Horse with head tilt and ataxia

[pasosx3]

Hi everyone--I have a sick horse and I would like any opinions or ideas on what might be wrong with him. The Vet doesn't have a Diagnosis and we are hoping for a full recovery. If he doesn't get better, we are thinking about taking him up to Auburn University Vet School for more tests. I know all of you out there have (accumulated) decades of horse experience and I was wondering if anyone might have some ideas.

Here's a brief condensed rundown of events and symptoms and treatment so far:
Horse had been at a Boarding Facility. He's a 19 yr old Paso Fino stallion. 3 weeks ago he began staggering and having an unbalanced gait (Ataxia), his head was tilted to the right. He would turn to the right and practically fall over on me when I led him (encephalopathy). Took him to the Vet Hospital and we also found that he had nystagmus (a kind of fluttering of the eyes) so he was showing vestibular impairment (vertigo/dizziness), too. He seemed to have problems chewing and swallowing which the Vet said probably was related to the encephalopathy. His appetite was good and he was peeing and pooping ok. His attitude was good but he appeared confused or disoriented but that might have been the dizziness. He actually looked like he was drunk (or like a person looks when they are tipsy). Horse was admitted to Hospital.

Vet drew blood. CBC normal. Vet began treatment for Bracken Fern toxicity (Thiamine) just in case and started him on steroids (Dexa). Sent off blood work/Serology. EEE and West Nile came back Negative. EPM came back Negative. EHV-1 also Negative. Horse later started on antibiotics. Vet said no real reason to start them but no reason not to either. Repeat CBC 4 days later was still Normal. EKG normal and no heart murmur.

Next few days the horse showed slight improvement of symptoms and the nystagmus went away. On days 4 and 5 horse showed no improvement--still ataxic and had head tilt. Vet discussed sending him up to Auburn if no further improvement. Following days, horse did show improvement of ataxic gait and head tilt not as bad. Horse was in Hospital for 11 days and discharged to my friend's Farm. He has been showing very gradual improvement, but seems to have reached a plateau in his progress. He still has the head tilt. He seems more willing to move around and during his brief turnouts, he shows interest in the mares and paces the fence line near them which is normal for him, but when he turns around, he still shows the unbalanced gait and loses his balance. He's never actually fallen that I've seen.

The Vet has not ruled out a lightning strike. He doesn't think it is anything the horse ate however the pastures where he was were very poor and weedy due to our droughts and the limited hay that he got was from round bales. Vet has not ruled out brain tumor which is what we will look at if he goes up to Auburn and doesn't get better. Two weeks before all of this started, the horse was vaccinated for encephalitis and tetanus, influenza/rhino, West Nile and rabies. Vet doesn't think this has anything to do with the vacinations.

So.....any ideas? Anyone else have a similar experience?
Thanks!

[Carol Nelson]

Two weeks before all of this started, the horse was vaccinated for encephalitis and tetanus, influenza/rhino, West Nile and rabies. Vet doesn't think this has anything to do with the vacinations.

This is the part that worries me...what can I say? I'm not going to tell you not to vaccinate your horses...it's just that I have seen too much happening in this time frame after the administration of vaccinations, particularly when they are given all at once.
Because I give my own, I split them up...of course, I realize it is costly to do that when you have the vet give them.
If nothing else in his environment had changed...
Truthfully I've had much healthier horses during the drought years than when the grass was high and lush and green. No bugs, no threat of founder, less vermin and snakes...no mosquitos. I seriously would doubt it would be something he'd ingested in the pasture, particularly since his surroundings had not changed immediately.
Glad he's getting better though. Recovery may take some time. Good luck!

[pnalley]

I had a horse that was suddenly grade two ataxic in all four legs. He was VERY wobbly. My vet looked at him and sent him immediately to UGA. The tested for everything (like they did for your horse) all was negative. There was no sign of a fractured vertebrae in his neck. It was later determined that he did in fact injure his neck, that is what caused the problem. He was at UGA for 10 days with intravenous DMSO (I believe). Then he was at home in a stall for about 2 months, only allowed out on a lead. NO PLAYING. While he was at home they had him on banamine.

