Allergy Testing

Allergy Testing

Tuesdays with Tony

If you’ve been by the clinic lately, you may have noticed my fancy new hairdo. If you haven’t, I’ve provided a picture for you all to admire. A few weeks ago, my staff felt the need to show me off to all the lovely people at the University of Florida Veterinary School. Of course, I was happy to oblige to my adoring fans.

Springhill Equine

 

My staff explained to me that the reason for my visit was not just to get scratches and loves from the veterinarians, technicians, and students at UF, but it was important that I get checked out for allergies. The dermatology department at UF spent the day checking me out and performing intradermal skin allergy testing (IDAT) on me, hence my fancy new haircut. Did you know that horses can have allergies too? And did you know, my doctors here at Springhill Equine can perform allergy testing on your horse to help figure out why he/she likes to itch his/her mane off every spring, or why they tend to have trouble breathing during certain times of year?

 

What is Allergy Testing?

You may be asking yourself the question, what is allergy testing? Luckily for you, I have firsthand experience on this matter and can give you the lowdown on what exactly allergy testing is. There are two different types of test available. One is a blood test that measures certain protein antibody levels in the blood that may be causing your horse’s allergic symptoms. While sometimes this is a good starting point for allergy testing, intradermal testing is much more specific. Allergy blood testing can occasionally cause horses (and cats) to test positive to allergens that they are not actually allergic to. This is why my doctors choose to test your horse with the intradermal method. Using intradermal testing, my docs can test multiple different allergens that may be causing your horse’s discomfort. In order to provide you all with a play-by-play of what occurs during intradermal testing, I had this testing done during my visit at UF.

 

Why do we perform Allergy Testing?

The main reason we perform allergy testing is for the comfort of your horse. The goal of allergy testing is to identify specific allergens that your horse is reactive to so immunotherapy can be developed and your horse can be treated.

 

How do the docs perform intradermal testing?

The first step of intradermal allergy testing in to discontinue all allergy medications. I know that up until my appointment at UF, I spent way too many valuable napping hours scratching. I suppose it was the price to pay to figure out just what was causing all my discomfort. Horses also must be off all allergy medications. This means steroids, antihistamines, etc., for at least 14 days prior to testing. After your horse has been off his/her medication, the next step is to bring them into the clinic to see my docs.  While you’re here you might even get a personal “cat” scan from yours truly. You’ll leave your horse with me for the day for monitoring, while my docs do the heavy lifting and perform the tests.

 

So, now you’re probably wondering what will happen while your horse is in my care.  First, the staff here will clip a rectangular pattern on one side of your horse’s neck. I keep a watchful eye on this part. I wouldn’t dare let a horse leave my clinic without an awesome new hairdo like mine. Next the staff will make a 6 by 6 grid in the clipped area with a permanent marker. This grid serves as a guideline to where the allergens will be injected to your horse’s neck. Next, 36 different allergens are injected just under the skin using a very small needle. This was my least favorite part of my visit at UF, though thankfully it was followed by lots of scratches and treats.

 Equine Allergy testing

A positive control (something we know your horse will react to) and a negative control (something we know your horse will not react to) are also injected under the skin, so my docs have something to compare the test allergens to. One hour after initial injection, the docs will compare the test allergens to the controls and mark those allergens which have any kind of reaction. Your horse will be looked at again three hours after initial injection and the reactions will be recorded. For the rest of the day, I will hang out with your horse and keep him/her company while he/she enjoys some tasty hay and my staff ensures no further reactions are going to occur.

 

What does all this mean?

So, you’re probably starting to think this whole allergy testing thing is sounding pretty cool, and you would be right.  You’re also probably wondering what the next step is after my docs have identified the allergens behind your horse’s discomfort. Now that reactive allergens have been identified, the docs will work with laboratories to develop immunotherapy specific to your horse. I too, got my own special immunotherapy developed specifically to treat the allergens my body was reactive to. I guess that makes me a pretty special cat, but of course we already knew that.

 

The goal of the immunotherapy is to slowly expose your horse’s immune system to low doses of allergens and gradually increase the dose. This will desensitize the immune system to the allergen so when your horse is exposed to it, it no longer reacts. And that means no more itching, no more mane ruined by rubbing, no more tails rubbed raw, and no more trouble breathing. Fortunately, once your horse’s immune system has been desensitized to the most reactive allergens, immunotherapy will no longer be needed.  A few shots for a few weeks/months seem well worth a life without scratching, if you ask me.

