Bartonellosis in Horses: Part One



The Bartonella Horse


Copyright June 1, 2013 by Brenda Bishop, VMD All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without prior written permission of the author.


Bartonellosis (bacterial infection with any one or multiple Bartonella species) in horses has escaped the notice of horse owners and equine veterinarians for so long that it now exists in epidemic proportions. Any environments where horses congregate, horse shows, race tracks, sale barns, boarding facilities, etc. are certain to have Bartonella horses in their midst. The fact that this tiny intracellular bacterium has eluded our detection for so long is a testament to its sophisticated biology. Humans are so ignorant about Bartonellosis in horses that what little we know about it amounts to ‘the tip of the iceberg’ in comparison to what we don’t know. As custodians of our equine partners, we CAN train ourselves how to recognize Bartonella in a horse early in the course of the disease. Failure to do so results (years later) in an assortment of dysfunctional systems which can promote the development of autoimmune problems such as Shivers, Equine Recurrent Uveitis and Autoimmune Hemolytic Anemia.


Bartonellosis is a disease within bundles and the biomechanical consequences thereof. All the different Bartonella species are opportunistic pathogens they are acquired through the bite of a blood sucking arthropod, i.e., ticks, mosquitos, fleas, horse flies, etc. Once in the bloodstream they congregate in endothelial cells which line blood vessels. Periodically (it is postulated once every five days) they shed into erythrocytes by penetrating red blood cells they effectively hitch a ride to any part of the body supplied by blood. Their victims become symptomatic when a critical mass is reached within specific bundles of vessels. Like other mammals, horses have arteries, veins, lymphatics and nerves that run together in bundles like tree trunks that branch to every part of the body. Major bundles in the front limbs are located under the shoulder area (brachial plexus) major bundles in the hind limbs are in the groin area under the femur (inguinal plexus). As these bundles are progressively compromised, the respective limbs served by them display biomechanical effects of profound restrictions on arterial perfusion, venous drainage, lymphatic drainage and nerve supply. The protraction phase of the forward stride is delayed and a virtual partial paralysis appears. If the limitation is marginal, a ‘shoulder lameness’ or ‘stifle lameness’ may not yet be evident. However the horse will keep pulling front shoes off with the hind feet, usually from the diagonal opposite front foot of the hind leg in the most pain. Careful examination of the groin area will reveal ‘cording’ of the lymphatics and muscles above and behind the stifle. (pictures below*)


Enlarged lymph nodes, arthropathy (lameness), lethargy and bleeding due to thrombocytopenia (low platelet counts) are symptoms common to dogs, cats, humans and horses. Of the many species of mammals vulnerable to Bartonella infection humans have been studied the most the best known types are referred to as ‘cat scratch disease’ and ‘trench fever’ (Baronella henselae and Bartonella quintana respectively). Infected humans can have dozens of health problems involving the heart, skin, the central nervous system, the eyes, skeletal muscles, the lungs, the gut and the lymphatic system. Cats with Bartonella typically display inflammatory reactions at these same soft tissue sites. Horses display subtle symptoms early in the course of infection, for example, muscle cramps, sore ribs, chronic fatigue, fibromyalgia, ‘stiff legs’, urinary discomfort (standing parked out), respiratory problems, hypersensitivity to anything that touches the skin, sore soles, patchy sweating, ulcers, heart valve insufficiencies (heart murmurs), and eye problems (conjunctivitis, uveitis, dry eyes and/or distorted vision). Horses with different species of Bartonella can eventually exhibit any or all of the above plus an assortment of dramatic unruly behavior patterns emanating from the brainstem (encephalopathy): dizziness, head shaking, strokes, confusion, explosive outbursts, aggression, rage, agitation, attention deficit, seizures or depression. (video **)


Good detective work requires a thorough collection of background information (history taking) from which patterns emerge. In the case of Bartonellosis, an overall pattern of dysfunction is more significant than any one of the countless variables. No two horses with this disease will look the same because no two horses will have the same combination of Bartonella species and/or the same absolute numbers of bacteria in the same soft tissue bundles. Different patterns will most likely be correlated with specific species of Bartonella sometime in the future (“Bartonellosis in Horses: Part Two”), when current laboratory testing methods become more refined. Given the widespread presence of infection in horses, cattle, dogs, cats, deer, elk, coyotes and other wild animals, the slightest suggestion of a pattern consistent with Bartonella allows us to make a good argument for treatment. As is the case with cats, horses can be successfully treated with a conservative dose of antibiotics once daily for 5 or more days. Most horses go through a healing crisis on the second or third day and return to total soundness of mind and body within two weeks. An ultra conservative dose of Azithromycin paired with Rifampin (2 mg per pound per day of each antibiotic) is readily absorbed by the oral route and can be administered as a compounded paste. Doxycycline (10 mg per pound twice daily) paired with Rifampin (2 mg per pound per day for 5 days) can also be used orally. Doxycycline is particularly useful if a simultaneous infection with Lyme disease and/or Leptospirosis is present, in which case it can be administered for a much longer period (up to eight weeks). Exposure to heat and sunlight must be avoided when using Azithromycin (due to risk of hyperthermia) and limited when using Doxycycline.


Our willingness to even suspect the presence of Bartonella in a horse with multiple unresolved medical issues is the key that opens ‘Pandora’s box’ with respect to a wide range of problems. Head shaking, recurrent exertional rhabdomyolysis (tying-up), chronic equine protozoal myelitis, chronic stomach ulcers, exercise induced pulmonary hemorrhage (bleeding from the nose on exercise), chronic obstructive pulmonary disease, lymphangitis, purpura, narcolepsy and seizures are just some examples of accepted diagnostic labels for which band-aid treatments are more often than not unsuccessful in the long term. By recording a horse’s rectal temperature at the same time every day, a chart can be created which will demonstrate a low grade cyclic fever pattern that will coincide with sudden lethargy, poor appetite and active shedding of the organism into the circulation. Shivers horses with Bartonella require special handling, i.e. a titrated dosing regimen. They typically develop soft manure or diarrhea and should be monitored for abdominal discomfort antibiotic therapy amounts to a stress on an already compromised immune system. Age and length of infection factor into the decision to attempt treatment. Older horses with Shivers are extremely fragile patients immunologically especially if they harbor multiple species of Bartonella. Autoimmune problems tend to cluster and antibiotics which effect a massive kill of bacteria within erythrocytes can precipitate autoimmune hemolytic anemia. Pulse dosing might prove useful as treatment protocols are developed and standardized based upon future improvements in laboratory testing. For any horse living with Bartonella a balanced diet rich in vitamins B1, B2, B3, B5, B6, B9, B12, C and E can only enhance the chances of a complete recovery from this elusive bacterial pathogen.


Pictures below * 3 geldings with inguinal lymphangitis and cording of skeletal muscle and 1 gelding with brachial cording of the lymphatic branches.


Video above ** 11 year old thoroughbred gelding before and after treatment for Bartonellosis


The author wishes to thank Jack Broadhurst, DVM (The Cat Health Clinic), Lisa Crescenzi, Lisa Oldroyd and Neil Schwartzberg for their personal contributions over many decades to animal welfare and to the advancement of veterinary knowledge for the benefit of all.



Bartonellosis in Horses: Part Two



Treatment Considerations


Copyright January 1, 2014 by Brenda Bishop, VMD All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without prior written permission of the author.


Nearly all autoimmune diseases in humans can be traced back to a specific primary infection, commonly bacterial or viral. Similarly, autoimmune scenarios in horses result from a cascade of events that involve immune system damage and specific infectious agents. Which of these two components came first is of little consequence in the long run because each can facilitate the other, usually synchronistically. Biting insects can transmit a plethora of infectious organisms with just one bite. Horses living in natural settings are prime candidates for insect bites especially when heavy rains flush ticks out of wooded areas into open pasture land. While Lyme disease is the classic infection associated with ticks, the reality is that the same tick can and often does inject more than one bacterial pathogen into the host horse’s bloodstream. Chief among these is one or more species of Bartonella. Infections become chronic because both Lyme and Bartonella bacteria can disable (suppress) immune systems. Once a Bartonella infection becomes well established, the trajectory is toward an autoimmune state for example, not all Bartonella horses ultimately become myasthenic horses but all Shivers horses are Bartonella horses (i.e., infected with one or more species of Bartonella) until proven otherwise. This is a perfectly safe assumption to make due to the current lack of a definitive laboratory test for Bartonella in horses. (There is no definitive test for Fibromyalgia or Chronic Fatigue Syndrome either.)


Probably the most important internal characteristic of a Bartonella infection is virtual annihilation of the horse’ s magnesium levels. Magnesium is needed by both Lyme and Bartonella species to multiply and the longer an infection persists, the more depleted the horse’s body becomes. The most obvious external hallmark of a Bartonella infection is a shortened forward stride length, especially when moving downhill. A helpful diagnostic exercise is to supplement the adult horse with oral magnesium (20 to 40 grams a day for a one thousand pound horse) for one to two weeks. If the stride length improves dramatically (especially going down a slope), a Bartonella infection can be considered likely. Invariably a fungal co-infection will be lurking in the background as well (see “The Fibromyalgia Syndrome (FMS) Horse”). In the case of foals and young horses, magnesium depletion will not have escalated yet but contracted tendons or any tendency toward overly straight legs is grounds enough for suspecting the presence of Bartonella. Kittens infected with Bartonella henselae commonly exhibit extensor tendon rigidity until they are treated with appropriate antibiotics. Restoration of magnesium levels (by the IV route, transdermally and/or orally) can be started two weeks before antibiotic therapy and will facilitate immune system recovery. In addition, access to a free choice mineral block (‘magnesium block’) should be provided at all times to help the horse’s body rectify long standing deficits.


Leaky gut syndrome, a common denominator in autoimmune disease, also contributes to loss of magnesium and other minerals from the gut. The horse is a grazing animal when enough stress triggers the development of bleeding ulcers in the stomach and diffuse ulceration in the hindgut, the lining of the gastrointestinal tract becomes a greenhouse for pathogenic bacteria and fungal overgrowth (usually Candida). Chronic inflammation distorts the integrity of the intestinal wall an overly porous gut lining resembles a formerly one way street that has turned into a two way street. Microbes and toxins that would normally be contained enter the bloodstream minerals and other micronutrients that would normally be absorbed pass on through the other end of the horse. Leaky guts have poor efficiency ratings across the board. Ulcer remedies make good band-aids but will not reverse the problem. In some horses transit times start changing, either too fast (diarrhea) or too slow (constipation). Depending on other environmental stressors such as the weather, colic can result. Putting the horse on a hypoallergenic (high fat low carbohydrate moderate protein) diet is the best way to start reversing the problem. Carbohydrate loading with high gluten content grains (wheat, barley, oats) should be minimized and replaced with a good fat source such as rice bran meal. Beneficial supplements for leaky guts include aloe vera juice, apple cider vinegar, n- acetyl-glucosamine, and all the B vitamins along with C and E. Grape seed extract is particularly suitable for a Bartonella horse it contains resveratrol which lowers a potent neurotoxin linked to depression (quinolinic acid) and helps detoxify the body in general. Along with magnesium supplementation, immune support is vitally important before, during and for at least two months after specific drug therapy. Our use of big guns (antibiotics) wrecks havoc on the battlefield (the horse’s body) and the foot soldiers (immune system components) need to be re-supplied consistently.


Bartonellosis can be caused by any one or any combination of numerous Bartonella species. The appropriate ‘antibiotic of choice’ can be determined by taking into consideration the affected horse’s symptoms, age, breed, history and overall condition. A five day course of Azithromycin is very effective for reducing enlarged lymph nodes. It is not a good choice for older immunodeficient horses or any horse with long standing leaky gut syndrome. Doxycycline is a good choice for a Bartonella horse with neuroretinitis, particularly if the horse has been diagnosed with Equine Recurrent Uveitis (ERU), as well as a horse that is a suspected Lyme disease case. Both Azithromycin and Doxycycline should be paired with Rifampin (see Part One “The Bartonella Horse” for dosages). Rifampin is a particularly good choice for horses with any of the psychiatric and/or neurological manifestations of Bartonellosis: panic attacks, mood swings, extreme anxiety, seizures, narcolepsy, extreme depression, etc. Rifampin has several disadvantages: it is highly unpalatable, it requires that blood counts and liver function be monitored regularly while using it, it can cause headaches, and Rifampin increases cytochromes, enzymes that speed metabolism of other medications. If the horse is on pain medications, he (she) will require higher doses of those drugs during the treatment period. Complicated cases of Bartonellosis are best treated with two antibiotics simultaneously.


Horses that are fragile immunologically can be successfully treated with three drugs that are familiar to most horse owners: Fenbendazole, Ketoconazole and Sulfamethoxazole. All share a common biochemical structure (azoles), all enjoy a high margin of safety, all are fairly palatable, and all are easy to administer. Fenbendazole given at the labeled larvacidal dose (a double dose a day for five days) addresses leaky gut syndrome, reduces Candida overgrowth in the large intestine, dries up ulcers, has a synergistic effect on leucocytes (white blood cells that fight infection), and jump starts the immune system. Many horses show improvement in their Bartonella symptoms by the fifth day. Ketoconazole can be started on day six and continued for up to four weeks. The same conservative dose used for Fibromyalgia (2 mg per pound per day) can be added to the feed once daily for three to four weeks (see “The Fibromyalgia Syndrome (FMS) Horse”). The azole derivatives (unlike other fungicidal drugs) are remarkably useful due to their broad spectrum of activity: they are active against fungi, yeasts, some protozoa and some bacteria, specifically Bartonella. Sulfamethoxazole is a large white tablet (“Trimethoprim/Sulfamethoxazole” or SMZ) that readily dissolves in water and can be added to the feed twice daily at the labeled dose for up to eight weeks. It has some activity against Lyme bacteria as well but requires longer duration of treatment for maximum results against Bartonella compared to other antibiotics. The azoles are good choices for horses under 4 years of age (with immature immune systems), horses over 18 years of age (with tired worn-out immune systems) and horses of any age in poor overall condition (unthrifty appearance, high parasite load, dull haircoat, etc.). ‘Routine’ vaccination should be avoided at all costs it creates unwanted additional chaos for handicapped battered immune systems, adding fuel to the fire of chronic Bartonellosis.


