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Leg edema following respiratory symptoms. Final update post 39

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  • Leg edema following respiratory symptoms. Final update post 39

    Two horses in the barn went to a horse show at Michigan State the first weekend in May. One horse came home and shortly thereafter had respiratory symptoms (coughing, runny nose) that cleared up with SMZs. Horse was also off his feed. I would like to mention that the horse went about 2 1/2 weeks before starting the SMZs. Not my horse, because I would have treated it much sooner. This horse and my horse share a pasture but live on opposite sides of the barn.

    My horse went off his feed on Sunday (for sure-maybe earlier, BO didn't notice or didn't say anything....). I suspect he was feeling poorly on Friday as well because his stall was abnormally clean. No cough, slight nasal discharge. Monday started a course of SMZs. (10 pills two times a day). Today I went out to the barn and he was turned out on pasture as usual and has swelling in all four legs--not above the knees or hocks however. Hind legs stocked up from hoof to hock but still definition around the fetlock. Front legs swollen between knee and fetlock joint, and one leg down to the hoof. No other swelling or edema anywhere else, I specifically checked his belly and sheath area.

    Temp is 102. Horse is going to the vet tomorrow (Hubby is taking him down as I have to work. It is a 2 1/2 hour drive).

    Horse is also slightly lethargic and looks like he's lost some weight or isn't drinking well.

    I cold hosed his legs, and hand walked him. Hand walking for 15 minutes took all but the swelling in the front tendons away.

    What could this be? One "old timer" vet my husband talked to (the vet is now "retired" from large animal work and only does small animals) said it sounds like "purpura hemorrhagica." I googled it since I have never heard of it before, and it is frankly TERRIFYING.

    Is this something I could be facing? Horse did NOT GET the strangles vaccine this year, don't recall if he did last year or not. I know that the live vaccine can cause bastard strangles/purpura hemorrhagica.

    FREAKING OUT here... obviously I will know in the morning after the vet sees him, but I'm incredibly upset/worried/nervous/angry for not being told sooner that this was going on.

    Jingle for Tuff please....
    Last edited by RegentLion; Oct. 24, 2009, 05:41 PM. Reason: Update title

  • #2
    It's smart of you to be vigilant and I would also be taking the horse to MSU or getting him checked out.

    Bonnie got purpura hemorrhagica after a course of TMP/SMZ as a weanling. It was truly awful, but she recovered very well. No more sulfa for her, though! She had not gotten the strangles vaccine before this happened, just a case of the "snots" and subsequent antibiotics and EqStim.

    Jingling that it isn't the case with your horse.
    Click here before you buy.

    Comment

    • Original Poster

      #3
      Deltawave...

      What was treatment like? And why no more sulfa drugs? I do not have a solid understanding of what this "purpura" thing is...

      Comment


      • #4
        Jingles!

        Comment


        • #5
          I suspect your hrose has a virus, and it is not uncommon for leg swelling to accompany this type oif thing, have seen it many times. I would have vet look into it but likely they will tell you just to keep him moving some. If he is feeling bad he is not miving much contributing to it, plus a fever is probably having him retain some fluid. We had a horse get a similar virus, but was the ONLY horse in the barn to get sick, and he had not been anywhere. He ran a fever (somedays pretty high) for about a week, was controlled with banamine, and he also had some edema, even a couple weeks after he recovered. My vet felt that anitbiotics were not indicated and his bloodwork showed no bacterial infetion and antibiotics are not effective against viruses. Time and good supportive care kept this old man going (he is 20 yrs old)
          www.shawneeacres.net

          Comment


          • #6
            A horse I used to take care of was diagnosed by the local cow vet as having that "purpura hemorrhagica" (only I think that vet called it hemmoragic purpura).

            Only symptom was MASSIVE edema -- the horse's legs, whole body, neck, and head were puffy. This was long before strangles vaccines were available, and the vet said this sometimes happens after a horse has strangles (which as far as anyone knew, this horse had not -- closed herd for many months, no symptoms at all).

            I think the vet said the survival rate was something like 50%, but this horse recovered uneventfully. I think the treatment was antihistamine shots, but my memory could be fuzzy on that; I know that horse did at one time get antihistimines for something.

            Horse went on to live another twenty years or so.