 

So next time you’re at the clinic, feel free to check on me and see how my immunotherapy is going. Actually, I’d be happy if you just give me pets and love. But, while you’re here, talk to my staff about setting up allergy testing for your itchy horse.

 

Until next week,

 

Tony

 

P.S. I listened to a particularly intriguing episode of Straight from the Horse Doctor’s Mouth this week. If you haven’t listened to it yet, make sure you put it on your list. It’s all about dentals, and I guarantee you will learn something you didn’t know!

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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The Ears Have It

The Ears Have It

Tuesdays with Tony

The Ears Have It 

 

First things first: please don’t forget that my biggest Meet Tony Event of the year- Open House- is coming up in just a few short weeks! Mark your calendars for Springhill Equine’s 12th Annual Open House on Saturday, September 29th from 10 am – 2 pm. This year you will visit booths themed after favorite movies, enjoy delicious BBQ, and explore what our local vendors have to offer, while getting entered to win a free Wellness Package for one of your horses! I’ll plan on seeing you all there.

Do you ever feel like your week has a theme? For example, you and two of your friends all get a flat tire, or you see a snake in your backyard then the next day you see one on your way in to work, or you hit 2 squirrels with your car within the span of a few days? Well, this week’s theme was definitely ears. We have seen itchy ears, swollen ears, abscessed ears, allergic ears, hyper-sensitive ears, and even an ear with a tick in it! So, I quizzed the docs on the common ear problems horses get, and how to recognize and treat them. Do you know what to do if your horse’s ears are driving him nuts?

 

My horse won’t let me touch his ear

So first, a few questions. Does your horse normally let you touch his ear? Because most horses generally don’t love it. Is it just one ear, or both ears? Both ears make it more likely to be an itchy, allergic, hypersensitivity condition. One ear makes us think of trauma such as a laceration or bruise, or perhaps a tick inside the ear. Side note: the docs tell me that in vet school they teach you that ear ticks are a super-common thing that you will encounter all the time…but in real life they are extremely rare. However, if your horse develops a sudden extreme hypersensitivity in one ear with no other symptoms, an ear tick is definitely on the rule-out list.

If your horse’s ears are irritated in any way, you’re probably darn right that he won’t let you touch them…they hurt! Spoiler alert: it’s going to require a good amount of sedation, a step stool, and a fancy light called an otoscope to get a good look in there. Read as: Call your vet.

 

But doc, this just happened today!

Far and away the most common ear problem our docs encounter is chronic, thickened, irritated ears secondary to a gnat allergy called “Culicoides hypersensitivity.” Often the vet doesn’t get called until the horse itches his ear so badly that he cuts it on something, and the owner finally takes note when blood and/or pus are streaming out of the ear. Without fail, they claim this “just happened” and the ears were normal a few days ago. While the wound may be new, the underlying condition that led the horse to be so uncomfortable that he self-traumatized his ear has taken months, or even years, to develop.

Springhill Equine Veterinary ClinicCulicoides (kyōō′lĭ-koi′dēz′) is a species of gnat very common here in Florida. Many horses are actually allergic to the saliva of this gnat, so every bite by one of these annoying little devils sends the poor horse into an itching frenzy. The early signs of this gnat allergy include frequent scratching and hair loss in the ears, mane, base of tail, and chest. Over time the skin in these places will become thickened, there will be multiple open bite wounds, the hair will be completely gone, and the horse will constantly be scratching on anything and everything he can find. Horses with chronic Culicoides hypersensitivity will often develop a “cauliflower ear” appearance over a period of years. Once this happens, the ears will never return to their original shape.

What can I do for my horse’s poor ears?

It is best and most successful when owners treat horses with gnat allergies early and often. Look closely at your horse’s ears. Is the hair thinning inside and around the edge of the ear? Are there tiny bug bites inside? Do you see any scabs or blood? Is the skin normal, or is it becoming thickened?

At this early stage, you should be able to get the problem under control with just some topical medication and fly gear. We always recommend a fly mask with ears for these horses; fly sheets, neck pieces, leg covers, etc. can be added at your discretion. The topical medication that works best for this condition is Equishield IBH (that stands for Insect Bite Hypersensitivity). It comes as a salve or a spray, depending on your preference. We find that the IBH salve works great for ears, but the IBH spray is awesome when you need to treat a larger area.

itchy horses Springhill EquineOnce the ear has gotten to a point where there is a secondary laceration, abscess, or hematoma, it can be difficult to treat. While we always try conservative options first, these horses sometimes have to undergo surgery under general anesthesia to drain the ear, followed by weeks with the ear taped down against the horse’s head to allow for continued drainage. No fun.

