Hi - I have a 21 yo Connemara gelding. He was tested about a year ago for Cushings as he was showing some symptoms (lethargy, shaggy coat, cresty neck)) but the lab results cam back normal. However, this winter, he has developed intense itching - to the point where he is rubbing himself raw on a tree. The hair on his neck and chest will come right on in your hand and his skin seems very 'scurfy' We (vet and I) tried him on a ten day course of dex, with no improvement.
He is on a balanced diet (through Poulin) of hay and MVP supplement.
Any other suggestions? I just want to make him more comfortable - he is really bothered by the itching.
Sorry if there is something in the files, but I did not find anything for this particular symptom. I have though of Gold Bond powder or something similar but I think I would need about 5 gallons of the stuff to coat his entire body, and then what do I do when he gets wet?
Any thoughts/suggestions would be appreciated.

Emily in NNY

I am still waiting on the test results on my horse for IR & Cushing. He has been itching for 3 years, year round. I have used at least 5 different vets and even seen an equine dermatologist. What is finally working is a human drug called doxipin. It is an anti depressant for people that is now being used in dogs and horses for itching. I was told it's a very safe drug. I hope this helps but please let me know because I have tried everything on the market!
Bonny in Louisiana

I forgot to add 2 creams that may help. Boudreaux's Butt Cream to his severe spots for a couple of days,
then a cream I think you need to get from your vet called SSD.
Bonny in Louisiana

Hi Emily,
Welcome to the group. We have a very simple protocol to follow. It is DDT/E.

DIAGNOSIS is by bloodwork. Please tell us what test you had for Cushings, the lab value, unit and normal range. Was any other test ordered like Insulin and Glucose? Thats what we use to confirm IR. A thyroid panel would give you a base line. I'll send you an "invite'' to join ECH4 which is where we keep our Case Histories. Please fill out the questionnaire! and tell us as much as you can about your boy. Photos of his body and feet would be good too.

DIET is a low sugar/starch/fat diet. Have you had your hay analyzed? Please download that in ECH4 too. Then the hay gurus can see what your hay looks like, and all the supplements you've added to balance his Diet. Another item needed is his complete deworming schedule. He may be suffering from Onchocerca.

TRIM is a balanced foot with heels lowered and toes backed.
EXERCISE if the horse is able.

Please ~ no more DEX until we see his history. Even a small amount of this steroid can cause laminitis. Its just not worth the chance.

Hang in there! We can help you find the answer to your boys' symptoms and get treatment started.
Keep reading the files. Start a journal on him. Its going to be a very interesting journey.

Mandy in VA
EC Primary Response
OCT 2003

--- In EquineCushings@..., "emilymck" <theponyplace@...> wrote:

Hi - I have a 21 yo Connemara gelding. He was tested about a year ago for Cushings as he was showing some symptoms (lethargy, shaggy coat, cresty neck)) but the lab results cam back normal. However, this winter, he has developed intense itching - to the point where he is rubbing himself raw on a tree.

Hi, Emily, and welcome to the list!

Here is a link to two of our moderator's posts about her "Queen of Itch" mare - just for your information:

http://pets.groups.yahoo.com/group/EquineCushings/message/150142

http://pets.groups.yahoo.com/group/EquineCushings/message/117947


The short story is that, when the diagnosis, diet, trim and exercise are all in place, these itchy episodes often resolve. So, to start with: test your hay (beg, borrow or buy a core sampler, test 20 bales, send to Equi-Analytical =Dairy One Labs) and ask for Trainer #603 ($49.00); we will help you figure out the necessary minerals to balance your hay; you may want to add 2 oz of Spirulina and 5 grams of Chondroitin sulfate daily; plus administer ivermectin every 4 weeks from spring to autumn; there are a variety of topical treatments to use in addition: if you search the messages, you will find lots.

Here is how to search: at the top of the messages page is a search box. Click on the little purple "advanced" next to it. In the "subject" box, type in "itch treatment" or "skin treatment" or similar.

The first step, of course, is the emergency diet, and the diagnosis.

cheers,

Jaini (BVSc)Merlin,Maggie,Gypsy
BC09
EC Support

Well, I also had a horse with an intense itch and it was Equine Mange. There was only a reference to it in a Practical Horseman's Ask the Vet, September 1997, I think and the reference was that the horse needed a week of ivermectin paste once a day for 7 days. It worked for her and we had done tests for ringworm, rainrot, fungi, etc. We spent three months washing her with pine tar/sulfur shampoos, etc. before trying the ivermectin...She had been at a stallion's to be bred and picked up the mites there where other horses had been in the paddock. I really think that due to the time of the year and the long term itch that your horse may be infested. Need to also disinfect her living area if possible. We used bleach solution. I08 hope that you find something to help as my horse took her hide down to blooding herself...
Angie B.
Luna and Cricket
Sept

I just want to bring up neck threadworms (Onchocerca) for those with itchy horses to research.

