Mystery illness

Four different vets are all stumped.

15 yr. old OTTB that I have had for 10 years. 100% healthy, never lame, perfect weight, lively, great personality, lovely to ride, barefoot with perfect feet — a dedicated cribber though.

Personality change late last summer, girthy, spooky, bucking. Treated for ulcers with GastroGuard (didn’t scope) — 90% improvement but still NQR = off and on mild colic/ gas while eating feed (forage based) always resolved quickly but sometimes lost interest in finishing feed and preferred to eat hay.

November/December sheath started swelling up — interest in eating feed did pick up; he was eating with gusto — but he started losing some top line weight. Pulled blood which only showed slightly low protein. Lyme test negative. ACTH normal. Fecal showed moderate to high shedding — wormed him with Zimectrin.

Re-treated for ulcers with GastroGuard, sulfracate, misoprostal.

After 3.5 weeks on ulcer meds he went completely off his feed was really NQR — lethargic and grumpy. I stopped all meds (my gut was telling me they weren’t agreeing with him (not ulcers) and he quickly began eating again with gusto and has never had any more mild colic/gassy episodes again —to date.

January/February sheath still really swollen (got huge) — second blood test showed slightly low protein again. Losing more top line weight. I started adding brewers yeast to his feed. 2nd vet thought IBD maybe. Vitamin E test came back normal.

Then in late March he got (what appeared to be) strangles! No nasal discharge, no temperature — just two burst abscesses under jaw. He was acting fine — certainly not your typical strangles case. None of my other horses caught it. I did get a new horse but he had been here for almost 10 weeks — could be a silent carrier — only infected my mystery case.

By April/May he had lost even more weight. Re-wormed with Zimectrin Gold. By now he was getting weak in hind quarters/ muscle loss + injured front tendon somehow in turn-out. Two different vets did neuro tests for EPM. Horse only showed reaction with tail pull and couldn’t place right hind easily (while backing up) but did show some lameness in right hind, cause unknown.

By now sheath swelling had gone completely down to normal size and is staying normal size.

I treated for EPM just in case — 10 days of Levamisole/Decoquinate. Horse immediately got a bad snotty nose (no smell) which took weeks to clear up + EPM treatment = no improvement.

Wanted to worm again with Quest for possible encysted strongyles but horse is too thin and too weak by now to do that with 100% safety. Coat quality excellent BTW.

About 10 days ago HE STOPPED CRIBBING. Not gradual — he just stopped.

Did full dental work-up — float + radiographed all his teeth. Showed a few minor anomalies that come with age but nothing that could explain his weight loss and certainly no EOTRH that would explain his cribbing cessation.

Tested for Cushing (TRH) — came back negative. Did a full abdominal ultrasound — all normal. Urinalysis normak. Kidney levels normal too. Low protein is really the only thing that stands out in all his bloodwork.

Currently waiting for a fecal to come back, but none of the vets think that worms are causing his weight loss and overall weakness.

Right now he looks like a hat rack — eating really well — shiny coat — weak hind end with a lot of muscle loss + one hind leg (the one he’s mysteriously lame on) is stocking up when he’s in his stall for any length of time.

Everything we can test for has been done short of a spinal tap for EPM. Not keen on doing that.

Vets are stumped. I feel like my horse is just slowly wasting away and isn’t going to make it. Some form of cancer a possibility.

I’ve researched adnauseum every known equine disease and nothing fits him. Frustrating, sad – and I feel utterly helpless.

I’m so sorry you and your horse are going through this. You’ve really done a great job trying to identify the cause. And now you’re consulting the COTH community and the awesome hive mind.

A couple of things might be helpful to know. Where is your horse geographically? (State, county if you feel comfortable) When you say forage based feed, what do you mean specifically? Is the hay source from a consistent producer or does the source vary? What is the water source for your horse? (Municipal, well, surface water) Does your horse get turnout, and if so what are the conditions and parameters? What is used for insect control? Since he cribbed, were any surfaces or fences treated/ painted around the time this started? OK. That turnout out to be more than a couple.

I’m not a vet nor a doctor but I’d consider a couple of things since all of the usual suspects have been ruled out. Give Vitamin E, lots (like 4000 IUs per day) of the natural stuff. Can’t hurt, might help. Sometimes horses with a normal E level in their blood really need a lot more.

You might have guessed from the questions I asked that I’d want to rule out a toxin, specifically a neurotoxin. I would want to rule out feed, hay, water, anything or product that changed around when this started, something in the pasture or if you’re near any industrial facilities, in the air. It may be something this one horse got into or is sensitive to so not having an impact on others.