If you have tried the fly protection and IBH products, but your horse is STILL uncontrollably scratching, talk to our docs about a systemic treatment such as an antihistamine to break the chronic itch cycle. There is even a new drug on the market called Apoquel that has been used to treat itchy dogs, but is now finally getting some attention for use in horses. While the medication is pricey for a 1000 lb animal, we have seen promising results with it so far!

As a cat who suffers from itchy skin, let me tell you that constantly feeling itchy is no fun. If (God forbid) I lived outside swarmed by the very creatures that made me so itchy, I would be miserable! So thank you in advance for not ignoring your itchy horses.

Fondly yours,

-Tony

P.S. Want more itchy horse info? Check out Dr. Lacher’s podcast on itchy horses. It’s the latest episode of Straight from the Horse Doctor’s Mouth. You can listen right from our website, or subscribe wherever you get your podcasts! What’s a podcast, you ask? It’s just like a radio talk show, except you can listen to it on your phone or your computer whenever you want to. Try it out, and see what the thousands of other subscribers have already figured out 😉

P.P.S. If you haven’t subscribed to this blog yet, make sure you scroll down to the purple box and sign up. Don’t rely on Facebook to deliver my weekly wisdoms to you, they’re very unreliable!

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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Tuesdays with Tony – Skin

Tuesdays with Tony – Skin

Skin

Skin is a truly amazing organ. It keeps our bodies from drying out, protects us against infection, plus it’s waterproof! I love my skin. Heck, as a cat, I spend several hours a day grooming it just to keep it in pristine condition. But the trouble with skin is that sometimes this protective barrier that surrounds our entire bodies can break down. Let’s take a closer look at the 3 biggest enemies of equine skin: Rain, Sun, and Bugs.

Rain
Just about every horse owner has heard of Rain Rot. But, did you know that rain rot is actually caused by a type of bacteria, and not a fungus? And did you know that this same bacteria can cause skin problems elsewhere on the body, like the pasterns and cannon bones? Rain rot is so named because this bacterium happens to thrive in moist environments. This is why it is usually found on your horse’s back or flanks after heavy rainfall, or on the back of his pasterns when he has been standing in a muddy pasture. So, while skin is waterproof, it is not a fan of prolonged exposure to moisture.

Sun
sensitive skin horseYou wouldn’t go outside all day in the middle of summer without any sunblock on, would you? Well, the same goes for your white horse, or even your chestnut horse with that little snip on his nose. If you are one of the lucky ones to own a mostly-white paint horse in Florida, you may want to invest in a full-body fly sheet with UV-blocking properties. But, if it’s just a strip or a blaze you need to cover up, daily application of sunblock or a fly mask may suffice. Don’t forget to protect your horse’s skin from sunburn just as you would your own!

Bugs
Nobody likes being bitten or stung by flies, gnats, bees, ants, and the like. But many horses are actually allergic to the saliva of these pests. As you may have guessed, the skin and hair of these horses is a complete disaster during the buggy season. The owners of these horses may as well invest in fly spray at the rate they have to buy it! Wouldn’t it be great if there were a single product you could apply daily to repel bugs, soothe skin, take away the itch, and treat already-existing bug bites? Well, actually, there is!

To find out about this and other magical equine skin products, don’t miss our free seminar, Managing Skin: From Itch to Funk! this Thursday, June 8th, at 7pm. One of my favorite speakers from Kinetic Vet will be talking about how to manage these and a variety of other equine skin conditions. Oh, and most importantly, I will be there! Check out the Event Page on Facebook for more details!

So, bring a friend, and a treat for me, and I’ll see you Thursday! Be ready to take home some free stuff, but please make sure that I am not among the prizes that wind up in your barn. Sometimes I accidentally go home with people…

 

Tuesdays with Tony – Pollen

Tuesdays with Tony – Pollen

We in the animal world think it’s fun to display our allergies in fun ways designed to mystify our humans.  For instance, I myself suffer from allergies.  My allergies manifest themselves as itchy skin.  Luckily, I live at a veterinary clinic.  My minions do their best to manage my allergies, but I do my best to come up with ways to avoid their treatments.  Turns out cats and horses are similar in this way.

