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Case Study: Sage

It was a long struggle, but Sage is a survivor of Valley Fever

Horses are amazing creatures. We love them and that is why we have dedicated our lives to their health and well-being. Every once in awhile, we meet a horse so exceptional that it is hard to find words to describe how fortunate we are that they have touched our lives. Sage is one of those horses for me.

Sage arrived at Southwest Equine in May 2012. She had been on pasture board in central Arizona and over the previous 6 weeks had been losing weight. Sage’s caretaker called her owners (who lived several hours away), and she was brought to Southwest Equine for evaluation. When she arrived, Sage was terribly underweight (body condition score 1/9, approximately 570lbs when she should weigh about 900lbs). Her coat looked awful, she had ulcers and grass awns in her mouth, she had a fever, yet she had a look in her eye that said “there is nothing wrong with me, I’m a proud, strong Arabian filly!”

After her initial examination it was determined that Sage had a severe systemic infection with masses in her liver, kidneys, lungs and spleen. Her largest mass was the size of a large watermelon in her spleen, but she had several grapefruit and smaller masses in her other organs. She was hospitalized and placed on broad spectrum antibiotics while awaiting the results of bacterial, viral and fungal testing. Once the grass awns were removed from her mouth, she began to eat… just a little at first, but her appetite improved greatly as the days progressed.

The results of Sage’s tests revealed that she had Valley Fever (Coccidiodiomycosis) affecting multiple organs. She was treated with systemic anti-fungals as well as anti-fungal medications administered directly into the largest mass in her spleen. Once she was strong enough and eating consistently, she was discharged from the hospital to begin her long recovery with friends and family. Sage has been back to see us several times in the past 18 months. The masses in her lungs, liver, and kidneys have completely resolved and the one in her spleen is about the size of a grapefruit now. She feels fantastic, runs, plays, and gets ridden. Her Valley Fever titers are still high, but are slowly decreasing. She is now receiving just one medication (fluconazole) once a day. She is a super star and a true inspiration.

Valley Fever is caused by infection with the fungus Coccidiodes immitus. The fungal spores live in the soil in Arizona and Southern California. Unlike dogs, Valley Fever in horses is unusual and typically occurs under the skin or in the lungs. Sage’s infection was very widespread and her antibody levels (titer) to Valley Fever was extremely high, reflecting the severity of her disease. Most horses with Valley Fever as extensive as Sage’s do not survive; however, with early and aggressive treatment it is possible for horses to recover. Sage never gave up and neither did her owners, and we are so grateful they are in our lives.


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