not significantly. I don't think there's much that can be done about that for the time being. I do need to have another endoscopy done to see if anything has changed.

We are still at a loss as to what has caused this. For a while I was convinced it was Lyme of some sort, or something else caused by the tick I pulled off her face four days before she crashed. It was near her esophogus. Nobody seems to think that is the problem though, oh well I guess. I just wish we knew.

This is the sweetest filly too, after all that was done to her, she's still the first to meet you at the gait. She'd much rather be spending time with humans than playing with her buddies or even eating. She holds her own in my little group of four weanlings. My 10 month old pony weanling has really taken to protecting her, she won't let the other weanlings near the filly at meal time. When they are running around, she's also very protective of her. I've found Immunall to be a real savior with her as well, I don't take any chances. At the smallest hint of a snotty nose, or lethargy, she's gets some Immunall, and after two-three days is totally back to normal.

At this point I'm thankful she's alive, and she is as happy as can be. She doesn't know she's different from the others, more fragile. I always hold my breath watching her tear around like a mad thing. She is so athletic, and always manages to turn or stop just in time... and make it look pretty! :D I so hope that she will heal completly with time, and be able to perform as a riding horse.

[Sunnydays]

Thank you for the update. I'm happy your filly is better, and giving you so much pleasure. Loving them can be bitter sweet.
Best wishes of the season,
Kathleen