I wonder if DMSO and dexamethasone have any documented effectiveness in mild head trauma. In kids, we certainly don’t give DMSO or dexamethasone for mild head trauma/concussion. Sometimes, the tendency is to treat with a medication just so you can do something. If your vet didn’t feel there was any reason to believe the meds would be helpful, she may have made the best decision by not administering them.
I was a ways away from the incident and couldn’t see exactly what happened. He did have abrasions above his left eye, though, and he stayed down for a while. I’ll be going out tomorrow morning, and if he doesn’t show good improvement will for sure be calling another vet. Ugh I would have preferred a bowed tendon or something similar over this. Something with a determined prognosis and plan of action. This waiting and guessing game is killing me.
I would be pretty optimistic if he always walked straight and doesn’t have a head tilt. Don’t beat yourself up. You really don’t know what is wrong any way. He could just be sore. I wouldn’t bother with a head X-ray. Nothing would change in how you are treating him. I would wonder if he has some soreness in his neck and/or back. A pulled muscle could be bugging him. Fingers crossed he improves soon.
Don’t let everyone freak you out at this point. I was lunging one time and someone’s dog ran into the ring, the horse freaked and flipped himself over backwards. He was down for a minute but I let him get up since I didn’t see any blood, eyes were both open and moving.
The vet didn’t prescribe anything other then supportive care. We put him in a quiet stall with a blanket hung up so no one would unnecessarily bother him. After a week or so we put him out with a baby sitter. He made a full recovery and is currently competing at training level.
My dog was hit by a car. Doggie emer center didn’t know about DMSO IV. We transported her on a stretcher for several days between night trauma center, and regular day vet. No response. About 4 days in, a different vet returned from vacation, and called me to ask if she could give DMSO IV to her. I had asked in the emer center but was told not to dogs. A few hours later they again called to tell me she was awake and eating off a spoon. DAYS later.
If someone can help me figure out how to scan stuff (I have a scanner/copier mix but have no clue how to scan) I have an Equus mag that has an article about equine head injuries. I can scan it to an online album and post the links here. The mag is a few years old but it is a very interesting read. I will be able to do it tomorrow morning as soon as I am up and moving.
[QUOTE=AKB;7886317]
I wonder if DMSO and dexamethasone have any documented effectiveness in mild head trauma. In kids, we certainly don’t give DMSO or dexamethasone for mild head trauma/concussion. Sometimes, the tendency is to treat with a medication just so you can do something. If your vet didn’t feel there was any reason to believe the meds would be helpful, she may have made the best decision by not administering them.[/QUOTE]
In humans, there is extensive evidence AGAINST giving any steroid (including Dex) for head trauma. So extensive that to do so would basically be malpractice. I’m not sure what the evidence is in equine medicine but I suspect it is not great. DMSO is much more rarely used in human medicine and doesnt have any role in the treatment of head trauma to my knowledge.
[QUOTE=blackwly;7888915]
In humans, there is extensive evidence AGAINST giving any steroid (including Dex) for head trauma. So extensive that to do so would basically be malpractice. I’m not sure what the evidence is in equine medicine but I suspect it is not great. DMSO is much more rarely used in human medicine and doesnt have any role in the treatment of head trauma to my knowledge.[/QUOTE]
Doesn’t DMSO increase circulation. I suspect it is used in horses and not people because for people, you are more likely to use more aggressive and effective treatments than we would use on a horse. While we all love our horses…not many are going to be medically treated the same or even similar to a person. I just know what was done by some of the top vets in the country to a top SJ horse worth several million. Not sure if he would have been fine otherwise…probably. Just know that it was considered the best course of treatment. Would be interesting to hear from vets on why this works and why it is different for people.
ETA: Here is a somewhat interesting article on the use of DMSO http://www.dmso.org/articles/information/muir.htm
GoodTimes what were your horse’s symptoms? Was it a very slow recovery? How long until you started riding him again?
ALL of the severe equine head trauma horses I managed returned to 100% after DMSO. I also know vets that would give it to their child - removing them from the hospital for a period as they just have that much confidence in it. It will never be well researched or approved for humans in the US as it is an industrial solvent. It is definitely a miracle drug. Sad that our medical community will allow people to remain damaged by not using it.
Do you think I should be calling a vet and seeing if I can get him on IV DMSO? Would it have any benefits this late?
Just want to say I hope your horse gets 100% better. I don’t know about medical knowledge so I won’t go there.
Best wishes.
