January Case of the Month: When it Rains it Pours
We often half-joke about how our horse is ‘high maintenance’, but this horse, Ellie, exemplifies the saying ‘when is rains it pours’ and ‘in for a penny, in for a pound’. In fact, we have previously written about Ellie’s health issues in April of 2022. To recap, Ellie’s owner thought she was buying a healthy young mare when she had her shipped from the East Coast of Canada. She knew several of Ellie’s siblings and thought she was a responsible and low risk purchase. Unfortunately, shortly after Ellie moved to the West Coast, she started developing hives from environmental allergies. This alone was not so uncommon, but then she developed head shaking syndrome. Equine Head Shaking Syndrome (EHSS) is a mysterious disease with many known causes and multiple rarely successful treatments. One cause/treatment is for allergies with an antihistamine called Ciproheptidine. Luckily, this did help Ellie. Impressively, the owner wanted to investigate the causes of Ellie’s allergies and invest in desensitization immunotherapy to hopefully prevent the need to keep Ellie on antihistamines or Ciproheptadine for life. During the allergy testing, it was discovered she had a marked allergy to Staphylococcus, a common opportunistic bacteria that infects wounds… and ears. Since ear infections can be a cause for EHSS, investigation and culturing of Ellie’s ears was performed. Sure enough, Ellie was growing Staphylococcus in her ears!!! So next step: treatment for ear infections which included intra-aural topical medications (administered into the ears) as well as a month of oral antibiotics. Thankfully this worked very well and her head shaking almost fully ceased.
However, this was not the end of Ellie’s story: Eventually the head shaking started again and she needed another treatment. No problem; it was repeated, except this time she developed a systemic allergic reaction with full body skin oozing, swelling, fever and hair sloughing. Turned out she developed an allergy to the oral antibiotics that she previously tolerated. Thankfully she recovered but her appetite and weight were waning, so she had a gastroscope performed. Sure enough, she had developed gastric ulcers, likely from the systemic allergic reaction. So on top of the antihistamines/Ciproheptadine, immunotherapy, topical ear medications, she also required gastric ulcer treatment. Poor Ellie and her well-meaning owner!!! We are happy to report that Ellie is now doing well, ulcer free, receiving ear medications to manage the Staphylococcus infection regularly, receiving her allergy immunotherapy weekly and is happy and able to be ridden without signs of head shaking. It’s been quite a journey for Ellie – hopefully there are no new curve balls in her future.
Image Source: https://practicalhorsemanmag.com/health/get-a-grip-on-headshaking-syndrome/