West Nile Recovery x 3

One day, Marla Gilvin heard whinnying uncharacteristic from her 5-year-old Kentucky Mountain mare Cocoa Rain. “I went out to see what she was doing and called her to the barn,” Gilvin recalls. “She didn’t move. Her 4-month-old foal was running circles around her.”

Frank Brown, DVM, of Mount Sterling Veterinary Hospital in Mount Sterling, Ky., was summoned. His physical exam found that Co-coa had an uncoordinated gait, generalized weakness, and muscle fasciculation (twitching) of her shoulder muscles and lips. Labora-tory testing confirmed his suspicion of West Nile viral encephalitis.

Brown administered intravenous (IV) butazolidin, dimethyl sulfoxide (DMSO), and a corticosteroid to keep Cocoa comfortable and to try to reduce central nervous system inflammation. He also gave her an IV electrolyte and glucose solution to support her metabolism and outlined detailed care instructions. Brown and the owner were committed to caring for three lives: Cocoa, her fetus, and the foal by her side. Brown wanted Cocoa out in her pasture where she was less likely to get cast and the ground was cushioned with grass should she go down. Her foal would also be able to move comfortably around her.

Cocoa was able to move unsteadily for a few days, then she began falling. Gilvin says, “When she fell, it wouldn’t be to her side, but she went down end over end. Her hooves cut her each time she fell.” Cocoa worsened to the point she could not rise.

Gilvin and Brown dreaded the worsening prognosis for Cocoa’s recovery, but the foal was nursing even with Cocoa lying on the ground. “That foal would come up to Cocoa and butt her in the flank and burrow his nose in to nurse,” said Gilvin. “Even more unex-pected was that the fetus was still viable.” Brown was confident that the nursing foal was at low risk for contracting the disease from Cocoa. In humans it has been reported that the virus can be present in breast milk, but there are small numbers of virus in the blood-stream of horses and therefore a low risk of contracting the virus through the milk. He was not hopeful that the fetus would survive due to the stress of the disease on Cocoa.

“We turned Cocoa frequently to prevent pressure sores and to give the foal an opportunity to nurse from both sides,” Gilvin said. “Moving a huge horse around was very challenging. It took all the strength and ingenuity my husband and I had to turn her twice a day. We treated her wounds frequently to keep them clean and keep the flies off. We carried food and water to her and had to hold her head up for her to eat and drink.”

“Cocoa was down for seven days,” she continued. “There were many times we didn’t think she would get up, but her foal was healthy and we wanted to get him as big as possible before considering giving up. One day she started trying to get up. It took her about two days and she stood—unsteadily.”

Brown credits the Gilvins for their persistent care. Cocoa had very few complications associated with her recumbence, no pressure sores, and her wounds from falling healed quickly. Her recovery was rapid.

Seven months later, at the time Cocoa’s new foal was due, Gilvin was concerned about Cocoa’s delivery. She had bagged up (had udder development) and had started to wax (the waxy coating of colostrum on the nipples). Brown was alerted that the delivery was imminent. He instructed the Gilvins on what to expect for a normal delivery and when they should call him. The Gilvins were vigilant, and late one evening watched a perfectly normal delivery. Cocoa, her new foal, and her yearling were as healthy as if they had never gone through the challenge of West Nile virus. The Gilvins now have an improved vaccination schedule and mosquito control pro-gram and say they “hope never to see anything like this again.”

About the Author

Kimberly Peterson, DVM

Kimberly Peterson, DVM, is an AAEP member and assistant professor in the Department of Veterinary Technology at Morehead State University in Morehead, Ky. Her husband, Eric, is an equine practitioner, and their family lives in Lexington.

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