It’s not snot

Usually, horses don’t get the runny noses and itchy eyes you humans encounter.  Instead, they get itchy skin, diarrhea, and sometimes coughing and wheezing, but very rarely straight up snot.  Diarrhea is most often a food allergy.  Itchy skin can be caused by allergies to pretty much anything: food, oak trees, sawdust, gnats, the sky, sunshine.  Coughing and wheezing are more common with allergies to pollen and dust.

What are they allergic to?!?  

The best way to treat allergies is to avoid the thing you’re allergic to.  Right.  Because it’s easy to avoid bugs and pollen in Florida.  So what’s a cat to do? There are a couple of options.  One is to treat the horse for allergies to anything.  The other option is to identify what your horse is allergic to, then treat with a combination of allergy shots and avoidance.

Let’s talk about identifying what your horse is allergic to first.  Just like they do for humans, my Docs do what’s called intradermal allergy testing.  They take very small amounts of allergens, like oak pollen, and inject it under the skin.  Next, they wait a few hours to see how big a bump that allergen makes on the skin.  The bumps get ranked on size, and a custom allergy shot mix is made for your horse based on that.

The other option is the broad-based drug approach.  This is like you humans taking benadryl or Claritin.  Horses can take Claritin, too.  Okay, they do better on Zyrtec, but whatever.  These treatments are aimed at reducing the entire body’s allergic response, but, as you humans know, there can be side effects.  The most common side effect is drowsiness.  This side effect makes many of these drugs a big no-no for show horses.

Making life livable with allergies

Now that you know the options for treating allergies, let’s talk about real world management.

Allergy shots work really well for the coughing, wheezing horse.  However, they do take a while (as in a year) to kick in.  Allergy shots start with a low dose, then gradually increase over about 2-3 months.  These shots get the body to tone down its response to allergens.  This means less coughing and wheezing.

Cetirizine (the drug in Zyrtec) and dexamethasone are the most common drugs my doctors use.  Cetirizine is cheap and easy to give, but again, can’t be used if you have drug testing at your shows. Dexamethasone is even easier to give, and can be used if drug testing is performed.  Depending on your horse, farm, and situation, our Docs can help you design the plan that works best for you.

There is a new drug available to help allergic horses:  Apoquel.  This drug has been used in dogs with some pretty fabulous results.  My Docs are among the first in the country to use this drug on itchy and wheezy horses.  I hear the result have been spectacular.

Avoiding Allergies

Okay, so let’s just agree that this is not a possibility for most allergens.  The only one it is sort of, kind of possible for is gnats.  This is done by covering your horse with fly sheets and masks from head to toe, dousing them in fly spray, IBH salve (ask my humans, they have it at the Clinic), and keeping them in front of fans at sunrise and sunset.

Need help in the eternal battle against allergies?  Call my humans.  They don’t just treat allergic horses, they own allergic horses.

Until next week,

-Tony

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

Tuesdays with Tony – Huffing and Puffing

Tuesdays with Tony – Huffing and Puffing

Yes we all know I’m not the most athletic critter on the planet. But heck I’m management; I don’t have to exert myself too often. When I do decide to chase off after a squirrel, I find I need to take a moment to catch my breath. After a brief respite in the sun, I am ready to chase that pesky squirrel again. It doesn’t work that way for some cats, horses, or people. Yep, I finally found something us cats have in common with horses (and people but I’m trying to ignore that part). We all get asthma and we all get it because of allergies.

Walk in the barn at feed time and listen for a cough. Horses with asthma will nearly always cough when they are eating grain, especially if it’s dry. Even the smallest amount of dust triggers their over reactive airways making them cough a dry, hacking cough. Cats experience a similar cough when they have asthma. Also there is no hairball after the cough. Another clue it’s asthma in cats anyway. I’ve never seen a horse cough up a hairball. Anyway back to asthma. Other clues your horse may have asthma are sudden poor performance for no good reason and really fast breathing after exercise that takes forever to slow down. Some horses will get so bad you can hear them wheeze when breathing without a stethoscope. On other horses you need a stethoscope to hear wheezes and crackles. Our Docs are happy to show you how to listen for lung sounds. I have never heard these sounds, since they don’t make cat stethoscopes but I have a request in to the manufacturer. How am I supposed to do a proper Cat Scan without a stethoscope?

