A Crash Course in Cholangiohepatitis

There are certain conditions in horses I'd be happy to go my whole life without having to study up on.  This is certainly one of them.  However, Trax decided that I needed to know about it.  

Some of you have followed this on facebook a little bit, what little bit I have talked about, but I figured it was time to tell the whole story.  

It started last Friday.  I was going to go sorting, and had decided to take Trax rather than Melody.  I wanted to see if any of his new training would carry over into the sorting pen, AND I really just felt like riding a horse that wasn't afraid of his own shadow while walking down the road.  

All the horses had been in their pens for that entire day, and I think for the day before too.  I had not been out with them much that day. I can't recall what I had been doing all day, but I had given them pellets for breakfast, grass hay for lunch and when I came out to get my horse I noticed that he had not eaten hardly anything.  

I was on the phone while I was haltering him, so I didn't actually LOOK at him until we got to the tack up area.  I tied him up, walked to the tack room to grab a brush and when I turned around I saw my horse.  He was standing there with his head down, drooling, and sides heaving like he had just run a marathon at mach nine.  

I said to my friend Mary, "Shit, my horse is colicking, I've got to go."  She asked if I had Banamine (which I was out of) and said she would be right there with some.  

I hung up the phone, dropped the brush and put my head next to his belly.  I could hear plenty of gut sounds, but realized that he was very warm.  I ran in the house and grabbed the thermometer and took his temp.  It was 106.5!!!!

I immediately started calling vets, couldn't reach the first one, so I called Arizona Equine, which is a major hospital, and of course they had me load him up and bring him in.  Mary showed up just as I was pulling out of the drive.  I had called and told her the change in plans and she stopped and grabbed some alcohol so we stopped in the middle of the road and doused him with it to try and bring his temp down.  

Why it didn't occur to me to hose him down first thing, I don't know.  Its not like I don't know what to do for a fever, but all I could think of at the time was getting the trailer hooked up and him into it.  He was passing manure, so I knew it was not colic.  

When I got to the clinic his temp was down to 102. The vet drew blood first thing and then gave him a shot of bute. Then we hosed him down until his temp was normal.  She said his gut sounds were very good, but his breathing sounded a little funny.  

The first blood test came back with a very high white blood cell count. At that point we started discussing possible infections diseases.  He had not really been in contact with any horses other than his own herd, other than one trail ride with some horses from the neighborhood.  He did not exhibit any symptoms of Strangles, although she did mention there is a strain of respiratory herpes virus that is slightly more common and could cause the symptoms we were having.  We did a nasal swab to test for any thing infectious or flu like.  

She suggested that we could do chest xrays if I wanted to see if there was a lung issue behind his odd breathing sounds, however she was very good about letting me know exactly where I was financially with each procedure, so I could make an informed decision about how far I wanted to go.  

This is Trax....my guy....I will go pretty dang far into debt for this horse.  Even though he isn't worth much money, he is worth everything to me.

Waiting on test results in horsey jail. 

Still I want to be smart about how I spend my money, so I opted to wait on anything else until we got the blood work back.  It was a smart move.  

When the blood work came back his liver enzymes were very high, indicating an infection in the liver.  The vet said that he has Cholangiohepatitis.  I heard "hepatitis" and my heart sank. She must have seen the look on my face, because she assured me that rarely is this ever fatal.  It usually just takes a round of antibiotics and goes away. She told me that this is actually much more common in horses than most people realize, but often goes undiagnosed.   

Here is a link to an article which my boarder sent to me on the subject 

For those of you who like technical terms here is a very medical version of what he has

This is not the first time Trax has done this.  I know it was at least the second time if not the third, that he has been off his feed.  I always assumed it was ulcers, and tried to treat with probiotics which seemed to help because a day or so later he would go back to eating normally. 

Trax has lost a lot of weight over this.  His spine is sticking up above his back, which I have never seen happen on him.  There is a gap between his butt cheeks.  While he is not skin and bones, he is skinny for him and I have been trying desperately to put weight on him. Extra food, wheat germ oil, worming, Nutrena grain.  

