UPDATE! Strangles and EPM -High fever, food coming out nose... Help!

My niece’s horse is at the vet hospital right now and everyone is stumped. Wondering if the brilliant COTH hive mind has any ideas.

This is a 3-year old mare otherwise healthy. Vaccinated a month ago for West Nile and 5-way. Moved to a new facility across the state to Western Wisconsin the following week. She’s been there for three weeks and was healthy/happy. Out in big pasture with creek through it and other horses, who are all healthy.

Four days ago presented with hives and fever. Banamine, cold-hosing brought down fever and reduced hives. The next morning fever jumped to 104 and hives still present. Vet came out and tested for anaplasmosis, erlichia,(both came back negative) and put on IV tetracycline. Fever reduced but when it was high, mare was wobbly and had water coming out her nose when she drank.

Next morning fever gone, felt better and everything seemed good. In the afternoon fever jumped back to 105 so she was hauled to the emergency vet. Neuro exam was fine, she was put on different antibiotics (can’t remember which kind), anti-inflammatories. They scoped her and did an ultrasound and all good.

Her fever has been decreasing and no more wobbling/neuro signs. She’s eating and drinking but they kept noticing her nose was wet periodically. This morning they took her out to graze and she would cough, then sneeze, then grass came out her nose. Rescoped. I had them check guttoral pouches, esophogus, swallow reflex, and for inflammation. All clear but a tiny bit of mucus in one pouch. Oral exam clear.

Tomorrow we test for EPM… but is there ANYTHING you guys can think of that would cause this? Her WBC was slightly elevated but everything else has come back normal. She’s alert, happy, eating and drinking (though grass coming out nose but not hay/grain) My poor niece. This is her very first week away from home at college and she’s just a wreck, as you can imagine. If anyone has experience with something similar, or ideas please jump in. Thank you!

Two similar but not quite. One was a reaction to the West Nile shot. It produced symptoms similar to West Nile. Horse was ok in a few days. That is kind of what you’re describing.

Second horse had colic symptoms. He was actually choking because he had started gulping his pellets and not chewing. Had food coming out of his nose. I don’t think that would be it … other than she is in a new herd. Is she competing for food? That wouldn’t explain the boomerang fever.

No bites evident anywhere on her? Keep us posted.

No bites or injuries evident. They were thinking possibly West Nile initially but vet said she would be much sicker if that was it. It’s her first West Nile vaccine a month ago so possibly a reaction to that? It’s just so odd and nothing is making sense. :frowning:

Is the food coming out of her nose because of her neurological problems? Humans often have difficulty swallowing when they have a neurological problem. Has she had rabies vaccine? I wonder if the one dose of West Nile vaccine was too late to offer protection. Have they checked for EHV?

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Aspiration pneumonia…food coming out nose, high fever. But neuro symptoms I don’t know? Scary symptoms your describing. Good luck, I hope they find answers very soon!!

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Botulism?

Good luck, sounds very scary!

Was just thinking that as well…hope not!

I’ve never heard of botulism causing a fever, though-- and I would expect it to have progressed quite a bit by this point.

Cleft palate?

Potomac Horse Fever? I don’t know how the nose/food deal plays into that.

3 weeks post-vaccination is really too long for that to really be an issue. Did she by any chance get vaccinated for strangles?

I can’t think of anything related to Potomac that would cause food to come out the nose. And the antibiotics would at this point have hit Potomac pretty hard so the fever coming back says more virus to me. I have seen horses who have difficulty swallowing due to inflammation from a virus have food/water come out the nose.

I’m not sure about strangles vaccine but they did rule that out. They did a thorough exam of mouth and scoping of everything and it all looked good and swallow reflex was perfect. She was eating hay and grain fine, but it’s water and grass that are coming out her nose. This is sooooooo weird. At least she seems stable and can eat, but I’ve never in all my years encountered anything like this.

Did they scope down to the larynx? A paralyzed open flap can cause food and water to come out of the nose–it’s a side effect of tie back surgery. Should​ be easy to scope and see if both flaps are moving as they should.

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Anaplasmosis? I have not had experience with it but IIRC, it presents with a sudden onset high temp. Please update when you can, and jingles for the horse and for all who love her.

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Did they test for fungus in the guttural pouch? All the symptoms are very similar to my horse who was diagnosed with it. It took 3 different tests to actually diagnose the fungus. The infection was at the very tip of one pouch and extended behind the pouch…seen via MRI

The infection damaged the nerves responsible for swallowing and he would have feed and water come out his nose…at one point his balance was affected.

I really hope its not that but i would insist they run lab for fungi…

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I had them check the guttoral pouch but it looked clear. Did yours look clear or was there an issue on a scope? They said it was fine and didn’t do a biopsy.

For my guy it was complicated because he did have a bacterial guttural pouch infection which was clearly visible on thr scope but it was masking the real issue. Im not 100% if the mycosis was ever truly visible through the scope…
I would have to hope the vet hospital would rule out mycosis but stuff does get dismissed and the presentation can vary. My horse was unlike any they ever saw before and treatment was a bit of a guessing game.

Did they perform a head xray or mri? A broken or damaged stylohyoid bone might interfere with the nerves that run through the head and guttural pouch and potentially affect swallowing…i know originally with my horse that was on the list of possible diagnoses.

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Not to argue with a vet (ha ha) - but, my guy had a reaction to the West Nile shot. It wasn’t as bad as your horse. So, your vet thinking it would be worse, if it was a reaction, may not be correct. My vet said he contracted a mild case of West Nile.

UPDATE!!! She came back positive for strangles AND EPM. What the what. She’s still at the hospital but stable, eating, drinking, etc. We are doing strangles quarantine and now discussing EPM treatment. I know we treated a horse for EPM successfully with something cheaper than Marquis once but is there anything you guys have experience with? My poor niece and this poor horse!! It’s unreal!

Well pewp!

I’d guess contracting strangles allowed the EPM protozoa to take hold. Most horses have been exposed, many theoretically harbor a latent infection just waiting to be “activated” by a stress. Moving and contracting strangles is certainly a huge stress!

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