In my last post, I explained to you that I had been waiting and waiting to update my blog until I found out what was wrong with me. And after almost 6 months, I was still waiting.
Well, in some ways the wait is over. In others, I now have even bigger questions than before. So, let me explain.
Spode was on orders to increase my exercise to see if that helped or worsened my breathing issues. Spode tried this for a few weeks, but in the end it was just not working out. I was miserable and started trying to stop her from taking me in the lunge pen. I had no change in how much I was snorting, and worst of all I just couldn't get the energy to do what she asked. Nothing could get me to trot some times, and it was starting to break both our hearts making me do it, so Spode called the vets again and sent me to the horse hospital. For the third time, might I add! I wonder just how many vets I've seen in my 5 and a half years with Spode in two countries (4 if you count my layover--I did see vets in Amsterdam and France, too!)? Too many for this horse to count.
At the hospital, I was trotted around and the vets agreed with my lack of energy, relatively "minor" respiratory issue, and exercise intolerance, but weren't concerned it was anything too serious. In fact, they were more concerned with my hind legs being stiff, but that was just from the trailer ride I think. Normally I feel fine.
After these observations, off I went for another ultrasound, another endoscopy (ugh, seriously the worst!) and chest x-rays. It was all very intense but worth it in the end. My repeated ultrasound showed increased roughening of my lung walls but still nothing too drastic, though admittedly it's a bit tricky due to my size. The x-ray, on the other hand, revealed a major problem. I was diagnosed with interstitial pneumonia. To put it in basic horse terms for you, the fluid filled space around my lungs that takes oxygen out of the air inhaled and puts it into my blood is all swollen, all over my lungs. The vets couldn't tell if this was permanent scarring or not, as the lungs are not regenerative and so are easily permanently damaged. Based on the fact that my breathing has been a problem for almost 6 months, it's not looking good in that regard. So finally, I understand what has happened. I have been breathing faster and struggling to exercise because I'm not getting as much oxygen into my blood stream. No wonder I've been feeling breathless when I run.
During the endoscopy, they took cells out of my lungs to test them for viruses, bacteria, and general inflammation. They've done this before already, but it was not as detailed due to the tube not reaching down all the way to my lungs last time (another big horse problem). So last time, we only saw inflammation and assumed it was asthma.
This deeper test revealed an even worse problem than interstitial pneumonia. It showed chronic inflammation based on my cell counts (already knew that), some evidence of blood in my lungs, and unfortunately I also tested positive for EHV-5, meaning I was infected with it sometime ago. Now, most horses are exposed to EHV-5 in their lives. There's no vaccine for this strain, and it's so common that for most horses it poses no problem whatsoever. In fact, until recently they thought it was not related to any issues at all. Nearly every horse in the world has been exposed to it. But some horses, and I am one of the unlucky ones it seems (possibly due to my already compromised immune system caused by my first major issue: leptospirosis/uveitis), respond negatively to it. Therefore I was given a new diagnosis: suspected Equine Multinodular Pulmonary Fibrosis (EMPF). They cannot say with 100% certainty that this is what I have right now, but EHV-5 is almost only found in lung fluid of affected horses, and the fact that I have interstitial pneumonia means it's even more likely. They have never had a case of EMPF that didn't test positive for EHV-5. So it's extremely likely that this is what I have. A lung biopsy would guarantee it, but Spode doesn't want me to do that as it's invasive and risky, especially for a horse my size. Even if it's not EMPF and just regular interstitial pneumonia, it's not looking good regardless.
Now, Spode has explained all this to me, so basically it means that I will have lung scarring caused by the pneumonia--once it's progressed further, it should eventually be seen by x-ray as it shows up as blobs of scar tissue, which first starts with lung wall roughening (which I already have). EMPF is only a very recently discovered disease and is quite rare. Unfortunately, there are only a handful of cases of horses surviving this disease, so the prognosis is poor. It's been a shock to me, and to everyone Spode has told, really. Mostly because I look great: I'm shiny, good weight, and happy to wander round and have a huge appetite as always. Aside from breathing faster and having a heave line at night and the snorting when exercising, I look totally normal. Everyone is hoping this means I have a better chance of survival. Most horses (and people with this disease) have a life expectancy of 2-5 years. How I respond to treatment will give the vets a better idea of my prognosis. I have definitely worsened since August, but not as fast as many horses who get this disease, so my hooves are crossed for a good chance of long term survival in my case. There is no cure for the disease, but a few lucky horses respond well to steroids to at least stop the progression.
So that's where I'm at. Spode and I are wrapping our heads round it and taking it all in. I've been on steroids for a week and half with no luck so far. It's the same steroid I tried back in November which didn't help, but we're hoping a longer course might do the trick. So I'm staying on this steroid for a few more weeks to see if it does anything to my respiration rate. After that I will try a month of another steroid (the same one I was on for my temporary blindness. What a life I've had).
If nothing works, then I will just go into a very early retirement. I won't be able to be ridden because it could damage my lungs more if I'm pushed further than I feel up to. I need to decide when I want to run and when I want to rest, and it's a bit hard to tell that to Spode during a ride. Retirement was certainly not what I expected to be saying at only 7 years old, but life is strange, isn't it? I think Spode will miss the riding, but as long as I'm happy and pain-free, she's happy to retire me for as long as possible. We'll see how the next 2 months go. Maybe I'll be a miracle horse. I already have, according to Spode. She doesn't mean the fact I came back from temporary blindness not once, but twice. Nor the fact that I was given a guarded prognosis last year when diagnosed with inflammatory bowel disease, which I bounced back from easily. No, it's how I've helped her in countless ways.
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| A massive appetite is surely a great sign, right? |
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| I have a heave line after being outside and moving around all day, but I also have a big belly and no weight loss=positive! |
Until later, old sports.
Jay.
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