Anyway, the vet sent me home with some antibiotics (TMZ is what she called them) and told me to take his temp several times a day for a few days and if it went up over 102, to go ahead and give a low dose of bute every 12 hours, and to hose him down again.  

I did as instructed, but his temp was normal, he was eating voraciously again, and even was running and bucking in the pasture again.  When I watched him do that I realized that he really had not done so in a while, so it was good to see him feeling good.  

Since he was feeling so good, I went a head and took him sorting the next day.   His temp was normal, his energy was high, but still I only sorted a couple of rounds on him and then rode someone elses horse. I did not want to wear him out or cause him to relapse.  

That night he ate fine, and was fine for several days.  

There is a new horse club in town which I have joined and we are putting on our first Ranch Versatility type show next weekend.  Of course I was planning on using Trax and since he has been eating fine, looking better, taking his meds like a champ, I decided last night it was time to do a little preshow training.

He had been in the pasture all day this time, and even when I walked out to get him he was out there mowing down on the new grass coming in.  I walked to him with the halter, he gave his usual half assed attempt to say no, and then let me halter him.  I tied him up turned and looked at him and damn!  His sides were heaving again.  No drool this time though.  I grabbed the thermometer and he was at 105.6.  This time I started with the hose, then got some alcohol and dumped it on him, then dosed him with 2 grams of bute. THEN I called the vet.  

By time we spoke his temp was already on the down slide.  They said I could bring him in again if I wanted, but really they wouldn't do much more than what I had already done.  Clearly he needs to have an ultra sound done, or possibly even a liver biopsy,  but we opted to wait until Monday.  While I am willing to go into debt for my horse, if I can do at home what they would do for him, and save a few hundred dollars in emergency fees, then I will have more money for the things that will really help him.  The vet agreed with my decision but said if I needed anything, had any questions, or could not get the fever down, to feel free to bring him in.  

Within an hour I had him down to 101, so we stayed home.  He was thrilled to have dinner and seemed much happier.  I was ok with staying home for now. 

I had to run and errand but when I came back I checked his temp again and it was normal. This morning I checked again, and it is completely normal, although he did not care to eat his pellets this morning so I gave him a nice big serving of grass hay.  

There has been some speculation that perhaps he ate some Alsike Clover, but we don't have that here.  Of course there are other toxic plants that could cause this, but my pasture is pretty much nothing but grass.  The only real weed issue we have here are the "goat heads" and the big broad leafed weeds (TC calls them button weeds) and neither are toxic to horses.  

If you look closely along the fence line you
will see the button weeds that we have been fighting
but everyone in town is fighting them and everyone's
horses have eaten them and no one is getting
sick from them

So I don't know at this time what caused the relapse.  I do know that more diagnostics are in order.  Of course the worry wort in me is convinced he has a tumor and that I am going to lose my horse.  I'm hoping that maybe he just needs different antibiotics, or perhaps it is simple like a stone.  I will get to the bottom of this, its just going to take some time and I have to be patient.

  Trax is a total trooper through the whole thing. He takes his meds without a fight, He will stand quietly without even a halter while I take his temp.  He just seems to handle it all.  For a horse who didn't even like people when I got him, he sure has changed.  

Clearly there is no horse show for him next weekend.  I won't ride him again until I know the issue is resolved completely.  I don't believe that riding him on Tuesday caused the relapse, but I am not going to ask him to work until he is back in full health again.  I'm pretty bummed about the show because I have been begging people to show up and support the new club and now I can't even practice what I preach.  

I guess I can take Melody and enter in a western pleasure class.  One of my neighbors has offered to let me use one of his geldings if I want, but I don't know if I will do that.  Maybe I'll just go and work the show and be of service.  

Seems to be the story of my life lately.  I work the show and watch everyone else ride while my horses sit at home.   Bummer!  

More importantly though, I don't want to lose my horse.  Of course I would be sad if I lost any of my horses, but to lose Trax....not sure how I would handle that one.