When you might as well use Dr Google

[Bluey]

@Ghazzu

I spent my first two years in practice working on talking my clients out of tube deworming.

We used pelleted dewormers and tube deworming for horses that were easy to handle.
Some old ranch broodmares were half feral.

Our old vets used to tell me to distract the horse scratching it around the shoulder, withers and chest area while they messed with their head and nose and passed a tube very slick, then horses just stood there quietly while they pumped stuff thru the tube.
Horses didn’t seem to mind a tube up their nose, it was the inserting that they were uncomfortable with.
Very rarely we ever used a nose twitch, at most if a horse was wiggly we back it into a stall or pen corner so it would be still.
The years tube deworming was the best way made many vets very good at that.

When ivomec first came out, it was by injection only, as by mouth it would burn horse’s mouth, plenty tried that.
Our vet was so relieved, it was way easier than tubing.
First time he came and used injectable Ivomec, had about a dozen broodmares, another dozen youngsters and another of horses in training and older, we had one weanling get very sick, but she made it.
Right after that the paste came out, safer yet and even better than the injectable.
The times, how they have changed …

[MsM]

Those of us who are older may remember the “not so good old days” when there was no paste wormer. You could buy a packet of granules and try different strategies to get your horse to eat it - usually unsuccessfully. Then once a year the vet came and tube dewormed.

When injectable ivermectin was introduced, there were a lot of horror stories and rumors about bad side effects and horse deaths. (Most were stories, but there were some unexpected problems and deaths. My vet at the time was rattled since he had a young, apparently healthy horse drop dead shortly after) So there were a number of people who wanted to continue tubing even after ivermectin paste was available.

[ThreeWishes]

@MsM

Those of us who are older may remember the “not so good old days” when there was no paste wormer. You could buy a packet of granules and try different strategies to get your horse to eat it - usually unsuccessfully. Then once a year the vet came and tube dewormed.

I remember the granule packets and the yearly tube worming. Those granules must have tasted like complete garbage. Even mixed thoroughly with the gooiest crackerjack like sweet feed barely elicited a sniff. And my sister’s mare would show her distaste by taking an enormous poo in her bowl. Lol

[Bluey]

Once we feed a new kind of deworming pellets.
We had a dozen weanlings in pens by the barn along with some horses in training.
Wild turkeys roosted in the many trees around the pens.
Next morning there were dead turkeys all over and horses running around the yard and assorted mixed ones in different pens.
Horses were ok, fences were ok, horses must have jumped in and out of pens.

Vet was called and said turkeys must have eaten some of the pellets and that killed them, raining dead turkeys into the horse pens.

[trubandloki]

@Bluey

I am thinking some wires were crossed there, a misunderstanding happened, as there is no vet that would not have known that horses do get infected from all kinds of insect bites, including with Lyme.

My guess is that this poster is stuck about 20 years ago and has not moved forward.

Yes, when Lyme first started there was lots of theories on it in horses.
Things have evolved.
Tossing out what happened back then as an excuse to not test and over medicate is kind of silly.

I am laughing at the discussion on tube deworming.
When I bought my first horse, back in the dark ages, I was told by people that I had to have the vet out to deworm her. So I called up the vet and they so politely explained that I could just buy the over the counter paste.
Oh how things change.

[Ghazzu]

Up until the '70’s or so, the only effective deowrmers were things like dichlorvos and other organophosphates, and carbon disulfide (for bots).

The OP’s tasted terrible, and it was hard to get the horses to eat the granules. I recall withholding evening feed so the horses would be that much more hungry, and then going down the aisle with a tub of Vicks’ to smear in their nostrils at the TB farm I worked on.
OPs also have a narrow therapeutic index (difference between effective dose and toxic dose.)

And the carbon disulfide was, as stated above, fairly caustic to the esophagus, hence the tubing. (Plus it smelled awful–reminded me of rotting pumpkin, for some reason.)

The original injectable ivermectin for horses had a significant risk of clostridial myositis, so was withdrawn in favor of the oral formulation.

[pluvinel]

@TwiSedai

Curious, what do you mean by “tube deworm”?

