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Extreme Veteran
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| Any additional thoughts, ideas, or advice appreciated.
Facts: I purchased my horse a few months ago. When we purchased him he had some nasal discharge, but during the pre- purchase vet check he ruled it out as a cold.
Since that time he has been on SMZ's, other high powered antibiotics, been scoped twice, two sets of x-rays and recently had a molar extracted.
First scope: he had large amounts of mucus present in his nasal cavity and trachea. Nasal discharge was present from both nostrils. He was cultured and tested positive for Staph. Vet also entertained heaves or allergies, but later ruled it out when the culture came back positive for Staph.
He was on 10 days of a high power IM antibiotic. After the 10 days, his discharge returned full force. A second round of the same IM antibiotic was given and after 10 days-the discharge returned only in the left nostril. From there we went back for a second scope.
Second scope: He had significant amounts of mucus draining from left nostril only. No mucus present in the trachea, however he did have mucus present in his nasal cavity. X-rays were performed at this time. They suspected a slight change to a molar tooth. X-rays were sent to a equine dentist. Guttural pouches were clean.
Equine dentist did another full exam and a second set of x-rays, decided we should extract a molar. He wasn't a 100% sure this was the cause but felt the tooth roots had some changes. We did the extraction. He did another round of antibiotics.
The discharge has now returned-left nostril only. We are using phenomenal vets but I am so discouraged. We have spend SO much money trying to diagnose this horse. Anyone have any ideas? Thoughts? or similar experiences?
Edited by Blueridgedreaming 2014-02-18 10:37 AM
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| Maybe they could try an allergy med and if they helps then you might try pinpointing the exact cause of his allergy. It sounds allergy related to me. |
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Extreme Veteran
Posts: 512
| Thank you! |
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Location: Somewhere up North | You don't mention if the horse had the sinus discharge just before you purchased or has had it for some time. What did the sellers tell you? |
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Extreme Veteran
Posts: 512
| He had it during the vet check the day we purchased him. Vet that did the pre-purchase exam said he thought it was a cold as the weather had changed quickly. We didn't think anything of it at the time. Sellers won't answer any questions after we purchased him.
Edited by Blueridgedreaming 2014-02-16 6:09 PM
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Location: Somewhere up North | Ok, the sellers not answering your questions is a big red flag. Did your vet mention a ruptured sinus cavity? A ruptured sinus cavity can cause lots of discharge and be very difficult to cure. I'm not saying this is what you have but sounds a lot like that may be the case. Keep us posted. |
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 Elite Veteran
Posts: 678
Location: Canada | Did you buy the horse locally or did you buy him from a different state? (If locally not likely airborne allergy, if from another state may be new pollen or airborne allergens affecting him)
Have you tried removing the hay source and supplementing with packaged foods? (If he's on hay can you switch for a week to cubed feed or prepackaged dust free hay) In the event it's something in his hay and see if that makes a difference.
Is he stalled at all? If so, if you leave him turned out is he better, if you can't leave him out have you tried wetting his bedding or switching bedding source?
Do you ride inside or out? If he's from somewhere warm where he was ridden outside and now in a colder climate and inside could the arena dust be the culprit?
If you've tried all that has your vet recommended a steroid allergy injection or a round of Dex to see if that eliminates the discharge?
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Extreme Veteran
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| Thank you for all the great suggestions!
He was purchased only 2 hours away in the same state-so he is being exposed to relatively the same allergens. He is never stalled-has access to a run in shed. We have changed his hay, but have not tried packaged roughage. He is being ridden outside. We have tried watering his hay, and we have kept him in the most dust-free environment possible.
We have not tried any steroids or allergy medications as the vet was convinced it was related to a Staph infection-and after that they thought it may be tooth related.
Can you tell me more about the ruptured sinus? Thank you! Would it show up on x-rays? Or a scope? Thanks so much everyone!
