Pythium insidiosum

[Heidi]

My Australian Stockhorse, Tommy, has been diagnosed with Pythium insidiosum, technically, a water mould, but in laypersons language, a waterborne fungal infection. It presents as a small wound that will not heal, but really, what is happening is the fungus is sending its insidious little hyphae (or rootlets) into the flesh, and destroying it mechanically.
Tommy is at the vets getting IV antifungals, and has had the fungus surgically excised from his leg. The vet was able to excise down to what he believes is clear, healthy skin. This wound is above his coronary band, on his left rear hoof, and thankfully, no ligaments or other structures were involved.
So, the vet is cautiously optimistic that we have caught this in time so that we will not have to euthanase him, however, it is way too soon to rule this out.
Through some research on the net, I have found out that Michigan State University has a vaccine that has proved very successful. I was hoping that a KFC'er that lives in Michigan, (so that it wouldn't be a long distance phone call), could possibly call them to see if the vaccine is available in Australia, and if so, where it can be obtained from. The phone number is...
The Pan American Veterinary Laboratories of Michigan State University Tel: [phone]
If someone does do this, could they then put a reply on this board.

My vet has gone away until Monday afternoon, and the vet nurse will be the only one on duty tomorrow when I pick up Tommy.

My vet hasn't mentioned anything about a vaccine, so he may not know, or it may not be approved or available in Australia yet.

But I thought I would ask. Please, no one ring long distance, as I do not want to cause anyone any expense.

I have no idea what the treatment thus far has cost... ignorance is bliss.

Also, this condition can also affect cattle, cats and dogs and is more often than not misdiagnosed, wasting valuable hours of treatment time.

For those of us who live in warm climates with some swampy areas on their land, its worthwhile familiarising yourself with this disease, just in case you ever come across it in your livestock.

Knowledge is power.

Bye for now,
Heidi

[Becky]

Hey there Heidi,

I called and talked to a gentleman whose name is Bob Glass. He said that they have a treatment that is 90% effective in horses called Pythium Immuno Therapy. They used the treatment as a preventative in a study in Brazil and found it to be extremely effective. They haven't submitted the findings of that study to the Feds yet.
Anyway, he is unsure if it is OK to ship into Australia and said that probably should be looked into, but he is more than willing to get you the med. Can and has been used on horses, dogs, cats, and cattle.
He is very helpful and wants to speak/communicate with you. You can skype him (?), or email him.
[e-mail]
He is aware that there is a lot of pythium in Australia. Just sounds pretty knowledgeable all the way around. Hope this helps...... Sorry your fellow is sick.

Becky

[epitts75]

Just want to say what an awesome support network we have here. Becky, THANK YOU for making that phone call.

Heidi, I hope it all works out for you!

[mtnmama]

I think everyone on this board is just fantastic- always ready to jump in to help, not criticize, unlike any other site I have seen! Best of luck with Tommy, Heidi.

[Heidi]

Becke07...Thankyou for doing this for me. I will email Mr Bob Glass now. I was reluctant to ask such a favour, then I reminded myself how genuinely willing KFC'ers are to help others in need. I'm glad I overrode my natural reluctance to ask for help. I'll let you know how I get on, and Tommy's progress (or otherwise). Moderators, please remove this from the 911 section.

Thanks again
Heidi

[oscar]

I dont know the tech terms, but it sounds like what we call Scratches, I bought a mare several years ago that I thought had been caught in wire.It turned out to be scratches.Couldn't find anything about a cure on the net, and I couldn't get it to heal. So in a last resort I soaked it down in Koppertox.Healed up completely. Now it may not be the same thing, but It may pay to check it out.

[Heidi]

Thanks Oscar. If caught early enough (as in under 14 days), then the old bush remedy over here is to scrape back the skin and douse it every six hours with bluestone (which is a copper sulphate powder). It is highly antifungal, but also pretty severely caustic, and will remove a good measure of healthy tissue with it.
However, this water borne mould is really agressive, and needed surgery to remove the mould/fungus before it reached his tendons and ligaments, and then it would be all over red rover.
I got him home this afternoon, and learnt how to redress his wound after packing it with antifungal medication. He also has a antifungal food supplement and will probably have more antifungal IV treatment next week. Scratches does sound like something it would be called, because it is insanely itchy. Tommy is raking it with his teeth whenever he gets the chance.

