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DIC- Mare critically ill- HELP

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    DIC- Mare critically ill- HELP

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ID:	10693500 My 9yo mare Skye is currently at the vet and bloodwork indicates DIC (Disseminated Intravascular Coagulation). We have no idea what’s causing it. Currently treating with Dex and Excede. So far, I can’t find a single story where the horse has survived and I’m freaking TF out. Has anyone dealt with (or know of) a horse with DIC that survived?!? Any lingering side effects? And the horses that didn’t survive- how did it progress? How long? I know this could be a really painful topic for some, but the lack of information is stressing me out and I need to know what I should be prepared for.

    Day 1- show up to feed, mares right nostril is a bloody mess. Small mark on nose, assumed she bonked it. Cleaned it up, was still bleeding a little, didn’t think anything of it.
    Day 2- R nostril still bleeding (mildly) starting to get concerned. No temp. Mare acting totally fine. BO texted me later said it stopped.
    Day 3- Bloody nose again in the morning. Stopped by afternoon. Mare still behaving normally. Spent all night researching. Learned about GPM, freaked out.
    Day 4- No blood in the am, when I showed up to feed in the afternoon bloody again, mare didn’t finish hay, start calling EVERY vet in the area to find one with a scope or time to see her. Almost all vets around here don’t do farm calls and the one big vet hospital that would for sure have a scope is an hour away in 95deg heat. I was afraid to trailer her and stress her for that long.
    Day 5- No nosebleed. Found a vet 25min away with a scope that could see her. Bring her there ASAP. Gutteral pouches clean, no indication where bleeding is coming from. No temp. Drew blood- anemic. We were about to leave when we noticed the venipuncture was still bleeding. Vet says she has to stay.
    Day 6- Another nosebleed. Vet scopes again to see if he can track the blood- nothing. It’s coming from the petechia in the membrane. Sends out more bloodwork for coag, dri-chem, EIA, EVA, Piroplasmosis, Anaplasmosis.
    Day 7- Bloodwork indicates DIC, I freak more. Vet consults with an internal med specialist at CSU and a vet at the big hospital nearby- current treatment is devised. Kidney and liver functions are normal. Mare is eating drinking and pooping normal, no temp.
    Day 8- no nosebleed, mare has been bright and alert this whole time but seems better? Definitely hungry as she’s only getting hay at the vet when she’s used to gourmet meals.
    Day 9- no nosebleed. small cath placed to help with Dex inj. and blood draws so we don’t have to keep sticking her.

    And that’s where we’re at... I’ve attached what I have for bloodwork for those interested.
    Attached Files
    Last edited by acequinesports; Jul. 20, 2020, 06:31 PM.

    I know nothing about this, but it sounds terrifying. Jingles for your mare and for you.


      Original Poster

      Thank you. I’m trying to stay positive since she appears to be improving, but there so little information out there aside from “once condition progresses to hemorrhage, prognosis is very poor”.


        Yikes, this sounds awful! I never heard of it so did some digging.

        As it seems DIC is an add-on issue to an underlying cause, obviously the treatment is to treat symptoms but also the root cause, which I know you're still looking for.

        So I'm just curious what the current treatment is like.

        DIC develops secondary to a primary disease—most commonly, gastrointestinal disease or sepsis. "


        " Because most horses that develop DIC have had a septic or toxic insult, much of the initial patient support involves stabilization using intravenous fluids, antiendotoxic agents, and antiinflammatory medications (e.g., flunixin meglumine) as well as other treatments specific to the underlying disease(s)/condition(s)."

        Many jingles!!

        The CoTH CYA - please consult w/your veterinarian under any and all circumstances. - ET


          I have no personal experience with this and I hope your mare gets better.

          I would think her prognosis is better than most since you were on top of this right away. If it's usually secondary to a primary issue like sepsis, then treating her for any possible infections is really all you can do. If she's happy, eating, drinking and passing manure then hopefully you caught it before most other people do.

          I don't know how you'd evaluate her for other gastrointestinal diseases. More bloodwork? Expensive scans?


            I’m so sorry. I know nothing about this either. Do you have access to an internal medicine specialist at CSU? Best wishes to you.


              I am hoping your mare makes a complete recovery and that the vet can find the reason it all began. I would be freaking out too. It is good to see she is doing better.


                DIC in the absence of some inciting cause is bizarre.

                The images of the bloodwork are unreadable at my end, but has rodenticide or other anticoagulant toxicity been ruled out?
                "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

                ...just settin' on the Group W bench.