Sorry that I have no answers, only questions. I look forward to following the discussion on this. Best of luck!

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I’m so sorry.

I hope you figure it out.

I went through something slightly similar with my very sweet standardbred mare. We went down most of the same rabbit holes. After a couple years of one step forward, two steps back, I finally decided to euthanize her last fall. I did not do a necropsy because of logistics/cost, but we suspect it was cancer of some variety involving her gut.

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It honestly sounds like some sort of cancer, the questions are where and what kind. Blood work is just usually poor at seeing that, at least sometimes until it’s really advanced. But, some sort of intestinal tumors would make sense, affecting the ability to uptake nutrition in general

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Man, sorry you are going through this. It sounds like you been very thorough trying to figure things out.

My only thought is that after seeing a friend go through the wringer with EPM; they were able to get the EPM under control with dec/lev but it was a much longer treatment window. Even with EPM titers looking ok, their mare had developed polyneuritis presumably from the EPM and after trying to battle it for two years, they decided to put her down after a particularly bad flare up.

My understanding with PNE is that it’s a clinical diagnosis and made after ruling everything else out.

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I’m familiar w two horses w lymphoma…if your vet hasn’t done blood work to rule that out, you might consider it.

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I’m also adding I’m really sorry. You’ve done so much…best of luck it gets sorted out somehow. I had to convince one vet to look at lymphoma based on the waning and waxing of swelling in the areas horses have visible lymph nodes.

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I’m sorry for your horse. It sounds like some kind of cancer to me too

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No toxins – hay, water, feed all good. He lives in Hudson Valley, NY on my own farm. Horse heaven – out with his 3 other (very healthy) buddies. Beet pulp, teff pellets, Cool Stance, top quality Vit/min supplement + hay + 5 acre pasture etc. Well water that I drink too.

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Thank you for ruling all of those things out. Jingling curb chains for him!

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I’ve seen heart failure cause similar weight loss in a horse that was eating and had a good coar. What’s his resting heart rate?

My regular vets plus neuro specialist did not find anything wrong when listening to his heart.

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P-Losing E has always been a possibility. Once I started him on the brewers yeast + a whey protein supplement (my decision – not even suggested by any vets), his swollen sheath issue began to go away and subsequently resolved = protein leaking into sheath (???) but no more.

None of the vets that reviewed his bloodwork could say Y/N to lymphoma. Everything is just a ‘maybe’.

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I have a friend w a mare with a thickened intestinal wall discovered during exploratory surgery for colic. I don’t know more than that about her medical problems; I don’t think they know why the wall is thickened. The recommendation from the university medical center was to feed her Triple Crown Senior Active. It is an extruded feed and easier to digest. It turned her around and she looks great. The only place to buy it is Tractor Supply. I hope this is helpful somehow.

Ultrasound revealed no thickened intestinal walls on my horse which was a nice surprise but made mystery continue. Thanks for your input anyway! Appreciate it.

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Are you working w a university vet hospital or close enough you could go to one???

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New Bolton and Cornell are each about 3.5 hours away by car, with trailer a bit longer. I will try to get a consult/ confernece call with one of them via my local neuro specialist if she thinks it will be revealing – fresh set of eyes etc., but I can’t see any point in spending big bucks for more ‘maybe’s’ or re-doing all the tests we’ve already done + stressing him out with a trip. And if it is cancer there’s no miracle treatment anyway.

At least at this point he’s eating really well – isn’t cribbing – seems very happy and content minus the lethargy he exhibits.

Perhaps he’s a ‘wait and see’ horse – benign neglect where it’s all up to him to either get better or continue to go downhill. Again, so frustrating that nothing makes sense – just a cascade of weird symptoms that resolve… but yet there’s something serious going on.

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One of the barns I boarded horses at had a horse that sounded similar, also a teenaged TB gelding. He lost weight to the point of being skin and bones. In addition to that he had major stocking up/scratches issues in all of his legs. The vet would come out and just drain pure fluid out of them. They were just huge. At some point strangles went through the barn and he didn’t fare well with that either. His bloodwork also only really showed low protein. Ruled out Cushings, EPM, etc…

They eventually put him down. All that to say, it sounds like it was something similar. They never did find an explanation. I hope you can find an answer. I might suspect something affecting the vagus nerve.

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Your sure the liquid is “pure”? My vet who diagnosed my boy with cancer based off a belly tap (the lab found the cancerous cells in the tap fluid) did that for him and we had him on laxis as well. I wanted to give him one last summer and realized I wasn’t doing myself or him any favours and let him go.

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