The continuing saga of Rip and NCS

[khall]

For those who have followed Rip's story in the goals thread, well he is still here and does not act like anything is bothering him at all. After his last appt I really thought I was going to have to make a difficult decision and boy was I freaking out. With new information that my vet has discovered from discussing his case with other vets he feels much better about Rip at this time and our ability to manage him (we hope) with various treatments. We are also going to try a new treatment recommended by the Tx vet. I don't know if I will ever be able to ride him again or not, but at least I hopefully won't have to make the terrible decision to euthanize him any time soon. This syndrome is still very serious and scary to deal with.

I have also talked with a vet that worked at Texas A&M who studied NCS there. One of her suggestions was if Rip got to the point of needing more air was a trach but I really do not think I could go there with him. It does not feel right to me.

Next appt is this Thursday so will see how his treatment to this point is working.

Also making some advances on trying to figure out the organism that causes the issue. NCS is found in the US in OK, TX, panhandle of FL, some in LA and now at my farm in middle GA and a farm in Aiken. It is also found in NZ, Australia and Brazil according to the one vet I talked with. No one has been able to isolate any possible organism. For years they thought it was a pythium species which is why they did the therapeutic vaccine (that was developed to fight "swamp cancer") but it was hit and miss. So what I did was to find a lab who specializes in testing for soil and plant pathogens (our ag extension agents were less than helpful) and sent grass and soil to them for analysis. I got the report on Monday and they found two different species (same genus) of fungus that emit mycotoxins (Texas A&M vet was very excited about this info) and one fungus species that can cause allergic responses in animals to it. We are hoping to send samples from other farms that have this issue and see if we can find a common organism then see if NCS can be reproduced somehow. The lab did find a pythium species that is in my grass roots but lab did not think it would be a problem with my horses. I am sending more grass samples next week of other areas of the farm and still waiting on soil assay. BTW the fungus lives in the roots of the grass. Also looking into possible treatments of our fields or what to do to make our farm safe for the horses. I hate to contemplate selling our farm.

[Dresseur]

I'm glad to hear that Rip is feeling better, I hope that you continue to find ways to manage this condition and keep him comfortable. I'm also jingling for answers for where this came from and if you can salvage the pastures and not sell. Keep us updated as you can.

[Flight]

That's great that he has improved and the threat of euthanasia has let up for now. I hope you can find an answer so you can keep your place. Will be keeping fingers crossed.

[Gwen]

I'm *so* glad to hear he's feeling better, and it sounds like a positive development in terms of getting to the bottom of the issue. It must feel good to be able to participate in the research into this issue, knowing your contributions will help others dealing with this as well.

[silk]

Excuse my ignorance, but what is NCS?

If he's got 'staggers', which is super common here due to mycotoxins in the rye grasses, there are various treatments, most of them easy.

[khall]

silk, NCS is equine nasopharygeal cycatrix syndrome. What happens is the horse is exposed to some unknown organism that causes an allergic response in their upper airway (mode of exposure is believed to be inhalation or ingestion). This allergic response sets up a inflammatory response in the upper airway causing irritation and ulcerative lesions usually accompanied by nasal discharge. With continued exposure or because just the progression of the syndrome the upper airway will scar. Some horses will advance to a point and then remain stable, some like my horse Rip will continue to scar and form fibrotic tissue closing his airway down. As of his last scope he had maybe 50 % of his airway, that is why some horses are trached so they can breath. When they do breath they sound like a roarer does. Rip in normal setting is not "roaring" at this point. His breathing does sound harsh when his neck is fully extended eating hay off the ground of if I try to work him which is why I have quit riding him. Right now treatment is pred orally and throat spray orally (furacin, DMSO and dex). Vet is also wanting to try a new treatment with a heavy metal of some sort sometimes used to treat rhodacoccus. I also have him on GMO free food and CurOst for immune/tissue support and stimulation. At this time there is no known way to reverse the damage already done. NCS has never been found in my area before but is considered to be a possible emerging issue with climate change.

