Uncle Mo diagnosis
 

Cholangiohepatitis

http://www.bloodhorse.com/horse-raci...-mos-diagnosis

Can someone expand on this? How serious/chronic is it?

The weight gain points towards a good prognosis, although he'll gain weight from not being in heavy training. Can't say the severity without seeing the bloodwork, but the last bloodwork they publicized only had mild changes, so I'd be very optimistic.

It doesn't necessarily have to be chronic - could resolve. They'll just have to see.

This fits precisely with everything they've ever said about the horse publicly.

In related news, Stay Thirsty was diagnosed as being a pig but is still pointed to the Belmont.

with Nick's posts, we can start a Nick loves (hates) Stay Thirsty tread ........

Why exactly is he a pig?

This is good news about Uncle Mo. Back to Pletcher beginning August. First race early September, next early October, then Breeders' Cup. They've kept him in light work, he should get right back to it, if he doesn't have any other problems.

Because he's not good?

... but I was wondering why Nick said it.

I mean he's not Citation but surely he's better than a lot of them no?

He's not better than the horses he rates to run against as he is always overambitiously placed.

No horse should be called a pig. Just sayin.:confused:

I know, I was just venturing a guess. I think, and it's just a guess, that Nick was making a joke with his post.

But Stay Thirsty sucks.

My post was certainly tongue in cheek.

I didn't mean to take anything away from the groundbreaking Uncle Mo news. Now at least they'll have an ironclad reason to retire him in a month and announce where he's going to stand for $7,500.

Stay Thirsty is a very average horse whose high profile trainer and owner have garnered him respect and attention that his racing prowess never warranted.

:tro:

Thank you for answering.

I just wanted to hear it from you.

Oh and yeah I agree Andy and Trackrat.

He said the same thing about you. :p

Undoubtedly. You should go ahead and carve that schedule in stone.

Anyone going to bring up Devil May Care's liver issues and subsequent death?

If he has equine hepatitis, what does that mean for his stud career?

That's the link I posted above, Steve. They really did a good job spinning this, didn't they?

Yeah, right .... :p

Nothing. It's not a contagious hepatitis.

The Great Internet Cholangiohepatitis Conspiracy Theory.

:wf

I've been thinking of her ever since they discussed his symptoms before the Derby. It's pretty ambitious to focus on anything other than his health right now.

As soon as they said "an elevated enzyme" I thought Oh gawd No!

There is no way that this colt races again, and while I know nothing about these things, I fear that the question of his survival at all is up in the air.

I sincerely pray for his recovery.

i would be incredibly surprised if he ever went back to the track. and yes, an odd coincidence with that barn and another illness like this. here's hoping toy cannon goes to mott.

Did you read somewhere that he might die?

I hope Mo will be ok. Sounds potentially serious to me.

It's not Stay Thirsty's fault. He didn't enter himself in the Derby. If it were up to Thirsty he probably would have entered himself in some nice allowance race. You can't blame the horse for running over his head.

I'm sure Uncle Mo is just fine. I'm sure they made the diagnosis some weeks ago, just delayed the announcement to the public. I'd say he's been treated, he's already responded well, he's gained back the 67 lbs, bloodwork shows it's under control, he's in light work, etc.

It's always possible to have a recrudescence, or an abscess, etc. in the future, but I wouldn't actively worry about it.

I'm relieved to hear you're not worried about it. At least now I can get some sleep.

That was rude and completely uncalled for, wasn't it?

I'm sure it had something to do with all the I'm sure's in your post.

Rude why? The horse is completely finihed and will never race again. Instead commenting on how lo and behold another Pletcher Stakes horse faces a life threaten liver disease you laud his weight gain. Who knows maybe they gave him steriods to help with his appetite?

Well, yeah, when people have posted here that they fear for the horses life (no reason to), and they fear he'll never return to the track (no reason to), and that it's weird of two cases in one barn (not at all weird, btw), and I'm a veterinarian who knows what was published and knows a little more yet about it, yeah, I'm sure.

Because unlike every other person on this thread, I'm not blindly guessing about something I really don't know a thing about.

Damn sorry I added my professional opinion based upon my experience and my local contacts in the veterinary community.

How could you possibly know the condition of Uncle Mo specifically, without having knowledge his medical history, examining the horse physically, reviewing the results of diagnositic tests performed on him, or observing his response to any treatment, even if you are a veterinarian?

You're gonna rely on Todd Pletcher quotes, WinStar press releases, and Blood-Horse reports to form a medical opinion? The opinion of one of those "animal talkers" that communicate through photographs alone sounds more reliable in comparison.

