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We Are Flying Solo

Showing posts with label vet care. Show all posts
Showing posts with label vet care. Show all posts

January 17, 2021

Belly-cosity: Dealing With Troubled Tummies

About a week ago, I went out around 11 pm to give the guys their "midnight snack," a winter routine where I take them warm soaked alfalfa pellets to provide some comfort food when there isn't much grass to nibble on overnight.  As per usual, Solo met me in the shed with a nicker, well-knowing what it means when I come out the back door in the dark, & I waited for Echo to wander in, as he is generally off amusing himself in a farther corner.
 
He was slower than usual & when he did step into the light of the shed, I noticed that his general attitude was a bit off.  He didn't come all the way up to the front of his spot & he stood with his head down, pawing at the floor, which was also unusual - I watched him more closely.  As Solo dug in to his mush with relish, Echo stated he had no interest in his treat.  Then I noticed he was panting beneath his sheet & I was fairly certain of my answer at that point:  he was feeling colicky.
Some random pics of when he's feeling better
My Colic Protocol
 
The first thing I do in response to any equine condition aberration is run through a quick timeline of (a) when things changed and (b) what the possible variables are.  In this case:
  • Echo had cleaned up his entire dinner at a normal rate about six hours earlier, appearing bright-eyed & bushy-tailed at that time.
  • He had not yet finished his hay in his net from dinner.  This isn't necessarily unusual by itself, but he had left a bit more than I would expect.
  • I had seen him take several good drinks with dinner & he is generally an enthusiastic drinker, so I didn't yet fear dehydration.
  • After putting him on x-ties, I walked his paddock with a flashlight & found some pretty fresh poo that looked normal.  Returning to shed, I saw he had also pooped in x-ties & that looked normal, so I didn't have immediate impaction concerns.
I took his temperature to confirm it was normal.  In a rare lapse, I didn't have my phone on me to time things (I like to keep it on me primarily for equine response needs), so I couldn't take a true pulse, but I was familiar enough with his baseline that I could tell it wasn't terrible, maybe just a tiny bit elevated. 
 
Normally, at this point, I call the vet to have him on the radar.  Here, I made an exceedingly rare exception, based on my past experience & knowing the horse.  I have a very long-standing relationship with Dr. Bob, so I was 100% (another exceedingly rare thing for scientist me, heh) certain of what he would tell me to do.  Presented with a horse showing obvious signs of intestinal discomfort -- poor Echo looked EXACTLY like I feel when I have eaten something that has gone horribly wrong -- with no other signs of infection, with poop functioning normally, not dehydrated, not sweating, not rolling around, he would tell me to give bute to ease the belly cramps & monitor.
So I had our phone call in my head as I made up a syringe of bute.  I've learned you can't get a horse who doesn't want food to eat it, so I put the powdered bute in a dosing syringe, mix it with water, & squirt it in their mouth.  You could also use applesauce to make the horse happier, I just didn't have any. 
 
At that point, it was time to just wait, there was nothing else to be done.  The least stressful thing I could do for him was leave him be in the quiet night, where he could hang out with Solo & let the painkillers do their thing.
 
Waiting
 
It's always a long stretch, staring at your bedroom ceiling, turning things over in your head while your brain imagines all kinds of nightmarish scenarios.  All I could do was just repeat to brain that we covered all the bases & patience was the only option.  I did send an email to vet, so they would see it first thing in the morning -- because of course this was a Thursday night before an ice storm, so if I did need any kind of service the next day, I wanted them to have the info.
 
As soon as it was light out, I went back out to check on Echo & found that logical brain was validated & emotional brain was once again vanquished -- Baby Monster was back to his normal, obnoxious self, clamoring for breakfast by chewing on anything that I didn't want him to chew on.  To be safe, I gave him only a reduced ration, made into soup with lots of water.  I kept an eye on him through the day, but he was fine, the passing cramps having thankfully gone away.
I'm not sure what triggered this incident; there was a big weather change, but both horses are generally pretty stable digestively with that sort of thing.  I did use a different cut of hay, I'd gotten a few bales to fill a gap while waiting for a new delivery, & while it didn't bother Solo, it's certainly possible that something irritated the more sensitive Echo.  But it's hard to say.   

