Unknown neuro issue, horse cannot eat! - FINAL UPDATE :(

[icarus]

My horse is exhibiting signs of a progressive neurological issue. 6 yr old TB, bought directly off the track in October 2014. No health issues until mid-July 2015.

It was at that point that he choked while eating grain. We thought it was because he was a pig so fed him more carefully.

*** Long post, if you want you can skip to the end ***

Choked 2 weeks later on soaked grain. Scoped, no issues. Changed feed and started making Equine Senior Soup (like SOUP soup).

Choked 3 weeks later. Scoped again, no issues found. Pulled blood for EPM since my vet has seen instances in past with EPM and dysphagia (difficulty swallowing). EPM blood test came back in the moderately high range, started on Marquis. Noticing significant muscle loss (symmetrical) along top line.

Choked 2 weeks later on literally a handful of soupy grain (just enough to add supplements to support neuro/immune issues). Taken off grain completely. Blood test for Lyme, came back negative.

2 weeks later, noticed horse had trouble swallowing water. Also, starting to act ataxic (NO previous instances, passed initial neuro exam prior to starting Marquis with only minor neuro defecits), fatigues easily, unwilling to do any work. Since he had not been stumbling or weak throughout his treatment, he had not been ridden other than 20 min walking trail to work and help build up his muscles. From this point on, he has not been ridden.

One week later, have equine neurologist out from UPenn. He now has SIGNIFICANT deficits, including failing tongue test and front and hind end ataxia. Spinal tap - comes back negative for both EPM and Lyme.

Next day, horse has bad colic. Refluxes out of nose, when we tube we bring up a large amount of old, sour food. Vet comments “its almost like whatever neuro stuff he has is progressing to the point where it may be shutting down his GI tract”. Ready to euthanize, horse looks interested in grazing when we take him outside. Decided to turn out and “see how it goes”, fine two hours later. Started on meds for Lyme just in case test is wrong.

4 days later, chokes on hay (which he has previously never had issue with). 3 other horses on farm now showing neuro symptoms so we start thinking toxin or virus as opposed to tumor/esophageal stricture/etc. Blood test for lead comes back negative. Cannot come up with another environmental toxin that has neuro and dysphagia as symptoms that manifest itself over such a long period.

In the last day or so he is becoming increasingly dull. He is still alert and always has an appetite but will sometimes “space out” or completely ignore whatever is going on and then seems to come back into himself and pay attention.

It is most definitely getting worse and I am 100% out of ideas!!! My primary vet and the neurologist are also unsure as to the next step and I have trouble being ok with the idea of “wait and see” in this instance since he’s getting worse.

My biggest issue is the difficulty swallowing! As of now the only thing that he hasn’t choked on (yet) is grass. But when winter rolls around I don’t really have that option and I fear that (if he is still alive) then euthanasia will be the only option at that point.

I need any and all input or suggestions: HAS ANYONE HAD A HORSE WHO SHOWED NEUROLOGICAL SYMPTOMS WITH DIFFICULTY SWALLOWING BEING THE MOST PROMINENT??

Sorry, that’s a lot, I know. To review:

Signs - Dysphagia, hypersalivation, muscle loss, gradually increasing ataxia, dulling mentality, easily fatigued. All over the span of 3 months (and counting)

Scope showed nothing (and also doesn’t explain neuro issues)

Tested negative for EPM, Lyme, and lead poisoning.

Has been vaccinated for Rabies, Botulism, WNV, EET/WET, and PHF. Horse has only been off farm once recently prior to first choking incident (paper chase, no contact with outside horses and did not eat anything while there).

We are trying the Botulism anti-toxin tomorrow as a last resort because a lot of the symptoms fit BUT that usually manifests in days (definitely less than a week and never over the course of 3 months).

I am just completely out of ideas and will take any and all suggestions.

Please

[Cayusepapoose]

where are you located?

[ladipus]

Yikes …what a whirlwind …my first reactions were : botulism, tetnus, west Nile, herpes virus…Epm, lyme…maybe perhaps send blood to Dr Ellison at Pathogenes…she’s a specialist with Epm and lyme and has more specific tests thans UC Davis …she recommends Orogin-Decoquinate/levamisole -a lot of horses respond better to that than Marquis or Protazil …could there be an obstruction causing the choke??

what kind of hay? Could there be the possibility of blister beetle??