Just like everyone else, you're on the outside looking in.

Nevertheless, whatever your skill set is, you are still merely guessing, too.

Because you're not directly involved with the horse.

As I said, damn sorry I added my professional opinion based upon my experience and my local contacts in the veterinary community.

Apology accepted.

Now that you have proven that you have the inside scoop on such matters, can you please distinguish Uncle Mo's case from Devil May Care's?

Going by the threadbare DRF and Blood-Horse articles that us peons have to rely on, the parallels between the two are remarkably similar.

Why has the most recent of the two garnered from you a "nothing to worry about" prognosis, while the earlier one resulted in a dead horse?

Here's a link to the Merck Manual Online. Just enter "hepatic" as your search term and go from the page of topics that comes up. "Enzymes" are at the bottom.

Edit: so, sorry, here's the Merck Veterinary Manual Online. Best to start with that. Same search terms.

http://www.merckvetmanual.com/mvm/index.jsp

From on-line Merck Vet Manual -

Cholangiohepatitis is a severe inflammation of the bile passages and adjacent liver, which sporadically causes hepatic failure in horses and ruminants. It is occasionally associated with cholelithiasis in horses.

Etiology:

Bacteremia due to an organism (eg, Salmonella ) eliminated in the bile, an ascending infection of the biliary tract after intestinal disturbance, or ileus are thought to be related to the development of cholangiohepatitis. In foals, duodenal ulceration and duodenitis may result in bile stasis, hepatic duct obstruction, and cholangiohepatitis. Parasite migration through the liver may predispose to cholangiohepatis in some animals. Gram-negative organisms, including Salmonella sp , Escherichia coli , Pseudomonas sp , and Actinobacillus equuli are frequently isolated from the liver. Clostridium sp , Pasteurella sp , and Streptococcus sp are less frequently recovered.

Clinical Findings:

Depending on the severity of infection and virulence of the organism, clinical signs may be acute with severe toxemia, subacute, or chronic. Most typically, cholangiohepatitis is a subacute or chronic disease process with affected animals showing signs of weight loss, anorexia, intermittent or persistent fever, or colic. Icterus, photosensitivity, and signs of hepatic encephalopathy are variable. SDH, AST, GGT, bilirubin, and total bile acid concentrations are usually increased. Peripheral WBC counts are variable, depending on the degree of inflammation and endotoxemia present. Acute, suppurative cholangiohepatitis may occasionally result in severe septicemia and death.

Lesions: In acute cases, the liver is swollen, soft, and pale. Suppurative foci may be visible beneath the capsule or on cut surface. Lesions in other systems may reflect septicemia and jaundice. Microscopically in acute cases, neutrophils are present in the portal triads and degenerate parenchyma. Purulent exudate is evident in the ducts. In subacute or chronic cholangiohepatitis, the inflammation is more proliferative and bile duct proliferation more pronounced. Areas of atrophy, regenerative hyperplasia, and periportal fibrosis may be evident.

Diagnosis:

Liver biopsy should be performed to confirm the diagnosis and to obtain a liver sample for aerobic and anaerobic culture and sensitivity. Differential diagnoses include other causes of acute to chronic hepatic disease, weight loss, colic, or sepsis. If neurologic signs are present, cerebral diseases must be considered. Because cholangiohepatitis is frequently associated with cholelithiasis in horses, the presence of one or more calculi must be ruled out.

Treatment:

Treatment based on culture and sensitivity results from liver tissue often gives favorable results. Therapy should be continued for 4-6 wk or longer. Liver enzyme (GGT) levels and biopsies should be repeated to monitor response to therapy. If no organism is cultured, broad-spectrum antimicrobial therapy against gram-negative, gram-positive, and anaerobic organisms should be administered. A combination of penicillin with either a trimethoprim-sulfa or an aminoglycoside or enrofloxacin may be used. Ampicillin or a cephalosporin can be used instead of penicillin. Metronidazole can be used in horses to treat anaerobic bacteria. Prognosis is good if fibrosis is not severe.

That was informative; thank you. For those of us not trained in the medical fields, we have no knowledge base to use in distinguishing severe hepatic conditions from less severe. We hear "hepatitis," especially from a stable where a horse has died from a hepatic condition, and it's easy to jump to conclusions, without knowing how distinct from each other the two cases may be.

Here's the direct link to cholangiohepatitis from the link Riot posted.
http://www.merckvetmanual.com/mvm/in...m&word=hepatic

So basically, hepatitis is any inflammation of the liver, but can be caused by a variety of things?