Has anyone ever dealt with purpura hemorrhagica?

Discussion in 'Horse Health' started by rjpaints, Apr 17, 2011.

  1. rjpaints

    rjpaints Full Member

    Jan 17, 2005
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    Ive been off for a long time. But I have a huge issue. My son came home with a horse and 5 days later full blown strangles. Got over it within a week all looking good. Then one night he looked as though someone had filled him up with water. He couldnt walk, had temp of 105 and totally miserable. Vet called prognosis purpura hemorrhagica. He is up and down goos one time bad the next.

    Anyone ever dealt with this and had good results. If so whats your treatment. Right now he is on 35 cc of penicillan 2x daily, as of now 5cc of dex 1x daily, banimine, and gastroguard and probios.

    Solid swellings have turned to soft edemas.

    Poor guy he is soooo miserable and help would be appreciated.
  2. murdoch

    murdoch Senior Member

    Nov 30, 2005
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    Yes several years ago I had a yearling come down with it. We followed basically the same treatment as you are. It's important to keep up with the banimine and dex. The swelling in my colt was so bad the skin split on his legs but he came through it ok. He will always have some interesting scaring and some minor hock damage but was eventually completely sound. I ended up selling him as a three year old and have since lost track of his progress but last I heard he was competing successfully as a hunter.
  3. Ittakes2totango

    Ittakes2totango Senior Member+

    Aug 12, 2009
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    So, I don't know anything about this purpura stuff. I decided to do some re-search on it. All I can come up with is Strangles is this basically what it is? Or is it something totally different?

    ETA: I finally found something on it. Nevermind. :)
  4. Ryle

    Ryle Senior Member

    Mar 4, 2006
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    Purpura hemorrhagica is an aseptic necrotizing vasculitis
    characterized primarily by edema and petechial or ecchymotic
    hemorrhage. Although the exact pathogenesis of purpura
    hemorrhagica is not fully understood, it appears to be
    a vasculitis caused by the deposition of immune complexes​
    in blood vessel walls...

    The severity of clinical signs seen with purpura varies
    from a mild, transient reaction to a severe, fatal disease.​

    The typical clinical signs seen as a result of the vasculitis
    include subcutaneous edema, most frequently involving the
    head, limbs, and/or trunk, and petechiation and ecchymoses
    of the mucous membranes. Severe edema may result in oozing
    from the skin surfaces, and sloughing of the skin may​
    occur. In some cases, the vasculitis may affect other sites
    such as the gastrointestinal tract, lungs, and muscle, resulting
    in signs such as colic, respiratory difficulties, and muscle​

    Corticosteroids are the primary treatment for purpura.
    Generally, dexamethasone at 0.1–0.2 mg/kg followed by a
    tapering dose regime is used. In those cases where purpura
    is associated with active bacterial infection or the horse is
    considered at high risk of developing infection, appropriate
    antibiotic therapy is also indicated. Nonsteroidal anti-inflammatory
    drugs may be of some benefit in some cases of
    purpura. Supportive care, including intravenous fluids, hydrotherapy,
    and bandaging may also be indicated. The majority
    of the 53 horses with purpura were treated for more
    than 7 days.​

    Purpura hemorrhagica can be a serious complication of
    strangle. One of the 4 cases with purpura was euthanized
    due to the severity of the skin necrosis.​
    1 Similarity, 3 of 22
    horses with purpura secondary to exposure to
    S equi did
    not survive.

    From the ACVIM Consensus statement on Strangles
  5. rjpaints

    rjpaints Full Member

    Jan 17, 2005
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    Yea I have read everythign i could find on it. Still on dex and still swelling everytime we lower the dose. Worried about the length on the steroids.

    EQUESTRIAN09 Registered

    Mar 24, 2009
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    Hi everyone,

    I got a paint gelding out of the kill pens getting ready to head off to slaughter in Mexico. He came down with purpura which I would assume is a resulting complication from his recent environment. Swelling, temperature, skin splitting, open sores, huge sotmach lumps -- the works. 102 degrees in the shade here and flys are everywhere, any tiny scratch in the skin makes for a fly fest so keeping flys off and skin from getting infected is an additional (and overwhelming) challenge. All I can suggest is aggressive and immediate treatment, be militant about cleaning and spraying wounds, keep stalls and paddocks spotless and stay in touch with your vet to monitor progressive daily and be ready to address any new complications. Hose off swollen areas with cold water 2 x day and make sure they have clean, soft bedding to lay on as they ( and their legs) recover. I do not know what his prognosis will be, but the dex, penicillin shots and above steps are helping ~

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