What are we going to do about the asthma? Well I’m not going to do anything because that’s what I do. My Docs are going to treat the allergies that lead to asthma. Asthma happens when the tubes the air goes through in the lungs gets clogged with mucous. The lungs release the mucous to try to get rid of pollen and dust. So the Docs try to reduce the mucous produced in response to pollen and dust, decrease the amount of pollen/dust in the environment, and help that mucous get out. The easiest, most economical, and most effective treatment is dexamethasone. This is a steroid which is given by mouth. Dexamethasone tells the immune system to quit worrying about the dust and pollen. Unfortunately, dexamethasone can have some nasty side effects when used at high doses for a long time so we have to be careful. Other steroids can be inhaled. This minimizes side effects but can be very expensive. There are a couple treatment options to help get the mucous out, such as Ventipulmin. Our Docs usually use these early in the treatment process then slowly taper them.

Management changes are really important for horses with asthma. The only way to change the pollen is to move far away but dust is a different story. Remember how I said that coughing happens around feed time? Wetting down feed and, more importantly, soaking hay reduces this source of dust. In fact some humans did a study about hay and found a 25% reduction in symptoms just be removing dry hay from these horses diets! Bedding is another important source of dust. Using the pelleted type bedding reduces mold and frequent wetting down decreases dust. The effects of pollen can be minimized by keeping your horse in the barn with a fan on them. Sure it doesn’t work great but it’s about the only option we have here in Florida short of moving to Arizona.

Since asthma is an allergy problem identifying what your horse is allergic to is very important. Our Docs do this skin thing that helps figure out what is causing the worst response. They call it allergy testing. A small amount of a potential allergen is injected under the skin. The Docs come back in a few hours and see if there is any swelling around the allergen. Based on what causes the most swelling, they make a super special shot to help the horse learn to tolerate those things. It’s pretty cool.

Our Docs are seeing lots of horses with asthma right now. If your horse suddenly isn’t right, give them a call and see if asthma is the problem. And put our 8th Annual Open House and See Tony Event on your calendar for October 22nd. Food, fun, prizes, learning, and you get to see me in cat!tony-on-hay

Tuesdays with Tony – Funky Skin

Tuesdays with Tony – Funky Skin

Last week me and about 60 of my closest human friends learned just about everything there is to know on the topic of skin funk! I almost wish I were a horse just so I could try out these products on myself…but I’ll stick with being a cat for the superior intelligence. Thank you to MaryLu from Kinetic Vet for her excellent talk, and the folks at HorseSox for their demonstration. They really should start making CatSox tho…less knitting.

For those of you who didn’t come out to see me on Thursday: ouch. That really hurt my feline feelings. But I’ll be the bigger cat, let it go, and tell you what you missed!

There are several types of skin funk that horses can get. There is itchy skin funk, scratchy skin funk, buggy skin funk, sunny skin funk, fungus-y skin funk, and bacterial skin funk. Lucky us, we live in Florida, so most of these are going to be exaggerated by our awesome warm weather! The first step is recognizing when your horse has a skin problem. Skin funk can show up as hair loss, hives, welts, crusties, scabs, redness, or abnormal hair growth. The second step is calling me! Well, more specifically, Dr. Lacher or Dr. Vurgason. With their experience, they will be able to tell what type of skin funk you are dealing with, what the cause is, and how to treat it. The third step is using one of Kintetic Vet’s awesome products (plus HorseSox for lower leg skin funk) to get your horse’s skin back under control!

Dr. Vurgason’s favorite KineticVet product is the IBH salve.  This is great for horses with Insect Bite Hypersensitivity (“I.B.H.”), and a little bit of salve goes a long way! Did you know there are 89 species of gnats (that’s not counting horse flies, mosquitoes, house flies, etc) that are probably going after your horse’s eyes, ears, mane, and tail!? Dr. Lacher’s favorite product from KineticVet is CK shampoo. This stuff is amazing for treating scratches, rain rot, and any other bacterial or fungal skin funk. Only a few treatments and the results are amazing! My favorite product is KineticVet’s new SB (sunblock). Not only does it provide sun protection for my delicate skin, but it also repels insects and contains aloe vera which makes it feel really good.

There was definitely a little something for everybody at Thursday’s seminar. Most notably, there was plenty of me!  Stay tuned for our next “Come See Tony” event on Equine Nutrition, coming up in May. Until then, take care of that skin!

Tony Skin Funk Seminar