Paid the vet bill... wish I'd had some sedation for that myself!

[oscar]

The mare didn't heal up in a week,it took about 2 months, But coppertox worked.(it's spelled with a K) It sounds close to the same thing. The vet said it treatment would cost more to cure than she was worth,and to just keep it clean. It was rough. You could smell her 30ft away. Her back feet (cornet band and up)were rotting off. I dont know know if you have access to koppertox or not. But it's a liquid, you can put this on and it soaks in instantly, you cant wash it off. It's for cattle, foot rot and such, But It was last ditch effort to save her. It worked. Wished I could help More. Hope things work out .

[Becky]

Heidi,

When my vet gets back from vacation I will ask him about an antifungal medication (it is and oral med)that he had me crush and mix with silver sulfa diozine(SSD) which is a white cream, to use on a NASTY fungal infection. It was an experiment that he had never done before and it worked like charm. I am often his guinea pig Easy and not caustic or good tissue damaging. That is the last thing you need...

Becky

[Heidi]

Hi Becky,
Bob Glass got back to me today by email. The immunotherapy is classifed as an "allergy extract". He has shipped allergy extracts to Australia before, but not this particular one. The course of three injections costs $145USD, which is fine. I'm currently trying to navigate importation permits through the Australian Quarantine, but its likely to cost be about $180Aust. in permit fees. I will ring Aust. Quarantine personally tomorrow and speak to someone who can hopefully help me with the paperwork.
I am keen to pursue this. Given that he's already had surgery to remove the fungus, I can only think that this will be money well spent, and give him a better fighting chance.
I'll let you know how it goes.
Thanks again,
H.

[Becky]

Heidi,

Thanks for the update! Keep 'em coming.... My vet should be home tomorrow, so hopefully I'll have something helpful for you.

Becky

[marseydoats]

I don't know if this will help or not. I've had a lot of good luck treating rotten wounds with raw honey. if your vet says its ok, it might be something to do until you get your shots.
Best of luck, and let us know how it goes.

[Heidi]

Thanks marseydoats.
Our vet is coming out tomorrow to do our horses' teeth. He specialises in equine dentistry. He will look at Tommy's wound then too. I was talking to my neighbour today, and he was talking about the use of medicinal honey on horse wounds too. I will speak to the vet about it. I believe that honey can work wonders, but wonder if I would need to discontinue the antifungal topical treatment that I am using as well. I'm so reluctant to discontinue that.
I feel sick to the pit of my stomach about this. I know I can only do my best and ultimately, what ever will be will be. But it really sucks!
I'm also having a hard time getting the bandages to stay on his hoof, and me telling Tommy the importance of him not ripping them off with his teeth, has made no impact!
Bye for now,
H.

[marseydoats]

Once you get your bandage in place, you can wrap around it with duct tape, just be careful not to get it too tight. Dh usually uses about HALF a ROLL when he does it, but it stays on. Then you can slide a tube sock over that, and spray something nasty (like alcohol) that Tommy won't want to put his mouth on. I think you can get one of those bucket collars (looks like a bucket with the bottom cut out, has snaps on it and fastens around the animals neck, usually they wear them after eye surgery) for a horse.
I've had horses that would wear anything you put on them and horses that you couldn't leave a halter on, they'd have it off in five seconds. I know how frustrating it can be.
Hugs to you and Tommy!

[Heidi]

Vet came and did all the dental work on our horses. Nothing unexpected this time! He examined Tommy's wound, and he is pleased that the it isn't any worse, some healing starting, but way too soon. He is an advocate of honey himself, but not in this instance, or rather, not just yet. He wants to continue antifungals for a good while. He is looking into getting a vaccine made from a swab from the wound, but once again, its a bit of an unknown. Similarly, he's looking into efficacy of infiltrating the leg via an IV with Amph(something or other) B, but is unsure about the latest on its efficacy or side effects. Tommy may become something of a guineapig. Ah, what's a few more hundred dollars?! Why can't Tommy be a horrble horse that has an ugly personality instead of a sweet loving sod that he is? Vet took pics and will email them to me, so I'll try and post a couple on here for your reference.
H
H.

