Page 86 - December 2021

EQUINE HEALTH
In late December, he went lame and was treated with low dose bute for 5 days. “Then on December 31, I received a call from the barn manager telling me that Cooper was lying down in his stall, not eating, and running a fever. By January 4 he had diarrhea, so he was rushed to Palm Beach Equine hospital, where the initial diagnosis was colitis. Ultrasound later confirmed that his colon was enlarged, and he had right dorsal colon ulcers,” says Debra.
The horse was given fluids and plasma, since a blood test showed that his protein level was very low. A catheter was inserted into his jugular vein to administer the fluids, but it collapsed, and the opposite vein was used.
Further treatment included gastrogard paste and sucralfate for ulcers, Misoprostol (a synthetic prostaglandin), metronidazole (an antimicrobial drug) and a probiotic, in an attempt to help his gut function, get back to normal. Cooper was discharged from the hospital after 4 days on these drugs.
“Later that same night, I checked on Cooper and noticed that his head and neck were significantly swollen. He was rushed back to Palm Beach Equine where the diagnosis was thrombophlebitis (blockage by a blood clot)
of the right jugular vein. He was treated with mesotherapy (injection of medications into the subcutaneous tissue with tiny needles), and the veterinarians assured me that he would show signs of improvement by morning. During
the night, however, the left vein also became blocked. The right vein was 100% occluded and the left was 50 to 60% occluded,” Debra recalls.
“They treated him for 4 days with heparin (an anticoagulant), buffered aspirin, Excede (an antibiotic) injections and pentoxifylline (a drug used for improving blood flow). He was released from the hospital and was kept on this new
drug regimen along with the previous protocol for colon ulcers but continued to have head/ neck swelling and low blood protein levels. The recommended diet was 1 quart of senior feed 4 times a day and 4 flakes of hay daily with at least one flake being alfalfa,” she says.
On January 17, just 4 days after coming home from the hospital, Cooper suffered severe colic and was referred to Dr. Meg Miller Turpin. “She instructed us to bring him to Reid Clinic in Palm Beach. He was immediately diagnosed with internal bleeding, likely from the heparin and aspirin, which
was immediately discontinued. He remained on ulcer medications but continued to have colic episodes one to three times per week, along with diarrhea and continued edema of his head/neck and sheath for about 4 weeks,” says Debra.
During this time, DMSO and hot packs were applied to the blocked jugular veins, and Dr. Miller recommended treatments in the
Debra Stoltz’s two-year-old gelding Mister Cool Jet suffered from severe right dorsal colitis, showing subtle signs such as not eating as much, looking dull and depressed, and exhibiting changes in behavior.
hyperbaric oxygen chamber to increase and improve blood circulation to aid the healing process. Cooper received 5 treatments in the hyperbaric chamber. His diet was senior feed 4 times daily, and one feeding (5 pounds) of alfalfa daily.
He showed no significant improvement by early February and was started on probiotics. His grazing time was limited to 1 hour per
day to limit the amount of time his head was down, since having his head low accentuated the swelling from the blocked veins. He was given 4 more treatments in the hyperbaric chamber.
On February 21 he was finally discharged from the clinic but was still physically compromised. His blood protein levels were
the lowest ever and his hair had started to fall out. Dr. Miller submitted blood samples to Kansas State University and the results led her to suspect something like AIDS or lymphoma. The good news was some improvement in blood flow through his compromised jugular veins.
He continued on with ulcer medication and the same feeding regime and was gradually allowed to graze up to 2 hours per day.
He remained relatively stable until another colic episode on March 11. The next day he was taken back to the Reid Clinic and Dr. Miller performed a biopsy and stomach scope, which ruled out AIDS or lymphoma. Protein
levels were slightly improved, and his hair
was growing back in. He was taken off hay completely (since fiber has to be digested in the hindgut) and his senior feed ration was increased to 16 quarts daily. He was discharged from the clinic on March 22.
Blood tests the end of April showed more improvement, and he was given a good prognosis for leading a normal life. Dr. Miller recommended that he should never be given bute again, and also said his jugular veins would never be suitable for injections.
The bute he was on in early December essentially set him up for problems on both counts (the right dorsal colitis, and the jugular vein thrombosis). Sometimes when a horse is on NSAIDs it will suppress clotting, and then when you take the horse off those drugs there is almost a rebound effect that stimulates clotting.
Debra was relieved to have her horse healthy again. “I felt extremely lucky, because there were a few times we didn’t think Cooper would pull through. At one point I was told that he would have to be prevented from grazing because he could never be allowed
to drop his head for more than an hour.” Fortunately, the blocked veins resolved, and he also overcame the damage in his colon. Debra feels that youth was in his favor, along with the excellent care from Dr. Miller.
84 SPEEDHORSE December 2021