                  Original Poster

                  Thanks guys! Update for today is basically no change from yesterday. Another day without a nosebleed so that’s positive, but her hematocrit is still low.

                  She’s currently being treated with a daily inj. of Dexamethasone (IV corticosteroid via catheter) to combat whatever inflammation she has going on. She has also received the first dose of Excede (IM antibiotic) which I believe is given in 2 doses 4 days apart. This is the treatment recommended by the internist at CSU who my vet is consulting with. I’m in Utah so having her physically examine Skye isn’t possible.

                  The thing is, we *didnt* catch it early. DIC starts with the body clotting too much using up all the clotting factors, which isn’t overtly evident especially in a case like hers where she’s acting COMPLETELY normal right up until the hemorrhaging starts because her body can’t keep up with platelet and fibrinogen manufacturing.

                  She hasn’t given any indication of sickness until the bleeding started. No temp, no depression, no colic or signs of GI distress. Eating and drinking normally. We don’t have *any* rodenticide on the farm, none of the horses have been off property in nearly a year. All the horses are mostly on the same feed too.

                  We did (hand) spray the pastures for weeds a few weeks ago, but it wasn’t windy, she’s the furthest away from the pastures on her own dry lot because she’s IR and can’t play nice with others, and none of the other horses have any issues. Everyone was locked off pasture for a few days and not let back out until it was irrigated.

                  Everyone is just stumped as to why this is happening. There’s nothing in the bloodwork that clearly indicates what the underlying cause is.

                  I hope that answers some of the questions. I’ve never posted before and I’m using my phone which is a bit of a PITA lol. Keep the jingles coming please, hopefully she can pull through this with no lasting side effects.


                    The only horse I ever saw in DIC was a non sweater that overheated to the point where he died
                    "You can't really debate with someone who has a prescient invisible friend"


                      Jingles & AO for your SKYE ~

                      ((hugs)) laced with extra strength and patience for you ~

                      * Hoping tomorrow brings a diagnosis and a treatment plan ~
                      Zu Zu Bailey " IT'S A WONDERFUL LIFE ! "


                        Original Poster

                        Originally posted by mroades View Post
                        The only horse I ever saw in DIC was a non sweater that overheated to the point where he died
                        Interesting. She’s never shown signs of anhydrosis before, I don’t believe it’s common in the breed either (Saddlebred). It’s hot here, but quite dry; she has shade and a 100gal tank all to herself.


                          ASB ~ please share your Skye ~ but only if you feel like it.

                          Breeder and bloodlines ~ and your ‘partnership’ = your adventures together ~

                          ASB Jingles & AO ~ Always Optimistic ~
                          Zu Zu Bailey " IT'S A WONDERFUL LIFE ! "


                            Jingles for a speedy recovery!


                              I have experience with dogs with DIC but not horses. Hoping you can find the underlying cause and get her on the road to recovery. Many jingles!
                              There is no joy equal to that found on the back of a horse.


                                Is it possible she got bit by a snake? In small animals, the venom causes the red blood cell walls to lose integrity and makes them look spiked. Have they looked at a blood smear manually?
                                When the student is ready, the teacher will appear.


                                  Original Poster

                                  Originally posted by fizzyfuzzybuzzy View Post
                                  Is it possible she got bit by a snake? In small animals, the venom causes the red blood cell walls to lose integrity and makes them look spiked. Have they looked at a blood smear manually?
                                  No snakebite that’s I could find, and I went over her with a fine toothed comb. No swelling anywhere. Yes we had a sample sent out to a lab for coag test etc.


                                    I think the fact that she is comfortable and eating is positive. I’m hoping for the best for you and your horse.


                                      Original Poster

                                      Originally posted by Zu Zu View Post
                                      ASB ~ please share your Skye ~ but only if you feel like it.

                                      Breeder and bloodlines ~ and your ‘partnership’ = your adventures together ~

                                      ASB Jingles & AO ~ Always Optimistic ~
                                      Reg. name is Winsdown Bella Luna (Winsdown Westinghouse x Oh What A Prize). I bought her from a lady in CA who pulled her from a kill pen. My goal has always been to promote ASBs as Sporthorses and she shows great talent O/F and on the XC course. She hates dressage tho lol. She’s had a rough life before me and is difficult, opinionated, and sensitive but SO smart. She may be an ass, but I love her. I’m hope she can recover without and serious side effects so we can continue our eventing journey. Click image for larger version

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                                        She’s beautiful! Sending lots of jingles from the Midwest
                                        Becky & Red
                                        In Loving Memory of Gabriel, 1998-2005 and Raalph, 1977-2013