Thursday, September 22, 2011

Update on Pie

The blood work was normal, except that two liver enzymes were slightly elevated.  The vet's best hypothesis at this point is that Pie is having bile duct pain - these two enzymes are indicative of that.  The pain could be due to a small bile duct stone that is irritating/inflaming the bile duct exit, but not blocking it - if it were blocked he would be much more ill, even jaundiced - or an infection due to gunk accumulating in the bile duct, or both.  The intermittent acute pain and the timing just after feeding time would also be consistent with that, as the irritation would be greater at that time.  Here's a description of what may be happening.  Horses do produce bile continuously, so that could also explain his general low-grade grumpiness.

So the treatment plan is Uniprim daily (apparently some horses are on antibiotics for up to 6 to 8 weeks to clear this sort of thing), and a 500-lb. dose of Banamine twice a day for 5 days and once a day after that.  We'll continue the Gastrogard, but not add probiotics at this point as they can result in firmer manure which is the opposite of what we want at this point.  No riding at least until blood work is rechecked in about 10 days, but he can have his chiro appointment, which will probably feel good.  And I'll be keeping a very close eye on him, and if there are any more acute episodes the plan may change, but for now we've got a plan - let's hope it works.

21 comments:

  1. Fingers and toes crossed that the treatment gives him relief!!!

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  2. Hope the plan works for Pie. I'm sure the Chiropractor will ease some of his tension too. Good luck.

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  3. Wow, I didn't know this could happen in a horse. I hope the treatment takes care of things, and you can get some sleep tonight.

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  4. Kate--I'm so glad you have a diagnosis. My friend (human) had this exact problem, and it was very painful. She is fine now--I hope Pie feels a lot better very soon.

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  5. Kids and horses - I hate it when they get sick.

    Hang in there.

    Dan

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  6. Sounds like you have a very sensible plan. He should be more comfortable now. Sweet Pie.

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  7. I'm always learning something new when it comes to horses... I hope the treatment works for Pie and he's feeling better soon!

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  8. Oh! I am sorry to hear of this developement Kate. So very glad you are super vigilent and have sorted it out- to be able to help him. Hopeing all goes smooth and he is good soon!

    KK

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  9. Poor Pie! I watched the video the other day, he looked miserable. Hope this works.

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  10. I'm glad you and the vet have been able to come up with a potential diagnosis and plan for Pie. Fingers crossed that he is feeling better soon.

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  11. Aw man, I hope it clears up quickly and doesn't take 6-8 weeks. Good thoughts heading your way!

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  12. Oh man...hope everything turns out ok. These ponies of ours sure can scare us.

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  13. Glad you have a good prognosis and plan. Hope his discomfort is eased quickly.

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  14. Oh no! I am so sorry Pie was sick again. May I ask which liver numbers were elevated? I'm trying to educate myself a bit more. Our Big Ben had elevated GGT when he had hepatitis. He is doing very well, but we are still watching him like a hawk, and will be for quite some time.

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  15. Hope Pie is feeling better! Glad to hear there's a treatment for what's bothering him. So scary when there's something off and nothing gets nailed down.

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  16. Sure hope it all works out, and that the abx take care of the liver problem. *fingers crossed*

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  17. Terry - Pie had elevated AST - only a little elevated - and a more elevated GGT - apparently the second is often associated with bile duct disease.

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  18. Kate, did your vet recommend anything to do diet-wise that would help prevent gallstones from forming?

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  19. Fetlock - no, there's no clear dietary correlation for bile duct stones (not gallstones since horses don't have gall bladders) or inflammation (unlike in gallstones for people and possibly enteroliths that can form in a horse's intestines). It's also possible that the "stone" is just a mass/area of inflammation rather than a mineralized lump. Hard to tell, and the equine bile ducts are difficult if not impossible to image with ultrasound and other techniques.

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  20. Glad you have a plan and some answers. I hope his recovery is on the horizon.

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  21. What an unexpected diagnosis! I hope he gets feeling better soon.

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