Vicki
SE/PA 11/02

And I'm right there with you Vicki:
As counter-intuitive as it seems - especially for anyone even on a mediocre de-worming protocol ( as many people are on this lest- i.e afraid of reactions).

I know 2 people who suspect this condition. Unfortunately- you can't kill the adults with any wormers.

Any ideas?

Barb (VT)
Aug 2001

I have a mother and daughter that began showing signs of neck thread
worm though I didn't recognize them for what they were until I read a
thread here in ECushings on the subject.

Went on to research it on line and found more and more evidence. Here
are a few things that are indicators and a few pieces of information
that convinced me. For some reason I could not convince my vet to test
or test or treat ... not taking me seriously.

I'll work backwards to show the time line.

I treated with Ivermectin according to Dr. Kellon's advice in the
aforementioned thread on neck thread worm.

The symptoms cleared.

The symptoms were constant heavy tail rubbing, to the point of losing
hair, some mane rubbing as well. In addition, a bumpy appearance to the
back and sides more pronounced on the elder horse.

More dramatic though and sooner, a constant lameness shared by both
cleared up. It was severe enough that both the mare and the filly could
not stand on three legs to have their hooves picked and trimmed. The
mare fell forward on her face at one point when had a hind leg in the air.

Prior symptoms that did not return;

The filly had foal scours which the vet attributed to "Mare Heat
Scours." I found much later that the Onchocerca parasite can be
transferred in the mares milk thus infecting the foal, almost from birth.

The filly, at about 4 or five months developed a draining abscess close
to the navel, yet another symptom of the neck thread worm.

It cleared on it's own without and prior to the later treatment.

The vet could not diagnose on a farm visit and suggested removing them
from the feed he had recommended from before the mare foaled and later
for the mare and foal. That didn't help but a very little. Both
remained oddly lame, in the same way, both tail rubbers, both with the
bumps, some erupting into small pustules that the midges went after.

I know now that the midges don't make the eruptions, they simply
irritate as they feed on them. The neck thread worm makes them and there
are picked up by the midges to be carried to other horses.

Suddenly Spring Itch has a logical explanation and a logical treatment -
find a way to interrupt the life cycle of the neck thread worm.

Ivermectin is, at present, the only known treatment to kill the larvae -
but NOT the adult. So far nothing seems to be removing the adult.

One more symptom was the deposit of chitinous material, the outer
covering of the larvae, that collect in nodules at various points on the
horse's body. My mare had, from the time I got her in mid 2008, one of
these just behind her left ear. A superficial diagnosis (by eye and
palpation, no removal and examination of tissue) was "Melanoma."
Common in grays, which she is.

It is, however, very solid, like a stone - about the size and exact
shape of a child's glass marble.

This information was gathered over a fairly long period of time before I
read the thread here at ECushings and decided to treat without
veterinary support. (It costs me about $500 per visit to come to the
farm) My vet was not being aggressive about responding to my
speculation. No offer to test, etc.

Others here had used Ivermectin on the suggested schedule so I gave it a
shot. And sure enough it all cleared up.

They have stayed comfortable throughout the coldest parts of winter. We
have had some weeks of warm weather recently and I'm starting to see
symptoms again so may opt to do the deworming protocol with Ivermectin
again. Mane and tail rubbing, a hatch of midges out, bumps coming up
under the skin that may open soon on the back. No real lameness but the
same characteristic stiff fetlock walk - the fetlock is where these
rascals can migrate to.

They are also implicated in "Moonblindness," also a condition in humans
called River Blindness and very widespread apparently on the planet.

I tend to look for sources that have research behind them, with equine
veterinary researchers being the more credible for my purposes and the
circumstances I and my horses are in.

I can't vouch for them one way or the other as outside of Dr. Kellon I
have no contact with veterinarians that know and treat for this.

Diagnosis is by skin sample, I believe taken around the anus and tail
area. They do not show in feces so the regularly suggested fecal sample
exam isn't going to be sufficient to Dx for this.