Being Ready
 
It's pretty inevitable for any horse to have some colicky episodes; even Solo, my Iron Horse, has had a crampy instance or two.  Many of these will be relatively mild, but as we know, they can go unpredictably awry for innumerable reasons & this can happen with even the very best of care.  While there are never any guarantees, because horses, you can try to stack the deck for yourself by:
  • Learn your horse's routine -- how does he approach his food, what is his energy level, what is his normal expression?  This can help you catch things early, although I recognize that it's trickier if you are boarding, but you can still build a good staff relationship to help monitor these things.  
  • Familiarize yourself with his baseline vitals:  temp, pulse, respiration rate.  Learn the normal colour of his gums, his normal capillary refill time, & his normal water intake.
  • Talk with your vet in a non-stressful time to outline an appropriate general response plan that's right for you.  This is the time to ask questions about when your vet would like you to call them, data they would like you to have ready when you do call, supplies you should have on hand, & any other steps they would like to you to take.
Normal equine values from Horse Side Vet Guide

Hopefully, you won't have to use this plan, but if you do, I've found it improves my ability to mentally & emotionally manage the situation if I have a checklist & some sort of decision tree thought out beforehand.  Are there any other tips you would add?

November 11, 2020

In Which We All Co-Habitate Once More

That's right, Echo is finally back home!  

I decided to go ahead & bring him home this past weekend since we were supposed to get rain this week.  He was doing well in his enlarged pen & I didn't want him to backslide if I had to pen him back up just to keep him out of mud.  His own paddock here drains very well & doesn't get muddy.

So with the help of the always-fabulous Erica, we marched Gabe, Solo's substitute buddy, back home next door & returned with an (aced, just so I didn't get accidentally trampled in exuberance) Echo.

True to his good nature, he has transitioned back seamlessly to annoying us here instead of next door, ha.  It took him about 14 seconds to pounce on Solo's head for some Face Tag (during which Solo looked at me going, oh yeah, now I remember how annoying this kid is...).  After which, he returned to his normal pastime of meandering around his paddock & watching the world exist.

Echo in full meander
I'll wait a week before allowing him & Solo to be together again -- Echo has not been able to play with another horse for 4 months, so we didn't want to throw it all at him at once.  

I did sit on him once last week, just walking around for a few minutes.  It didn't feel great -- his feets are sore from not being on grass & his whole body felt tight.  But he seemed to enjoy getting out & doing something, even if he did get bored in about three minutes.  I at least know all the buttons I installed are still there.  And he behaved completely, which was the most important part.  He really tries so hard to be good.

No muscle, but shiny. I wore my vest just in case, but he was uber-chill

Moving forward, I will probably just stick to light work on the longe.  It's not really necessary for me to sit on him at this point & it will allow me to watch him.  I will just see what he tells me he's up for.  Right now, that is essentially walking.  But hey, it's walking AT HOME & it's walking WITH NO STALL CLEANING anywhere in the vicinity.  Vast improvements...

October 31, 2020

The End Is Near!

 By which I mean...the end of cleaning that bloody stall!

To my relief & no small amount of surprise, Dr. Bob actually got to give us GOOD news on Tuesday:  Echo's fracture line is completely healed!!

 *pause for strange feeling...is that...dare we...hope?*

We are not completely done.  Echo still has some bruising in that area to heal & the lytic area around the toe is still filling in.  But now he is a "bruise horse" instead of a "fracture horse," which is somewhat less terrifying for "owner of horse."

The schedule is to let him out on a little larger paddock area (already done with success!) for the next two weeks.  If nothing untoward happens during that time, he can then come home & be in his paddock here for two more weeks & wean off the Equioxx, after which he can go back to regular turnout.

First grazing at liberty since July
I can also begin sitting on his sorry butt (well, technically, his sorry back) next week & tack walk him.  I'll bring along my friend, Ace, for the first attempt, of course -- I know he will try to be good, but he is holding in four months of PLAY-PLAY-PLAY, even a Very Good Boy can only contain so much.

Dr. Bob had us go ahead & transition out of his "fracture shoe" that farrier had devised, consisting of an extra sturdy draft horse pad, into a medium-soft EquiPak pad (forgot to take a pic of that), to provide a softer cushion for the bruising.  

Cut-down draft horse pad
I'm a long way from not holding my breath anymore, but it's a big step forward, so thanks for all the good vibes because they worked!!