Edited by Blueridgedreaming 2014-02-16 6:24 PM
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| Even if he came to you from that close by it could still be an allergen on your place. A friend of mine had a mare, a really good 1D mare, that exhibited symptoms very much like you are describing and worked for two years to get her cleared up. She ended up giving the mare to a friend that lived 20 minutes from her just to "use" as a lightly ridden trail horse but not to run barrels. Within two months the mare was totally well and the "friend" was literally sneaking away to run barrels with her. Come to find out the original owner had mold or something growing in/around in her barn that the mare was apparently breathing in. He could be allergic to something in your general area and the original owners may of had the same problem with him which is why they sold him.
Edited by runs4fun 2014-02-17 6:27 AM
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Extreme Veteran
Posts: 512
| Runs4fun! Wow! That is amazing!
Sadly, he did have the nasal discharge at the barn where we bought him from. We did the pre-purchase exam at the seller's farm.
Edited by Blueridgedreaming 2014-02-16 6:26 PM
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Elite Veteran
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Location: Canada | He tested positive for the staph so maybe he needs stronger antibiotics or lower dose longer time. Has the vet tried or recommended changing treatment? Have they re-cultured since he was on the meds to see if the infection has cleared up. If the antibiotics haven't cleared it he's still going to have the discharge. |
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Location: Somewhere up North | You may want to ask your vet if they checked for a sinus condition (ruptured, perforated, etc.) when they did the scope. A horse with this condition will often exhibit a lot of nasal discharge due to food processing in their gut irritates the sinus cavity. Salt in grain or free choice salt can be a primary irritant. |
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Extreme Veteran
Posts: 512
| They did a sensitivity test and the staph only responded to two different antibiotics, we have done two rounds of a drug called Naxcel and one round of a drug called Exceed (condensed form of naxcel). We actually were there for both scopes and everything looked really clean. They found nothing alarming or concerning on the scopes. Just to be noted I do not believe the sellers sold him knowing this condition. |
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 Crazy Doggy Mommy
Posts: 1419
Location: Where Governor's make the liscense plates | makes me think of some sort of allergy? |
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  Neat Freak
Posts: 11216
Location: Wonderful Wyoming | I'm going to PM you a supplement that might be a great thing to try. It's really beneficial to anything lung, breathing related and for allergies. It could definitly help. |
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| Could you PM me as well:). Thx! |
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 Veteran
Posts: 268
| I've seen this before, the horse had a cyst in the nasal cavity. Not saying it's that, but could be something to look into |
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Extreme Veteran
Posts: 512
| RunNitroRun: He did indeed test positive for Staph, but after 3 serious treatments of antibiotics it came to the conclusion there must to be a primary reason for the infection being created such as: tooth root, cyst, Ect. That is what has left the vets scratching there heads.
CocoChex: How was the cyst diagnosed? Were they able to see it on x-rays or during a scope?
Thank you everyone so much!
Edited by Blueridgedreaming 2014-02-17 7:40 AM
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Elite Veteran
Posts: 678
Location: Canada | Have the vets suggested anything else or sending him elsewhere? The only reason I ask is we have a local vet that will have you spend $1000's of dollars and if he can't find the problem just walk away instead of offering further options and I often hear of people who use him are totally stumped and frustrated. We have another vet who will try a few things but before offering you expensive treatments he will say if a/b/c doesn't work here is what our plan would be going forward and here are the costs. If those don't work my recommendation would be XXX.
If your vet is more like the first one and hasn't offered anything else is there another vet in your area or nearby state that you could call and say here my horse had all of these treatments, x-rays, scopes etc and we are still having the problem do you have anything else to recommend? If they say no, call the next recommended place until you get an answer. I can only imagine your frustration and I hope you get to the bottom of this soon.