In the beginning…like back in the dark ages…perhaps before you were born…vets ran an NG tube to administer anthelmintic meds. This was normal protocol to administer wormers

[Paks]

The tests came back. The trainer nailed it. Both horses are positive with numbers that show it was caught early. I asked when to do a follow up titer. Response was well we don’t like to chase titers instead we rely on the symptoms going way. We already have signs of both horses feeling better. Tripping frequency and severity down about 80% and husband’s horse is moving out again and cantering.

[JB]

that’s great that you have an answer!

I hope you will still understand all that has been said about treatment without a diagnosis for this particular disease.

I WOULD re-test about 3-6 months after finishing the meds.

I also start to wonder if there are different sub-strains of Lyme that generally cause X symptoms in one area of the country, Y symptoms in another, and that’s part of what makes diagnosing via symptoms so unpredictable.

[Paks]

I found it interesting the vet didn’t want to diagnose via symptoms. ( I was always going to do the titer to confirm). But prefers to rely on symptoms to determine if treatment was successful and not do a follow up titer at all. I’ll take your 3 to 6 months for a titer advice. I want to track that. My trainer has titers done with spring shots to keep ahead of things if needed.

Another factor is this my horses trot, foxtrot, flatwalk, run walk, rack, step pace and true pace. It takes some one who is used to these types of horses to see what is going on and determine is a horse is off or just in continuous transmission mode. And most of the horses he works with are regularly on trails and camping in the woods. Similar to my horses with a higher incidence of tick exposure and tick born diseases. Hence my giving a lot of credence to my trainer’s opinion.

[trubandloki]

@Paks

I found it interesting the vet didn’t want to diagnose via symptoms. ( I was always going to do the titer to confirm). But prefers to rely on symptoms to determine if treatment was successful and not do a follow up titer at all. I’ll take your 3 to 6 months for a titer advice. I want to track that. My trainer has titers done with spring shots to keep ahead of things if needed.

Someone else mentioned this, if you love how your trainer does things, then maybe use their vet.

Using testing to determine what is wrong, but watching the symptoms as a means to determine if treatment is working seems like a very logical way to do things to me.

You know what you are treating now. How the horse reacts will let you know if the treatment is working.

[JB]

@Paks

I found it interesting the vet didn’t want to diagnose via symptoms.

It’s not terribly interesting, because as many said, those symptoms can be caused by a LOT of things, some are diseases (EPM), some are not (hock/si/stifle/hoof)

@Paks

But prefers to rely on symptoms to determine if treatment was successful and not do a follow up titer at all.

That isn’t out of line at all. Titers are just an indicator of an antibody response. They don’t dictate symptoms. And with Lyme, it’s likely you may never get a 0 again.

What were the 3 numbers from the test?

@Paks

Hence my giving a lot of credence to my trainer’s opinion.

Nobody said your trainer’s opinion wasn’t worth anything. The ONLY issue here was starting an antibiotic based on “well your horse looks like what I have seen” without any proof it was, for a disease that isn’t life or death in the 5-ish days it takes to get test results.

[MsM]

My horse just finished treatment for Lyme. Diagnosis was made on the basis of titer plus symptoms. His titers were not so high that we would have treated in the absence of symptoms. Vet recommends doing a titer in a few months to see where things stand and what might be baseline for him going forward.

[Paks]

My trainer is based 7 hours away. He comes here once a month. It’s too far to use his vet.

[trubandloki]

@Paks

My trainer is based 7 hours away. He comes here once a month. It’s too far to use his vet.

It might be worth asking your trainer if their vet can recommend a vet in your part of the world.

[beowulf]

@Paks

I found it interesting the vet didn’t want to diagnose via symptoms. ( I was always going to do the titer to confirm). But prefers to rely on symptoms to determine if treatment was successful and not do a follow up titer at all. I’ll take your 3 to 6 months for a titer advice. I want to track that. My trainer has titers done with spring shots to keep ahead of things if needed.

That’s because the prevalence of symptoms is not based on a titer result. It takes several months for the ABX to really work and for antibody count to reside AFAIK. Most doxy regimes are 2 months, oxytet and tetracycline can be a few weeks to a month - there is no point in retesting until the full treatment and recovery has run its course. Your vet is being budget conscious and considerate of your time and money when she says this.