October 26, 2020

The Hits Keep Coming

Poor Echo. 

Baby Monster has been on small pen rest since July. His shoulder was making progress, but there was an element to his limp which persisted in a way that nagged at me. I scheduled radiographs with a secret hope that Dr. Bob would tell me I worry too much & everything looked fine. 

That's not exactly what happened. 

I did, however, get an answer. Echo, at some point (same time as shoulder? Hard to say), fractured his left front coffin bone. No horse owner wants to hear that particular f-word (it prompts even heavier use of the OTHER f-word). I did what I do - research.

Coffin bones are heinously slow to heal (of course), but, as long as the fracture doesn't extend into the joint, the prognosis for full recovery is very good. Echo's fracture does not extend into the joint & that whole joint is very clean.  This is good as long as it doesn't change.

He needed to be restricted, though, & I didn't have the setup to do so for 4-6 months or more. Thanks to my very kind neighbor, he is staying next door instead while I once again borrow Gabe, who kept Solo company when I sold Encore. 

At least he got a chance to learn about pigs...
This means that every day for the past 4 months, I work, then I walk next door & feed/muck out the Pig Boy, who loves nothing more than to walk in circles in his poop & mince it into a shavings jambalaya. I come home & have just enough energy to check out, which is why it's taken me so long to write this. 

Dr. Bob comes tomorrow to do follow up rads & see where we are, if it is healing, if it has spread - given our luck, I give it about 50/50 at this point. Obviously, I am hoping for some good news. I keep giving this horse chances because he really is something else. This 6 y.o. TB has been in this stall/pen for 4 months, only coming out a few times a week for hand grazing. And I can take him out in his regular halter, no chains, no drugs, he is obedient & sensible & as adorable as ever. 

One of many chill graze sessions

I had been originally hoping to try & sell him this year -- he is an exceptional horse to handle & ride, but he shows little to no talent or enthusiasm for jumping.  He does have, however, an amazing potential for serious dressage, which I have neither the money, the inclination, nor the facility to pursue.  But this will all have to wait for him to hopefully finish healing. 

In case you are wondering what kind of crappy horse owner doesn't realize their horse has a fractured foot -- there was never any heat, no swelling, no digital pulse.  He wasn't terribly lame; it could easily have been an abscess or bruise.  So my advice to anyone who has a mild mystery lameness that doesn't sit right with you:  do the radiographs sooner rather than later.  

We could use some good vibes if you have any to spare.

April 17, 2020

Echo's Vet Update

Before I dive into the latest installment of Echo's vet addiction, I do want to send out my best to all of you.  I went back & forth, but decided that I wasn't going to write much, if anything, about The Virus -- it was already all the words on all the channels & I didn't think I had anything meaningful to add to all that noise.  The best any of us can do at present is to follow reputable safety protocols to the best of our ability & for your own sanity, turn off the news & the facebook (if you even watch it, I do not anyway as I don't need to add to my sources of anger).

We are fine (at least as much as we ever are) here -- my job is secure & I can do much of my office work remotely to the extent that my limited rural internet access allows.  Our field work is reduced, but we will still be working on mission-critical projects; there is plenty of room for social distancing in the river though.  I generally don't go many places outside of work anyway; I hate grocery shopping so much I only go maybe once a month (basically when there is literally nothing left in the house), & as an introvert, I don't encounter other humans often.  I remain grateful to have the horses at home, so not many changes for us.  I definitely feel for all of you who can't see your horses right now & am hoping that ends as soon as possible! 

If you are in a position to help others, but are not sure what to do, you can follow this link to a summary page from Charity Navigator of groups which are accepting donations to help with everything from medical supplies to food to financial assistance.  Sending even a dollar from your living room is risk-free for you & can make a difference to someone else.
Click to find a reputable charity helping those in need
Turning back to my problem child...

Earlier this week, I took Echo back to the vet, as his shoulder was just...lingering.  I had started doing stretches & massage about a week prior to that following a phone consultation with vet.  That treatment did bring about some improvement & Echo was moving a bit more freely with a little less limping, but I wasn't comfortable proceeding without a better idea of what exactly we were dealing with.

Also..."Echo's Vet Update" should probably be the new name of this blog.