This syndrome has been around for 30 yrs with not much known about the problem, the organism responsible for the syndrome has never been isolated for some reason. Cannot culture from the tissue. Lots of theories but not much hard data.

[silk]

Ooh ok sounds nasty, I've never heard of it in this neck of the woods to be honest. I hope the management plan continues to work for him!

[piedmontfields]

Khall, please keep us posted on what you find out about the species found at your farm, the soil results, and strategies for mitigation. It is scary to think about, but will educate us all.

[khall]

As most have seen on goals thread Rip's vet visit yesterday showed an airway that is almost normal now. The vet Dan and I were beyond thrilled and really were shocked at the positive changes that had occurred in just 2 weeks. It was my understanding from the Texas A&M vet that you could not reverse the damage done. I don't know if the closing up of the airway shown on the last 3 scopes was just swelling or if it was actual scarring, regardless the throat spray worked! So the treatment Rip has been on has been pred (tapering dose now) and throat spray (which is furacin, DMSO and dex, 20cc 2Xs daily, now down to once daily) and I had put him on a supplement called CurOst that I had run across in my research being used for helping NCS. I also have scaled his TO back and moved to the "Jenny Craig" pasture that has been shown to not have the issue. Dr. Dan my vet had found a vet in TX that treats at least one case of NCS a week because it is such a problem out there. So in his discussion of Rip the vet indicated they use the throat spray to control the syndrome combined with pred and have had good luck with it. Dan has also learned more of the history of NCS of what has worked and what has not worked. The TX vet is also extremely excited that I found the CA lab to work with all of us to see if we can determine the organism that is causing the issue.

What we are doing moving forward is to continue the throat spray right now once daily. Back down on the pred. Stay on the CurOst and TO schedule. Rescope May 24th to see if the treatment is holding Rip. I sent more grass samples in from the other TO areas on my farm to see what if any fungus is out there. In talking with another GA, from south GA almost pan handle of FL, who has a horse with this, she is sending grass samples to CA lab as well. TX vet is going to send grass samples from TX farms to see if we can find a common fungus that could be causing the problem. TX vet believes this issue is spread by tropical systems as he and his father have watched it move and spread when these systems come through. I don't remember 100%, but I do believe in 2015 when all this started we had a tropical system that came up from the pan handle of FL and sat on top of us with lots of rain. My vet is convinced there are other horses local to me that are affected but just have not been diagnosed. He is wanting to come scope other horses here to see if he can detect NCS in other horses locally.

If the organism can be isolated and shown to cause NCS then the next step will be to develop a vaccine for the organism. Dan has someone with a biotech company interested in developing the vaccine.

I have also reached out to the the UGA extension office for their help in hopefully treating the issue in my fields. One good thing Dan found out though is that just as quickly the issue will show up on a farm, a couple of years later it is gone and not causing problems on that farm again. So still learning as we go. The common issue in the farms is bermuda grass, do not think other grasses are affected and definitely not a problem in cool season grasses.

Rip and I are just incredibly blessed for all who have been pulling for us, for finding a vet who has the desire to figure this issue out, for having a DH who has been there supporting me through this roller coaster these last few months. Now to tract this organism down and keep Rip healthy!

[musical comedy]

Do you think the Cur-ost helps? Are you using the one for Immune Health? I have considered it and kept meaning to call the guy that sells it. He gives consults.

You sure are fortunate to have such a good an understand vet. I also have one that goes the extra mile for me. I think when you have used the same vet for more the a decade, you develop a good rapport.

[khall]

MC I really don't know but at this time Rip is on it (the immune health yes) and I don't want to rock the boat!! I am going to run it by my holistic vet see what she thinks, Dan knew of it but did not really say much about it. Again though something is working at this time, not sure how much if any the CurOst is but hey I am willing to keep using it at this time.

If you do start with it, please let me know what you think. Information is always a good thing to share.

[Flight]

Great to hear he is improving!!

[Ryeissa]

I am so happy for you-- thanks for updating us on his progress!