            Comment


            • #7
              Don't rule out colic. Colic can present in different ways as I found out heartbreakingly this past winter. Lethargy, off feed, nasal discharge, fever....within 24 hours horse was dead from stomach rupture/sepsis. Horse was passing manure the whole time.. Vet was called but decided a visit was unnecessary...prescribed SMZs over the phone ("there's a flu virus going around") had the vet actually come and seen him, do a thorough eval/rectal/?NG tube, who knows if the story would have had a different ending. Up to the dire end (in the vet clinic) the vets didn't even suspect colic..maybe its congestive heart failure?...then they ultrasounded his swollen abdomen, drained huge amount of bloody fluid...oh maybe its a ruptured tumor/abscess? we just don't know, well have to get a specialist in tomorrow morning. It wasn't until he was on the table later that night and opened up they figured it out. And it was much too late. I can only imagine the suffering.

              the nasal discharge in question turned out to be foamy stomach contents.

              Horse was not in my care at the time, I wonder if things would have been different had he been home with me. Sorry if I sound bitter and angry. It's just the grief talking I guess.

              Just to spread the word, sometimes colic presents in strange ways. Never underestimate it, it is the deadliest of horse ailments.

              Comment


              • #8
                This sounds very similar to what happened to my horse that was eventually diagnosed with purpura hemorrhagica. Risky had a cold, which the BO decided to treat with an extremely short course of antibiotics (one shot), without telling me until after the fact. He got better for a little while, then all the respiratory symptoms got worse, he became lethargic and had swelling in all four legs. Have you checked for petechia? (sp?) If I remember correctly, the petechiation plus all his other clinical signs is why they (at the vet school) diagnosed purpura. He was in isolation at the vet school for about 5 days and came home on antibiotics (penicillin, I think) and we had to keep his legs wrapped to keep the swelling down. He made a full recovery, by the way, and was practically breathing fire by the time he was out of isolation.

                Jingles for your boy!

                Comment


                • #9
                  Originally posted by RegentLion View Post
                  Two horses in the barn went to a horse show at Michigan State the first weekend in May. One horse came home and shortly thereafter had respiratory symptoms (coughing, runny nose) that cleared up with SMZs.

                  My horse went off his feed on Sunday ( Monday started a course of SMZs. (10 pills two times a day).

                  What could this be? One "old timer" vet my husband talked to (the vet is now "retired" from large animal work and only does small animals) said it sounds like "purpura hemorrhagica." I googled it since I have never heard of it before, and it is frankly TERRIFYING.

                  Is this something I could be facing? Horse did NOT GET the strangles vaccine this year, don't recall if he did last year or not. I know that the live vaccine can cause bastard strangles/purpura hemorrhagica.
                  Really, the live vaccine causes purpura hemorrhagica? I've not heard that. What I have heard is that once a horse gets strangles you should not treat it with antibiotics but rather let it run its course, because doing so can cause purpura hemorraghica, bastard strangles.

                  Comment


                  • #10
                    Don't panic.

                    Shawnee Acres is probably right. The assorted edema is a pretty standard reaction to a viral infection/fever.

                    He'll be feeling like crap with a fever of 102--I'd try to get that down with bute or banamine if I were you.

                    It's sensible to get him checked out, but don't work yourself into a lather over it until you know what it is.

                    Comment


                    • #11
                      More than likely, it's a simple virus.

                      "Bastard strangles" can occur when a horse has been exposed in the past to the strangles virus. Giving the vaccine after a recent exposure is thought to increase the risk of bastard strangles.

                      Will jingle anyway. I work right across the street from MSU...so my jingles should carry just fine.

                      Good luck.
                      A good horseman doesn't have to tell anyone...the horse already knows.

                      Might be a reason, never an excuse...

                      Comment


                      • #12
                        Good luck. A virus has to run its course, and I would be concerned if the vet tried to give him antibiotics, if he thinks its virus, try to get him not to do that, I don't know if it would hurt him or not, but I wouldn't want them myself. I'm sure he'll recover. good to get the vet out to make sure he is treated correctly. I'll be thinking of you (I don't jingle. I send out love and healing thoughts. Much more productive, psychic-ly, ). Poor thing. You I mean. Be well. Try to sleep.
                        Airborne? Oh. Yes, he can take a joke. Once. After that, the joke's on you.

                        Comment


                        • #13
                          Originally posted by BuddyRoo View Post

                          "Bastard strangles" can occur when a horse has been exposed in the past to the strangles virus.
                          Bastard strangles can occur when the horse is exposed to S. equi period. No prior exposure is necessary.
                          And strangles is a bacterial infection, not a viral one
                          "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

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

                          Comment


                          • #14
                            Purpura hemorrhagica

                            Purpura hemorrhagica is an immune-mediated vasculitis.
                            IOW, the immune system causes damage to the animal's own blood vessels--particularly the small ones in the skin, causing them to become leaky. This is due to the deposition of antibody-antigen complexes.
                            Fluids and proteins leave the vascular system and accumulate in the tissues--edema.

