Mystery illness, could use jingles and/or advice UPDATE: It's Pemphigus :'(

[Say_Goodnight_Gracie]

Hi COTH! I could use any magical medical wisdom you may be able to impart here, I have a sick horse with no diagnosis who partially fits several things but nothing completely.

Rough timeline of symptoms:

About 3-3.5 weeks ago: noticed neck and base of mane was itchy and kind of crusty/dandruffy (seemed kind of gritty, no visible sores or obvious scabbing at base of fur). i thought she was dirty.

2.5 weeks ago: skin issue seemed to be slowly spreading, decide to do a REALLY thorough curry all over in case it was dirt and sweat trapped under winter coat (in n. illinois, too cold for bath)…next day first fever happened (upper 102s?), possibly some leg swelling but I don’t remember, had vet out to treat and I believe she got banamine and an injection of Excede and we gave the second one 3 days later. Fever stayed down until the 4th day after the second injection. blood work showed inflammation and some anemia. ran a coggins test just to be totally sure, came back negative. vet was not overly concerned about skin at this time, prescribed antihistamine.

About 1 week ago: fever spiked up to 103.6, obvious swelling in legs and under belly (shelf). vet gave something to help break the fever and a dose of oxytetracycline, which we stayed on for 2 more daily doses before switching to powdered doxycycline 2x daily. blood was more off than the first time, i don’t have any actual values unfortunately. on the second day we added 3 days of naquasone to get the fluid out of her legs and stomach. it did help. vet believes possibly tick-borne (anaplasmosis?) or auto immune. skin looks more like sterotypical hive bumps with white flaky dandruff, very itchy when scratched.

recheck yesterday: blood work showed some movement in the right direction but not normal, took blood for a cushings test and discussed skin biopsy for pemphigus (delayed). tonight temp went back up to 102.7 with some leg swelling, contacted vet and gave 10cc banamine. still on doxy and antihistamine, no skin improvement…one or two small patches of hair missing now.

Any thoughts? Has anyone dealt with anything like this? We still have no diagnosis =( horse has never been sick in 4 years before this, no vaccines or dewormer given recently (fecal showed a couple types of worms and an FEC of 400 so I’ve been ready to deworm but she keeps getting sick, I would be happy to list what kind if anyone thinks it’s actually relevant). Appetite has been pretty solid except during the fevers, not quite as great as normal but seems at least partly due to meds in grain.

[Say_Goodnight_Gracie]

Thank you for replying! I think that may be our next step, she is now also negative for Cushings and we are going to do a skin biopsy to test for Pemphigus after all because we are kind of at a standstill here.

[chai]

I’m so sorry that your horse is ill. It sounds like your veterinarian is doing a great job. Are you in a tick-prone area at all? Tick bites can cause topical inflammation and 2 of my horses got Ehrlicciosis (granulocytic anaplasmosis) from tick bites. It caused a huge fever spike, extreme swelling in the legs, off feed and the looks that says, “I’m miserable.” We did a course of 4 days IV tetracycline followed by 4 months of doxy.
Just something to consider when you’re ruling things out. I hope your horse will rally and recover.

[Zu_Zu]

no advice

just sending Jingles & AO for a diagnosis and treatment plan soon !

((hugs)) for your worried heart ~

[AKB]

I think your vet is doing a great job. For your peace of mind and your vet’s peace of mind, I would ask your vet to recommend a specialist for a second opinion. If she would call the specialist, it will help you get a quick opinion. Is there a vet school near you?

is there any chance your hay or hay cubes are contaminated? We had a horse with similar symptoms 14 years ago and concluded, after his death, that our hay cubes probably had hoary alyssum weeds in them.

[Brown_Derby]

Oh that poor horse. Your vet sounds really thorough. Having witnessed a case of pemphigus folioceus at our barn–it is the most awful thing I’ve ever seen. Please rule that out ASAP. Have your vet biopsy the sores right away (skin scrapings can be inconclusive if the horse has been washed or groomed). My barn’s attending vet consulted with Dr. Nicola Pusterla at UC Davis. He was helpful and kind.

[Say_Goodnight_Gracie]

hey everyone, just heard back from the vet regarding the biopsies and unfortunately, my sweet Gracie does have pemphigus foliaceus :(:( we have her on steroids now (dex) and I think we will definitely try to reach out to the doctor that Brown Derby mentioned (thanks for that recommendation!).

[Zu_Zu]

[B]Jingles continue ~ AO that Gracie gets some comfort and recovery from her medical treatment ~

((hugs)) laced with strength and patience for her owner ~ [/B]

[bathsheba8542]

I hope you can find a way to manage her so she is comfortable! Glad you were so proactive in discovering what was going on so treatment could begin.

[Brown_Derby]

I’m so sorry to hear of that diagnosis. At least you now have one, and an early one. I am impressed by your vet for considering it–the disorder is so rare.

I searched pemphigus on these forums and read of a couple of cases that were treated successfully at Texas A&M VMTH. Perhaps it would be helpful to consult with their large animal dermatology dept. Good luck and mega jingles for your sweet mare.