Sometimes solving a medical problem is like solving a puzzle. That was certainly the case for my 21-year-old grade gelding, Cavalier, and me. After a routine vaccination administered by a vet, "Cav" suffered an injection-site infection that drained his health and my resources. My gelding endured agonizing treatments for two-and-a-half months because of one critical piece missing from a diagnostic puzzle. It took a second opinion, a diagnosis of Cushing's disease, and aggressive care to save him.
By sharing my tale of Cav's Cushing's disease diagnosis, I hope to keep you and your horse from ever enduring this sort of nightmare.
A Hard, Angry Lump
Wednesday, May 7 - The mystery begins. Just days after the local vet gives Cavalier a 5-way vaccination, there's a hard, baseball-sized bump at the injection site. Cav's neck is so stiff that I hang a hay bag at shoulder level, just so he can eat. On the vet's telephoned recommendations, I begin several days of applying hot compresses to the injection site. I also administer two grams of bute with a balling gun to control the fever, which spikes to 103 degrees.
Tuesday, May 13 - The vet arrives and punctures the lump. A geyser of foul-smelling fluid gushes out. He prescribes a powder antibiotic twice daily, mixed with applesauce and administered from a drenching gun, and has me apply a topical salve to reduce the swelling. Relieved, I figure Cav's on the road to recovery.
Wednesday, May 14 - A nasty surprise. Cav's chest is enormous and filled with fluid. The lump is large and his fever rages. I call the vet out again and he cuts an inch-long slit in the lump for drainage, and tells me to flush it with hydrogen peroxide. He prescribes a diuretic powder to reduce the chest fluid and orders blood work.
Friday, May 16 - Cav's chest fluid is almost gone, but the neck lump still oozes. He's lost a lot of weight, and retains a long, thick winter coat. He's been shedding out late for the past couple of springs, but I've never seen his coat this heavy.
Monday, May 19 - A week of medication hasn't solved the infection. Over the phone, the vet prescribes a second antibiotic and Granulex topical spray to avert proud flesh. I begin twice-daily penicillin injections into Cav's rump muscles, alternating sides. The blood panel results don't reveal anything significant regarding the infection.
Friday, May 30 - Incredibly, the penicillin hasn't helped. I'm distraught that the infection hasn't responded to anything we've tried. I swab the pus and take a sample to the vet's clinic for analysis. In the meantime, he prescribes yet another antibiotic. I'm still using bute for his fever and flushing the hole multiple times per day.
Tuesday, June 3 - Culture results show three different bugs at work in the infection. The vet prescribes a fourth antibiotic to combat all three. I'm beginning to feel there's no cure, and worry the twice-daily injections could lead to another infection. I kick myself for having sold my horse trailer the year before, a move that now complicates my second-opinion options.
Friday, June 6 - Cav's neck is sore and bruised from the flushing process. He's endured multiple injections, pills, pastes, flushings, and fevers for weeks. His coat is yaklike, and his neck and left shoulder are scalded bald by the oozing infection and various treatments. His ribs protrude despite the fact that he's kept a decent appetite.
Wednesday, June 11 - I continue doggedly with treatment. I've been making morning and evening trips to the barn every day for weeks, and spending hours with Cav each time out. Yet there's been no real progress. In horror, I begin to wonder if I may have to put him down.
Thursday, June 12 - I decide we need to help beyond the never-ending cycle of phone messages and antibiotics. I ask an acquaintance with a trailer for help, and call the Loomis Basin Veterinary Clinic, about an hour's drive away.
Wednesday, June 18 - At the clinic, Dr. Kim Sprayberry, an internal medicine specialist, sonograms Cav's infection site and detects extensive "channeling" (pathways created by the infection) throughout the muscle. She draws blood for analysis and cultures the infectious ooze, then advises me to stop the antibiotic injections and target the infection site directly. She formulates a system of flushing the channels through a four-inch-long canula (a narrow metal tube), using Betadine solution and sterile saline instead of hydrogen peroxide. Cav remains at the clinic for two days so staff members can better establish paths for the canula, and flush the pus=filled channels several times per day.
Thursday, June 19 - Dr. Sprayberry tests Cav for Equine Cushing's Syndrome while he's at the clinic (it's a two-day procedure). His long coat, advanced age, frequent urination, and ongoing infection are all symptoms of a "Cushing's Horse."