Resources


www.horsetech.com 1-800-831-3309 rod@horsetech.com “Custom Product # MS-010514” (daily vitamin mineral supplement)


www.PerformanceEquineUSA.com 1-707-766-8624performanceequine@pacbell.net. “Mag Restore” (daily magnesium supplement)


www.EquiVision.com 1-859-873-1220dr.bill@equivision.com “EC” (daily vitamin E vitamin C supplement)



Bartonellosis in Horses: Part Three



Alternative Approaches


Copyright September 1, 2014 by Brenda Bishop, VMD All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without prior written permission of the author.


Horse owners in the twenty first century have easy access to a wide range of treatment modalities, the vast majority of which (with respect to a Bartonella horse) amount to sophisticated temporary quick fixes. Immune dysfunction in the host horse, the result of a disabled immune system, is an important aspect of both Lyme disease and Bartonellosis. The implications of this ground zero damage are weighted heavily in favor of the acquired bacteria, amounting to a David and Goliath situation. The microscopic invader simply catches a ride to anywhere the horse’s red blood cells travel, including the brain, reducing the availability of nutrients and oxygen everywhere it goes simultaneously it feeds on the host’s supply of available magnesium, engendering chaos within the horse’s body chemistry: energy availability, necessary enzymatic reactions, electrolyte flow, elimination of metabolic waste products, etc. This is why a Bartonella horse never has normal manure. Horses are grazing animals their manure is a mirror for their internal state of health. Simple routine observation of their manure (quantity, consistency, color, etc.) is a highly accurate means of gauging whether any attempted treatment has actually eliminated the infection. A passing glance on a regular basis is all that is required.

Bartonella is considered a ‘stealth pathogen’. This is because it is a shifty clever bacterium. It leaves the various locations where it has set up housekeeping (endothelial sites lining the blood and lymphatic vessels) to travel through the bloodstream at regular intervals, usually every so many days. For infected horses, some days are better than others they are consistently inconsistent in their ability to focus and do their jobs. When veterinarians initiate antibiotic therapies, Bartonella bacteria have the ability to go into hiding, back to their various niches throughout the body. In this respect the bug is adept at going to work only on odd days when left unmolested and when challenged, going on long vacations. Big guns such as high tech antibiotics will take a toll on the horse’s bacterial populations to be sure. Unfortunately for the horse, there are a number of down sides to this approach: a certain number of healthy useful bacteria are killed in the process even with concurrent use of probiotics many antibiotics do not cross the blood brain barrier and even after prolonged administration (60 days or more of Doxycycline for example) the bacteria can come back out of hiding only to start multiplying and traveling again as if with a vengeance. Typically around 6 to 12 months down the road, it becomes abundantly clear that the infection has secured a firm foothold in the central nervous system the horse endures odd panic attacks that appear unjustified, might become argumentative and even aggressive, and/or has unmistakable periods of attention deficit.

It would seem that Bartonella horses are doomed to be lifelong carriers of this infection. Certainly we cannot help them become 100% infection free using only conventional, that is to say Western, reasoning. Alternative medicine on the other hand offers us a viable avenue that is horse friendly, user friendly, and unencumbered with any down sides. As we examine more fully the mechanism of action of the various Bartonella bacteria, it becomes clear that those neurochemicals classed as neurotransmitters rule the day. (This group includes Acetylcholine, Serotonin, Dopamine, Epinephron, Histamine and many others.) A compelling demonstration that this is the case is the example of Shivers horses their immune systems have been stressed to the extreme, to the point of no return, i.e., the autoimmune state. When their Bartonella infections are eliminated these horses steadily improve toward the status of being nearly Shivers free. (Attention to correction of magnesium depletion enhances their degree of improvement and allows for ongoing recovery.) Their peripheral neuromuscular junctions will still reflect the presence of autoantibodies, either calcium channel antibodies or acetylcholine receptor antibodies (or rarely both) but they will enjoy a much higher overall quality of life. Freedom from infection can be achieved through the use of various herbal formulas added to the feed over a 45 to 90 day period. Magnesium can be supplemented until a desired comfort level is achieved. (See “Resources”) Successful handling of Shivers cases mandates that treatment protocols promote both healing of damaged neurons and neurotransmitter balancing where the problem begins, upstream at the level of the brain. Another example of the fundamental role of neurotransmitters is the drastic improvement noted in cribbers when treated for their Bartonella infections, usually to the point wherein a cribbing collar is unnecessary. Generally considered an unwanted behavior which escalates in times of stress, cribbing allows the horse to self medicate himself by stimulating the pituitary gland at the base of the brain to release endorphins. Higher endorphin levels help offset low dopamine levels, a characteristic of chronic Bartonellosis. As with all Shivers horses, by virtue of the fact that no other treatment alleviates the problem to such an overwhelming degree, all cribbers should be considered Bartonella horses until proven otherwise.

Explosive outbursts, bucking, aggression toward humans and/or other horses, panic attacks and violent pulling back while tied are some of the behavior patterns typical of low levels of magnesium and/or Dopamine. Bartonella horses have miniscule levels of both so their behavior can be quite dangerous. Being hypersensitive to touch they dislike being groomed. Standing on the ground near them or riding them, it should be abundantly clear that ‘a Bartonella horse can kill you’. Other signs of magnesium depletion include: separation anxiety, sudden shying for no apparent reason, nervous habits, short attention spans, insulin resistance, a grass belly even on little grass, tying-up, excessive sweating in summer, shivering in cold wet weather, sweet itch, watery eyes, sore feet, laminitis and shortened stride length especially going down hill. (This is due to inappropriate toe-first landing of the hoof which is difficult for the horse to achieve on a downward slope.) It takes a long time (up to one year) to correct magnesium depletion in a horse whose body has been continuously drained round the clock by Bartonella bacteria. Hair analysis is an accurate way to identify abnormal levels of various minerals and metals in the body. Horses store toxins in their body fat and their hair. Discovery of heavy metal toxicity can be likened to a pre-purchase exam it pinpoints specific needs for detoxification before precious time and money are wasted. If a horse is toxic due to high levels of selenium or lead for example, chelation therapy will be required to eliminate specific toxins prior to treatment for chronic infection. High levels of lead will reduce magnesium, calcium and iron absorption, contributing to the problems of low magnesium and reduced oxygen carrying capacity of red blood cells.

Neurochemical imbalances created by Bartonellosis ensure that the affected horse will eventually go ‘out of his mind’. Research on Parkinson’s disease in humans has established that part of the midbrain, the Substantia Nigra (SN), accounts for the neurochemical basis of the disease. The dopaminergic neurons of the SN play an indirect role in motor control they account for dexterity of the legs for example. These neurons can generate insufficient Dopamine (as in Parkinson’s disease) or an excess of Dopamine (as in humans with Schizophrenia). Different neurotransmitters balance each other if one is high or low, the others will be impacted. Bartonella horses have low Dopamine levels as well as low Acetylcholine levels as a result of cellular damage to these important neurons. Before total eradication of infection can be achieved, the individual cells must be cleared of the bacteria first. Herbs can do this job in as little as 15 days. Subsequent regeneration of healthy neurons in the SN (as well as other parts of the nervous system) can be jump started by feeding appropriate herbal formulas over a minimum of 30 days. In the case of a Shivers horse, simultaneous addition of specific formulas that raise individual neurotransmitter levels (for example Acetylcholine or Dopamine) helps maximize the overall healing process. Working with the body instead of against it, these herbal formulas are adaptogenic. They exert a normalizing influence on the body, irrespective of the direction of the imbalance. Adaptogenic herbs normalize neurotransmitter production neurotransmitters continue to assume their functions, one of which is to rebalance each other. Comprehensive healing happens naturally. Steadily the horse emerges into a calmer happier state of being, the behavioral polar opposite of a Bartonella horse. Best of all, herbs have the ability to do the job right the first time re-treatment is a non-issue. At the end of the day conventional manufactured antibiotic regimens are not even on the same playing field. Prolonged daily magnesium therapy is indispensable for supporting total recovery. For horses with Bartonellosis the holistic approach serves the whole horse quite nicely.




“Any intelligent fool can make things bigger, more complex and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction…… The most beautiful thing we can experience is the mysterious. It is the source of all true art and all science. He to whom this emotion is a stranger, who can no longer pause to wonder and stand rapt in awe, is as good as dead: his eyes are closed.”
- Albert Einstein-



Resources

www.PerformanceEquineUSA.com 707-766-8624

“MagRestore”, “Focus Equine” (and article “Magnesium: The Mineral Superhero”)

www.depaoloequineconcepts.com 940-686-9111

Horse Hair Analysis (and numerous articles by Mark DePaolo, DVM)

www.galaxydx.com contact@galaxydx.com “Enrichment PCR testing and DNA sequence verification” (the gold standard in Bartonella testing)



Bartonellosis in Horses: Part Four



Applied Concepts Symptom Based Analysis and Strategic Treatment Design


Copyright May 1, 2016 by Brenda Bishop, VMD. All rights reserved. No portion of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without prior written permission of the author.



“My aim is to help the reader share in my understanding. But a text can only act as a scaffolding of concepts, a ladder for others to climb. Real knowledge of what I am saying must be earned, and lived, by each individual, in his or her own way.”
-Daniel Pinchbeck-


“You cannot connect the dots looking forward you can only connect them looking backwards.”
-Steve Jobs-


Horses with chronic Bartonellosis can present owners and veterinarians with a complex array of seemingly unrelated symptoms, problems, surprises and occasionally dangers. Murphy’s Law (anything that can go wrong will go wrong, at the worst possible moment, in the worst possible context) rules for these horses regularly. Their human partners, armed with enough clarity about Bartonella’s mechanism of action, have ample opportunity to set these horses right. Infection fighting formulas such as the “Bartonella Kit” (www. effectivepetwellness.com) paired with magnesium supplementation (www.performanceequinenutrition.com) are always and in every case the first steps toward resolution. These steps could be called Stage One. The order in which treatments are administered is important because a lingering infection will eventually derail any and all other interventions whether simple or sophisticated. Key to effective treatment planning is a healthy respect for Bartonella’s game plan. Upon entering the bloodstream the first thing this bacterium does is annihilate the horse’s immune system. One cannot afford to underestimate the efficiency with which it accomplishes this. The inevitable cascade(s) of subsequent issues (multitudes of problems months and years down the road) that share a common computer malfunction (a compromised immune system unable to handle stress) will progress and converge along specific logical pathways. Strategies designed to facilitate normalization of multiple system interconnectedness will reduce overall demands on the handicapped immune system. Any such advanced approaches to treatment will be exponentially more successful when applied after infection is initially addressed.

Targeted treatment plans are an art form in that a total body focus and penetrating insight are necessary to achieve the desired result, as exemplified by traditional Chinese medicine (TCM). Due to the multiple variables within each case history, the almost infinite possible combinations of overt symptoms (see “Symptom Check List”), and diversity within management situations, there is no ‘one size fits all’ Stage Two. The relatively small percentage of horses (about 20% in the author’s experience) that require additional treatment after completing Stage One will need custom tailored protocols. Layers of problems stemming from deeper pathology built up over time can be debrided (removed) like taking skin off an onion. The primary over-riding principle to comprehend is the fact that ***Bartonellosis is a disease of microcirculation failure***. The bacterium colonizes inside red blood cells (erythrocytes), on endothelial cells (the innermost linings of arteries, veins and capillaries) on collagen (i.e., connective tissues such as tendons, ligaments and their sheaths), and potentially anywhere circulating blood goes. Being a stealth pathogen, it has a predilection for good hiding places such as the bone marrow, the spleen, liver, kidneys, pericardium and brain. Unfortunately for the infected horse, these remote sites are rarely examined, perhaps at autopsy. Eventually the infection will establish residency in the mid-brain leading to neurotransmitter imbalances and an array of downstream conundrums. An easy way to remember the more obvious locations where symptoms can be appreciated is to consider the parts of the horse’s body farthest from the heart: the skin (integument), the feet, the back, the ribcage, the pelvic girdle and hind limbs, and the head from the bottom of the nose back to the upper cervical area.

The numerous ramifications of Bartonella induced circulation failure can be difficult to recognize because individual horses experience downstream effects of circulation deficits in a number of possible ways. A spectrum of vital functions are increasingly delayed examples are prolonged circulation time, reduced hemodynamic flow (blood stasis), prolonged healing, prolonged clotting, and prolonged muscle contraction with or without delayed forward phase of stride. The subtle biomechanical result that surfaces as ‘chronic fatigue’ is sometimes overshadowed by more dramatic symptoms that develop spontaneously. The body finds ways to compensate (coping mechanisms) that may or may not include intermittent lameness, different ways of going, shifting leg lameness, bridle lameness, added strain on supporting limbs, etc. Some horses exhibit a pattern of tendon / ligament / foot soreness that includes blood pooling in the feet. Dormant abscesses can form at the back of the foot and remain quiescent for months, only to ‘wake-up’ suddenly when the horse is suddenly stressed. Such lameness that appears to have an acute onset has actually been silently simmering, ready to flare when fatigue becomes intolerable. If these abscesses have been sitting in the feet long enough they can calcify and show up on radiographs. An appropriate Stage Two for this scenario (digital suspensory syndrome) is the “Nitric Oxide Pathway Formula”: Jiaogulan, basilicum and AAKG (arginine alpha ketoglutarate) (www.copperfieldequinetherapy.com). The objective is reperfusion of tissues starved for oxygen which consequently fosters clearance of metabolic waste products, toxins and cellular debris.