Turns out he did indeed partially tear his triceps muscle.  Good news:  that muscle is enormous, covering the entire scapula, so there is plenty of "extra" to do the job it needs to do.  Also good news:  it will heal without any functional limitations.  Also good news:  he is at the point in healing where he can start to go back to work as he needs to use it to continue making progress.
Equine shoulder; From horsesidevetguide.com
Less good news:  muscles heal slowly & giant muscles heal even slower.  It will probably 5-6 months until it is completely healed.  He may have a permanent divot to add to his existing scar collection, but at least it won't affect anything.

In the balance, while it's not great, it could be so much worse.  At least we can start doing things again, while is a huge relief to us both.  I will, as always, be conservative -- I got on a couple days ago & we just did walk work & stepping over poles.  Of course, Echo is already happily trotting & cantering around in the pastures on his own.  I'll never know exactly what happened -- maybe it was a kick, maybe he just slipped, maybe it was both.
His lump 10 days ago
I did put him back on the Equioxx, carefully, after we finished other meds, & am relieved that he is having no issues with it, so he has that mild anti-inflammatory support as we work through the physical therapy process.  He also completed a week of Ulcerguard & his stomach is much happier, so he's back to eating his meals (although still at the slowest....speed.....possible).

Farrier also put the hoof testers on him last week & he had no reactions, so it looks like the coffin bone bruise is healed up too.  At least it helps me to gauge lameness without the compounding factor of that foot on the same leg as his shoulder.

I'm sure Echo will find new things to do, but it still felt good to cross at least a couple of the more recent issues off the list.  And even though I hate any injury in my horses, it's going to happen one way or another, because horses, so I'm still grateful when it is at least something that will heal, because I've dealt with enough things that won't & that is much worse.
Shaking off gnats while regaining weight, shine, & getting less lumpy every day
Baby steps for Baby Monster, but we will begin re-building that topline once again.  It should be easier this time since he has more skills than he did a year ago - some of them are even useful.

April 6, 2020

Bute Vs. Equioxx: Tradeoffs

Because it's a good time to learn about things, right?

I recently had the unfortunate but useful opportunity to compare the results of the two most commonly used equine NSAIDs (Non-Steroidal Anti-Inflammatory Drugs; bute & Equioxx) on the same injury -- Echo's shoulder.  There are pros & cons to each.  Because I firmly believe in making the most informed decisions possible, let me share with you what I learned.

Background

Heat, pain, & swelling are the result of the body's inflammatory cycle.  One of the primary mediators of this cycle is a group of prostaglandins created by cyclooxygenase (COX) enzymes, which convert a substance interestingly named arachidonic acid (does it have spiders in it?).  There are different varieties in this group, referred to by number:  horses have COX-1 & COX-2, while humans have additional variants.  NSAIDs aim to break the inflammatory cycle by inhibiting the production of these enzymes, during which the body can break down harmful prostaglandins which have already formed (which takes about 12 hrs).

As you might suspect, COX-1 & COX-2 have different functions.  COX-1 plays important roles in things like maintaining stomach mucous coatings, keeping blood flowing through kidneys, & coagulating blood.  COX-2 is only found at low levels in normal tissues, but levels surge when that inflammatory process begins & COX-2 feeds that cycle. 
A simplified illustration from previcox.com; click to embiggen
Drugs

Bute refers to phenylbutazone, our old friend which has been around for decades.  It's cheap & fairly effective for pain management.  Given orally, it takes about 2-3 hrs to absorb from the belly & peaks in 3-5 hrs.  Persisting about 12 hrs, bute blocks both COX-1 & 2 production.

Equioxx is a brand name of firocoxib, a newer drug that is known in the canine world as Previcox.  It was developed for the treatment of osteoarthritis.  It's also given orally by owners, but is much slower to take effect.  It takes at least 24 hrs for levels to begin to peak & does not reach steady state for 4-6 days.  It also has a half-life of 44-46 hrs, so it takes an additional two days minimum to disappear after you stop giving it.  Firocoxib is a selective COX-2 inhibitor, which means it preferentially blocks COX-2 but still has a minor effect on COX-1.