Retesting 6 months from date of positive test result is standard practice in my area. My vets don’t even like to do 3 months, but they will if symptoms return or never abated.

Did it take until your trainer showed up for you and husband to notice these symptoms? Are these horses not ridden regularly, or is it just that the work is harder when trainer is around? This is a judgment free observation, do with it what you will - maybe ask your trainer to show you what he sees so you can find these problems sooner, especially if he is remote and only comes once a month.

One thing I thought worth mentioning since a few people seemed confused: vets will prescribe ABX if there is a fever or active infection without waiting for test results - both of which can happen with tick borne diseases like Lyme, Anaplasmosis, etc. Absent a fever I have never seen a vet prescribe ABX without waiting for results first.

[JB]

@beowulf

Retesting 6 months from date of positive test result is standard practice in my area. My vets don’t even like to do 3 months, but they will if symptoms return or never abated.

Good point on the earlier testing, I’ll remember that.

@beowulf

One thing I thought worth mentioning since a few people seemed confused: vets will prescribe ABX if there is a fever or active infection without waiting for test results - both of which can happen with tick borne diseases like Lyme, Anaplasmosis, etc. Absent a fever I have never seen a vet prescribe ABX without waiting for results first.

100% Several of us (probably even you at some point) mentioned this at least once. I don’t even think fever is common with Lyme, but yes, if there IS a fever, especially sudden onset (which is more likely with anaplasmosis) then without something else suggesting it’s not a tick disease, starting doxy asap is an excellent idea. A fever DOES suggest that waiting 5 days may not be a good idea.

What’s also necessary to point out is that if a horse IS starting to show symptoms, and it IS Lyme, then whether you use doxy or mino depending on whether it’s acute infection or chronic. Of course you can start with doxy and switch to mino if you get the results which show chronic, there’s no real harm there if you started before getting results. But you still shouldn’t start UNTIL you have that titer (barring fever) because you don’t KNOW that it’s even Lyme

[Paks]

I didn’t ask her to redo the titer right away. I asked her when after the treatment should we retest. She said she didn’t believe in retesting unless the symptoms didn’t go away. As far as noticing symptoms. Yes I noticed the tripping in my horse when it started and that his gaits weren’t as true and his lateral work was resistant. He was at the end of his shoeing cycle so I suspected that as a possibility. But tripping continued after being reshod. The trainer was coming on the weekend and I work 10 hour days so not much time. My husband’s horse was just slower which we mistakenly thought was just him finally listening. (husband is not at a level where he can tell which gait his horse is in and getting him to do ring work is a bit of a trial, yes horse is a saint.). If the trainer wasn’t coming I probably would have contacted him about exercises etc and sent a video. I even had a vet who had gaited horses herself who wouldn’t comment on the shoes my horse came with and told me to ask the trainer who I was seeing for the first time that weekend. It’s a definite rare skill set.

[Janet]

@Paks

I consider the extremely slight risk of antibiotic resistance developing in two horses with no history of antibiotic treatment in the past 7 years

Antibiotic resistance has ABSOLUTELY NOTHING to do with the animal (in this case horse) receiving the antibiotic. It has to do with the population of the “bug” (in this case the bacterium Borrelia burgdorferi) the antibiotic is intended to kill.

Since the antibiotic is NOT intended to kill the horse, it makes no difference whether, or how often, the horse has been treated with antibiotics.

It makes a BIG difference how often the population the antibiotic is INTENDED to kill (bacteria in general, not just the bacterium Borrelia burgdorferi) is treated.

If your horse does NOT have Lyme, and you give it antibiotic, you risk making OTHER (possibly much more deadly) bacteria even more antibiotic resistance.

I have no medical background, but even I understand that much.

[Paisley_Pony]

I think it might be time to take a step back and realize that the OP posted here because she was frustrated and concerned about her horses, has had some devastatingly faulty family medical care, and simply needed a group of equine enthusiasts to listen. Veterinary medicine at any point in history is not an exact science (as has been demonstrated by the memories of some posters in this thread). It would be wise to refrain from treating people with opposing viewpoints as if they are ignorant or intentionally obtuse because as the science advances, some of the things that seem to be very clear today according to available research, may look completely different in the future. Sympathy and tact, however, never go out of style.