Facial abscesses?

[redandwhite]

Hello there,
My horse had an abscess under her jaw which popped followed by four more abscesses in and around that area(under jaw and throat) she has been on two antibiotics for 20 days and we are flushing our the abscesses daily to try to help get the pus out. We have just been told to put her on another 7 days of antibiotics. She has a leaky bum probably from all the antibiotics . We gave her bio sponge for it which did nothing. The original abscess as well as all of them continue to drip pus day and night- it seems endless. Face is swelling and owchie on one side.

We have tested for strangles(neg) and taken a few facial X-rays which didn’t show anything (tooth specialist vet looked at the roots of teeth) we found a broken tooth which was pulled but nothing else. temperature is normal. She’s eating and drinking. She is on prascend and previcox(on hold while she has a few days of Bute with the bad facial swelling)

My vet is at a loss and is asking other vets . I’m going crazy. What in the world is going on. Has anyone heard about this/dealt with something similar?

[Kirikou]

So sorry to hear you’re going through this—sending healing vibes to your mare!

This is probably not at all helpful OP but I’ve heard of that exact scenario a couple of times over the past few years—where a horse tested negative for Strangles, “but what else could it be?”
It makes me wonder about the accuracy of the test in cases like this. Could it be possible to get a false negative if the timing of the test wasn’t ideal, like how early COVID tests sometimes gave false negatives if you took it too early/at the wrong time?

Hoping you find answers soon and that your mare starts feeling better!

[redandwhite]

Thank you. It would have killed strangles with the antibiotics though, no?

My friends are saying maybe it’s fungal?

I’m going insane

[ThreeWishes]

Have you scoped the Gutteral pouch? Honestly first step would be a culture. To target the appropriate bacteria.

[Twhgirl]

I’ve seen/ heard of a few of these odd cases where the horse had something foreign deep in the area causing the constant abcesses/drainage. Particularly one at the clinic that presented much the same way and nothing was found on xray, no bad teeth etc but after several rounds of tx and finally an ultrasound was done to reveal a small piece of wood lodged deep in the jaw of the horse- perhaps chewing on something. Once that was surgically removed (they did this under standing sedation with ultrasound) all the abcess trouble and draining stopped. May not be helpful but also something to consider since it sounds like you’ve tried everything else! Also in regards to the diarrhea as you said it’s prob antibiotic induced, you might try putting her on a good oral pro/prebiotic for a while to help mitigate the affects of antibiotics- CRS Gold, Probios, Forco are all ones I’ve used with good success.

[Kirikou]

@redandwhite

It would have killed strangles with the antibiotics though, no?

Not much of a scientist here (I was a Philosophy and Classic double-major #EquallyUnpreparedforLife!). But from what I’ve learned, antibiotics for Strangles do seem to be a bit controversial, perhaps? My vet was saying that they’re usually prescribed more for managing symptoms like fever rather than targeting the abscesses directly. And he had lots of “stories” about antibiotics potentially prolonging the course of strangles or increasing complications.

I did some reading yesterday night and According to Cornell University Lab, false negatives can happen if the bacteria die during transport, if testing is done early in the disease, or if the bacteria are present in low numbers. They also say that samples with large amounts of discharge might still test negative despite the horse obviously having Strangles.
And the Merck manual says that false negatives are possible in early stages of the disease or with intermittent shedding. They also say that PCR testing is more sensitive than culture testing and recommend it.

It might be worth discussing with your vet whether another PCR test or culture could help, given everything you’ve already tried?
Hoping your mare gets better soon—this sounds like such a tough situation, but you’re clearly doing an amazing job caring for her! Sending lots of good vibes your way!

[PaddockWood]

One of the odd symptoms that led to me test for PPID on my Arab WAS abscessing lymph nodes under his jaw. It was nothing like you describe on your mare. And he was positive. So, interesting you say she is PPID. As soon as we started Prascend the small sores went away.

When did you last test ACTH?

I’m so sorry you are going through this . It sounds awful.

[4horses]

The broken tooth could have allowed an infection to set in? Also could there be tooth root fragments allowing for more abscesses to develop?

[redandwhite]

I have emailed my vet that it’s time to put this love down. I am heart broken but don’t have the resources for more discovery.

[PaddockWood]

I’m so sorry and it does all get SO expensive these days. My mare had two molars extracted a month ago and a week ago she developed green snot and we started her on SMZs. Years ago another horse of mine developed a sinus infection and they ended up drilling into her head to drain it. She had
a fractured molar too.

Again, I’m so sorry.

[Kirikou]

I’m so sorry you’re going through this—it’s one of the hardest decisions we ever have to make for our beloved horses. Thinking of you during this incredibly difficult time.