Intrinsic communication between the immune, endocrine and central nervous systems, when seriously impaired, can generate a pattern of blatant episodes characterized by tissue destruction accompanied by profuse bleeding, typically triggered by a stressful (high serum cortisol inducing) event such as a horse show, a race, vaccination, a long haul, excessive work, an adverse drug reaction, and/or a secondary bacterial or viral infection. As with digital suspensory syndrome, the parts of the body farthest from the heart suffer the most damage. Examples are ruptured alveoli deep in the lungs (exercise induced pulmonary hemorrhage (EIPH) (aka Bursting)), torn large muscles of the hindquarters (recurrent exertional rhabdomyolysis or tying-up (RER)), hindgut (colonic) bleeding ulcers, endocrinopathic laminitis (tearing away of the soft laminae from the outer hard lamellar wall), exercise induced trigeminal neuralgia (pressure on the trigeminal nerve(s) running from the brain to the lower face), purpura haemorrhagica (vasculitis and leakage of blood into soft tissues with pooling in the lower legs, head and underbelly) and autoimmune hemolytic anemia. Individuals with resting high blood pressure (normally balanced by the endocrine system) are at higher risk for these events. In the case of laminitis, a ‘bounding pulse’ can usually be palpated over the posterior digital arteries and the external hoof can be hot. Slightly less catastrophic examples of endocrine dysfunction are subclinical laminitis (especially in easy keepers), equine metabolic syndrome (EMS), Cushing’s syndrome (high serum cortisol due to elevated ACTH courtesy of low dopamine), anhidrosis (non- sweating) and cystic ovaries in mares. A reasonable Stage Two for this group of horses is appropriate magnesium supplementation coupled with transdermal skin patches that re-balance the horse’s electrolytes (minerals that carry an electric charge such as calcium, potassium, magnesium, etc.) (www.signal-health. com). Bleeding ulcers can be addressed concurrently with the supplement Succeed, which restores healthier acid-base balance and simultaneously promotes healing necessary for reversing leaky gut syndrome (www.succeed-equine.com) thereby re-establishing necessary absorption of nutrients like vitamins and minerals.

Bartonella horses that have endured chronic infection for years are inevitably destined for autoimmune states. These cases have acquired central nervous system (cranial nerves, brain and spinal cord) involvement that can prove frustrating for the horses as well as their owners. Strategic planning for this group is like closing the barn doors after the horse has escaped. The ratio or gap between cortisol and dopamine (neurochemicals that are inversely proportional) has widened. By the time acetylcholine receptor antibodies and/or voltage gated calcium channel antibodies start appearing, Shivers horses already have damage in the substantia nigra of the mid-brain, not unlike humans with Parkinson’s disease (see “Clinical Aspects of Myasthenia (‘Shivers’) in Horses”). Mid-brain dopaminergic neuron destruction for example can be addressed with herbal formulas that target specific neurotransmitters such as dopamine and acetylcholine (www.effectivepetwellness.com). Also at the head end of the body, cranial nerves such as the optic nerve(s) can be irritated to the point of eventual Moon Blindness (also known as equine recurrent uveitis or ERU). It is no coincidence that both descriptive names for this condition reflect characteristics of a chronic Bartonella infection most cases have flare-ups around a full moon and nearly all cases are cyclic, i.e., recurrent. Both intense and quiescent intervals of painful hypersensitivity to strong light and watery weepy eyes can be managed with herbal formulas (“ERU acute” and “ERU maintenance”) designed to deliver maximum relief according to real time symptom evaluation (www.wholehorse.com).

Autoimmune conditions tend to cluster, so the odd horse can have any combination of calcium channel antibodies, acetylcholine receptor antibodies and/or potassium channel antibodies. Voltage gated potassium channel antibodies with peripheral (farthest from the heart) myoclonus (muscle spasms) (“Morvan’s syndrome”) can manifest as periodic autonomic dysfunction: feverish thermoregulation (higher than normal body temperature), hyperhidrosis (excessive sweating), erythema (congested capillaries, obstructed sweat glands and spontaneous patchy sweating), intense pruritis (itching, mainly the head and groin areas), seasonal asthma, excessive salivation, laryngospasm (spontaneous hyperventilation at rest), weight loss, constipation, herring-gutted appearance, and/or muscle cramping (fasiculations) in the front legs and/or quadriceps. A simple intervention that serves these cases beautifully is freeze dried chopped garlic, one teaspoon in the feed twice daily. Garlic is a potent antihistamine in addition it has mild anti- cholinergic properties. Autonomic functions such as salivation, thermoregulation (which includes sweating) and asthmatic breathing are dialed up when the operative neurotransmitter, acetylcholine, is out of balance (excessive). These symptoms are exacerbated by dangerously low dopamine. Garlic achieves its result by closing the wide gap (improving the ratio) between too much acetylcholine and insufficient dopamine, while simultaneously counteracting too much of another neurotransmitter, histamine. Ideally one would pair garlic (neurotransmitter balancing) with transdermal skin patches (electrolyte balancing) electrolyte balance is crucial for proper neurotransmitter functioning. These horses also benefit from liver detoxification (www. OmegaAlphaEquine.com) and Succeed for ulcers. Similarly, neuroses associated with chronic Bartonellosis revolve around neurotransmitter imbalances and as such, can appear sporadically or continuously. Magnesium is indispensable especially when repetitive, obsessive compulsive, and/or attention deficit hyperactivity type behavior surfaces. Chronic neuroses reflecting deeper patterns of dysfunction can surface as panic attacks, explosive outbursts, grumpiness, aggression, depression, withdrawal, OCD, ADHD, head shaking, mouthiness, etc. in random combinations. Custom treatment plans designed from a thoroughly panoramic perspective can reverse negative pathways for these horses suffering from a wide array of multiple downstream problems, convoluted web-like reflections of chronic Bartonellosis.



“Design is not just what it looks like and feels like. Design is how it works.”
-Steve Jobs-



Resources

www.horseflynet.com / info@horseflynet.com / 434-973-0121 (barriers against flies)

www.wholehorse.com / whole horse herbs / 559-683-4434 (ERU formulas and more)

www.signal-health.com / info@signal-health.com / 877-378-4946 (transdermal patches)

www.holisticvetclinic.net. / Gerald Wessner, VMD / 352-245-2025 / (nosodes for Bartonella, WNV and other co-infections)

www.copperfieldequinetherapy.com / coopcath@icloud.com / +353 (0)62 53940 (custom herbal supplements)

www.PerformanceEquineNutrition.com / service@performanceequinenutrition.com / 707-766-8624 (MagRestore and more)

www.springtimeinc.com / 800-521-3212 (Spirulina Wafers, Bug Off Garlic)

www.OmegaAlphaEquine.com / (Chill, Liver Flush)



Bartonellosis in Horses: Part Five



The Thyroid Adrenal Connection

Copyright December 15, 2016 by Brenda Bishop, VMD All rights reserved. No portion of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without prior written permission of the author.



“Simple can be harder than complex. You have to work hard to get your thinking clean to make it simple. But it's worth it in the end because once you get there, you can move mountains.”
-Steve Jobs-



No discussion about bartonellosis in horses would be complete without reference to the adrenal glands and the thyroid gland. Traditional genetic classification of different horse breeds is based on basal metabolic rate (BMR) for all cells in the body which is influenced by thyroid hormones T3 and T4. Thoroughbreds and Arabs have a higher BMR, most draft breeds a lower BMR and a wide range of others (American Quarter horses, Eastern European warmbloods, pony breeds, etc.) fall somewhere in the middle. Superimposed upon this genetic aspect of thermoregulation, any horse with an underactive thyroid (aka hypothyroid) will have a lower then normal core temperature (always cold and sensitive to cold weather) horses with an overactive thyroid (aka hyperthyroid) will have a higher than normal core temperature (a tendency to run hot and prone to heat stress). Horse breeders have spent centuries developing breeds with desirable characteristics based on intended use of the offspring. Thoroughbred racehorses have a faster neuromuscular junction (reaction) time, a preponderance of fast twitch muscle fibers, a long ground covering stride and shorter total circulation time. Arabians have all of these traits as well as cardiac muscle famous for rapid recovery (endurance). Draft horses have a slower neuromuscular junction (NMJ) time, a preponderance of slow twitch muscle fibers, a shorter stride length suitable for pulling weight and longer total circulation time. The Baroque breeds (Lusitanos, Andalusians, Lippizaners, Friesians) have body types that once served knights in battle and today excel at dressage. Historically, alignment of desirable genetic traits with specific job descriptions is nothing new. But specific manifestations of thyroid and adrenal gland malfunction within different gene pools during times of chronic stress (years for some horses) are poorly understood. While human horse breeders have been honing their skills over generations, stealth bacteria such as Bartonella species have been improving their own skills, becoming adept at scavenging and systematically depleting key vitamins, minerals and amino acids essential for the body's defense systems, components of the immune system. Simultaneously these opportunistic invaders appear to have achieved a ramped-up level of pathogenicity, aided in part by 21st century stressful environments within and outside the body, contributing to a complex matrix of chronic inflammatory issues.

Bartonella can distribute itself anywhere the horse's blood goes and establish itself in a variety of tissues which translates into long term survival for the bacteria and a convoluted trip to Hades for the horse. As a stealth pathogen in a league of its own, it maneuvers from every conceivable angle of attack. Bone marrow, vessel linings and collagenous tissues such as tendons and tendon sheaths, the liver and spleen, all places where replication can proceed in relative obscurity, are subject to invasion. Infected horses suffer a spectrum of possible 'symptoms' in relation to the specific multiple loci (locations) of bacterial presence and eventual cellular damage. Neuroscientists know that any significant ongoing stressor attacks cells of the hypothalamic-pituitary-adrenal axis along with the hypothalamic-pituitary-thyroid axis, two systems that connect the body with the brain, the entire central nervous system is vulnerable to attack. Bartonella is a neurotoxic pathogen neurotoxins disproportionately affect the hypothalamus, creating dysregulation of downstream hormones. The thyroid and adrenals help mediate a host of natural defense mechanisms but working under stress, they become deranged as exemplified by overactivity of the adrenal cortex aka Cushing's. Autoimmune problems tend to cluster and Bartonella horses can develop autoimmune thyroiditis and/or Low T3 Syndrome, an autoimmune disease rarely considered in the brain the hypothalamus produces thyrotropin releasing hormone (TRH) which passes through the bloodstream to act on the anterior pituitary gland which secretes thyrotropin aka thyroid stimulating hormone (TSH). TSH acts on the thyroid gland to up regulate T3 and T4 synthesis. InactiveT4 is converted to active T3 by multiple tissues, many of which can shelter Bartonella bacteria: the gut lining, the liver, and the brain among others. T3 requires transport proteins made by the liver to make its journey to the thyroid receptors located within cell membranes of final destination tissues such as laminae in the feet, alveoli in the lungs, delicate tissues of the eyes, and skeletal muscles closer to the pelvic girdle. Failure within any one or more of these stages, with or without pathology in the thyroid itself, can result in low T3.

Chronic infection impinges on thyroid function coming and going. Across species lines there is a two way street between thyroid function and gut health. The gut is ground zero for the immune system, for example, most of a horse's serotonin is manufactured in the gut. A compromised thyroid gland with or without Low T3 Syndrome opens the door for a degenerative gastrointestinal spiral without thyroid hormone present in cell membranes, neurotransmitters will not activate (excite) neurons at the neuromuscular junction muscle contraction is delayed the gut lining remains flaccid and porous, unable to absorb nutrients and water, and leaky gut syndrome (LGS) develops. (By the same mechanism, insufficient thyroid hormone in multiple tissues engenders delayed neural transmission.) Horses with leaky guts have skewed neurotransmitter production, malabsorption of necessary nutrients, and environments conducive to fungal overgrowth (usually Candida). Another aspect of stealth infection is chronic inflammation which fuels elevated angiogenic cytokines (the immune system shifts between a Th1 response and a Th2 response) and over-activation of pro-inflammatory interleukins. This inflammatory cytokine cascade can block cellular thyroid hormone receptors even in the presence of adequate T3 and T4. Neurotoxins can also block these receptors as minerals are steadily depleted by Bartonella bacteria, heavy metals move in and occupy the vacant receptor sites at the cell membrane, preferentially in the throat area (where the thyroid gland sits), the face and sinuses. The Baroque breeds are suspected by some horsemen to have genetic vulnerability to heavy metal toxicity Eastern European warmbloods have a higher incidence of ERU than other breeds. Thyroid glands can also be infiltrated by lymphocytes, which translates into reduced thyroid hormone producing tissue and lowered T3 and T4. Both Bartonella and Borrelia (lyme) rob their hosts of specific nutrients these same deficiencies just happen to be associated with sub-par thyroid function: magnesium, manganese, copper, iron, zinc, iodine, and vitamins A, C, D, B2, B6, B9 and B12. The thyroid uses tyrosine and iodine to produce T3 and T4, a process thought to require manganese. T3 and T4 production are dependent on dietary phenylalanine, which requires vitamins B3, B6, C, copper and iron to form tyrosine. Oxidative stress, a component of chronic inflammation, contributes to low T3 particularly in the absence of anti-oxidant vitamin E.

