Saturday, August 02, 2008

Chronic Fatigue Syndrome in horses

I had an interesting call this week about Chronic Fatigue Syndrome in horses. I know there is much debate about the issue in people and actually a lot of research that is still remarkably inconclusive. When you do a google search for chronic fatigue syndrome, horses , you come up with
432,000 hits. Almost every page references reports from Dr. Walter Tarello in Italy.
If you have read anything I have written then you know I'm a skeptic and with this one my bullshit-ometer is redlining. I have read his publications and have some serious questions as to scientific method and the conclusions made ( much less how it even got published). I do not doubt that these cases are sick, they have fever, weight loss and lethargy. What I do doubt is the diagnosis and the way it was arrived at.
"After staining
with the Wright technique, slides were microscopically examined (x100) showing the presence of
micrococci-like organisms on 5-6% of Red Blood Cells, and the absence of alternative causes of
chronic fatigue in horses (Babesia and Ehrlichia spp.) Taken together these observations led to a
diagnosis of Chronic Fatigue Syndrome."
Excuse Me! That is really weak and doesn't stand up to the bright light of scientific rigor. The presence of "micrococci-like organisms" on red blood cells is a real stretch without concurrent hemolysis and positive blood cultures. They look a lot like Howell-Jolly bodies to me but they could also be contamination or stain precipatate.....who knows. Another paper did state there was a positive blood culture for Staph Intermedius in 2 of 5 birds showing vague symptoms. Thats only 40% of cases and different bacteria was found. I have to question contamination . If you suspect septicemia from Staph then appropriate antibiotic treatment dictated by sensitivity testing would be the standard course in any hospital. Instead Dr Tarello choses to treat these with an Arsenical (thiacetarsamide sodium (Caparsolate) the drug that years ago was used to treat heart worm disease in dogs. If I tried to pass that diagnosis by my Chief of Service or the ACVIM I would have been laughed out of the Hospital. There obviously needs to be more science bout starting here. If you suspect Staph spp adherence to RBCs then why not do IFA (immuno florescent antibody) testing and see if that is what it is ....instead of guessing. You then have to prove that this sepsis is actually causing the symptoms you are seeing and be able to reproduce it. Before I get on this band wagon I will have to see some REAL science and not ...since I don't know what else it could be so it has to be this.....kind of pseudo-science.
Now I'm sure I stirred the pudden on this one and everyone will now call me a heretic and a blasphemer...but when I went to scientist school the hand book sez.....don't guess.
Chronic Fatigue Syndrome in horses....I don't buy

1 comment:

thehorsedoctor said...

Your blog is very informative with a wide range of subjects, i like the material on babesiosis. Good luck.