He is now 13, and still isn't quite right. He walks like a linebacker, kind of swings his front lags to the side. He had good days and really good days. He is limited use. We can ride him on level surfaces, like around the block. He is a happy, well adjusted pet.

My opinion, get him to Auburn NOW!

[Cindy]

Could he have had a seizure or a stroke?

[Mrs. E.]

Could it be Equine Protozoal Myeloencephalitis (epm)? Need a spinal tap for it to be sure.

[pasosx3]

Thank you everyone for your comments, thoughts and ideas.

Carol, I have wondered about the vaccines, too. Another Vet (not the same Vet that I took him too for all of this, because that Vet told me "it was not a medical emergency") gave the vaccines and he did get them all at once. My husband thought it was curious that the horse got vaccinated for encephalopathy and then gets encephalopathy. But, the vac's are not "live" so I don't know, but still something I wonder about. I very well may consider splitting them up in the future--good suggestion.

PNalley: How did they diagnos the neck problem? I questioned some kind of trauma, too. Other than the nuerological signs/symptoms, the horse is normal and healthy looking. It really broke my heart to see him so wobbly and unsteady and for a few days I thought I was going to have to make a really hard decision. The way he is now, even if he never gets better than he is currently would be ok with me. I mean, I would still value him as part of the family. He's a really special horse to me because he is the first horse I've ever owned and he has a special place in my heart. The Vet held off giving DMSO because he said it can make some conditions worse. Still haven't ruled out Auburn.

Cindy: I did ask about a stroke. The Vet said horses don't usually have strokes, but I think that's why he did the EKG and checked out his heart--to make sure he wasn't throwing any clots. Don't know about a seizure, I'll ask. But the Vet said if we send him to Auburn (they just opened up an Equine Nuerological Unit), they would have equipment to check this out. Don't know what the treatment would be. For people, it's Rehab. We had an equine chiropracter look him over (my friend suggested it since he was there working with her horse) and he gave me some excercises I could do with him.

Mrs. E: We did check his blood doing a Western blot for EPM and it came back Negative. From what I've read, a Negative means Negative whereas a Positive can be a maybe and a spinal tap is then needed. But, the Vet said that if we do send him to Auburn, a spinal tap would be done as part of the workup.

One more thing I forgot to mention. The horse had been on Isoxsuprine for Navicular Syndrome. The same Vet that gave the vaccines and also told me "this was not a medical emergency" prescribed it (he also prescribed a high dose ie. excessive dose, because he was basing the dose on a "standard horse" and not a pony sized horse) and also diagnosed navicular. The Vet that I used to treat the horse for this Ataxia and head tilt problem took the horse off of the Isoxsuprine. But, he didn't think that the Isoxsuprine had any to do with all this. Do any of you have any experience with side effects or adverse effects from Isoxsuprine?

Thank you again for all of your input! I would welcome any additional thoughts.

Question: Can horses get ryegrass staggers, or something like it from eating round bales of bermuda? The reason I ask is because the boarding place he was at used round bales and kept them outside on the ground. It had been droughty, but for 3 days before all this happened, it rained and stormed (which is why we haven't ruled out lightning strike). I still wonder if it was something toxic he ate?

Also, anyone have any experience of horses surviving a lightning strike? I thought they died instantly?

Thanks again.

[Cindy]

I have only known horses that died from lightning strikes. However, how would you really know if one got struck and lived? I would get a second opinion on the navicular if he pulls through this as it is really not common in Paso Finos and seems to be a commonly used diagnosis for some vets when they don't really know what is actually wrong with the horse. Doesn't sound like you have too much faith in the vet that diagnosed it anyway.

Keep us posted especially if you take him to Auburn and get a definite diagnosis. Sounds like an interesting and unusual case that we could all learn from.

[pasosx3]

Cindy: Thanks for responding. Yeah, I agree, it is "an interesting case" and a "good medical mystery". Just wish it wasn't my horse!

Totally agree with getting a second opinion on the navicular. My farrier laughed when I told him the diagnosis and my current vet (that's treating my horse for the ataxia) also told me he's never seen navicular in a Paso. He would work him up but said he can't now while he's still ataxic--can't evaluate the gait properly.