This is were I started my online search, and I suggest you look there
and of course here in the message posting archives on the subject:

http://www.google.com/search?q=equine+onchercerca&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a#hl=en&client=firefox-a&hs=ZN0&rls=org.mozilla:en-US:official&&sa=X&ei=_Md3TJa5A4SisQPs0YyuBQ&ved=0CCMQBSgA&q=equine+onchocerca&spell=1&fp=1
<http://www.google.com/search?q=equine+onchercerca&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a#hl=en&client=firefox-a&hs=ZN0&rls=org.mozilla:en-US:official&&sa=X&ei=_Md3TJa5A4SisQPs0YyuBQ&ved=0CCMQBSgA&q=equine+onchocerca&spell=1&fp=1>


*http://tinyurl.com/45l8umu*

Caveat: any errors you find in my relating the findings I list on this
subject are attributable to either the sources mentioned, or a rapidly
aging old brain. LOL

Do your own research and come to your own conclusions. Get a vet on
board if possible.

My outcomes have been good so far.

Best wishes,

Don - Pacific Northwest U.S. Temperate Rainforest, 11/2007

--- In EquineCushings@..., Don <don@...> wrote:

They have stayed comfortable throughout the coldest parts of winter. We
have had some weeks of warm weather recently and I'm starting to see
symptoms again so may opt to do the deworming protocol with Ivermectin
again. Mane and tail rubbing, a hatch of midges out, bumps coming up
under the skin that may open soon on the back.

Sorry, moderators if this is too OT.

Two things - first I've found that the symptoms can be different in different horses. The horse here had no lameness, but intense itching on midline and chest. A friend's horse was not itchy, but had what she called a skin "munge" - which showed up about 2 weeks after deworming and which the vet tested and found positive for NTW. Varying symptoms make it pretty hard to diagnose I suppose.

Second thing is if the life cycle is 14 years, wouldn't you have to KEEP doing the ivermectin thing to kill off the microfilare so you don't get any new adults. But how often? And for 14 years? Yikes.

Vicki
SE/PA 11/02

Don:

Have a friends horse going thru EXACTLY same scenario..
If Ivermectin doesn't kill the adult - what does? I've done some research and the life-span of the adult is 5 YEARS!!!

Barb (VT)
Aug 2001

At present I've found no information that says the adult can be killed. I believe in humans a similar parasite (related to this one and causing the condition River Blindness) is removed surgically. I've not heard this is possible with horses, though I'm curious if it has been tried.

There are different estimates of the lifespan mentioned.

I've also read that we need to think, with all parasites, that "management" rather than parasite "free" should be the watchword. Apparently our dear horses are absolute circuses of parasites, internally and externally, and varying conditions determine them showing up clinically with symptoms we can recognize. Most appear to not be much of a burden to the horses' system UNTIL the horse is compromised.

Know where there's any health compromised horses?

Along with all the other care we give our PPID and IR horses I think it's safe to assume we have to do more in terms of addressing parasites than the average non-afflicted equine, just as we have to be more attentive to bacterial and viral infection, and dietary exactness.

Using more of the meds more often, that our horses need, may be hard for vets who are concerned about development of resistant parasites but we may have fewer choices about how often and how much meds we use.

I read of rumors, and rumors only, that onchocerca may be becoming resistant to Ivermectin - on the other hand it may be that those claiming so aren't aware of how easily and rapidly a horse can become re-infested by this parasite to clinically visible levels.

Wait a month or two after de worming and sure enough symptoms will begin to return because that IS the life cycle of this beastie. The parent is always or frequently putting out larvae, apparently. At least in warm weather. Might mislead some to think it's a matter of resistance to Ivermectin.

Don - Pacific Northwest U.S. Temperate Rainforest, 11/2007

Hi Emily -

Had a chance to take a look at your history. Fievel sounds like quite a guy! Mandy gave you a great intro a few days ago. Let's expand just a bit...

At his age, and being a pony, it's highly likely he is IR, even without the lab work to support it. Plugging around the arena is a typical description of a horse with low grade laminitis. I realize you are in wintery NY, but I think it well worth your while for Fievel's health that you start to soak his hay. If this is more problematic than a bit of a pain in the neck, you should easily be able to get Ontario Dehy Timothy Balance Cubes. These are a complete feed, low s/s and high fiber. All you need to add is flax, vit E and iodized salt.

While you're not feeding a lot of the MVP, it does contain some ingredients that can be and are problematic for some horses - the soy bean meal, wheat midds, canola oil. I would probably stop that for now.

I suspect that I am the biggest opponent here for the use of steriods since all I need to do is whisper the *S* word and Pap has problems. I certainly would not allow the dex test for your boy to determine if he has PPID or not. The ACTH will safely give you the same information. It's also been well over a year since you had an ACTH run, so while it was apparently normal then, doesn't mean it is now.

I would schedule with your vet a day to draw insulin, glucose and ACTH. These are drawn **non-fasting**, regardless of what the vet might instruct, with the horse eating his regular diet prior.

It's up to you as to if you want to take the steps now to soak the hay or change to ODTBC, or not. You do describe a pony that needs some diet modification.