Humans and horses with bartonellosis are always 'cold' due to microcirculation deficits. The presence of a Bartonella infection within the context of all those characteristics of slower metabolism (low BMR courtesy of input from the thyroid hormones) facilitates multiple variations in immune mediated manifestations of disease. The 'cold' blooded breeds and by extension the 'warm' blooded breeds can be expected to handle a stealth infection differently from the 'hot' blooded breeds. Bartonella generates impaired blood supply restriction of hemodynamic flow (stasis) will express itself more readily as sudden onset lameness (digital suspensory syndrome) in a front leg of a sensitive thoroughbred or Arab prone to spikes in blood pressure under stress, as chronic lameness (laminitis) in small feet supporting a heavy body, and more often as delayed onset lymphangitis in a hind leg of a heavy breed horse (or as swollen gums where capillary pressure is lowest farthest from the heart). Delayed forward phase of stride, a hallmark of Bartonellosis, will be obvious sooner and appear more frequently in low BMR individuals with slower longer NMJ timing horses with genetic faster shorter NMJ timing can outpace their infection induced delays in forward striding until a critical mass of damage to specific groups of neurons in the brain is reached. For the lungs, downstream delays (defined as loss of compliance in physiology) manifest as prolonged recovery times, asthma, COPD, etc. the alveoli suffer delayed expansion and contraction forcing the body to increase respiratory rate and abdominal effort. Ultimately critical mass for any system in the body is a reflection of site-specific quantal damage back at mission control: the mid-brain and hypothalamus. In reality horses with Shivers are inevitably 'lame' in all four legs (usually RH>LH>LF>RF) in direct proportion to degree of infection. Historically Shivers was considered a disease of middle aged draft horses mainly, warmbloods occasionally (larger individuals), ponies never, geldings mainly and mares rarely. Those days / centuries / millenia are over. As of the current century, most soy (the highly estrogenic protein source in commercial horse feeds) is GMO. Most hay and grain crops are now sprayed with glyphosate which promotes LGS and subsequent vitamin deficiencies. Internal biochemical environments are repeatedly assaulted by humans administering modern chemical dewormers. For ever increasing numbers of horses with chronic infection(s), adrenal glands clogged by neurotoxins get trapped in a repetitive loop generating high serum cortisol, increased likelihood of multiple co-infections and dysregulation of sex hormone synthesis. Sex hormones contribute to BMR (intact males have a higher BMR than intact females) and their dysregulation manifests differently in different sexes. Adrenal health has a much closer relationship to testosterone than to estrogen and progesterone. Sacroiliac (adrenal) area pain (CRPS) is another hallmark of bartonellosis in horses by the time a male horse develops Shivers, it will stand 'parked out' most of the time giving the appearance of straining to urinate. Factors that further lower BMR and adversely effect the thyroid and adrenals are castration, age, starvation diets and iodine deprivation. Individuals that have been castrated, are middle aged or older, harbor chronic infection(s) (with concomittant low T3, high cortisol, etc.), and have an inherited low baseline BMR (naturally cold blooded) are at higher risk for loss of lean muscle mass (topline) and Shivers. Due to overwhelming adrenal exhaustion, net lowered testosterone and net lowered BMR they become far too cold. Extremities suffer extreme lack of perfusion feet should be warm not cold, tails should not clamp at the slightest touch and teeth should not be hypersensitive. Mares are at less risk due to their relative lack of testosterone despite a healthy amount of neuroprotective progesterone they can become 'hot' and wring their tails due to disproportionate estrogen. Similarly, acquired infertility in stallions (and mares) with upstream hypothalamic, thyroid and adrenal gland distress is well within the repertoire of Bartonella bacteria. The author has seen cribbing (for no apparent reason) in a six month old Welsh pony colt as well as Shivers in an older nutritionally stressed (starved) mixed breed small pony mare (with dropped head syndrome, recurring laminitis, hallucinogenic behavior, chronic fatigue, uveitis and numerous other symptoms consistent with bartonellosis) and Shivers in a middle aged heavy Irish Sport Horse mare previously dosed with synthetic progesterone because she was 'difficult' to break as a two year old. Stress is cumulative and internal environments, more stressful than ever before (such as tissues deprived of T3 and/or oxygen due to bartonellosis and/or lyme), are starting to impinge on neurochemical, thyroid and adrenal balance across breed divisions in ways previously non-problematic.

Regardless of breed most scientists agree that all autoimmune problems descend from two factors: genetic predisposition and environmental stress (poor nutrition, repeated ingestion of hay and grain sprayed with chemicals, exposure to external electromagnetic radiation, chronic infection such as Bartonellosis, etc.). Numerically the draft horse breeds and some European warmblood breeds have gone through a period over the last hundred years of net gene pool shrinkage. Draft horses have been replaced by tractors and carriages by automobiles. Simultaneously modern farming practices have precipitated near total depletion of minerals from the soil and the crops grown in those soils. Minerals available to horses a century ago are absent in today's hay crops and grains. This amounts to metabolic stress for grazing animals, who are forced to use energy draining convoluted body chemistry in lieu of the DNA designated pathways nature intended. When was the last time any of us saw Lanthanum on a feed bag label? Lanthanum is the rare earth mineral associated in the genetic code with phenylalanine, the amino acid precursor of tyrosine (thyroid) and neurotransmitters dopamine (brain) and epinephron (adrenals). (Tyrosine and iodine are the building blocks of T3 and T4 tyrosine is also used by the adrenals to produce epinephron.) As previously discussed, low dopamine has been associated with neurologic impairment and explosive behavior hypothalamic neurons have been associated with aggression. Which brings us back full circle to the fact that many chronic immune mediated and autoimmune states mimic each other. When the clinical symptom lists for magnesium deficiency, low T3, low dopamine, low serotonin, fibromyalgia syndrome, chronic fatigue syndrome, bartonellosis and lyme disease are superimposed on each other, they overlap uniformly. Adding accelerant to the fire, there is growing anecdotal evidence that Bartonella can be passed through the mare's placenta to the offspring. If a mare is infected she is at risk for placentitis, retained placenta, endometritis, etc. and her foal's brain, thyroid and adrenal glands are vulnerable. If that foal matures to breeding age and carries a subclinical stealth infection, recognized as such or not, the stage is set for an abundance of immune mediated problems in adulthood that can potentially carry over to succeeding generations. Increasing numbers of regressive management nightmares (Shivers, ERU, asthma, COPD, etc.) amount to sentinels for stealth infection spread.

Ultimately Bartonella reigns supreme over other infections as a stealth pathogen it transmutes other pathogens into static layers of blankets under which it can elude detection. Predictably it will stalk and suppress multiple co-infectious agents, much like a ransom virus holds hostage a computer. An example from the 1980's is protozoal myelitis (EPM) it was only a few years after the advent of ivermectin that EPM first appeared in horses despite the fact that those same infectious protozoa have lived in nature for thousands of years. Over succeeding decades the acute form of EPM has diminished into a far less debilitating condition. Very few domestic large animals (horses, cattle, etc.) in North America have never been administered ivermectin. It lingers for years in the soil via horse manure. A neurotoxic inhibitory neurotransmitter (GABA) agonist, ivermectin delays muscle contraction Bartonella, which already owns first, second and third bases (the brain, thyroid and adrenals) simply elevates its game. Wearing invisible t-shirts that say “Co-infections Welcome Here”, Bartonella horses are magnets for 'outbreaks' of EPM, monocytic ehrlichiosis (potomac horse fever), Corynebacterium pseudotuberculosis (pigeon fever), Borrelia (lyme disease), babesiosis and (in foals recently weaned) Rhodococcus equi. Even a clostridial infection like C. tetani is not necessarily a death sentence for a horse with a chronic Bartonella infection horses can recover from tetanus, EPM, etc. if they are treated for underlying bartonellosis. Assuming chronic infection has been addressed with infection fighting herbal formulas starting orally at the level of the gut, restorative nutrition will influence the immune system to go back to work more competently. Immune support mandates consideration for the thyroid and adrenal glands, specifically availability of phenylalanine, tyrosine and iodine. Diet alone supplies phenylalanine (an essential amino acid) found in mares' milk (high levels), wheat germ and oats (low levels). It can directly affect brain chemistry by stimulating endorphin production. Chronic infection inevitably leads to chronic inflammation which lowers endorphin levels. (Horses that crib are addressing pain by raising their endorphin levels.) In addition to lowering endorphins, chronic inflammation in and of itself immobolizes the thyroid. Controlling it allows the brain, thyroid and adrenals a window of opportunity to re- calibrate their various and assorted functions such as thermoregulation, neurotransmitter balancing and hormone regulation.

Low dose naltrexone (LDN), a compounded drug, is the 'go to' treatment of choice for reducing long term chronic inflammation and oxidative stress. It appears to work by balancing Th1 and Th2 dominance, both of which can be simultaneously overactive or underactive. By virtue of the fact that it blocks opioid receptors, it signals the brain to dial up production of endorphins thereby reducing a Bartonella horse's incentive for cribbing. LDN has been shown to reduce (and in some cases eliminate) symptoms of FMS (see The Fibromyalgia Horse), histamine intolerance (severe itching on the head, neck and/or chest), chronic regional pain syndrome (CRPS) (100% of Bartonella horses have sacroiliac adrenal regional pain), irritable bowel syndrome (IBS/LGS) and autoimmune thyroiditis. Best of all, it works at sites where Bartonella henselae tends to persist as in bone marrow. LDN enhances maturation of exceedingly potent dendritic cells from stem cells upon migrating from bone marrow to blood and lymphoid tissues (peripheral niches for Bartonella), dendritic cells modulate B and T lymphocytes and reorganize appropriate immune responses. Patients with neurodegenerative diseases characterized by low dopamine improve on LDN much like recipients of stem cell transplants. LDN should not be given with thyroid replacement therapy concurrently unless response to TRT alone has been evaluated. Low cost and ease of administration add to its user friendliness like magnesium and iodine, it can be given transdermally, bypassing the gut. The inside of the groin and the underside of the tail are ideal places to apply transdermal LDN. It is important to use a pharmacy that specializes in compounding LDN (see Resources below). Unlike anti-inflammatories and thyroid replacement therapies, LDN reverses chronic inflammation cascades paving the way for normalization of thyroid and adrenal gland responsiveness. When employed for specific immune mediated conditions (Shivers, ERU, IBS, laminitis, cribbing, etc.), a wide range of seemingly unrelated issues concurrently begin to resolve, providing broad spectrum relief. Availability of LDN presents today's horse owners and veterinarians with unique opportunities to more fully appreciate chronic inflammation's all encompassing stranglehold on Bartonella horse health. On their journey back to wellness these horses are set free to gradually recoup their true peaceful nature.



“We return victorious to the spirit, having descended into hell. And from hell we bring trophies. Understanding is one of our trophies.”
-Don Juan Matus-


Resources

www.antennasearch.com (free search for all towers and antennas within a 4 mile radius of your barn)

www.wholesomeequinenutrition.com (Karen Bates, USA) / 561-601-2310 / wholefoodsforhorses@gmail.com

www.copperfieldequinetherapy.com (Catherine Cooper, Ire) / +353 (0)62 53940 /
coopcath@icloud.com

www.GeorgiaEquineDentistry.com (Diane Febles, DVM, CVA) / 770-954-0793 / DianeDVM1@charter.net

www.redmondequine.com (Redmond Daily Gold Stress Relief mineral supplement)

www.stanceequine.com (shredded coconut “Cool Stance” for horses available in Australia, New Zealand, South Africa, United Kingdom and USA) / www.stanceequineusa.com / 803-647-1200

www.homeopet.com (Equiopathics homeopathic dewormer “Horse Clear”) / 800-555-4461

www.skipspharmacy.com (compounding pharmacy specializing in LDN and veterinary prescriptions) / Boca Raton, Florida / 800-553-7429 / info@skipspharmacy.com

“Light Relief” infrared pain relief device for CRPS (www.amazon.com key words infrared light therapy)

“The Immune Laminitis Connection” @ www.forloveofthehorse.com

“A Survey of Adverse Effects Associated with Ivermectin Use in Louisiana Horses” 1984 JAVMA @ www.ncbi. nlm.nih.gov>pubmed

Minerals for the Genetic Code by Charles Walters @ www.amazon.com/books

Detoxify or Die by Sherry A. Rogers, MD @ www.amazon.com/books

LDN fact sheets, LDN and autoimmune diseases @ www.ldnresearchtrust.org access LDN research and video “How LDN Works” @ www.ldnscience.org


www.valhallafarmsus.com / (McLaurine Clarke, USA Bicom Bioresonance Therapy) / 425-308-2379 / mclaurine22@iglide.net




Congratulations to Takashi Kodama and jockey Ross Coakley (pic below) on winning the Irish Cambridgeshire Handicap with Elusive Time. Having struggled previously with chronic bursting (EIPH), Elusive Time was the smallest horse and the oldest horse in the field going one mile at the Curragh. Thank you for impacting the direction of horse racing history, taking a role on the leading edge of enlightened reform that puts horse welfare first



Acknowledgements





Bartonellosis in Horses: Part Six



Lessons from The Masters

Copyright January 15, 2018 by Brenda Bishop, VMD All rights reserved. No portion of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without prior written permission of the author. The author asserts her moral right to be identified with this work.Comments in [brackets] relate to chronic stealth infections such as Bartonellosis in horses.



“…………The horse, on the other hand, is never wrong.”

-Ray Hunt-



‘We stand on the shoulders of others’ and some of those others have manes and tails. All too often horses take their lessons with them to the grave, but being Master teachers, they leave behind memorable life histories, complex conundrums left unsolved while they lived among us. There is an emphasis today on ‘One Health’, a concept very familiar to veterinarians and epidemiologists who study zoonotic diseases, i.e., diseases common to and transmissible between humans and animals. Stealth infections such as Lyme disease (Borrelia spp.) and Bartonellosis (Bartonella spp.) fall into this category. It seems almost counterintuitive that chronic stealth infections could generate in their hosts an oceanic array of symptomatic consequences across species lines. Horses with Bartonellosis, for example, can have seemingly random clusters of problems as described in the Symptom Check List (see Frequently Asked Questions). No two Bartonella infected horses are alike yet they all have underlying systemic infection in their lymphatics, i.e., invisible pathology that can generate a wide range of problems. Dr. Elaine Hammel gives a good overview of the equine lymphatic system in this YouTube video:


VIEW OR DOWNLOAD VIDEO HERE


The question arises, “How can bacteria from one Genus (Bartonella spp.) lead to so many different health complaints that appear seemingly at random in different individuals?” This leads to the question, “What elements contribute to and modulate such highly variable expressions of chronic stealth infectious disease?” Factors that operate on the molecular level, unseen and elusive, are a good place to start looking for answers.