I guess it would be hard to know if it was a lightning strike unless you actually witnessed it.

I will keep everyone posted. Thanks again.

[pnalley]

In my horses case we were able to track down his injury (we think). He was in an 8 acre pasture with a safe run in shed and 2 gates. We found mane hairs on the gate. We think he stuck his head through and a horse on the other side scared him and he yanked back damaging his neck.

This made sense with the soreness his neck developed a few days later. He's 13 now, and that happened when he was about 8 months old.

Darn shame too, he is one of those "born broke" horses. Very gentle. He would have made a great beginner level horse.

With our horse they checked his face & ears like you would a person that had possibly had a stroke. They needed to see if his face drooped on one side, or he had eye issues. He was actually OK in that regard.

Good luck with your boy, this can be heartbreaking.
Please do keep us updated.

[pasosx3]

Paula: That's so unfortunate about your horse, and so young, too. My horse's swallowing and chewing problems have resolved along with the nystagmus. Never saw any drooping of eye lid or lips either. It will be interesting to see how he does now that the last Steroid injection/treatment has finished--to wait and see if any symptoms return. The vet said something about examining his skull/neck if he goes to Auburn. At this point, he's giving him a few more weeks to see if he "fully recovers".

Thanks again. I'll keep ya posted.

[CarolU]

I have two ideas.

One is a head/neck injury. The horse may have run into something and caused damage to the spinal cord in the neck area. I have seen two like this, one horse ran into a pole, pole bending, and hit hard in the head, and the other horse spooked and ran into a chain link fence. The second horse was a friend's, and I'll just leave it that he died later that night. An MRI is very expensive, but it will show spinal cord injuries.

The other thought is non-viral encephalitis. Encephalitis technically is an inflamation of the brain. It is not always caused by one of the virus's that are named Encephalitis. Those viruses are named for encephalitis because brain inflamation is the primary symptom. Encephalitis (the symptom) can be caused by flu or other viruses,or bacterial infection, bleeding, etc. You would treat the symptom.

[Carol Nelson]

Ah....there's another clue....the round bales! No, a horse can't get staggers from eating round bales of bermudagrass...but they CAN develop neurological symptoms from eating MOLDY round bales....BOTULISM!! One of the deadliest bacterial agents to horses...google the word and see what you come up with...

Here's one for a start:

http://www.omafra.gov.on.ca/english/livestock/horses/facts/info_botulism.htm

Ask your vet...however, if no other horses became affected...then it probably wasn't that...unless your horse was just more sensitive to it, or ate more of it!

[pasosx3]

Thanks for the input.

CarolU: Appreciate the thoughts on head/neck trauma and we will look into it if he doesn't get better.

We, too also think that the encephalopathy was a "metabolic" encephalopathy--meaning it was not induced by a virus because he didn't "look" sick ie. no fever, no depression, not off his feed, etc. But, as you say, the encephalopathy was a symptom. So....

Carol N: I had wondered about Botulism toxicity, too. I asked the Vet if he had ruled it out and he said he had. But I didn't get a chance to ask him why or how he ruled it out. It's been 3 weeks now, so would there be any benefit at this point to give the anti-toxin? Your article (thank you for the link) indicated it needed to be given soon.

I do wonder if perhaps this was some kind of toxin (yet-to-be-identified) that he ate. As far as plant toxicity, it seems from my reading, that if it doesn't kill them right away, then they do get better once they are removed from eating the plant (or mold). I think that's why the Vet wants to wait a few more weeks to guage progress before we do any more tests.

I will say tho that after this, and all the reading I've done, I don't think I want to feed my horses round bales. Just too risky for me in my opinion. This has been an awful thing to go through and the thought that it could have been from something he ate makes me feel really bad, and guilty! Unfortunately, when you're in a Boarding situation, there's not much you can do.

Thank you again so much everybody. I will keep you posted and please, keep any ideas or thoughts coming!

[pasosx3]

Hey everyone, Just wanted to give a quick update. Today, the head tilt is barely noticable! He almost looks normal. Joy Joy Joy. The ataxia is much better too. It seems like he goes through spurts where he will show improvement and then show no change from that stage, and then a few days later show more improvement. I'm really thinking he may make a full recovery from whatever this is!