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Tried and True
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Location: Where I am happiest | I didnt read all the replies but alot of times with all this going on, persistant nasal discharge and staph present it is a gutteral pouch infection. |
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 Elite Veteran
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Location: Do I hear Banjos? | You said they did a culture and found Staph. Well...did they run a Sensitivity on the sample to see what that particular infection might be resistant and sensitive to as far as antibiotics? Bacteria can develop resistance and never truly clear from treatment with some antibiotics. Just because it's a "strong" antibiotic doesn't mean it's the right antibiotic for that infection. They may very well have run a sensitivity along with the culture...and should have. But you should ask to see.
Good luck. It's unfortunate and suspicious that the original owner isn't willing to answer any questions.
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Extreme Veteran
Posts: 512
| Threecorners: I wish it was a guttural pouch infection so we could clear it up, but on both scopes the guttural pouches were clean.
They did run a sensitivity test on it and the only antibiotics that the Staph strain was sensitive to was penicillin and Naxcel. We did two rounds of Naxcel for 10 days. One round of a low dose, and one round of a high dose. Before we scoped him we just did two rounds of general SMZ treatment. The last thing we did was remove a molar-and after his molar was removed we did a round of Exceed which is a form of Naxcel. So our only other real option at this point is penicillin and they suggested 14 days of that. I really do not like using penicillin and they said that the Staph was slightly more sensitive to Naxcel. So if something was going to clear it up, it would have been Naxcel. The horse has basically been on antibiotics since October on and off. His body condition has decreased also. |
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Tried and True
Posts: 21185
Location: Where I am happiest | Antibiotics do kill the good gut bacteria so I'd hit him with a good probiotic to help with his body condition. Beside all that, I think I'd take him to a high end internal specialist or university to get to the root of the problem and get it cleared up once and for all. |
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Extreme Veteran
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| ThreeCorners - 2014-02-17 11:26 AM
Antibiotics do kill the good gut bacteria so I'd hit him with a good probiotic to help with his body condition. Beside all that, I think I'd take him to a high end internal specialist or university to get to the root of the problem and get it cleared up once and for all.
Thank you! Any recommendations of a good probiotic?
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 "Drank the Kool Aid"
Posts: 5496
Location: Iowa, LA | When I get home I will tell you about my experience last year! It took taking my mare to LSU to finally figure out the problem and we are still not sure what actually caused it! PM me if I forget! |
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Extreme Veteran
Posts: 512
| annemarea - 2014-02-17 11:37 AM
When I get home I will tell you about my experience last year! It took taking my mare to LSU to finally figure out the problem and we are still not sure what actually caused it! PM me if I forget!
I would love to hear about your experience! |
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"Drank the Kool Aid"
Posts: 5496
Location: Iowa, LA | Last February my mare developed sinus drainage from one side only (left) and began doing strange things like holding her mouth agape. First vet told me to treat her with a round of SMZ's. It did nothing. We then did xrays and found no obvious issues with her teeth. I then left her for at least a week for sinus flushing/stronger antibiotics. She came back home with not real improvement. After several visits and several thousand in vet stays, sinus flushings, antibiotics, I chose to send her to Louisiana State University. We re-did xrays and again found nothing other than obvious fluid build up on left sinus cavity. The vet drilled a large hole into her sinus cavity and scoped finding really nasty stinky puralent material. As he got in deeper we discovered she had purelent material that had been in there so long (this was June/July and drainage started in February) that it had turned rock hard. He removed serveral pieces, but to ensure it was finally cleared completely, he would removed a flap of her bone covering the sinus cavity in order to completely clean her out. Basically her body was now seeing these hard pieces of puss as a foriegn body and so the infection was not going to clear until we completely removed it all. She stayed another week-two weeks with daily flushing and that finally cleared her up! It was a long long battle and she ended up having complications from the last surgery with re-occuring abscesses when a small bone chip was left behind. But, by December we had her on the mend.