It totally turned around my dog 4 days later
[QUOTE=Delaine;7889094]
I also know vets that would give it to their child - removing them from the hospital for a period as they just have that much confidence in it. [/QUOTE]
I’m sorry, but this statement is ridiculous. Would they also manage the ventilators of their severely injured children at home while they were at it? Removing ones child from the hospital to practice medicine on them (without a license) using a unapproved prescription medication is illegal and would never happen.
DMSO has some roles in horses. It does not currently have a role in the treatment of traumatic brain injuries in human beings. Prehaps someday someone will investigate it further.
1 Like
[QUOTE=blackwly;7889398]
I’m sorry, but this statement is ridiculous. Would they also manage the ventilators of their severely injured children at home while they were at it? [/QUOTE]
It was a statement by a vet that couldn’t see themselves standing by and watching their child be severely, permanently damaged, when they had the ability and drug to probably cure them in 5 minutes.
My horse flipped over in the long lines & hit her head a year ago the first of June. She had no bleeding but did have a head tilt, her ear wasn’t floppy but she couldn’t use it like the other one & she had paralysis in her bottom lip. The vet was there within 15 minutes & gave her a DMSO IV & I think Dex. That in my opinion saved her because the brain didn’t have much time to swell. It took her about 3 months but all the issues resolved & she is perfectly normal & jumping 3 foot again.
It’s so odd that my vet didn’t bring up DMSO. I feel like now at a week later there’s nothing much I can do but wait and pray. I’m going to call another vet tomorrow though just to get some other thoughts. I had just nailed down dressage training and shows for next year, too. Horses never let you make plans.
[QUOTE=Delaine;7888232]
My dog was hit by a car. Doggie emer center didn’t know about DMSO IV. We transported her on a stretcher for several days between night trauma center, and regular day vet. No response. About 4 days in, a different vet returned from vacation, and called me to ask if she could give DMSO IV to her. I had asked in the emer center but was told not to dogs. A few hours later they again called to tell me she was awake and eating off a spoon. DAYS later.[/QUOTE]
In dogs the more typical and appropriate drug is Mannitol IV. It is also highly recommended against giving steroids to a head trauma cat/dog.
I would be interested in seeing any actual published studies about using DMSO in dogs/cats, as we often treat head trauma cases. however, I suspect that since the vets I work with are top of the line and very UTD on their medicine that there’s not much actual research to back it up.
So sorry to hear of Arty’s injury. I treat my share of equine head trauma cases. Unlike the situation in humans, we rarely have advanced imaging and such to guide medical/surgical management so treatment is a bit of a blunt instrument. In general those that are up and around with no dramatic neuro deficits tend to do very well but it can take time. FWIW I would likely treat a horse like this with DMSO for a few days on grounds that his mental status is still abnormal and it won’t do him any harm. Despite the lack of strong supporting scientific data pretty much everyone that uses the stuff becomes convinced of its magical powers. 
I would check his eyes for optic disk swelling that reflects increased intracranial pressure - if present I would treat with hypertonic saline. Depending on what actually happened (backwards flip versus striking the top/front/side of the head) I would consider antibiotic coverage on grounds that you don’t have skull films and the nosebleed may reflect fractures with bleeding into the sinuses - this can lead to development of bacterial sinus infections. Fractures of the bones around the inner ear can also lead to bacterial meningitis, though Arty’s signs do not specifically indicate this. I am assuming there is no evidence of depression fractures of the skull, which can be surgically addressed when present. If he’s drinking well enough to maintain hydration there’s no indication for IV fluids at this point, and DMSO can be given by stomach tube in horses without an IV line. I would definitely continue anti-inflammatories a while longer though we tend to use Banamine rather than bute in such cases. I supplement these horses with thiamine at a gram a day. I would confine him to a stall and offer his feed from an elevated position (shoulder height) versus on the ground. Of course the judgement of the vet examining him should prevail, as s/he is the one assessing his physical and neurological status in person and there can be contra-indications to all of these treatments. The good news is that these guys can look vastly better within 7-10 days. Fingers crossed for a rapid recovery!
Wow thanks so much for the response visorvet! Wish I had known all this when it first happened. This past week he has been in a small paddock on his own; I don’t have access to a stall. He’s been fed on the ground as I didn’t know feeding him up higher would be beneficial. Why is this so? Also we dis-continued the bute after four days as the vet prescribed. Would you recommend I keep going with the bute? Also are you saying that DMSO would be a good idea for a few days even now a week after the incident? How many months do you usually allow for a full recovery? Thanks again very much.