Thank you everyone for all of your thoughts, suggestions, ideas, support and well wishes. And Candeloso thanks you, too! I'll continue to keep you updated. Thanks again.

[CarolU]

Well, you managed to find some news to top a perfect day. I'm so glad to read that he's doing better. It's always so scary when these things happen and there is no cause.
Keep us updated...and I'd sure like to see some pictures of him.

Give you/him a hug! :hug It's sure hard to go through these things.

[PasoVicki]

I don't have any personal experience with either Navicular or with your horse's symptoms -- but I recall reading something about Isoxsuprine toxicity. I wish I could remember exactly where I read it. I tried google, and this is the closest I could find:

http://www.horseproducts.stablemade.com/articles2/Isoxsuprine.htm


I'll keep looking for the other article. It was a scientific study, and it definitely showed toxic reactions -- especially at high doses (which your stallion apparently had, for his size). If I recall correctly (which I might not), the toxicity reactions could be similar to "stroke" symptoms.

[pasosx3]

My horse is doing as well as he was yesterday, the head tilt seems so much better. Balance improving too.

CarolU: Thanks for the kind words and thoughts! It's been a stressful 3 weeks. And you are right--also scary. The helpless feeling is awful. Things are continuing to look up, tho!

PasoVicki: Thank you for the info on Isoxsuprine. Since it can cause an elevated blood pressure, I wonder if it could cause a stroke? Please, let me know if you locate that other article....sounds interesting. When this is over ie. he's fully recovered, I will have this Vet give me (a second) opinion on his foot/leg and I will ask him about the side effects/toxicity of the Isoxsuprine that was prescribed (by someone else).

I would've liked to have posted some pic's but I broke my digital camera a few months ago and haven't replaced it yet. If you want to see pic's of him when he was healthy, I think I posted some under the Topic: Castellano offspring. The horse of mine I've been posting about is a stallion son of Castellano--his name is Candeloso de Casta. So, if I had lost him, it would've not only have been a huge tragedy and loss for me personally in my life, but it would have been a sad loss of another branch in a line of the "old" Colombian Paso bloodlines. I really don't know how many stallion sons of Castellano that are still living, but I don't think it is many.

Thank you again everyone for your ideas and comments and warm wishes for my horse's recovery. It means alot to know there's so much support here! I'll keep ya posted on progress.

[Carol Nelson]

Oh gosh...I remember that horse...a look-alike to my stallion...a Castellano grandson. Oh my gosh...I do hope he recovers totally...he is such a beautiful boy, and if he's anything like my Red, he's a total baby too. God bless...

[pasosx3]

Thank you Carol N. Would that make Candeloso your "Red's" Uncle? And, yes, he is a total baby. He has enjoyed all of the extra attention I've been giving him thru this. But, he deserves no less.

He is progressing well at this point. Thank you again, everyone. I'll keep ya posted if anything changes.

[Carol Nelson]

Yes, I would say that would make him Red's uncle. :smile:
Good luck...keep us posted.

[CarolU]

Can we get an update on him? How is he doing now?

[pasosx3]

I've been away from a computer for awhile. I've been horse sitting for my friends where my horse is Boarded. I've been able to see and observe my horse alot over the past 5 days. Candeloso is doing about the same. I haven't seen much more progress. He's doing pretty well overall but not 100% yet. He still has some head tilt and it seems he still gets off balance at times, like he gets dizzy. The Vet comes out next week for a Follow-up Check-up, so I'll wait and see what he thinks.

I'll keep you posted and thank you all so much for your concern and interest. It is still an "interesting case".

[pasosx3]

Vet was out last week for a Follow-up Check Up. He's very pleased with the progress the horse is making. He wants to see the horse again around Christmas which would be 6 months since all of this began. He wants to see a full and complete recovery by then. The horse still has a slight head tilt and still gets off balance at times.

I asked if I could ride the horse yet and the Vet said "no, too dangerous at this time", due to the gait ataxia. He said I could lunge him for exercise, starting with about 15 minutes daily.