[StormyDay]

Holy crap. What grain are you feeding? Is it the same in all the horses? What is the same among all the horses having the issues? Are you on well water, and if so, have you tested it for imbalances and for any fungus?
Are all the horses on the same hay? Have you tested the hay? What is in their pasture? Make a list of every plant, rock, stream, puddle in that pasture. It may be something the horse is ingesting. Is it possible the horse has been exposed to any tropical horse diseases? If so, test for those.
If the other horses’ symptoms are possibly overactive imagination, then I would inclined to say your horse has a brain or upper spine tumor. If the other horses are definitely showing similar symptoms, then I would suggest finding a barn with no other horses at it and moving them there to see if the symptoms improve.

[Calamber]

Mold poisoning, not necessarily the hay, the environment, some kind of leakage, seepage anywhere? Wet spots in the walls, overhead, ground? I agree with Stormy Day, move the horses.

[BuddyRoo]

Wow. I am so sorry. I commend you for doing all that you’ve done thus far.

I like to know what i’m dealing with. So I’m one of those who will go pretty far (as long as critter can tolerate) to find answers. So with that in mind, would your vet/neuro vet be willing to reach out to others? Like give a call over to some universities? I’m near Michigan State University and they routinely do consults over the phone. CSU would be another to consider.

On the flip side…and I hate to be saying this because I know you want an answer…but having to euth your horse in a crisis might make for an easier choice, but not an easier situation overall.

It might be time to go that route before he has a crisis. I wrote this poem for a fellow COTHer several years ago. Maybe this will resonate with you as you work towards a solution but also consider an end.

This It Be Right

Better a week too soon than a moment too late, they say.
Better while the eyes still sparkle than wait til they dull.
Better while the good days outnumber the bad.
Better when it’s hard for us than hard for them.

It will never be easy for us

As stewards of these great creatures
We have the opportunity to give the one final gift

Peace.

We grant them peace in lieu of our own.
But granting peace, the end
When we wish for more time?
Eventually becomes a gift to ourselves.

Knowing that we gave a final gift to one we cherished,
Knowing it will leave an empty spot in our hearts,
Doing it anyway.
Because we DO love?

That is what makes us human.

For the love of my horse, I know who I am.
And I know love.

This it be right.

[Calamber]

But Buddy Roo, other horses are getting sick so this be not right.

[DancingArabian]

Pharyngeal paralysis?

http://www.merckvetmanual.com/pethealth/horse_disorders_and_diseases/digestive_disorders_of_horses/pharyngeal_paralysis_in_horses.html

[BuddyRoo]

[QUOTE=Calamber;8352232]
But Buddy Roo, other horses are getting sick so this be not right.[/QUOTE]

But if they can’t figure it out, better to euth than to let them die in crisis. Wouldn’t be my first choice as I said…but they’re going to have to reach out and broaden the professional reach because this is just…not standard.

[Calamber]

Fumonisins

Horses and ponies are very sensitive to, and face considerable risk from, these Fusarium mycotoxins, which are found in grain and ready-mixed feeds (especially those containing maize). This toxin causes a disease called equine leukoencephalomalacia (ELEM) – which basically means the brain develops lesions or holes. This results in muscle tremors, poor co-ordination, loss of the swallowing reflex and depression – rather like an equine form of Parkinson’s disease or dementia.

Fumonisin B1 at a concentration of 10 ppm has been found to be associated with leukoencephalomalacia. The clinical signs associated with the neurological form include apathy, drowsiness, pharyngeal paralysis, blindness, circling, staggering, seizures and eventual recumbency. Death usually follows within 2-3 days. Outbreaks of ELEM typically occur sporadically from late autumn to early spring. Maize or corn screenings can be heavily contaminated and so should not be fed to horses at all.

Concentrations of 5 ppm FB1, FB2, FB3 or higher can cause colic and even death in horses and feed containing more than this level should not be fed to

I wonder if very low levels can cause it to draw out the process longer?

[PeteyPie]

Some ideas:

-Tetanus
-Botulism poisoning
-Surra/Chagas Disease/Trypanosoma evansi or similar (in humans, American trypanosomiasis)
-Rabies

The symptoms of Trypanosoma are a little different in horses (compared to Chagas in humans) but there are wasting and neurological effects. Don’t know what part of the country you are in, but Chagas is now in the southwestern states. The equine variant, Surra, is listed as an emerging disease. There is a test for it.

[Cherry]

Well said, Calamber!

I have nothing to add at this time, icarus. I need to do a little research before putting in my two cents! But I want you to know how sorry I am that you are having to go through this with your horse… Been there, done that–& have the T-shirt! Nothing worse than a sick horse or pony!