Please feel free to post pix of his feet and/or x-rays. As we've discussed a couple of times recently, the trim is often the last piece of the puzzle to fall into place to make all the difference in the world. A balanced trim has many interpretations/iterations out there...we advocate one that tightly hugs the coffin bone (low heel/short toe) and allows for appropriate loading of the hoof.

Linda
EC Primary Response
West Coast
May 2004

I did a quick PubMed search, and it looks like an old de-wormer "Closantel" is quite effective- it's use being revived and looked at again in 2010 for threadworm. 2nd reference shows the dose per/kg for horses.

I'm not sure if the drug is available now though for horses or humans.

I also think you're correct, in that it['s the immunocompromised horses that may have the hardest problem - with worms, and being de-wormed.

Barb


New research suggests closantel drug may be useful in combating ...
Feb 8, 2010 ... Scientists at The Scripps Research Institute have discovered a potential new use for the drug closantel, currently the standard treatment
www.news-medical.net/.../New-research-suggests-closantel-drug-may-be-useful-in-combating-river-blindness.aspx

Am J Vet Res. 1985 Jan;46(1):16-8.

Activity of closantel in the prevention of Gasterophilus and Strongylus vulgaris larval infections in equine foals and yearlings.

http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=3970420&itool=pubmed_docsum

Hi Barb,

On 2/15/2011 6:10 AM, B wrote:

New research suggests closantel drug may be useful in combating ...
Feb 8, 2010 ... Scientists at The Scripps Research Institute have
discovered a potential new use for the drug closantel, currently the
standard treatment
www.news-medical.net/.../New-research-suggests-closantel-drug-may-be-useful-in-combating-river-blindness.aspx

This link is broken, truncated by the poster of the citation. Here's
the corrected URL/Link:

http://www.news-medical.net/news/20100210/New-research-suggests-closantel-drug-may-be-useful-in-combating-river-blindness.aspx

*http://tinyurl.com/46kywj6*

Am J Vet Res. 1985 Jan;46(1):16-8.

Activity of closantel in the prevention of Gasterophilus and
Strongylus vulgaris larval infections in equine foals and yearlings.

http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=3970420&itool=pubmed_docsum
<http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=3970420&itool=pubmed_docsum>

I don't think this abstract establishes the med is effective against
onchocerca.

I am unable to establish if the Neck Threadworm, Onchocerca, falls into
the same or either phylum as the two listed, and the article doesn't
specifically point to onchocerca.

Gasterophilus is the pest we know as botfly, a digestive organ parasite
and unrelated, as far as I can determine, to onchocerca.

Strongylus vulgaris is a bloodworm, and does reside in the intestines as
part of its life cycle. Again, not onchocerca.

The good news in the above abstract is that IF it is effective against
onchocerca it is not harmful to foals, and I presume adult horses.

Now to find tests on horses specifically for Onchocerca.

The critical link, as yet unproven I think is this:

What works on /Onchocerca volvulus/ in humans are both Ivermectin, and
Closantel. This suggests similar efficacy with Onchocerca cervicalis,
our neck threadworm by both. Let's hope.

I'm still searching for a specific use of Closantel with NTW.

Thanks for the pointers.

Don - Pacific Northwest U.S. Temperate Rainforest, 11/2007

Don:

My friend Deb has the horse she suspects may have O.cervicalis adults along the nuchal ligament. He also has a bulbous sheath with swollen lymphatics on each side- with some diffuse edema each side of the belly. Not sure if the Closantel works- but it looks like it's not avaiable anymore in the USA anyway for horses... I brought it up, only because it was a safe wormer and sometimes when wormers haven't been used in a long while- bringing them back will solve a resistance problem to current drugs.

Deb's horse: When wormed 1 week appart with Ivermectin 3 times : edema was worse after the 1st time, then improved after the other 2. He is a little itchy now ( still wintry here)but not as bad but his sheat is still plenty big, with swellings on each side in front of it.

We are both down troddened thinking the adults live for 5 years once they migrate to the neck, and there's nothing that kills them.

It isn't very satisfying to think that for this for to happen the horse is probably immune suppressed ( for some reason ) either.

Barb (VT)
Aug 2001

Hi Barb and Don

It's not unusual to see the die off after worming as bad as reaction from the actual bugs.

They can become resistant to Ivermectin. That's happened to my non- IR guy.

Since we've gotten OT - not discussing specific ECIR horses - we need to move this to ECHorsekeeping. Tons of info in the archives there re Onchocerca and certainly lots of room for current discussion.

Thanks in advance for your help with this.

Nancy C in NH
February 2003
Moderator

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