Geneticist Kathryn Tayo Hall (Brigham and Women’s Hospital, division of Preventative Medicine) has focused her work on the gene for Catechol-O-Methyl Transferase (COMT), an enzyme involved in the breakdown of dopamine. Neurotransmitters such as dopamine and serotonin rule the day in horses with chronic Bartonellosis (see Bartonellosis in Horses: Part Three: Alternative Approaches). Dr. Hall has identified at least two enzyme variants of COMT, one associated with overall higher levels of dopamine in the brain and one associated with lower levels of dopamine. Furthermore, she has found that in humans with irritable bowel syndrome (aka leaky gut syndrome, a hallmark of Bartonellosis in horses) responses to certain medications fall into one of two categories: those that reflect higher levels of dopamine (individuals who are highly sensitive to stress) and those that reflect lower levels of dopamine (people who are relatively insensitive to stress). Outwardly, people with more dopamine exhibit greater (more acute) levels of attention, memory and anxiety but in general they can’t handle stress very well. People with low levels of dopamine suffer in the attention / memory department (an example is Parkinson’s disease) but their abilities paradoxically increase under stress. One could anticipate the higher level dopamine group would strive to escape conflict, whereas the lower dopamine group would up their game and dominate their rivals when challenged. Dr. Hall describes these two subtypes as Worriers and Warriors. This ground breaking research bestows an awesome opportunity for horse lovers to begin to understand specific paradoxical famous athletes, memorable individuals past and present. Infected horses certainly tend to fall into one of these two categories: “Worriers” (henceforth referred to as Type B), those individuals who respond to the slightest traumatic trigger with dramatic behavior, at best an accident looking for a place to happen and at worst, lethal to all those around them, and “Warriors” (henceforth referred to as Type A), those horses of whom it is said, “It takes a lot to rock their boat.” These cases appear unaccountably placid in the face of nearly all stressful situations, yet repeatedly rise to the occasion when pressured.

As in the human sports world, those individuals classed as ‘elite athletes’ present very detailed, historically accurate lessons for their human caretakers, more so within those sports requiring extreme physical exertion and intense mental effort such as thoroughbred horse racing and eventing. (For an interesting illustration of this important principle, see “Sudden Cardiac Death in Swedish Orienteers”.)



VIEW OR DOWNLOAD ARTICLE HERE


Horsemen the world over can thank three modern day researchers for their meticulous labor spanning many years which has given us profound insights into the lives of three undisputed Masters: The Byerley Turk (Jeremy James), Seabiscuit (Laura Hillenbrand) and Ruffian (Jane Schwartz). Of this group, perhaps the most impressive achievement is that of Jeremy James, who transports the reader into the lives of horses bred by the Ottoman Empire, horses bred for war. By the time the pure Karaman doru stallion later named the Byerley Turk was foaled (1678) at the height of the Ottoman Empire’s dominance, the various Turkish clans had selectively bred in excess of two million horses. Their collective objectives (horses were NOT bred for money) contributed to nomadic survival: endurance, strength, speed, calmness and intelligence. Their horses were treated with respect and raised like children. Mr. James tells us parasite control compounds (walnut, wormwood, garlic and often pomegranate) were administered in sync with internal parasitic migrations, at the waxing of the moon. Such practices would have had a deleterious effect on live bacterial pathogens such as Borrelia and Bartonella species living in the horses’ bloodstreams. Many humans today report that their ‘Lyme and/or Bart symptoms’ flare during a full moon. The Turk must have been fairly healthy to win an impromptu match race near Down Royal in Ireland (in 1690) after years of exhaustive fighting and traveling. Male Ottoman horses were not routinely castrated in those times and well trained stallions (who went into battle bedecked with diamonds, rubies and emeralds) were priceless. Presence or absence of stealth infections aside, Ottoman breeders would have needed and appreciated Type A horses for many centuries.

Over the course of the next two hundred years, horse sports such as racing began to attract more attention and more financial investment. The thoroughbred breed became established in England and Ireland and record keeping was taken more seriously. By 1881 a brown colt from the Darley Arabian sire line was foaled near Newmarket (St. Simon) who would become one of the most influential thoroughbred sires of all time. Described as ‘quite over at the knee’, he actually had flat knees in his surviving pictures but stood crooked due to knees that buckled forward. His tendons and ligaments behind the knees must have been under extreme tension to allow such deformity. A nervous, high strung Type B stallion, he could trounce his competitors easily enough but gave his riders a hard time after crossing the finish line. Champion jockey Fred Archer could not pull him up after winning the 1884 Ascot Gold Cup, making another circuit of the course. His temperament, reported to be vicious, worsened with age. Attempts to subdue him by force never went well. His legs jarred at the end of his three year old campaign and never recovered. [Jarring is the term used in England and Ireland to describe uniformly round edema of the leg column (commonly both hind legs or all four legs) more or less associated with lymphangitis and impaired venous drainage. A systemic problem, it can result from infection within the microvasculature.] An extremely popular and successful stallion, he mysteriously died from an apparent heart attack in 1908. At this point both human and veterinary medicine were fairly primitive with regard to infectious disease recognition and treatment.

Within a decade the odd ill tempered horse was tolerated and even bred if it displayed the slightest proclivity for speed. Such was the case of Cinderella, a bay mare foaled in 1885 in England. More like an evil stepsister, she was vile tempered and vicious. More importantly, her progeny displayed the same qualities. Her first two colts won a number of races and both died young. She slipped her next foal (1891) but rebounded with a speedy two year old son who became a failure at stud. Her next foal, a brown colt named Hastings (1893), inherited her bad temper but managed to do some winning. He had exceedingly upright shoulders and pasterns and would fight being saddled. By age 4 his temperament had deteriorated to the point where he was impossible to train and so was retired to stud. The reign of terror that surrounded Hastings at stud is legend. The older he got, the worse he got. By age 24 (1917) his hindquarters had become paralyzed and he was humanely destroyed. [Bartonellosis transmitted through the placenta often causes upright angles due to tendon contracture as Bartonella invades tendon collagen. Saddling can be extremely painful due to the swollen lymphatic channel that runs from the withers down to the elbow. Sore lymphatics swollen with infection promote behaviors akin to demon possession. Progressive circulation and neurologic deficits of the lower legs and hindquarters are inevitable.] Of her thirteen named foals, most of Cinderella’s runners could be described as Type B and none as Type A. She died at the age of twenty-one reportedly from heart disease. Was she passing on the Worrier (high dopamine variant of COMT) gene along with a chronic stealth infection? Hastings suffered through 24 years while his humans wielded long sticks and merely learned strategies for getting a number of mares covered while keeping themselves from getting killed.

Whatever lessons went unlearned in Hastings’ lifetime came back with a vengeance just a few generations later. Hastings produced a sire line that generated the famous American racehorses War Admiral (1934) and Seabiscuit (1933). The older Seabiscuit had the good fortune to be trained by an old school horseman who instilled confidence with gentle persuasion. Both colts had front legs bent forward by contracted flexor tendons (buckled over at the knees like St. Simon) and both shared a curious habit of sleeping for hours in their stalls, much longer than normal horses. But Seabiscuit was able to best War Admiral by virtue of the fact that his humans recognized his Type A attributes. A Triple Crown winner, War Admiral was Type B to the core. As a three year old he was spastic enough that upon bolting from the gate at the Belmont Stakes he hurt himself badly, crossing the finish line first with blood covered legs. Official start times were delayed by longer and longer intervals because of his violent outbursts, the Admiral often dragging whatever humans were attached to him along down the track in tow. By age five he had injured a fetlock and was retired to the breeding farm where he died in his stall twenty years later. Seabiscuit in contrast often appeared sleepy on his way to the post. Slow to leave the gate, he would stalk his rivals and proceed to bury the field. At this point in history horses crossing the country were loaded onto railroad cars equipped for their comfort. Initially terrified of train travel, Seabiscuit learned to lie down on a thick bed of straw and sleep until the train stopped. However many days the journey took, he would not remain standing in the moving train. Upon retirement he had many visitors for whom he stuck his tongue out to be scratched. [Horses with chronic stealth infections lose their balance in a moving conveyance and easily fall down. Tongue pruritis is an indicator of stealth infection.] At age 14 he unexpectedly dropped dead of a sudden cardiac event despite enjoying a moderate exercise and breeding program on his owner’s cattle ranch.

A somewhat happier story is that of Chase Me (1929), a brown colt with unusually large knees. Veterinarians had declared he would never make a race horse and so he was gelded and turned into the family pet. Later known as the Gentle Warrior, his endearing temperament made him everyone’s favorite pet. The Bosley children taught him every trick imaginable over the first four years of his life. In the Spring of 1933 it was discovered by chance that he could run alongside the family race horses in training with impunity and make them look useless. What followed was a fairy tale with a sad ending. While other horses went into panic mode in the starting gate, Chase Me offered to shake hands with the gate crew (all of whom subsequently fell in love with him). After racking up 7 wins from 7 starts at different tracks he was entered in a race against a field that included the great Equipoise. As was his custom, he broke slowly from the gate and came from behind to surge ahead of Equipoise, only to stumble badly and break a foreleg. It was reported that the fracture high near the shoulder could have resulted from having crossed his legs while making the turn. Only five years old, he died (by gunshot) with his lessons unlearned. His was a case of ‘learn the trick and get the reward’. It is likely he had learned to raise his low dopamine levels by learning tricks that earned him a sugar cube, truly a Type A Warrior (low dopamine variant of COMT) living with chronic stealth infection. [Stumbling, crossing legs and falling down are random events for Bartonella infected horses.]

Another much beloved Type A elite athlete later in the same era was the great Irish chaser Arkle (1957 - 1970). Bred from a Phalaris sire line, he had some Byerley Turk genetics in his veins and delighted his humans with phenomenal strength, speed, intelligence, endurance and tranquility under all circumstances. Described as “a saint”, countless children were invited to sit on him for pictures. The winner of three consecutive Cheltenham Gold Cups, Arkle so outclassed his competition the rules had to be changed. He always raced with a cheerful obvious joie de vivre and had a habit of crossing his forelegs when jumping a fence. In December 1966 he hit the guard rail at an open ditch jump, fracturing a pedal bone. Subsequently retired, he deteriorated rapidly and was variously described as having advanced arthritis or possibly brucellosis, leading up to humane euthanasia at the age of 13. [Per the NIH, “Bartonella spp. and Brucella spp. are closely related alpha proteobacterial pathogens that by distinct stealth attack strategies cause chronic infections in mammals including humans.” Both systematically deplete their hosts of magnesium, copper, zinc, iodine, cobalt and manganese thereby negating any possibility of healthy fracture repair.] Arkle’ s skeleton is on display at the Irish National Stud today. Are dead Bartonella bacteria hiding in plain view, within the bone marrow of the champion’s long bones, genetic fragments of which might be found with twenty-first century technology?

Midway, Kentucky was a thoroughbred mecca in the 1940’s and it was here that a small chestnut colt was foaled who would become the architect of today’s American Quarter Horse breed. Three Bars (1940 – 1968) had plenty of health issues early in life but in the end he contributed three important qualities: blazing speed over short distances, powerfully muscled rear ends, and prepotency at stud. As a yearling he always left the starting gate like a bullet and would not be rated. With such blazing speed he could easily get out of hand. Always out of the gate on top, he would get mad and not run if the rider got in his way. One day in the Spring of 1942 he came off the track with a bunched up ice cold hind leg. His local Kentucky veterinarians were mystified. It was as if the circulation had been turned off. The leg continued to turn cold whenever he exerted himself. A series of different owners ensued and he was moved around the American southwest, always hypersensitive to being groomed and having his feet trimmed, and almost never lying down to rest. While in Arizona he almost died twice from what was then termed ‘the sheep virus’. [Sheep (like grey horses) are tick magnets and they consequently become reservoirs of zoonotic infections like Babesia, Anaplasma and Mycoplasma along with co-infections Lyme and Bartonella. The practice of pasturing sheep and horses together, even rotating pastures, continues to this day and one has only to visit the world class thoroughbred breeding and training yards at the Curragh in Ireland to see sheep grazing over much of the 5,000 acre grounds.] A Type B elite athlete, Three Bars became progressively unhealthy as he aged and reportedly died of a heart attack at a ranch in western Oklahoma at the age of 28.

Like Quarter Horse breeders, thoroughbred breeders in 1960’s America had started breeding for more speed over shorter distances and unwittingly fostered a collection of what came to be labeled ‘soft boned runners’. The black filly Ruffian is one of the most famous examples from this group. Native Dancer (‘the grey ghost’) was a popular stallion due to his pedigree (Phalaris sire line), conformation and sprinter-like speed. His grey daughter Shenanigans (1963 – 1977) was lightly raced due to unsoundness and dropped her first foal in 1969. Named “Icecapade”, her grey colt had plenty of speed and made everyone around him nervous because of his erratic ‘crazy’ Type B outbursts. His initial trainer, a master of disaster prevention who put a high premium on trustworthy reliable help, was convinced it was only a matter of time before the horse got someone hurt or killed. [Stealth infections acquired through the mare’s placental blood supply can manifest much earlier in life in comparison to those acquired through the blood sucking insect route.] Icecapade was sold to different owners, became a successful racehorse and sire and died at the age of 19. Bred to a different stallion (Reviewer), Shenanigans produced Ruffian in 1972. Like Seabiscuit, Ruffian had the good fortune to be trained by an old school horseman (the same fastidious trainer who knew Icecapade was an accident waiting to happen) who catered to her Type A proclivities. For example, the filly detested the traditional sponging down that followed hard work on a hot day. She simply would not tolerate cold water touching her inner hind legs. Her grooms were allowed to apply a nose twitch (a humane form of acupressure that releases endorphins) while working as quickly as possible. [Bartonella infected horses cannot tolerate water dripping over their skin especially if it is cold water on tender body parts.] In her fifth and last race as a two year old, she suffered a hairline stress fracture in her right hind leg. [The right hind leg is nearly always the first place a circulation deficit will rear its ugly head. It is the corner farthest from the heart on the diagonal opposite end of the body. Systematic depletion of key minerals magnesium, copper, zinc, manganese and cobalt engenders diminished tensile strength of cortical bone. The ultimate favorite colonization site of Bartonella henselae is soft marrow tissue inside long bones.]

