Hives! Hay?

Yesterday morning Susan called with the Hive Report. Kaswyn was bad again. I told her not to do anything but get him outside if possible and I'd start making phone calls.

At 8:10 am I called Ohio State and tried to reach the dermatology specialist that my other friend with the hivey horse recommended. I left a message and then called Dr. B. I told him what was going on and updated him on Kaswyn's allergy testing and shot situation. He told me that the best thing to do would be to start eliminating things that might be giving him a reaction. I told him that I suspected the hay, and he told me to get him on the old hay from the last barn if possible. He also said not to change anything else so that we know which thing made the most change in him. He also said that he was going to let the vets from OSU tell me what to give my horse next as far as medications go, since they are the experts and they'll know how they want to proceed.

Then I called the owner of my last barn to beg for hay. Hay is not easy to get right now so I was worried that she'd be short on hay herself. Thankfully I was very lucky, and she was very kind, and agreed to sell me six bales. She also gave me the name of her hay guy and said that although she wasn't getting a shipment soon she knew that he delivers to many barns in the area so I might get lucky and be able to pick up more soon if needed.

By noon I still hadn't heard from Ohio State, so I called again and left another message saying that it was urgent and asked if there was another way of contacting the vet. They said no, but she usually checks her messages so she would call me back. At 3:00 I still hadn't heard from anyone so I called yet again. Various miscommunications between the message takers and the doctors resulted in my not being able to speak to an actual vet until 4:30 in the afternoon. By that point I was pretty aggravated, but I think I had finally gotten my point across that I needed to speak with a vet TODAY because my horse was very reactive.

I spoke with a resident because both of the other docs were busy either teaching class or giving seminars for the rest of the afternoon/evening. She's a dermatology resident for small animals, so she has limited experience with horses but knew enough to advise me. I gave her the history and current situation, and my first question was - should I medicate him, give him an allergy shot, or leave him alone?

Here is the deal with his allergy shots - he got tested in 2002 and we found that he was allergic to bugs like most horses, but he was also severely allergic to mold as well as some other grasses and trees. I got several vials of serum and began the desensitization protocol. It was a pain in the ass but after we were done with the whole protocol Kaswyn was almost 100% hive free. Occasionally he would get 3 or 4 hives but they would go away in a day or so and I never needed to give him anything. Every year when I would order more serum I would speak to a vet so they could get his progress. They were always surprised at how well he responded to the shots. After four years I asked the vet if she thought I could stop giving the shots since he didn't seem reactive anymore. She said that every horse is different, and that my horse might not need a shot every week. She told me to try every other week for a few months, and if he was still okay then maybe try every third week. She did say that I'd risk having to re-sensitize him, but I could try it if I wanted to.

So I tried every other week. No reactions. Every third week was fine too. Then I did once a month and he was still fine. Then I got kind of blase about it and gave him one when I remembered to do it. I'm guessing now that this was a HUGE mistake and I never should have tried to reduce his shots.

Now, back to my phone call with the OSU resident. Based on what I had explained, her recommendation was to not give him an allergy shot, that she agreed that switching the hay was a good place to start, and that more dexamethasone should be given with caution and with the specific orders from my vet. We discussed his issues and history at length and she said she would speak to both doctors in the morning and then someone would call me back.
She also suggested that I bring him in this week for a consultation. Since I don't have a trailer and I'm 2.5 hours away, I told her that I really didn't want to bring him down there unless they were able to do something to him. She said that they wouldn't be able to test him or do anything but examine him at this point, so I said I'd pass on that.

My theory (which I've made based on conversations with vets and owners of hivey horses) is this - moving Kaswyn put him in a stressful situation. Then he was exposed to hay that has a higher mold and/or pollen content than the other hay. The fact that I hadn't been giving him weekly allergy shots put him in a situation where his body couldn't deal with the increased levels of allergens so he overreacted with the bad hive breakout.

I don't know what the vets are going to recommend to do. They might try and re-establish the needed concentration of antibodies in his blood by re-doing the sensitization protocol with the old serum mix. Or they might want him to be retested, which means he needs to be reaction free and medication free for at least three weeks. My guess is on the re-testing, which is fine with me. My thought is that I don't want to have to worry about every flake of hay Kaswyn eats, because any bale could be exposed to things he's allergic to. I want to get him back to a place where his body can handle any environment, within reason.

So we'll see if switching hay works. And if it does I imagine that I'll be keeping him on it long enough to get him nonreactive, get tested, and begin the new desensitization protocol. Again, I seem to have become somewhat of an expert on horse hives and immunology. Add that to my current list - navicular syndrome and splint bone issues - and I almost sound like I know what I'm talking about. But lets not add anything else to that list, okay? I kind of like saying "I don't know much about colic."

I decided not to give Kaswyn any dex yesterday. His hives seemed better in the afternoon, and since he had already gotten three doses of dex I'm a little nervous about giving him more. And if we have to get him off of drugs for three weeks I don't want to load him up if I don't have to. Hopefully he's better today.

Here is one good thing that's happening with Kaswyn. Believe it or not, he's perfectly sound. Go figure.