Choices & My Observations

It just so happened that I was able to directly compare the two as Echo was on bute for the first week of his shoulder pain, then on Equioxx for a second week.  Pros & cons:

Bute Pros:
  • Much more effective pain control (side note: I've heard the same from others)
  • Significantly more rapid action - both to start & finish.  The latter can be especially important if you need to take a lame horse to the vet the next morning & you need the pain unmasked for an exam.
  • Relatively cheap
  • Easy to give -- even picky Solo will usually eat it on his food.  If they start refusing it after multiple days, I just dump it in a syringe with a little water & shoot it in their mouth.
Bute Cons:
  • Blocking both COX-1 & 2 is what brings about the higher incidence of GI issues with bute.  This is why I switched to Equioxx, as Echo had already been on bute a lot for his foot bruise & I was beginning to see ulcer signs.
Equioxx Pros:
  • Primary benefit is its selective COX-2 action:  this spares the GI tract some abuse, as well as protecting other COX-1 processes (cartilage maintenance is another one not mentioned above).
  • Also pretty easy to give as a tablet -- Echo snarfed it up when I put it in my hand with a little grain.  I've also heard of people stuffing them in cookies or gumdrops.  Just don't let other humans eat the gumdrops.  I've also heard of that happening once, LOL.
Equioxx Cons:
  • I saw significantly less pain control that definitely seemed better suited to something milder like arthritis.
  • Slow action, both to kick in & withdraw.  
  • Not cheap -- I did find (too late for me) that it was significantly cheaper online than through my vet.  Vet also did say that he did the math & it was actually cheaper per hour of pain control than bute was.  I believe him, but almost $2 a pill still hurts me.
Related note:  Equioxx & Previcox are both firocoxib.  Because Previcox can be cheaper, many people use it for their horses & just divide pills themselves.  However, be aware, it is now illegal, through the FDA, for a vet to give Previcox for a horse.  This is because accurate dosage for firocoxib is important to avoid adverse effects & it's very easy to over- or under-dose when manually dividing dog tablets.  This legal change occurred around 2016, when the tablet form of Equioxx became available; here is a good explanation.  I'm not going to call the drug police on you, just informing. 

One more note:  I learned from the Equioxx package insert that all NSAIDs have the potential to also block the prostaglandins which control body temperature.  This isn't common, but is something to keep an eye on if something goes awry.

Take Homes

Just like pretty much all of life, there are tradeoffs with each option, but I hope this will help you better understand which might work best for you.  I still consider bute my first line tool in acute pain control due to its strength & speed.  However, if you need to give an NSAID for a long period of time or are treating a horse who already has ulcers, Equioxx may be a more appropriate choice to protect GI tracts.

If you really want to dig in, here is a really nice paper from the Journal of the American Vet Med Association from 2017 on the COX enzymes & use of selective COX-2 inhibitors.

March 31, 2020

Disaster Horse Votes No To Boring

Without doubt, we are in tumultuous times.  Echo the Disaster Horse did not want to be left out of this & had no interest in my plea to be boring.  Not that I thought he actually would.

Right after my last post, he galloped around the pasture like an idiot & re-aggravated whatever he did to his shoulder.  Two weeks later, he still has some lingering soreness.  Vet says it's possible he bruised a nerve, which will take a little longer to heal.  I wish that was our biggest concern.

About 9 days ago, last Sunday morning, Echo was just looking kinda sorry for himself at breakfast.  I took his pulse on a whim & it was a bit elevated, so I took his temp & discovered he had a fever of 101.8 F.  He was already on Equioxx, so I consulted vet & he said go ahead & give bute if the fever gets higher.  At 102.1 F, I went ahead. 

The bute did control the fever well & Echo perked up, but then Monday night, I went out to give the horses their midnight snack of alfalfa cubes only to find the poor kid was completely covered in hives.  As in, his whole body looked like furry cottage cheese & his neck felt hard as a rock, I have never seen anything like it -- even his butthole had hives on it.  He was extremely tolerant of me shoving my shaking hands up his nose to make sure he still had an airway while I dialed the vet emergency line yet again. 
Gee, mom, you didn't actually want to sleep ever, did you??
A few doses of dex took care of that & we never did determine exactly what he reacted too.  It wasn't fire ants (no bites), he had no changes in food (not even a new bag) -- the best guess is maybe a wasp sting but invisible aliens are equally plausible.  At this point, I had no idea what was going on & took him in to the clinic to figure out what the heck to do before I had an aneurysm.