Undefeated in her first ten races, Ruffian suffered a catastrophic breakdown when both sesamoids in one front leg snapped apart. She was euthanized post surgery under similar circumstances to those that befell both her sire and dam. All three had problems akin to panic attacks leading to more broken bones coming out of anesthesia, Ruffian at 3, Shenanigans at 14 and Reviewer at 11. Were all three athletes products of ‘soft bone genetics’? Put another way, what would make bones brittle aside from genetic factors? Ruffian was the daughter of a mare whose first foal (Icecapade) epitomized chronic stealth infection presumably acquired from the dam. A Type B elite athlete, Icecapade exhibited Worrier subtype (enzyme variant of COMT) tendencies in contrast to Ruffian, a Type A elite athlete typical of the Warrior subtype (enzyme variant of COMT). Different sires would have contributed different genetics to their offspring, both of which appear to have been infected through the dam. Ruffian, her sire Reviewer and her dam Shenanigans all died young following violent reactions to the stresses of surgery and/or anesthetic drugs. (The abilities of Type A’s paradoxically increase under pressure, i.e., they fight harder.) [Genes that can cause faulty cellular respiration (mitochondrial disease) are inherited from both parents. Defective manufacture of mitochondrial Complex I has been linked to hypersensitivity to inhalation anesthetics, heart attack, liver disease and kidney disease.] On closer inspection, all three horses shared the same fate having illustrated different outcomes of a common underlying chronic denominator: immune system weakness. Immunocompromised bodies cannot handle stress whatever their intrinsic genetic make-up. Shenanigans illustrated the example of colic requiring surgery (a factor in leaky gut syndrome) Reviewer illustrated the example of mal-union of an old fracture (a downstream effect of vascular compromise and mineral depletion) and Ruffian simply reiterated (for twenty million viewers) the unlearned lessons of St. Simon, Hastings, War Admiral, Seabiscuit, Hail to Reason and many others. [Embedded behind the fetlock joints are the non-weight bearing vestigial sesamoid bones which make up part of the suspensory apparatus, a vertical soft tissue sling of sorts that allows horses to sleep standing up. Interconnecting parts of this apparatus include the check ligaments above and below the knee, the carpal canal area behind the knee, the larger suspensory tendon, and several smaller ligaments above and below the fetlock. Infection within these tendons and their sheaths leads to contraction and occasional rupture when repetitive motion fatigues the normally flexible apparatus components. Seabiscuit for example could never straighten his front legs and one suspensory finally ruptured near the end of his next to last race.]

Coal black Sunday Silence (1986 – 2002) nearly died as a weanling from a viral infection but survived thanks to 18 liters of IV fluids and a dedicated veterinarian. As a two year old he was shipped cross country in a horse van that flipped over into a ditch in Texas, killing or injuring all the horses on board. His Type A demeanor allowed him to calmly walk away and prove his elite status, winning almost five million dollars. Just seven days before his Preakness win, he came off the track in Baltimore dead lame. He was diagnosed with a bruised sole and treated accordingly, dodging disaster again. At age four he injured a ligament in the Hollywood Gold Cup and was subsequently retired. As a breeding stallion he became Japan’s leading sire and also a sire of sires. At sixteen he developed laminitis refractory to treatment along with an infected leg. He died on his own in his stall apparently of heart failure. Back in Kentucky, Easy Goer (his famous rival as a colt) dropped dead suddenly at age 8 from an apparent heart attack. [Compromised immune systems are hallmarks of chronic stealth infections. Nagging health issues like co-infections, sore soles, tendon and ligament injuries, chronic laminitis, lingering infections and unforeseen cardiac failure are all downstream events.]

Handsome nearly black champion War Emblem (1999 – 2016) was intended to replace Sunday Silence as a leading sire in Japan but it didn’t quite work out that way. An ‘expensive disappointment’, he proved to be a notoriously shy breeder despite hormone therapy and was eventually returned to Kentucky for retirement. Famous for his temperamental Type B demeanor on the racetrack, he never liked people or other horses. He could be troublesome in the starting gate and was fond of biting and kicking anyone within reach. War Emblem today entertains visitors from behind a double fenced paddock, a rational precaution for the safety of all concerned.

When lessons go unlearned they come back in spades and so it was that a number of horses and their humans had a very distressing day in Baltimore on May 20, 2006. The first race of the day at Pimlico was won by nine year old gelding Homeboykris. On his walk from the winners’ circle to the test barn Homeboykris dropped dead. In the fourth race, a four year old filly (Pramedya) crashed through the gate for a false start. [Hypersensitivity to sound is associated with cranial nerves under stealth infection attack.] Reloaded, she made it to the final turn, broke her left front leg and was euthanized on the spot. Her owners had an even bigger shock when the featured race (the Preakness Stakes) ended in disaster for their brilliant Kentucky Derby winner Barbaro (2003 – 2007). Prior to his rise to fame Barbaro had been carefully handled by his experienced trainer from the beginning. Following his final workout before the Florida Derby (five weeks before the Kentucky Derby), his Type B attributes (‘touchy personality’) came to the fore in dramatic fashion. A ‘hands-on’ horseman, his trainer was sponging off the colt’s hind legs when he literally got nailed to the wall, lucky to walk away with only a fractured arm. Shades of Ruffian were already glimmering. [As fitness increases a certain amount of playful biting and kicking is expected. Bartonella infected horses can unleash violent aggressive tendencies in lightning fast bursts that appear to come out of nowhere.] In the post parade at Churchill Downs he never broke a sweat, ran a very impressive race and was hardly breathing afterwards, reminiscent of Seabiscuit in the 1930’s. Upon hearing the gate close on the last horse to be loaded for the Preakness, Barbaro crashed through and had to be re-loaded. Just a short distance down the track he suffered catastrophic injury to the right hind leg, shattering a sesamoid and additional adjacent portions of the bones above and below the fetlock. Transported to a world class hospital just north of Baltimore, Barbaro was given the best (state of the art) care available. Unfortunately the healing that was necessary for his continued survival met with one delay after another and he was humanely destroyed months later. [Delays in healing including slow hoof growth, foot abscess formation, and chronic laminitis are well within the realm of expectations in a stressed horse already dealing with chronic stealth infection. The superior level of care he received bought the horse an extended window of time before the inevitable became obvious.]

Elite equine super stars attract large fan clubs and four star horses in the Eventing world are no exception. Imported from Ireland in 2009, Irish Sport Horse TA (Trading Aces) (2004 – 2016) was soon sold to a syndicate who respected his many talents. Despite the advantages of world class trainers and riders, superior nutrition and careful conditioning TA increasingly struggled to complete the cross country phase as if running out of gas. Slightly anhidrotic on occasion, he managed an impressive record in Type A fashion (his signature was pinned ears) before being re-sold to a less stressful show hunter home. About one year later he dropped dead from ‘cardiac arrest’. In hindsight his human connections had made choices based on available knowledge at the time that in the end were best for the horse. [Horses today live in a world of expensive band-aids. Artificial track surfaces and drugs like steroids and diuretics, illegal everywhere except America, simply homogenize the overall picture and actually enhance long term survival of stealth infectious bacteria in the horses they are intended to help. Every horse in the starting gate for the 2006 Preakness had been pre-medicated with furosamide. Diuretics and anti-inflammatories treat symptoms, not causes. It should come as no surprise that Nature wins and horses die when humans focus all their attention on carnage management. Sir Winston Churchill said it best, “The farther back you can look, the farther forward you are likely to see.”] " New York state, famous for its zoonotic disease infested ticks, reported fifteen catastrophic breakdowns during their short 2017 Saratoga meeting."





ACKNOWLEDGEMENTS



The story of Chase Me was first told to the author by Elizabeth Bosley Bird, younger sister of Sara and John Bosley, who hired on a young veterinary student in 1973, one who had much to learn. Mrs. Bird had recently imported the Best Young Horse at the Dublin Horse Show, Fort Devon. A strapping big chestnut, Fort Devon had reached over and lifted a man off his horse by the seat of the pants while out fox hunting in Ireland. He intimidated all his handlers but Mrs. Bird (who had trained and ridden the grey stallion Count Stefan to multiple working hunter championships after he had killed a man on the racetrack) succeeded in training him to a Maryland Hunt Cup victory in 1977. ​A horse some considered untrainable, he won by 30 lengths. Famous for combining perseverance, discipline and sensitivity when working with temperamental horses, she never came to the barn without a pocketful of sugar cubes. Elucidation of idiomatic use of the words ‘jarred’ and ‘jarring’ (as they are commonly used in Ireland and England) was provided by Catherine Cooper, to whom a profound debt of gratitude is due.


Her lifetime of hard work practicing diagnostic acupuncture and Traditional Chinese Medicine in Ireland and England now empowers horse owners across the planet to surround the dreadful many-headed dragon known as chronic stealth infection in horses. The intangible rewards of seeing these horses return to good health and wellbeing, victorious over their dragons, are gifts that all the money in the world could never buy. Thank you Catherine for the privilege of sharing the view from the top of your shoulders with others eager to learn. In the words of Red Pollard (spouting Shakespeare) upon winning the Massachusetts Handicap with Seabiscuit, “Hail the conquering hero comes…….”


The first Western veterinarian to travel to China, Korea and Japan for advanced education in Chinese acupuncture for horses was Marvin Cain, DVM (1931 - 2017). One of Dr. Cain’s maxims after years of practicing and teaching diagnostic acupuncture was “Routine lab work is not worth the paper it is printed on.” [His admonition certainly applies to horses with chronic stealth infections, whose hemograms are nearly always pristine.] Bill Bass, PhD (retired from the University of Tennessee) is a Master researcher, educator and innovator in the field of forensic anthropology. In his biography “Death’s Acre” he uses the phrase ‘the cross fertilization of ideas’ to describe the value of looking at the same problem from different educational backgrounds. He was inspiring students and practicing One Health before One Health was cool. Dr. Bass looks at his work as a scientific puzzle in the search to uncover the truth.


To see where he will be speaking next go to www. bonezones.com. American horse owners have a unique resource in ‘Zen Master’ horse trainer Buck Brannaman. His clinics address multiple training issues with horse friendly techniques and thought processes that work to produce safe partnerships between horse and rider. Following in the footsteps of Ray Hunt and Tom Dorrance, he works to preserve Vaquero tradition that originated in Spain. When asked to comment on a dangerous rogue colt filmed attacking a man near the end of the movie “Buck”, he explains “The humans have failed this horse.” [Such explosive aggressive outbursts are associated with neurotransmitter aberrations in Bartonella horses.] “Buck” is available on DVD. Master clinician Ray Hunt (1929 – 2009) said of his early career, “I was working in the mind of a lot of people who didn’t want to believe the horse had a mind. Get a bigger bit. Get a bigger stick. That was their approach.” He famously started every clinic with the statement, “I am here for the horse, to help him get a better deal.” His approach has been described as, “If you get bucked off, kicked or bitten, you obviously did something wrong….The horse, on the other hand, is never wrong.”


A legend in his time, Ray Hunt suffered from COPD, a disease also seen in horses with chronic stealth infections. Sir Winston Churchill (1874 – 1965) was an English statesman and world leader. He once offered this advice to his contemporaries: “Don’t give your son money. As far as you can afford it, give him horses. No one ever came to grief, except honorable grief, through riding horses. No hour of life is lost that is spent in the saddle. Young men have often been ruined through owning horses, or through backing horses, but never through riding them unless of coarse they break their necks, which, taken at a gallop, is a very good death to die.”



Contributions from Equine Veterinarians





“......I diagnose a lot of EOTRH (Hypercementosis) in horses. Mostly older warmblood geldings, males more frequently than females. Western medicine has nothing to offer except extraction of all incisors. I use and recommend a mushroom product called Equident and have had amazing success in stopping progression of the disease. I think there is a correlation between the two diseases ......”


-Diane Febles, DVM, CVA (Veterinary Equine Dentistry and Acupuncture)


“Why is there soy in horse feed? Soy is a cheap form of protein. It is highly estrogenic so it should never be fed to horses with any type of metabolic disorder like Hypothyroidism, Insulin Resistance or Cushing's Syndrome. 99.9% of soy is genetically modified to be Round-Up Ready. Glyphosate, one of the active ingredients, is the leading cause of leaky gut syndrome in horses. Leaky gut syndrome can cause allergies, diarrhea, mal-absorption syndrome, colic and irritable bowel syndrome.”


-Mark DePaolo, DVM (www.depaoloequineconcepts.com)


“God never meant for horses to be larger than 16 hands.”


