Weight loss and loss of appetite

Question
QUESTION: My 9yo QH gelding has been sick since around June-first with Summer Sores, including one in his mouth where at which time he lost more than 100lbs.  Summer sores have been treated, next, he developed an allergy to new feed, symptoms included stocking up, lameness, sucked in appearance, and loss of energy and coat quality, vet then diagnosed Staph infection, treatment over, now, but still not gaining weight back and has less appetite over the last few days.  His teeth are OK and he has been wormed (3-4 times in last 2mths on vets orders). He is back on regular feed with addition of beat pulp and rice bran for more than a month. I have pretty much run out of money for vet care at this point and need some advice on what I may be able to carry out without alot more expense.  Energy and coat quality is a little better, but he is not himself and is now pretty nervous and he has Always been pretty calm.

Thank you.

ANSWER: Vincent:

i really dont know enough about this situation to offer much specific advice. As a board-certified internist, I am always curious as to how completely the case has been evaluated. If you have not run a complete blood count AND a complete serum chemistry, you really should do this right away. I realize you are concerned over spending money on diagnostics, but also remember that you will spend alot of time and more money on treating this too, and if its not the problem(s) you think it is, then you are also wasting that money and not getting any results, forcing you to continue the same therapies to which the horse may never respond. You can increase his feed/caloric intake as much as you can, but if he wont eat, you cant get weight on him regardless of how good the feed and how rich in calories the diet is. In my experience, if the horse wont eat, there is something more wrong. Unless the Summer sores are horrendously painful and ugly, In my hands, Id be looking for another explanation for the lack of appetite. Im sorry to suggest that there may be more need to investigate this, but if you keep treating this to no avail, you will also spend the equal amount of money in useless treatments and supplementation of his feed with no real results. In my opinion, he needs to be further evaluated for this condition. If he wont eat, you cant put the weight on, and the lack of appetite is a red flag that something else may be a problem. Feel free to keep in touch. Again, if its not been done yet, at least get the blood work done. If its been a while, it might also be worthy of repeating. good luck to you. Happy new year to you and yours.

---------- FOLLOW-UP ----------

QUESTION: I neglected to mention that yes, a blood panel was done and nothing alarming came to light.  Do you have any idea of what I can ask my vet to look for?

Thank you,

Vincent

Answer
Vincent:

If I were looking at this horse I would evaluate it for stomach ulcers, colonic ulcers using the occult blood tests available by Suceed and using a gastroscope. I would do a fluid analysis of the abdomen to look for infection, or abnormal cells that could suggest a pathologic process in the abdomen, I would listen to the chest and ultrasound the chest to look for masses or infections, I would to a rectal exam to feel for masses in the abdomen, I would ultrasound the abdomen to lookd for liver and other abdominal pathology, I would repeat all the blood work, i would dso a good complete oral exam, I would do a quantitateve fecal parasite evaliuation and I would devise an increase in the caloric intake if the appetite is good. If it is not, I would continue to to more diagnostic testing. however, if your horse's appetite remains poor, you may need an internist at a hospital or outpatient clinic to evaluate things further. Id try to stimulate the appetite BEFORE deciding to do all that unless you are comfortable with pursuing all that testing and the associated expenses. good luck to you again. Happy new year.