'Novel' Equine Hepatic Parvo Virus, Ponyboy Has Tested Positive..Now What?

[carman_liz]

Ponyboy tested positive, anyone know anything about this, experience with it, convince me he is not doomed?? This virus is brand new apparently in the equine vet community, as in just a few yrs old.

His UTI is slowly clearing up, temp is normal again, 99 to 100 range. White blood cells are back in the barely normal range (vet said 6?), proteins still elevated showing inflammation somewhere internally, edema under his belly is gone. Sheath is still gross on the outside daily, still barely eats his hay, I have tried from 3 different hay people at this point. He will eat senior feed with his multitude of meds n supplements slowly but finishes it.

Asked vet to please have Cornell check for hepatitis, after the rescue mare passing from either liver failure or cancer I just could not let it go after a deep google one night. Test came back from Cornell, he shows positive for equine parvo hepatitis. Here is the thing…his liver enzymes are perfectly normal, but his kidney values are still low, she did not tell me how low but said it is weird that his liver seems fine even with the parvo diagnosis especially since he keeps getting so sick.

Help/commiserate/arm chair vet brainstorm with me!!???

[JB]

No help, sorry, just wanted to say I’m jingling hard for him!

[NaturallyHappy]

Can you call Cornell yourself for support?

[cayuse]

I’m not going to be much help here I don’t think, but I just want to say my pony has hepatitis (chronic) from an unknown cause, possibly from a blockage in his bile duct. He was tested for the hepatic parvo virus but was negative. He did did have a liver biopsy which showed some inflammation (or something, i forget). The vet put him on Denosyl for liver support, AKA Sam-E which he will remain on for life. His liver enzymes were very elevated at the onset and still remain slightly elevate a year later. I just wanted to give you a little history on my guy, just in case in helps in any way and send some jingles along. Liver issues can be tough.

[carman_liz]

They will only talk to my vet about my horses results they won’t talk to me is what the lab told me. They won’t even send me his lab results and I think my vet is sick of me calling and asking them to email me his labs every other week, ugh. I kinda want to call cornell and just talk to a vet anyways though!

[carman_liz]

His protein values are still high, so inflammation somewhere, but his liver levels are normal, that is the weird thing, but his kidney values are ‘low’ I’m on hold with the vet to annoy them and ask for more emailed lab results right now. What is “SAM-E”?

[carman_liz]

Thanks, it does really suck, and I’m already mentally doing the countdown the yrs thing… Currently trying to find hay that he will eat! I am going to buy a couple bales from yet another source tonight before grocery shopping…hay and people food in my jeep…ohhhh how my DH will be thrilled to find stems and stalks in our food…hehehe.

[cayuse]

Sam-E I believe it’s an amino acid that helps liver function. It is also supposed to help with depression in people.
I can’t remember, is he on anything to prevent ulcers? The picky eating makes me wonder how his gut is.

[carman_liz]

He has been on G-Guard but tapered him back down, we have done daily B12 injections, but he is off of that for right now, trying so hard to get him as back to a normal state as we can but it’s just wait and baby him along right now I guess?

[Ghazzu]

SAM-e is s-adenosylmethionine. It’s a fairly ubiquitous compound in the body, but the liver has particularly high amounts of it. It’s involved in several metabolic processes and is found in particularly high amounts in the liver (not surprising, since the liver carries out many metabolic reactions.)
While there isn’t any definitive information about precisely how, there is some evidence that it can be of benefit in liver disease.

Regarding the parvovirus–do you know if it is the recently isolated one associated with Theiler’s disease? (aka serum hepatitis in horses).

[carman_liz]

@Ghazzu, All I know is we sent blood in, and this is what came back… I just called there the lab won’t tell me anything, neither will the vet portion of their equine stuff. Said they can only talk to my vet… they wouldn’t even tell me what “CT Value” means as far as his numbers. They were one of the first places to develop this test, finding this virus is pretty new from what I can tell, why wouldn’t I want to talk to the lead ppl about it and what it means for my lil guy? Arrrggggg but his liver values still are normal but his kidney ‘values’ are low…??? I’m just being an impatient helicopter mom but it’s driving me crazy worrying now…

Pages from Spirit (1).pdf (454.2 KB)

[Ghazzu]

Ct value means “cycle thres hold”. It reflects the level of virus. Generally, the higher the Ct value, the less virus present.

[carman_liz]

So he has alot of the virus, pretty much around 75%? Does that mean that much is actually clinically affecting him? Or it is just there hanging out? Do I need to do a liver biopsy even though his liver values are good since the kidney values are bad? This is why I need answers!!! This is his bloodwork from this week besides the Cornell results, if anyone can tell me what part is the “kidney value” being low?Spirit CBC.pdf (840.4 KB)

[frugalannie]

I am neither a vet nor an MD, but I spent some years working in a human blood lab. I’m sorry that I can’t answer many of your questions but in humans, the BUN (blood urea nitrogen) and creatinine levels can be related to kidney function. If you do a Google search, you may get some answers.

Oh and maybe consider soaked hay or alfalfa pellets to get more calories into him.

[carman_liz]

Tried, he doesn’t like them… and his protein levels are high so alf pellets worry me. he still has some weight to keep him healthy, and I am going to go look at other hay tonight and I’ll chop it into smaller pieces myself this weekend if I have to, if he will eat it chopped… need spring and the grass to come in already. His BUN is low, so that would make sense then, thank you!!!

[Ghazzu]

@carman_liz

So he has alot of the virus, pretty much around 75%? Does that mean that much is actually clinically affecting him? Or it is just there hanging out? Do I need to do a liver biopsy even though his liver values are good since the kidney values are bad? This is why I need answers!!! This is his bloodwork from this week besides the Cornell results, if anyone can tell me what part is the “kidney value” being low?Spirit CBC.pdf (840.4 KB)

Not sure where you came up with a percentage for the parvovirus.
It’s the number of cycles of replication they need to do in the lab in order to detect genetic material from the virus. So, higher is better because that means they had to amplify it more times to even find it.
I don’t know enough about this virus or the lab’s methodology to comment further, but it looks like the other virusthey tested was deemed “negative” at a Ct of 45 or greater.

Liver values look pretty good, and I would be too worried about low BUN and creatinine–I’m more worried about high values for those.

I haven’t been following this case (if you’ve been posting about it), so I’m not sure what clinical signs you’re seeing.

Your DVM really needs to talk to you about the findings, and perhaps to Cornell as well.

[carman_liz]

That makes more sense to me once you explain the how they find the values thing versus a percentage, my brain understands that now thank you!

[cayuse]

Ghazzu, you are the best!

[erinmeri]

Not a vet, and I haven’t been following along… but a few things:

What did the vet say about the anemia? Low RBC, Hematocrit & Hemoglobin?

Also, the Total Protein is likely elevated because the globulins are elevated. Immunoglobulins play a part in the immune response, but they are proteins so elevations in them will often reflect in the protein being high. I wouldn’t necessarily be concerned about a high blood TP level and protein levels in your feed or forage being high. But I would consult your vet (or maybe @Ghazzu could confirm if I am correct there…)

Jingles!

[carman_liz]

Just that he is still mildy anemic and keep him on the redcell. When he first got sick a few weeks ago he basically had no immune system. Instead of his white blood cells going sky high to fight an infection, it was like he had none at all to even start fighting it.