I have a horse with allergies and this is what I can tell you was the difference between him and her. He never actually has discharge, but will cough and if scoped you will so some flem in his trach....if discharge is colored, thick, or stinky---- think INFECTION, not allergies. If discharge is only coming from ONE SIDE think INFECTION. Also, if this has been going on long term, don't forget about how rock hard some of that sinus pus had become inside of her sinus cavity. It had to be removed and that is why no amount of antibiotics was clearing her infection. My mare's discharge did smell on/off. If it smells, something is infected! You will know that smell! It is the smell of horrid breath! LOL I wish I would have taken my mare to the university in the first place because my local vet just did not have the instruments he needed in order to explore those tiny sinus folds. I basically wasted thousands and they sent her home still smelling like death and with drainage no better. So, my thoughts are possibly this started as a respiratory infection (both nostrils and trach drainage), but then something was left inside the left (still draining) nostril so that side will not clear up? Just something to think about.
I've had tons of typical respiratory infections and they all run their course and all involve both nostrils. This one was different because she was totally clear on that right side. No smell, no drainage, etc. You can try covering her good nostril and taking a whif of her breath on that left side. I really wonder if you would smell anything! Let me know if you have any other questions! Will be glad to help any way that I can!
Anne |
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Extreme Veteran
Posts: 512
| annemarea - 2014-02-17 5:53 PM
Last February my mare developed sinus drainage from one side only (left) and began doing strange things like holding her mouth agape. First vet told me to treat her with a round of SMZ's. It did nothing. We then did xrays and found no obvious issues with her teeth. I then left her for at least a week for sinus flushing/stronger antibiotics. She came back home with not real improvement. After several visits and several thousand in vet stays, sinus flushings, antibiotics, I chose to send her to Louisiana State University. We re-did xrays and again found nothing other than obvious fluid build up on left sinus cavity. The vet drilled a large hole into her sinus cavity and scoped finding really nasty stinky puralent material. As he got in deeper we discovered she had purelent material that had been in there so long (this was June/July and drainage started in February) that it had turned rock hard. He removed serveral pieces, but to ensure it was finally cleared completely, he would removed a flap of her bone covering the sinus cavity in order to completely clean her out. Basically her body was now seeing these hard pieces of puss as a foriegn body and so the infection was not going to clear until we completely removed it all. She stayed another week-two weeks with daily flushing and that finally cleared her up! It was a long long battle and she ended up having complications from the last surgery with re-occuring abscesses when a small bone chip was left behind. But, by December we had her on the mend.
I have a horse with allergies and this is what I can tell you was the difference between him and her. He never actually has discharge, but will cough and if scoped you will so some flem in his trach....if discharge is colored, thick, or stinky---- think INFECTION, not allergies. If discharge is only coming from ONE SIDE think INFECTION. Also, if this has been going on long term, don't forget about how rock hard some of that sinus pus had become inside of her sinus cavity. It had to be removed and that is why no amount of antibiotics was clearing her infection. My mare's discharge did smell on/off. If it smells, something is infected! You will know that smell! It is the smell of horrid breath! LOL I wish I would have taken my mare to the university in the first place because my local vet just did not have the instruments he needed in order to explore those tiny sinus folds. I basically wasted thousands and they sent her home still smelling like death and with drainage no better. So, my thoughts are possibly this started as a respiratory infection (both nostrils and trach drainage), but then something was left inside the left (still draining) nostril so that side will not clear up? Just something to think about.
I've had tons of typical respiratory infections and they all run their course and all involve both nostrils. This one was different because she was totally clear on that right side. No smell, no drainage, etc. You can try covering her good nostril and taking a whif of her breath on that left side. I really wonder if you would smell anything! Let me know if you have any other questions! Will be glad to help any way that I can!
Anne
Your case sounds so similar to mine! I really appreciate you taking the time to write your experience. They are not able to find anything super obvious with my horse on a scope/x-rays. They did remove a molar, but almost as a last resort sort of thing-I have some pictures from today that I will post. His drainage started out from both nostrils, it localized to just the left nostril after antibiotics. But you will see in the pictures I post that today it has returned to both nostrils.
We have spent thousands of dollars also, and I am just beyond discouraged. Did your horse swallow continuously? My horse swallows at least 5 times a minute.
