Persistent Ventral Edema

Doesn’t that sound like a very clinical title?

Basically, one of Tristan’s old man things has become persistent edema on his stomach. Some days, it’s mostly up near his sheath. Some days, it extends along his ventral line – the center of his stomach – almost to the girth area.

It’s a fairly hard edema, but it is a pitting edema. In other words, when you push a finger into it, it gives, and leaves a slight dent that fills in slowly.

I know some of you are reading this and freaking out a bit, because when you google “ventral edema” you get nothing but bad news. It’s frequently indicative of some kind of system or organ failure. Heart, kidney, and liver are the most likely culprits.

He started showing this in the summer of 2020, and at that time the vet pulled a CBC panel on him, which came back pretty darn normal, so we waited.

Last week, while the vet was out for his fall shots, we examined him again and had a good long conversation about it. The vet pulled blood to run a CBC and also to check on packed cell volume (basically, how many red blood cells per unit were in his blood) and total protein. We also talked through the idea of congestive heart failure.

The vet did a full, thorough physical examination, and I reported on how he’s going right now – really darn well. He’s fitting up nicely, adding muscle (as best he can, he’s slow to do it because of his Cushings), and comfortable in his 4 days a week of solid work in a program. He coughs a little bit while warming up, but not again once he’s fully into his work.

The vet thought that if he had any kind of real internal problems, he would have a secondary constellation of symptoms – for congestive heart failure, he would be struggling with his work, coughing more, sluggish, you name it. Right now, I would describe his physical limitations as muscle, not wind – as we ask him for more self-carriage, he’s getting tired but not out of breath. And when he does start breathing hard, his recovery time is fine.

This week, the blood work came back pretty darn near perfect. His white blood cell count is a tiny bit low, but it often is. His packed cell volume is the tiniest bit low, but nothing at all to worry about. Everything else is pretty normal.

So that means we’re looking at our other theory: he’s just not moving around enough in turnout. He’s in a somewhat small dry lot right now, since his allergies flared badly this year and it’s a dangerous time of year for his Cushings. I talked things through with the barn manager and we have some options, so – we’ll see what we can do for him as fall continues into winter.