[Heidi]

Well, news is that there has not been great success with the vaccines in Australia. The IV antibiotic is not effective either. I am concerned that as I am still removing kunkers from the wound, then the mould is still very much active, and I don't believe I am getting adequate cover from the Immaverol into the wound. So, Vet (hereafter called Oliver), is emailing the surgeon to see what he thinks of further surgery, and of course price of such. Also, started down the route of coppersulphate today. Puffed it on to the wound and let it alone for one and a half hours (Oliver suggested 2-4). Came back to a bloody, but very clean wound. I ran water over it for about 10 minutes to neutralise any residue, then with the help of my big burly husband, dressed it with the antifungal and bandages.
Feel sick to the pit of my stomach.
H

[wyomama]

Oh Heidi, I'm so sorry!

As far as the bandage - I've had great success cutting the leg or arm off a pair of sweat pants or a sweat shirt. Bandage, then slide it over the leg like a great big sock - don't pull the opening over the hoof. Then use a wide bandaging tape to affix it to the leg at the top. Here we have what is called "Elasticon" - it is a stretchy tape with a very sticky adhesive.

[Becky]

Heidi,

This is a fairly involved wrap, but it will stay on and keep things clean. It's expensive too...

Clean extremely well, cover everything EXCEPT the wound with furicin ointment (the yellow junk), then put your antifungal cream on a gauze 4x4. Put the 4x4 on the wound then cover/wrap lightly and evenly with brown gauze (in a roll kind)go above the wound several inches and clear down over the hoof make sure the furicin is under any part that you are planning on wrapping. Next put a layer of cotton batting, then a layer of vet wrap/co flex, then a layer of elasticon. Make sure that your vet wrap is snug but not tight and the pressure is even. Same with your elasticon. If you are having to change the wrap 2x daily, skip the elasticon and lightly duct tape the top and bottom so that is doesn't ride up or down. With the elasticon I have been able to leave these wraps on for 2 days. My vet (the one I talked to for you) took an entire Saturday and taught me how to wrap horse legs. Everything from the hoof, pastern, knee, hock, and all combined, clear up to the shoulder. I shudder to think how much he spent that day on wrap material....
I don't know about over there, but you should be able to get all the stuff at you local feed store, except maybe the elasticon.

Hang on there!!

Becky

[Becky]

Heidi,

I talked with Wally again today and he wants pictures. Just tell him your with me and he will roll his eyes and say "What have I gotten into with Becky AGAIN " You can e-mail them to him off of his web site:

www.panoramaequine.com/

In a nut shell he said that if there is still necrotic tissue and kunkers then IV or Oral antibiotics will not help as there is no blood flow into necrotic tissue. SOOOOO, it is my understanding that the bad tissue needs to again be surgically removed, then the IV or Oral antibiotics will have a chance of being effective. Same with the topical treatment.
He is REALLY advocating the vaccine. The one that he is recommending is a "soluble concentrated antigen". Have you found out of if it is available or can be shipped into Australia yet? I will help you get it if we can pull it off. If nothing else, maybe your vets can consult with Wally. He is ummmm, shall we say, pretty well respected in the equine industry. I think that is how one would put it in "polite" company. Some would bluntly say that he is the best equine vet/surgeon in the western USA.

Becky

[Becky]

Heidi,

Don't know what your vets are using, but here is some info out of the Merck Vet manual:

*In horses, the prognosis is guarded, and timely recognition and treatment are essential for successful management. Factors that influence the prognosis include size and site of lesion and duration of infection. Small lesions of short duration that have not invaded critical structures usually respond best to treatment. Surgical excision, immunotherapy, or a combination of both may be effective. Immunotherapy consists of a series of intradermal or SC injections of killed, sonicated, whole-cell hyphal antigens or precipitated soluble antigens of the causative fungus. Subcutaneous abscesses at the sites of injection, osteitis, or deep-seated laminitis may be a complication of such therapy. Surgical removal plus systemic or local administration of amphotericin B may be a satisfactory treatment if the disease is localized.*

www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/51112.htm&word=pythiosis

Becky