His drainage doesn't smell is the only thing, it does not smell of infection. His discharge is a thick, milky, white.
Does anyone have any recommendations of a vet in North Carolina?? That can do a advanced scope or MRI? |
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| Pictures
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Veteran
Posts: 268
| Blueridgedreaming - 2014-02-17 7:38 AM
RunNitroRun: He did indeed test positive for Staph, but after 3 serious treatments of antibiotics it came to the conclusion there must to be a primary reason for the infection being created such as: tooth root, cyst, Ect. That is what has left the vets scratching there heads.
CocoChex: How was the cyst diagnosed? Were they able to see it on x-rays or during a scope?
Thank you everyone so much!
They took a drill and drilled a hole above his sinus cavity then flushed through the hole. A lot of gunk came out. They then went in and surgically removed it
ETA: his gutteral pouch was good and also the cyst did NOT show up with the scope
Discharge was from one nostril
Also I noticed this shortly after I bought him, antibiotics would clear it up temporarily then it would come back.
Edited by CocoChex 2014-02-17 10:18 PM
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Extreme Veteran
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| CocoChex - 2014-02-17 8:01 PM
Blueridgedreaming - 2014-02-17 7:38 AM
RunNitroRun: He did indeed test positive for Staph, but after 3 serious treatments of antibiotics it came to the conclusion there must to be a primary reason for the infection being created such as: tooth root, cyst, Ect. That is what has left the vets scratching there heads.
CocoChex: How was the cyst diagnosed? Were they able to see it on x-rays or during a scope?
Thank you everyone so much!
They took a drill and drilled a hole above his sinus cavity then flushed through the hole. A lot of gunk came out. They then went in and surgically removed it
ETA: his gutteral pouch was good and also the cyst did NOT show up with the scope
Discharge was from one nostril
Also I noticed this shortly after I bought him, antibiotics would clear it up temporarily then it would come back.
Thank you Cocochex! |
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| Your vet does know that straph is naturally occurring in the nasal passages right? Pretty much every horse tested will come back positive. If it is a white (ish) discharge I am willing to bet it is IAD. (Inflammatory airway disease) get your vet to refer you to a respiratory specialist. They need to do a flush in the lungs. A respiratory specialist (or knowledgable equine vet) will tell you instantly what it is. A nasal swap will not. You have to do a scope right into the lungs. Mucus in both nostrils and trachea and a persistent or intermittent cough (depending on severity) are all signs of IAD. Especially if the horse is otherwise healthy. (My one horse coughed once in a blue moon, my other all the time)
Edited by Kaye 2014-02-18 5:01 PM
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 Warmblood with Wings
Posts: 27846
Location: Florida.. | id look at allergys .
But Id be concerned about a secondary infection in his lungs.. as well..
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Extreme Veteran
Posts: 512
| Kaye - 2014-02-18 4:59 PM
Your vet does know that straph is naturally occurring in the nasal passages right? Pretty much every horse tested will come back positive. If it is a white (ish) discharge I am willing to bet it is IAD. (Inflammatory airway disease) get your vet to refer you to a respiratory specialist. They need to do a flush in the lungs. A respiratory specialist (or knowledgable equine vet) will tell you instantly what it is. A nasal swap will not. You have to do a scope right into the lungs. Mucus in both nostrils and trachea and a persistent or intermittent cough (depending on severity) are all signs of IAD. Especially if the horse is otherwise healthy. (My one horse coughed once in a blue moon, my other all the time)
Thank you for all your great knowledge.
He didn't tell me that all horse would test positive for Staph, however I do know Staph is present everywhere. What the vet did say-whether this is significant or not-is that the Staph was present in the tissue sample he took from inside his nasal cavity. This vet is the go-to Equine vet in North Carolina and comes highly recommended, but is not a specialist for respiratory conditions.
