What is going on? Lyme? Help

[Loudlaugh12]

Hi all,

I’ve posted a few times about my horse and have gotten amazing feedback. The clinical picture keeps looking different and I’m in tears tonight trying to figure out what has my boy so upset.

Horse has been having what really look like panic attacks. Very inconsistent in terms of what energy you get from him on a given day. Sometimes he is great, sometimes he is so reactive he starts quivering. He goes from very quiet and chill to suddenly set off by something that shouldn’t warrant the degree of reaction. Trying to figure out why. It’s completely out of character.

Context:
We moved barns 4 months ago. He is a worrier type but very safe and sane. Knew he had ulcers (I have a whole other thread on that here), and for last 2.5 months have been treating glandular and non-glandular ulcers with GG, sucralfate, and misoprostol. They are not healing. Glandular ulcers on scope 3 looked worse than scope 2.

A few weeks after moving my poor guy got anaplasmosis. Classic presentation. Was treated literally minutes after he spiked a fever and symptoms resolved quickly.

Two Lyme titers (Cornell) taken 2.5 months apart are not zero but low enough to indicate treatment. However, horse has not only this weird spooky reactivity but skin sensitivity to the point that moving a cooler on him makes him kick out. At first I thought it was just from freshly clipped fur, but now I’m suspicious.

Horse is 100% sound. Did have full lameness work up and some injections 2 months ago. When he’s good, he’s more rideable and balanced than ever and feels great. He’s building up top line and muscle lost when ulcers flared up. I’d question EPM but zero neurological issues in terms of gait/balance/soundness. He has never had a soundness issue other than SI and hock injections helping him be more comfortable.

Diet is low sugar, low starch, grain-free.

I’m leaning toward this being Lyme even with low antibodies. The ulcers were long standing and I also wonder if we need to try an antibiotic for them next.

Thoughts?

[skipollo]

What are his #s from the Cornell test?

I’ve had to deal with Lyme with my horse, he didn’t have the weird skin sensitivity or spookiness but he was extremely reactive and prone to blowing up under saddle, and like your horse it would change every day. Sometimes he would be great, and sometimes he would have a soaked in sweat, trying to bomb off meltdown over a crossrail.

I treated him with doxy, and he was a new horse. He’s never been a super ulcer-y horse prior to this, but I do think being on antibiotics for a long time kind of upset his digestive system. In early spring of 2020, I did a second round of doxy which transitioned to a month of SMZs due to an injury, and he developed ulcers from that. I did get them under control, but it took several months of treatment.

It wasn’t clear in your post—did you treat for Lyme yet or just test?

[Loudlaugh12]

Nope haven’t treated for Lyme. Titer was too low to indicate it but we’re going to talk to vet about the whole picture.

[frugalannie]

There is a horse in my barn whose sole Lyme symptom is hypersensitivity. We know when he’s having a recurrence because he gets very tense and jumpy. A course of doxy fixes him, and after years of this (and feeding him special stuff like olive leaves) he has stopped it so far this year. I give his owner tons of credit for catching it quickly each time and his vet credit for understanding what’s happening and treating it.

Around here we start doxy and while waiting for test results, knowing it could be one of a bunch of other tick borne diseases (Babesia, other Borrelias etc), most of which doxy treats. Just be aware that doxy has some anti inflammatory effects so while it may make your horse better, it’s not because it addressed an infection. But as long as it works, I’m OK with it for my horses.

[Loudlaugh12]

What are thoughts about treating with doxy when Lyme titer is technically too low to indicate treatment but horse is clearly showing symptoms?

[Critter]

My gelding started having panic attack/random outbursts (normally a super calm and sweet guy). He also had some mild stifle lameness. Lyme titer was like yours - low…but we live in an area that many horses will have a low titer due to chronic exposure.

My guy ended up being diagnosed with EDM. He didn’t seem neurologic until right before we decided to euthanize…until then it was all behavioral and intermittent lameness.

Given your guy had anaplasmosis, I would go for the course of Doxy to see if it does help. I would also see about getting more aggressive with treatment for ulcers since you know the ulcers are still an issue…I had one get very, very reactive with ulcers.

[IPEsq]

I’ve also seen that kind of intermittent crazy with a neuro issue. In the most pronounced cases, it was spinal compression from an old neck issue. Maybe it’s Lyme for yours, maybe something else. But I would guess a neuro component, whether from infection or injury or disease. I would doubt the ulcers in his particular case since those have been going on a while and this behavior is new.

[Loudlaugh12]

IPEsq, would this kind of spinal compression/neck issue fail to cause changes in performance/movement…? The thing that has us heavily considering Lyme is that when this horse has been good (and good as in between reactive episodes) he has been so very soft and rideable, and flexible with zero resistance. The puzzling thing is that even with this going on, training has stuck and he’s been riding better than ever on the good days (and we’re talking behavior that’s only been going on for 6-8 weeks).

I also forgot to add another piece to this: he’s only 10 but blood glucose was a touch too high and vet recommended testing for IR and Cushings. Can this cause these symptoms…?

[hut-ho78]

Has anyone suggested testing for PSSM 1 or 2?

[Loudlaugh12]

I think PSSM is interesting to consider, but I’m not sure he fits it. He’s never felt stiff, no lameness, no obvious tying up. He’s typically nice and loose. He did resist more exercise after a break but that disappeared when we treated the ulcers.

He has tensed his abdomen lately but he also did that when he developed the acute anaplasmosis—eerily similar to what he’s doing now.

But, even if it is PSSM, he’s essentially on the diet for it: copra, alfalfa pellets, timothy pellets, and hay, with a ration balancer. He’s also moving more now than at previous barn (work is more consistent and he’s being lunged on non-ride days) and he’s always been a horse that can be ridden after a day or two off. So even if it is PSSM, only thing to ensure is that he’s getting consistent exercise, and building him up slowly is the point of the program he’s in.

I figure, if we treat presumed Lyme and we’re wrong, the antibiotic might help the ulcers (same tetracycline class has been floated as something to try next for stomach), and worst case, we’ve done him no real harm of it is PSSM, given the above.

[IPEsq]

That is how it started with these other horses. Then there was mild lameness that shifted and didn’t respond to direct treatment. But if I remember correctly, that was months after the intermittent crazy started for the one I worked with personally. The other horse had a previous neck injury and then did start looking neuro up front. Anyway, the one I was riding was a very easy horse normally. One you could ride once a week or less and be sane. He could also start out a ride fine then bolt out of the blue and come totally unglued after that. Very much not his normal character.