                            This is the reason one wants to be cautious in vaccinating a horse for strangles if it already has a high level of antibody to the organism.

                            There are numerous triggers for purpura hemorrhagica --Strep equi being one, and probably the major one, in terms of those which can be determined to be from a particular etiology.
                            Others include various viral or bacterial infections, reactions to drugs of one sort or another, vaccines, and even wounds.
                            "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

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

                            Comment


                            • #15
                              Originally posted by RegentLion View Post
                              Deltawave...

                              What was treatment like? And why no more sulfa drugs? I do not have a solid understanding of what this "purpura" thing is...
                              Treatment was supportive--about half of her skin and hair came off, she lost so much weight she was skeletal, and her joints were swollen and achy and she didn't eat well for about 10 days. She just got skin care, daily walks and lots of food. Oh, I should mention I was 9+ months pregnant when this happened and had my son right when poor Bonnie was at her worst! Thank GOD she was at a great TB layup/breeding barn (I'd taken her there after weaning so she could be with other youngsters) and they took great care of her. She had to be clipped and it was January so they kept her in the office all day so she could be warm. It's no wonder she's a big lap dog, nine years later.

                              Since in Bonnie's case the presumed "trigger" was a sulfa reaction/allergy, I just won't chance it again.
                              Click here before you buy.

                              Comment


                              • #16
                                Sweet jesus...I need to not post at the end of a long day. Goodness. Thank you for correcting. I know this...I apparently go brain dead in the evening.
                                A good horseman doesn't have to tell anyone...the horse already knows.

                                Might be a reason, never an excuse...

                                Comment

                                • Original Poster

                                  #17
                                  UPDATE-talked to the vet today

                                  Thank you Ghazzu for the explanation! It makes more sense to me now that I know what it "is".

                                  The vet that initailly said "purpura hemorraghica" didn't actually treat the horse. He's an old time livestock vet who is retired to doing small animals, but will do phone consultations with us as he's a friend of my husband's family. He suggested getting the horse to a vet hospital ASAP, as this could be something we were facing. He didn't say definitively but let us know it could be serious. I appreciate his candor!

                                  Anyway, an update.

                                  This morning I called the vet first thing to make an appointment for Tuff to go down there. I spoke with the vet directly and she felt it was not in his best interest to travel as he is weak/lethargic. The trip is 2 1/2- 3 hours each way, and it is the closest vet.

                                  She discussed his symptoms at length and felt that it was probably strangles or something like it. She prescribed penicillin, genomyacin (sp?), and some bute for the fever. She did say that not too much bute as it can cause something--anemia maybe? My father in law was in the area of the vet's office this morning and picked up the antibiotics. I was told to watch to see if he continues to decline, or has diarrhea, in which case he needs to go to the vet. She did not seem overly concerned outwardly, but she did say "good luck" in tone that has me concerned.

                                  She said that if we had caught this sooner, it would go away sooner. I'm even more upset that the BO didn't notice the leg swelling or mention it to me. She claims she noticed it on Tuesday but didn't let me know--IDK if she noticed and didn't call or else didn't notice and was trying to cover it up. Furious either way.

                                  The vet said that he will need to stay at the barn for 21 days after he is better. She also said that she doesn't think the barn needs to be quarantined, which confuses me. I'd think that if my horse has it, and two others have it (at least) and the index case had it and is better.... might be going to go thru the whole barn? Or if it isn't "strangles" but another strep infection maybe she feels it isn't contagious as it took almost a month of my horse sharing the same pasture to contract the disease?

                                  Anyone have any light to shed on this?

                                  Comment


                                  • #18
                                    Not to cause you further alarm and stress, but IMHO, it wouldn't hurt to do some icing and tape some styrofoam on his feet, just in case.
                                    "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

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

                                    Comment

                                    • Original Poster

                                      #19
                                      Ghazzu

                                      Yes I can do that. What kind of styrofoam? Should he be on stall rest or out in his pasture (there is grass but not a lot, very cold spring/summer for us)?

                                      Comment

                                      • Original Poster

                                        #20
                                        Also what would cause the laminitis? The condition (purpura hemorrhagica) or the drugs?

                                        Comment

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