-Bill Moyer, DVM (professor emeritus, Texas A&M University)





Contributions from Bartonella Horse Owners





Case Report from Hiawassee, Georgia, USA (thank you Musa Wiles)



My 13 year old gelding Crimson was diagnosed by two veterinarians with COPD/Asthma. His symptoms were constant coughing, flared nostrils, abdominal lift, weight loss and mucus discharge from his nose. Although both agreed there was no cure, just manageability, the standard care offered was steroid injections, bronchodilators and the like. The prognosis was manage as well as possible, but one day he’d have to be put down due to his struggle to breathe. Unwilling to accept this prognosis, I started researching and came to change his diet to a completely non-gmo, whole food diet, as well as, came upon Dr. Brenda Bishop through an article I read, and called her. She pointed me to the Bartonella Kit. I am delighted to report that my horse is healed! All the symptoms are gone, he is better than ever. The two vets just scratch their heads, but there is no denying that my horse is completely healthy. Many thanks go to professionals like Dr. Bishop for thinking outside the box and looking for all natural remedies to chronic diseases. My horse’s life was saved as a result.





Case Report from Waddell, Arizona, USA (thank you Carol Stinner)



“Lily is a 9 year old grey warmblood mare who after being started at age 4 had issues: no forward, grumpy, bucked and would stop then not take one more step forward or rear. In 2014 Lily spent a few months at a large working cattle ranch in Arizona where she did well but worked very hard both physically and mentally. After returning home all heck broke out and she was then visibly ill for 2 years. She was treated with conventional medicine for stomache and hind-gut ulcers, systemic bacterial infections, even endometritis, which was diagnosed after a biopsy and ultrasound reproductive work-up. She became depressed, lethargic, hypersensitive to sound, and had severe fibromyalgia. Lily began the Bartonella herbal treatment from Effective Pet Wellness in January 2016. She layed down and rested a lot but progress towards health was slowly happening! I chose to treat her with advanced herbal therapy after the Bartonella cleared, to help heal the damage to her body after 5-6 years of illness. We recently started riding again after 2 years off and it is a miracle! I have a lovely, FORWARD, soft, responsive, happy mare. Lily was supposed to be my amateur dressage horse but I am now humbled as a horsewoman to see what Lily has endured. Therefore we will enjoy each ride and do what she loves…trail riding in the beautiful Arizona desert!”









Case Report from Ft. Myers, Florida, USA (generously contributed by Julie Griffin)



“Luna” is a grey 12 year old Oldenburg/Thoroughbred mare. “Luna was destructive in her stall, unpredictable, antsy, anxious. No topline, hard to keep weight on. Came into heat every two weeks. Her hind end was weak, and you could not groom her without objection. Now having completed the holistic treatment, she keeps a clean stall, enjoys grooming, is calm and has a topline. She is easier to train and is engaging her hind end.”. (Click on picture below to watch video)





“This is Luna, after one class at 2nd level. She is starting treatment today.” (April 2015) (Comments: This is a typical posture for a Bartonella horse. She is stretching out her brachial (shoulder) plexus, bundles of sore lymphatics, and cocking her hind leg to relieve the inguinal plexus area.)





One year later Luna is training at 3rd level. March 2016 “The top photo is Luna (February 2015) before the Bartonella treatment. The bottom is March 2016. As you can see Luna’s back is hollow, head is up, tense in the back, tail out and not swinging back and forth as a tail should be in a relaxed back. She is not using her back end effectively and you can see her hind end trailing a bit. Spooking at anything to get out of work, short attention span, she is bleached out in her coat. The rider would have to push her to move forward as you see in her position and fight to keep her on the bit. After treatment she is more relaxed in the back and her tail is swinging back and forth. She is using her hind end better and is getting some more air time because of it. Luna has a better work ethic and is no longer spooking and is accepting the bit. She has more dapples and has put on 100 pounds of top line muscles. The rider can sit the trot better, she no longer needs to push for every step, and the horse now has self carriage.”



Case Report from Roanoke, Virginia, USA
(thank you Susie Whiteside)



“My horse Boomer, now a 3+ year old Shire/Appaloosa cross gelding, was sick for the entire first year I owned him, as we struggled to find the exact cause. After treating with traditional antibiotics for Lyme, we still had many symptoms that were progressively getting worse. Exploring Shivers, EPM, PSSM and even Wobblers Syndrome, I was ultimately facing euthanasia and actually had it scheduled! With Dr. Bishop’s advice and recommendation, I put my very sick horse on the Bartonella and Mycoplasma herbal protocol from Copperfield Equine in Ireland, administered by Catherine Cooper. We had amazing results in just a few months! My horse could hardly stand and was miserable. Now he is comfortable, bright and energetic, shiny and healthy, and we are actually riding together again! I am beyond grateful for both Dr. Bishop’s and Catherine Cooper’s guidance and help, long-distance no less, as they came together to save my horse!”





Boomer before





Boomer after



Case Report from Seagrove, N.C., USA (thanks to Karen and Joe Campbell)



Here is an old picture of Joe roping on Zane and a recent picture. We are very pleased without Catherine’s herbs Zane would still be a WRECK. He looks healthier than ever and feels so much better. Joe finally put a saddle on him yesterday and rode him lightly. He didn’t show any of his usual signs of pain when saddled as before. And he didn’t try to jump out from under Joe when he got on and off which he did terribly before. He had his liveliness back and had pep in his step walking forward where before he didn’t even want to walk! He has about a week of Stage 3 left to go. Zane looks so much healthier and happier now. Thank you for putting us in touch with Catherine Cooper. We are truly impressed with these herbs.









Naturopathic Tick Prevention Formula (thank you Tara Badorek, Connecticut, USA)



This Tick Prevention Tincture formula is a basic tincture 1:4 50% of the following:

Andrographis

Cat’s Claw

Neem Leaf

Astragalus Root

Japanese Knotweed

Flower Essence of Garlic


Mix 1oz of each of the above except the Flower Essence of Garlic (use 16 drops) in a 50/50 grain alcohol, distilled water menstrum.

Let it sit 6 to 8 weeks, with a daily shake.

Use a French press and a cheese cloth to extract the liquid.


Administer ½ teaspoon to ¾ teaspoon per day per horse orally during tick season.



Biting Insect Repellent Spray Formulas

(contributed by Paula Denardo, N.C., USA)


Mix in a 16 ounce spray bottle:

½ teaspoon vegetable glycerine

14 ounces witch hazel

40 drops of essential oils (choose one of the following options)


Fly Option:

20 drops lavender

10 drops mint

10 drops rosemary


Tick Option:

20 drops eucalyptus

10 drops lavender

10 drops peppermint ​


Mosquito Option:

10 drops eucalyptus

20 drops citronella

10 drops lemon.



FREQUENTLY ASKED QUESTIONS





Copyright August 1, 2015 (last updated June 1, 2019) All rights reserved.

No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without prior written permission of the author.








1. WHAT DOES BARTONELLA IN A HORSE LOOK LIKE?

As a stealth pathogen, Bartonella is adept at staying under the radar of human recognition underneath a multitude of disguises. Clinical signs of a chronic Bartonella infection are mysterious in onset, appearance, severity and duration (periodicity). A relapsing bacteremia is expressed as multiple recurring deficiencies, a sliding scale of dysfunction much like a roller coaster various system imbalances can produce polar opposite symptoms. Just like autism spectrum disorder, chronic Bartonellosis will induce a vastly different constellation of symptoms from one horse to the next. “Stress is cumulative” and so are the clues that reflect a lurking problem that defies description. Since the trajectory over time is toward autoimmunity, those conditions that correlate with serious immune system dysfunction (notated ***) are significant red flags in and of themselves the presence of just a few of the many conditions listed here constitute grounds for further investigation into the possibility of chronic Bartonellosis.

SYMPTOM CHECK LIST

(How many of these clues can you recognize in your horse?)


Lethargy / Chronic Fatigue Syndrome / Poor Exercise Tolerance

__chronic inflammation in a wide range of tissues including the brain, bone marrow

__delayed forward phase of stride at any or all gaits (slow bringing the leg(s) forward)

______extensor rigidity / contracted flexor tendons

______subluxating pasterns and/or fetlocks

______upright angles (straight) in the fetlocks and pasterns

______tendency to land toe first

______dragging toes / toes worn flat

______hanging one or both knees over a jump

______hitting jumps with one or both hind shins

______subluxating patella(s) (locking stifles)

______curb (ruptured plantar ligament)

______sesamoid bone fracture(s)

______tallus fracture(s)

______forging (clicking front heels with hind toes)

__abrasions on front of pasterns from difficulty standing up

__riding “as if the hand brake has not been released”

__poor exercise tolerance

__refusal to move forward (with or without rearing)

__reluctance to bear weight on sore feet (hypersensitive soles)

__muscle deconditioning and/or muscle spasms

______total body soreness / uncomfortable posture

______digital suspensory syndrome

______carpal tunnel syndrome

______back soreness, topline muscle atrophy

______chronic regional pain syndrome (CRPS) in sacroiliac area ***

______dropped head syndrome

______tendency to travel hollow backed and high headed

______skipping / cross cantering / cross firing at the canter

______fibromyalgia (EFMS) *** (see “The Fibromyalgia Horse”)

______grunting / moaning / groaning under saddle

______diaphragmatic muscle spasms (hiccups aka thumps) ***

______esophageal rotation within the diaphragm

______esophageal muscle spasms (choke, swallowing problems)

______laryngeal muscle spasms

______displaced soft palate (with or without holding the breath)

______chronic intercostal muscle soreness, cramping (ribs)

______shivers *** (in 1, 2, 3 or 4 legs)

______rigid muscles between hips and stifles (cording)

______fibrotic myopathy *** (in one or both hind legs)

______“thickened suspensories” / annular ligament desmitis (ALD)

______degenerative suspensory ligament desmitis (DSLD)

______calcium deposits in tendons / tendon sheaths

______rupture of the extensor carpi radialis (in one or both forearms)

______audible ‘snap, crackle, pop’ from stifles and/or hocks ***

______cardiac muscle fatigue (weak heart valves / systolic murmur)

______cardiac conduction disturbances / dropped heart beats

______flaring nostrils at rest (chronic)

______spontaneous periodic heavy breathing episodes

______chronic obstructive pulmonary disease (COPD / heaves) ***

______dribbling urine / odd urination habits

______retained placenta (uterine atony)

______leaky gut syndrome

__________constipation /scant dry manure OR diarrhea / colitis

__________herring gutted OR bloated abdomen

__________right dorsal colon ulcers

__________inflammatory bowel disease (IBD) ***

__________abundance of tape worms resistant to deworming

__________overgrowth of Candida in the large intestine

__________malabsorption of nutrients

__________gas colic (chronic)

________________epiploic foramen entrapment (seen at colic surgery)

________________gastrosplenic ligament entrapment (ditto)

__________stringhalt *** (in one or both hind legs)

__________neuritis of the cauda equina / polyneuritis ***

__________peripheral myoclonus

__________wobbler syndrome / intervertebral disc disease

__________‘neuro crab walking’ / ‘sidewinders syndrome’ ***

__shifting leg lameness

______lameness that shifts from front to back and/or side to side

______“bridle lameness” (commonly lame on one diagonal)

______frequent tripping on even and/or uneven ground

______“stiff leg syndrome” (micro muscle spasms)


Microcirculation Deficits

__sensitivity to cold weather, particularly cold and rain (regardless of blanketing)

__absence of dapples (branches of the capillary tree)

__pale mucous membranes (in mouth, pale tongue)

__tendency to bleed

______increased central arterial and venous pressure

______thrombocytopenia (low platelet counts)

______thrombocytopenic purpura ***

______prolonged clotting time

______exercise induced pulmonary hemorrhage (EIPH) ***

______spontaneous (non-exercise induced) nosebleeds

______vasoproliferative tumors (malignant melanoma)

______progressive ethmoid hematoma

______autoimmune hemolytic anemia (AIHA) ***

__complications associated with poor tissue oxygenation

______prolonged healing time (> 7 to 10 days)

______surgical repair failures

__________wound dehiscence

__________fracture site non-unions

__________colic surgery anastomosis break-down

______recurring ‘scratches’

______scirrhous cord following castration

______yeast-like secretions in the sheath (geldings and stallions)

______low grade chronic endometritis ( mares)

______placentitis in pregnant mares

______overgrowth of organisms that thrive in low oxygen locales

__________maggots in poorly perfused wounds (Rx: desitin)

__________chronic thrush in and around the frogs

__________tape worms

______presence of common co-infections *** (all of these)

__________lyme disease (Borrelia)

__________babesiosis (Babesia) (Piroplasmosis)

__________protozoa (EPM in the cerebrospinal space)

__________toxoplasmosis (chronic)

__________leptospirosis (chronic)

__________tetanus (Clostridium tetani)

__________botulism (Clostridium botulinum)

__________“bastard strangles” (Strep equi) ***

__________salmonellosis (Salmonella sp.)

__________pigeon fever (Corynebacterium pseudotuberculosis)

__________fungal conditions resistant to treatment (“rain rot”)

__________chronic bacterial foot abscesses / subsolar abscesses ***

__________brucellosis

________________poll evil ***

________________fistulous withers ***

__________late summer foal pneumonia (Rhodococcus equi)

__________Lawsonia intracellularis

__quittor (necrosis of the collateral cartilage)

__EOTRH (hypercementosis) +/- sensitive teeth +/- swollen gums ***

__frostbite (commonly the tips of the ears)

__chronic laminitis ***

__chronic exertional rhabdomyolysis (tying-up) (muscle damage and bleeding)

__periodic paresis (tying-up) at rest

__cording of lymphatic vessels

__generalized lymphadenopathy ***

__axillary / inguinal lymphangitis ***

__pedal osteitis

__lymphangitis (commonly in a hind leg previously injured)

__cellulitis (recurring)

__swollen liver (hepatomegaly)

__swollen spleen (splenomegaly)

__swollen joints (knees, hocks, stifles)

__pericarditis (swollen pericardium)

__peroneal nerve paralysis (consequence of a hind leg stuck under a fence)

__radial nerve paralysis (historically linked to ill-fitting neck collars)


Head and Neck Issues

__swollen eyelids

__surface eye infections with tearing

__random cranial nerve dysfunction

______optic nerve

__________micro-ophthalmia (one or both eyes)

__________blindness (one or both eyes, normal outwardly)

__________ERU (equine recurrent uveitis) ***

__________autoimmune keratitis ***

__________depth perception deficits (altered spatial behavior)

__________preference for shade vs. bright light (sore eyes) or

__________refusal to move from bright light to dark shade

__________head shaking (photic) (Rx: guardian mask)

______olfactory nerve

__________flehmen response (repetitive)

______facial nerve

__________mouthiness

________________cribbing *** (various manifestations)

________________nipping, biting, licking

________________chewing wood
________________facial nerve paralysis (Bell’s Palsy)

_________________teeth grinding / jaw clenching

______vestibulocochlear nerve

__________hypersensitivity to sound (for example clippers)

__________balance problems (in a moving horse trailer)

______trigeminal nerve

__________pruritis (itchy head during and after exercise)

__________exercise induced trigeminal neuralgia

__________head shaking (non-photic)

______hypoglossal nerve

__________tongue laxity

__________tongue pruritis (histamine intolerance)

__________odd compulsive habits involving the tongue

__________hypoglossal nerve palsy

__neurogenic atrophy of various head and neck muscles (masseter, supraspinatus, etc.)
__temporomandibular osteoarthropathy (TMO)
__entrapment of the epiglottis and/or soft palate problems ***
__recurrent laryngeal nerve paralysis, partial paralysis, roaring recurrent airway disease (RAD)
__impaired drainage from salivary glands (mainly the parotids)
__choke (that does not resolve without veterinary intervention) ***
__dry mouth or excessive salivation
__megesophagus (food lodges in the esophagus) ***
__goiter (enlarged thyroid gland)
__sweet itch (topline pruritis along base of mane and/or base of tail)
__alopecia areata (aka vitilago) (hair loss around eyes and/or muzzle) ***
__equine sarcoid *** squamous cell carcinoma
__adenocarcinoma
__head pressing (headaches)

