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Persistant Sinus Infection / Swelling Side of Face


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#1 Hosscrazy

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Posted 16 January 2010 - 09:29 PM

I posted this a few weeks ago and now I'm reposting with pix - I'm still struggling with a sinus infection in my mare Gracie. The vet has been out 3 times now and we are not sure what is causing it. She has a history of sinus infections - when she was younger she had sinus reconstructive surgery and has had reoccurring sinus infections ever since. Each time, however, she has responded well to SMZ tabs. In addition to the sinus infection, she has a large hard swelling under her eye down to her jawbone (same side as the sinus infection).

She is on SMZ tabs and metrondazole and is not responding. The xrays do not show anything unusual - she does have some bone deterioration, but that could be left over from her surgery when she was younger. Teeth look fine in the xrays. They did cultures on her nasal discarge and also drew serum from the swelling on her face - the cultures showed nothing unusual.

She acts normal - eating and drinking just fine. No fever, no heat in the swelling. She still has nasal discharge with a foul odor - she's been on the meds now for 3 weeks. I just sent the xrays and pix to my former vet (before I moved) to see what she sees. If she sees nothing unusual from the xrays, then we're going to take her to the hospital where they have a great surgeon who specializes in sinus issues.

Ideas anyone?






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#2 Crabby-Chicken

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Posted 16 January 2010 - 09:38 PM

OH My that poor little thing. How sad,,, I hope a vet finds something to help her soon. I am sorry it has been such a problem finding an answer. She makes my face hurt to see her!!!
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#3 Marty

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Posted 16 January 2010 - 10:26 PM

OH crap, that's go to hurt. Darn it.
Is she on anything for swelling?
Have they tried running a tube up there as in draining a blocked tear duct?
My only guess would be to get her on something a whole lot stronger as the SMZ's have not kicked in and pull out all the stops on the antibiotics and give it the big guns. Rats.

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#4 wildoak

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Posted 16 January 2010 - 10:30 PM

Yikes, that does look painful. We've had some sinus issues in big and small horses but never had one that extreme. I don't know where you are & whether Carl Mitz works in your area, but it might sure be worth asking if he would take a look at her. He might pick up something that has been missed, just looking from another perspective.
Just a thought - any possibility she might have gotten a thorn or something embedded in her face? I had a big mare years ago that we were convinced had strangles, she had a large swelling under her jaw, nasty oozing etc....but she actually had gotten a thorn stuck in her & it caused an infection - nothing contagious fortunately.
Hope you find the answer.
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#5 wwminis

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Posted 16 January 2010 - 10:53 PM

Two things come to mind as I look at your horse! 1. There may be a tooth root protruding into the nasal passage causing an on going infection.
2. Have your vet scope the gutteral pouch and see if it full of infection! We had this happen to a little mare a few years ago, only it was on both side of the face! She had 2 teeth roots grown into her nasal passage causing a nasty infection! After surgery and a long recovery she did just fine!
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#6 Hosscrazy

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Posted 16 January 2010 - 11:11 PM

Bill - that's exactly what I'm wondering. The xrays don't show anything unusual, but I'm sure they can see more at the hospital. We discussed a gutteral pouch infection - this vet doesn't feel this is the case and did not feel comfortable scoping a mini. There is a vet up here who will scope minis (he is good) - I guess the question (for me) is if I should have the other vet scope her, or at that point should I just bring her to the hospital for further treatment. Good question, though, about the tooth root. I will call her in the AM and bring it up.
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#7 Minimor

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Posted 16 January 2010 - 11:20 PM

I was thinking the same about a tooth root extending into the sinus cavity--one tooth looks suspect to me on that x-ray, but I am no expert at reading x-rays!

That swelling does look nasty and uncomfortable--glad to hear she is eating and drinking fine, but I hope you can get it figured out & cleared up soon. Best of luck!
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#8 Matt73

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Posted 16 January 2010 - 11:25 PM

Those rear two teeth look like they're in the sinus cavity.

#9 Hosscrazy

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Posted 16 January 2010 - 11:53 PM

Thanks, Matt. I see what you're looking at and just put a call into the 2nd vet to ask her to specifically look at those 2 teeth when she gets the xrays. Much appreciated...
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#10 albahurst

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Posted 17 January 2010 - 01:08 AM

HI Liz-
My mare that had the sinus infection was scoped twice, actually, and at one point the infection was in the gutteral pouch. We got the gutteral pouch cleared up with Baytril, but the sinus infection that was persistent was caused by the tooth root that didn't show on the xrays, as it was just barely into the sinus, but enough to cause a huge problem. The tooth root was found during the surgery. Our mare had a bone flap surgery and her sinus lining was removed as well as some other work on her tooth root and bones - the lining does grow back. She has been infection free for over a year now. I would encourage you to have your mini scoped by someone proficient in doing this in minis and then proceed from there. My impression is that the bone deterioration could be caused from the infection itself- once the infection gets so deeply imbedded into the lining of the sinus it can affect the bone in this manner. This is precisely what happened to our mare. I hope your 2nd vet can give you some advice in a very timely fashion. I am glad you have a good hospital to take her to.
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