The vets initial thought it was IAD, but after the scope and culture he ruled it out. The vet also did a lavage during the scope (did not do the lungs) and had it tested and he said there were not any cells that made him believe it was IAD.
Again, I am uncertain.
I really appreciate your time and advice! I think a specialist is in our near future.
Edited by Blueridgedreaming 2014-02-18 8:41 PM
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| Blueridgedreaming - 2014-02-18 7:23 PM Kaye - 2014-02-18 4:59 PM Your vet does know that straph is naturally occurring in the nasal passages right? Pretty much every horse tested will come back positive. If it is a white (ish) discharge I am willing to bet it is IAD. (Inflammatory airway disease) get your vet to refer you to a respiratory specialist. They need to do a flush in the lungs. A respiratory specialist (or knowledgable equine vet) will tell you instantly what it is. A nasal swap will not. You have to do a scope right into the lungs. Mucus in both nostrils and trachea and a persistent or intermittent cough (depending on severity) are all signs of IAD. Especially if the horse is otherwise healthy. (My one horse coughed once in a blue moon, my other all the time) Thank you for all your great knowledge. He didn't tell me that all horse would test positive for Staph, however I do know Staph is present everywhere. What the vet did say-whether this is significant or not-is that the Staph was present in the tissue sample he took from inside his nasal cavity. He just said he had some "super bugs" we were dealing with. This vet is the go-to Equine vet in North Carolina and comes highly recommended, however have doesn't have all the capabilities as State hospitals or some Equine hospitals. The vets initial thought it was IAD, but after the scope and culture he ruled it out. The vet also did a lavage during the scope (did not do the lungs ) and had it tested and he said there were not any cells that made him believe it was IAD. Again, I am uncertain. I really appreciate your time and advice! I think a specialist is in our near future.
Well if he did rule out IAD then you have a mystery. I had a mare here that got a bug and after she kept getting on and off nasal discharge. I got it cultured and it came back as normal nasal flora (just high amounts), my local vet said I could use Naxcel, but though possibly time might help more. Since she was young and i didn't want to stress her body with drugs (yet). I tried an immunostimulant on her. It took three consecutive shots (following the label directions) and after that it cleared up and never came back. Now maybe she just needed time to fully recover or maybe it was the stimulant, but her nasal discharged cleared right up after. |
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Extreme Veteran
Posts: 512
| Kaye - 2014-02-18 8:41 PM
Blueridgedreaming - 2014-02-18 7:23 PM Kaye - 2014-02-18 4:59 PM Your vet does know that straph is naturally occurring in the nasal passages right? Pretty much every horse tested will come back positive. If it is a white (ish) discharge I am willing to bet it is IAD. (Inflammatory airway disease) get your vet to refer you to a respiratory specialist. They need to do a flush in the lungs. A respiratory specialist (or knowledgable equine vet) will tell you instantly what it is. A nasal swap will not. You have to do a scope right into the lungs. Mucus in both nostrils and trachea and a persistent or intermittent cough (depending on severity) are all signs of IAD. Especially if the horse is otherwise healthy. (My one horse coughed once in a blue moon, my other all the time) Thank you for all your great knowledge. He didn't tell me that all horse would test positive for Staph, however I do know Staph is present everywhere. What the vet did say-whether this is significant or not-is that the Staph was present in the tissue sample he took from inside his nasal cavity. He just said he had some "super bugs" we were dealing with. This vet is the go-to Equine vet in North Carolina and comes highly recommended, however have doesn't have all the capabilities as State hospitals or some Equine hospitals. The vets initial thought it was IAD, but after the scope and culture he ruled it out. The vet also did a lavage during the scope (did not do the lungs ) and had it tested and he said there were not any cells that made him believe it was IAD. Again, I am uncertain. I really appreciate your time and advice! I think a specialist is in our near future.
He ruled out IAD based on a tracheal wash, however as I was reading more about IAD, studies are saying that a tracheal wash is insufficient. It takes a bronchial wash to diagnose.
Thanks again for your advice!
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