Another thing I want to mention to everyone is that I have observed a personality/behavior change with this horse since all of this began. I'll make a long story short, but the Vet said this was not uncommon. He said that horses that have survived a bout with encephalopathy can show changes in their behavior/personality. He said we don't know why but it may have something to do with the inflammation of the brain that the horse experiences. He said that with time, the horses' seem to "get back to their old selves" but it takes time. I hope that's true in this case.

[Carol Nelson]

Can I ask what type of personality change? Does the vet think it was some sort of encephalitis?

[pasosx3]

He did have encephalitis, but we don't know from what (the EEE, etc came back Negative). The Vet has not ruled out a Lightning Strike (indirect hit). He doesn't think it is a brain tumor because he said he would have expected the horse to get progressively worse, not better. I asked about a possible stroke or bleed into the brain. He said there is no way to know and that it wouldn't matter if we did know because there is no treatment other than what we are doing. I asked about Isoxsuprine toxicity or side effect and he said he didn't know (we've stopped the Isoxsuprine). Bottom line is that we don't know what happened and what caused all the problems. The Vet is concerned about the amount of weight the horse has lost and the amount of muscle he's lost too. We're limiting his turnout, because he paces alot when he's out (he's a stallion) and we've upped his feed, etc. It will interesting to see what effect the lunging has on him. After reading some other posts, I may add rice bran.

As far as the personality changes, I hesitated to even bring it up to the Vet because the changes are hard for me to describe. It's nothing real specific, but he just seems "different" to me. He seems to have a greater startle response. He almost seems as tho he's scared or it could be he's disoriented or maybe just dizzy still. (I wish horses could talk to us and tell us these things!) He seems less confident, less sure of himself. (This is a horse who is very noble and strong--a Castellano son). My husband agrees but other people haven't noticed it, but they don't have the history with this horse that we have. Like I said, I almost didn't even bring it up to the Vet because I didn't want him to think I was crazy or neurotic. Fortunately, this Vet is an excellent listener and is very interested in the owners observations so he encouraged me to talk to him. And, turns out I'm not crazy--horses can experience a change in behavior/demeanor/personality after an encephalopathic event. He said it's like they have to relearn things, learn to trust again, and so forth. (Doesn't this sound like what humans go thru after they've had a stroke or head injury?). Anyway.....this continues to be an interesting case, just wish it wasn't my horse. I'm treating the lunging as a form of horse Physical/Occupational Therapy.

[Carol Nelson]

Go back to the origin of your horse...as a prey animal. In the wild, as he is now, he would be food for the predators. He knows that. That may help you understand the personality change you see in him.
Or it may be from whatever caused the affliction. Bless his heart...am glad he's improving...hope he starts to feel back to normal quickly!

[pasosx3]

Carol, I think you're right! It's as though he feels vulnerable now, like his confidence in his world, for lack of a better description, has been shaken. And, another thing I noticed with him is that he is more "clingy" towards me. He looks more excited when he sees me, almost like he's relieved I'm there. He settles down and will eat. This horse has always been people friendly, but he seems more distant to others, and closer to me since all of this. I always hesitate to put human emotions to animals, but based upon what you wrote, maybe all of this does make sense. Thank you! And, yes, I hope he does get back to himself soon. I miss the old Candeloso.

[Laura S]

I hope your stallion makes a full recovery!! It is so hard not knowing what is really going on. He is lucky to have you, an owner that really cares.

[pnalley]

My colt was easy to startle after his ataxia too. BUt he diod get over it. It was almost like he was more noise sensative

[Carol Nelson]

I always hesitate to put human emotions to animals

Those aren't human emotions, that is the basic primal instinct of the horse.

He knows that you won't "eat" him...or at least he wants to believe that. He probably knows that while you are there nothing else will eat him either.
He's sick now and he IS vulnerable.

Could explain why the "startle reflex" seems stronger too. Their only defense is to run.

[pasosx3]

Thank you everyone for your good wishes and for your insights on his behavior and other comments. I'm staying positive that he will fully recover with time and will get back to himself. I'll keep everyone posted on changes. Thank you again!