Endocrine / Neurochemical Imbalances *** (all of these)
__anhydrosis (non-sweater) OR excessive sweating
__sudden total body hair loss / total loss of hair on the head
__hyper-reactivity to repetitive vaccination (localized soft tissue inflammation)
__delayed systemic allergic reaction to vaccination (colic / laminitis within 30 days)
__mast cell activation syndrome ***
__severe allergic reactions to intravenous drugs
__endocrinologic laminitis
__food allergies
__sensitive skin
______callouses on one or both elbows
______chronic “shoe boils” / capped elbow(s)
______hypersensitivity to touch (ears, face, hind legs, blankets)
______hypersensitivity to rain / bathing hypersensitivity to strong sunlight (sun burn)
______hypersensitivity to grooming tools
______hypersensitivity to certain bedding
______reactivity on girthing / hypersensitivity to tack
______reactivity to shampoos, fly sprays, detergents, leather dye
______hypersensitivity to insects and insect bites
__________sweet itch (mane and/or tail)
__________intense pruritis along ventral midline, sheath / udder
__hair that stands on end in a linear pattern (along meridians)
__static electricity under blankets
__birdcatcher spots (named for the Irish TB stallion Birdcatcher 1833-1860)
__“skunk tail” (especially in combination with alopecia areata and/or birdcatcher spots)
__neurotransmitter imbalances (neuroses)
______explosive outbursts (low dopamine) (ex: bolting)
______depression (low serotonin)
______anger, aggression, temper tantrums
______moodiness, grumpiness, argumentative attitude
______changes in temperament (mild mannered to a bully)
______panic attacks (fear based) (for little or no reason)
______running backwards (during a panic attack)
______violently pulling back while tied
______tendency to kick walls, humans, other horses (violently)
______tendency to dorsiflex violently and randomly (buck)
______hallucinations / bizarre fearful behavior
______frequent yawning (yawning resets neurotransmitters)
______narcolepsy (random sleep apnea and/or collapsing)
______random seizures
______proprioceptive deficits (anywhere on the body)
______attention deficit/hyperactivity disorder
__insulin resistance
__cushing’s syndrome (early onset high serum cortisol)
__peripheral Cushing’s
__equine metabolic syndrome (EMS)
__altered estrus cycles (short or long, flagrant or silent)
__cystic ovaries
__chronic intermittent lactation (over months, years)
__prolapsed uterus and/or retained placenta (after foaling)
__testicles that are slow to fully descend / cryptorchidism (linked to ill behavior)
__low testosterone / shy breeders
__mineral depletion (Bartonella feeds on magnesium)
______consistently inconsistent behavior from one day to the next and/or from one season to the next
______dangerously high levels of toxic metals on hair analysis
__________lead
__________aluminum
__________copper
__________arsenic
__________mercury
__________selenium
______patchy sweating (magnesium +/- potassium depletion)
______inability to relax (muscle twitching / trembling / prancing)
______self mutilation (biting at chest and/or ventral midline)
______repetitive behavior (weaving, stall walking, pacing)
______neurotic separation anxiety
______obsessive compulsive behavior patterns (OCD)
__________spontaneous Spanish walking, spontaneous piaffe
______tendency to escape from normal horse enclosures
______inability to tolerate changes in routines
______shortened stride length going downhill
______oxidative stress / improvement with large doses vitamin E
______marked improvement with 10 grams Mg malate /day in diet


2. IS THERE A TEST?

Bartonella produces a relapsing bacteremia some days it is floating freely in the circulation and some days not. For this reason, our chances of obtaining a positive test result are enhanced by collecting blood samples on at least 3 alternate days. The veterinarian sends all 3 samples with a completed submission form to Galaxy Diagnostics (www.galaxydx.com). Turn around time for test results is 3 weeks. Galaxy uses a technology (BAPGM) that is considered the gold standard in Bartonella testing. For more information visit their website. Additional information regarding ePCR testing can be found in the research article “Enrichment Blood Culture Isolation of Bartonella henselae from Horses with Chronic Circulatory, Musculoskeletal and/or Neurologic Deficits” (Journal of Advances in Biotechnology and Microbiology, volume 4 issue 5).



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3. WHAT IS THE CURRENT TREATMENT OF CHOICE?

For best results, the Total Infection Clearing Kit (TICK), a combination of staged herbal formulas, is superior in efficacy, user friendliness and safety for the horse. It is available through www.copperfieldequinetherapy.com. Most horses go through a mild healing crisis which amounts to a few days of tiredness followed by steady gradual return to good health. Additional nutritional support is necessary as long as the horse’s body remains depleted with respect to magnesium in particular. As of August 1, 2017 this protocol has addressed the following successfully:

respiratory tract infections / chronic
mucus recurrent airway disease (RAD)
spontaneous periodic heavy breathing
chronic obstructive pulmonary disease (COPD / heaves)
exercise induced pulmonary hemorrhage (EIPH / bursting)
microcirculation deficit disorder
lymphangitis / recurring cellulitis
muscle deconditioning / muscle spasms
hypersensitivity to touch
topline muscle atrophy
sacroiliac pain
poor exercise tolerance
total body soreness
exertional rhabdomyolysis (tying-up)
arthritis / joint inflammation
audible “snap, crackle, pop” from hocks and/or stifles
kissing spines
stringhalt, shivers, wobbler syndrome
digital suspensory syndrome
chronic bacterial foot abscesses
laminitis
hypersensitive soles
chronic thrush
leaky gut syndrome
gastric and/or colonic ulcers
head shaking / seasonal allergies
depression, hallucinations
moodiness, grumpiness, argumentative attitude
anger, aggression, temper tantrums
cribbing / obsessive compulsive behavior(s)


4. CAN A BARTONELLA INFECTION BE INHERITED?

Yes. Evidence for transmission of infection from mother to offspring has been demonstrated in small rodents. There is growing anecdotal evidence that larger mammals (humans, horses) can also pass the infection along from one generation to the next. Much work needs to be done to elucidate this aspect of Bartonella epidemiology.


5. HOW DOES A HORSE ACQUIRE BARTONELLOSIS?

The usual mode of transmission to horses appears to be biting insect vectors: biting flies, mosquitos, ticks, dog fleas and cat fleas. Immature immune systems (orphan foals and foals weaned too early) are particularly vulnerable as seasons change (end of summer, early fall) when many insects go into a feeding frenzy prior to onset of winter and below freezing (insect killing) temperatures. Many horsemen find that white, grey and palomino horses are more attractive to biting insects than dark colored horses.


6. WHO ARE SOME OTHER FAMOUS HORSES THAT CARRIED A HIGH INDEX OF SUSPICION FOR CHRONIC STEALTH INFECTIOUS DISEASE?

(See Part Six: Lessons from The Masters)

Both Robert E. Lee’s Traveler and Stonewall Jackson’s Little Sorrel displayed Type A attributes, and both proved suitable for mounted combat. Like his thoroughbred sire Grey Eagle, Traveler was grey and would have been an easy target for various biting insects which were by all accounts plentiful in southern swamplands. Little Sorrel was famous for his ‘ability to doze peacefully in the middle of the hottest fights’. Infected horses sometimes use their lips in prehensile ways to manipulate objects out of their way. During his retirement Little Sorrel refined this ability to a fine art, lifting fence rails down on a regular basis as well as latches within his own stable. Jackson’s widow (Anna) wrote, “he would go deliberately to the doors of all the other horses and mules, liberate each one, and then march off with them all behind him….” Another Type A in the twentieth century was ‘the chocolate soldier’, Equipoise. A liver chestnut, he was much adored by starting gate crews who appreciated how all the nervous horses got peaceful once ‘the best assistant starter in America’ entered the gate area. (Chase Me exuded the same mysterious quality.) Equipoise never raced sound due to poor quality feet (microcirculation deficits perhaps) and struggled with recurrent rhabdomyolysis (tying-up) (microcirculation deficits certainly). He died unexpectedly at the young age of ten. Additional examples of Type B horses are Go Man Go and John Henry. Distantly related to Equipoise through his male line (via Seabiscuit’s female line), Go Man Go was dangerous to himself and others as a young race horse. Having a ‘difficult temperament’, he was prone to running off with his rider. As a breeding stallion he would lean over his stall door and beg people to tug on his upper lip. (The author has seen an infected Type B horse chase people down to have his tongue pulled in the manner of an obsessive compulsive disorder.) An ‘outstanding candidate for castration’ as a two year old, John Henry would yank steel buckets off the wall and stomp them flat near the end of an impressive career he injured a deep flexor tendon. Retired behind extra fencing at the Kentucky Horse Park at age 10, he was euthanized at 32 due to kidney failure. (See Part Five: The Thyroid Adrenal Connection.)


7. WHAT DEWORMING PROTOCOL IS SAFE FOR HORSES THAT EXHIBIT SYMPTOMS OF CHRONIC STEALTH INFECTION(S)?

The author’s current (2019) preferred treatment of choice for all horses (infected or not) is LIQUID Cydectin oral sheep drench (Moxidectin) administered orally by dose syringe or mixed in the feed at the rate of 1ml / 5 kilograms body weight (100ml for the average size horse), preferably given on a full moon twice yearly. This is far and away the most effective and safest strategy for elimination of intestinal parasites. Infected horses with compromised immune systems tend to carry excessive internal parasite loads despite frequent dosing with conventional drug combinations. As these horses’ immune systems falter, parasite resistance ramps up making elimination of these parasites next to impossible. Making matters worse, efficacy of conventional paste dewormers is canceled out for several reasons, among them something human epidemiologists have recently discovered. Their discovery implies how dewormers in paste form can precipitate a dramatic increase in worm loads whereas the above described dose of liquid drug gets the job done with half the total milligrams. Researchers have connected the dots between histories of tick bites and immune system hypersensitivity to a specific oligosaccharide, galactose-alpha-1, 3-galactose (“Alpha-Gal”). Examples of Alpha-Gal containing substances are red meat, animal by-products, gelatin and stearates. Gels and various stearates are widely used additives in drugs, vaccines, supplements and even foods. A CAUSAL RELATIONSHIP DEFINITELY EXISTS BETWEEN LONE STAR TICK BITES AND DELAYED (BY SEVERAL HOURS OR MORE) ANAPHYLACTIC REACTIONS TO INGESTED SUBSTANCES CONTAINING ALPHA-GAL.

In recent years paste (gel) dewormers have been incriminated in isolated groups of horses that have foundered badly and/or died within 24 hours of receiving a single tube of commonly prescribed paste dewormer. While respective active ingredients (various drugs) in over the counter dewormers have been proven safe, the additional (potentially unsafe) ingredients in these reports are in every case gels and stearates. The author has seen one horse go to unsuccessful colic surgery six hours after ingestion of Xanax (a stearate-containing medication for anxiety) administered by the owner for prevention of panic attacks. (Horses should never be given prescription drugs without veterinary supervision.) Panic attacks are clues suggesting chronic stealth infection (see the Bartonellosis Symptom Check List above). Whether ticks carrying one or more stealth pathogens such as Borrelia (Lyme) and/or Bartonella in their saliva are the connecting link to delayed anaphylactic (albeit apparent) “Alpha-Gal allergy” in horses is the abundantly obvious question we should be asking. It has been established in recent years that this group of pathogenic bacteria target immune systems from a multitude of angles, leaving their hosts vulnerable to an array of potential horrors from which recovery is challenging at best. Owners of horses suddenly foundering or going to colic surgery within 30 days of being vaccinated nearly always report histories commensurate with chronic stealth infection. The details of exactly how these zoonotic bacteria manipulate and elicit host immune responses across species lines are bound to be unexpected and staggering in complexity. At present, these stealth bacteria are much smarter than we are.






“You are never given a wish without also being given the power to make it true. You may have to work for it, however.”
-Richard Bach-