You have my support! PM me if you need to… I may not have any info for you, but I am always willing to listen. I’m sending you the strength to get through this! :yes:

[BilyandJack]

Are all the horses on the same hay, feed and in the same pasture? Where are you located? What feed and hay do you feed? What’s your water source? Is it tested regularly? Is there a stream or any body of water in the pasture?

[maunder]

I’m so sorry you and your horse are going through this.

I have a little miniature horse that has neurological issues that definitely involve his tongue and head. They are not as severe as what your horse is experiencing, however I think that they will be the end of him eventually.

I was told that he was born with narcolepsy. I got him almost two years ago and he had been confined to a teeny stall and had developed a circling habit, which certainly didn’t help his issues. Since being with me he has graduated to a full free-choice in or out lifestyle and is quite happy. His circling habit is mostly gone, although he will dive to the right if he wants to turn.

The mouth issues are not as pronounced as what your horse has but he has a very weak tongue. I can hold it between my thumb and first finger and all he can do is weakly pull it. He seems to have no ability to move it side to side and there is no strength. As a consequence he also will choke on food, quid and gets food stuck between the teeth and the side of the face. It was so bad when I got him that he had a hole in the side of his face from accumulated rotting food. I have to put my hand in his mouth to clear the gob of masticated food almost daily, and I swirl his mouth out with a rinse.

Unlike with your horse he doesn’t seem to have too much problem with swallowing, although I watch him eat and he does ‘think’ about what he is doing when he swallows. He gets a sloppy mash of grain and beet pulp. He eats hay, and he does nibble at grass. He has to open his mouth quite wide sometimes with chomping motions. I have my vet check his mouth and do dental twice a year.

He has recently had a minor colic issue. When I got him he had a severe cow pat type manure with squirty diarrhea, but I think that was related to stress and the fact the former owner was giving him enemas and suppositories (what the heck?!). That has completely cleared up with a gut supplement and a good lifestyle.

He will zone out like your horse. It’s like the light has gone out. My little guy is 14 now and we take it day to day. He’s just a lovely little dolly of a horse. It’s so much easier when he is only 33 inches tall instead of being a full-sized horse. If he was a full-sized horse he’d probably be too dangerous to himself and me to keep.

I feel for you, OP. I wish I had a solid diagnosis to add but we really don’t know quite what it is.

[fordtraktor]

What other horses are getting sick, calamber? I read OP’s post three times And she only discusses one horse. I just don’t see what you are talking about.

[arapaloosa_lady]

[QUOTE=fordtraktor;8352358]
What other horses are getting sick, calamber? I read OP’s post three times And she only discusses one horse. I just don’t see what you are talking about.[/QUOTE]

4th time’s the charm? The OP mentions 3 other horses on her farm getting some neuro symptoms, leading to a concern of an infectious or environmental etiology.

I agree with the suggestion (if possible) to move him to a quarantine area by himself at a new facility with a new environment and new feeds. Have you been running repeat bloodwork? It would be strange to see normal bloods over a 3 month period if it were infectious. Have you sent out any blood for toxin screens? It’s hard when you don’t have any idea what could be the cause & you’re just throwing money at the problem hoping you find the right answer.

[AKB]

If you euthanize him, get a necropsy done. If he has a brain tumor, you will know that nothing could have been done. If he has something else, it might be important for the care of the other horses.

It is hard to have a horse with an unexplained, serious, disease. I hope someone can find some answers for you.

[Chall]

[QUOTE=Cayusepapoose;8352223]
where are you located?[/QUOTE]
"One week later, have equine neurologist out from UPenn "

[fordtraktor]

[QUOTE=arapaloosa_lady;8352372]
4th time’s the charm? The OP mentions 3 other horses on her farm getting some neuro symptoms, leading to a concern of an infectious or environmental etiology.

I agree with the suggestion (if possible) to move him to a quarantine area by himself at a new facility with a new environment and new feeds. Have you been running repeat bloodwork? It would be strange to see normal bloods over a 3 month period if it were infectious. Have you sent out any blood for toxin screens? It’s hard when you don’t have any idea what could be the cause & you’re just throwing money at the problem hoping you find the right answer.[/QUOTE]

Thanks, not enough coffee I guess, I just wasn’t processing that! :dead: What’s going on with the other horses now, OP?

[Bluey]

Since other horses are affected, consider getting that horse over to some University clinic, where they can do an exhaustive series of tests and if euthanized, run all kinds of samples.

It may save the other horses just starting to come down with whatever it is, if they find a cause and can address it so no more go downhill with whatever it is.

I expect your vets have already suggested that?