Long story short, blood work came back showing a possible bacterial infection (origin unknown).  Even though the fever had quit by Wednesday, vet prescribed a course of SMZs, which we've just finished.  In addition, & completely unsurprisingly, he also has some acute ulcers from the on-and-off bute over the last few months for his foot bruise.

Baby Monster, you be killin' me.

I have UlcerGuard on order & will be stalking the tracking number, since Echo is now off his feed & he doesn't have weight to spare.  After the last 10 days, I'm off my feed too!  Until it gets here, I'm offering him soaked alfalfa cubes & anything else he will pick at -- at least I have grass coming in & he is grazing some. 
Alfalfa slurpies
I have been itching to get him back into work, as he has lost all that muscle & weight I put on him last fall & he just does better overall when he is doing SOMEthing.  But I don't have the heart to ask him to do anything extra with a sore belly sloshing around, especially when I can't even give him any painkillers.  I'm even afraid of the Equioxx now, which will take a whole 'nother post to get into.

I am absolutely grateful they are at home with me right now & that Echo can at least keep himself mobile since they live out.  I think Solo is also grateful Baby Monster is wayyyyy less annoying right now.  And at least I can keep a close eye on him since I am working from home most of the time right now.

I hope you all are staying safe out there & I hope all your horses stay very very boring! 

February 18, 2020

It's Not An Abscess

Echo decides to prove yet again that my paranoia is not unfounded.

We finally made it to the vet today for spring shots & the planned radiograph I mentioned previously.  It was supposed to be last week, but the rain prevented the machine from coming out to play & it was so wet, I couldn't get the trailer hooked up & out without tearing up half my property.

Turns out, Echo's prolonged on again/off again soreness on his left front is in fact due to some bone bruising on the medial wing of that coffin bone.  Which Dr. Bob also referred to as "crushing" & "micro-fractures."  Which I did not really appreciate because I don't care what the vet-land rules are, but these words do not all mean the same thing to me & shave several years off my life!  I am just going to call it bone smooshing because that is descriptive without being quite so terrifying-sounding.
Smooshing is right where the #4 is on this coffin bone
This type of injury happens when a horse's heel impacts something hard, such as a rock or a hard piece of ground, with too much force or just the right angle or it's Tuesday.  Fortunately for Echo & I, his smooshing is right at the tip of the bone.  Which means it will heal, is already healing, & he should be fine.  If you get smooshing farther forward on the bone (like by 3 or 5) or extending up into the joint, that is when it becomes a Really Bad Thing.  I am hopeful I never have to learn any further detail about that.

Since this has been going on since early December, Echo is already a "fur piece" down the healing road.  Having had a gnarly bone bruise, I am familiar with their slowness; Dr. Bob said this type of thing can range from 6-8 weeks for a mild one (like Echo's) up to 6 months for something more severe.  So we should be on the "improving" side of the curve & we should see continued gradual progress over the next month or so.

Also fortunately, my gut management instincts (& repetitive haunting of Dr. Bob's phone line) guided the correct course of action over the winter, even though I wasn't certain of the cause.  He's done very little work, which consisted entirely of walking & an occasional short trot for feels on soft ground.  He's been able to move freely in the pasture, which is what needed to happen for circulation which then fuels healing. 

And for the last month or so, as he's moving more & when we get more frozen ground cycles, both front feet have been protected with full support across the heels & frogs.  The exact devices will get their own post, because farrier & I have been learning about new technology, but right now, he's wearing a pair of EasyCare's flip flop boots & they are working pretty well.
One of his expensive slippers
These allow his heels full lateral freedom (which is his particular Princess Pony Foot demand), but provide a thick, sturdy pad under his entire foot while still providing good traction in mud or frosty grass.  All the details will come in the next post.

Until then, he has been cleared commanded to go back into more consistent work under saddle on the flat (with bute as needed) to use that 5-yr-old energy most constructively (although I am sure he will still engage in many spring frolics) & help the rebuilding process.  I am sure I will be ultra paranoid conservative about it, but I suspect I shall receive no arguments from Echo other than "SO WHYYYY IS ALL-CANTERZ A BAD IDEA????"

Definitely not as "benign" as the abscess I was voting for, but on the upside, it involves no wrapping & will be far less messy.  Another plus:  this was the only foot I didn't have radiographs of yet, so now I have images of all four (yes, horse owners celebrate weird things).  Joint spaces were clean & lovely, navicular bone was fine, soft tissue had no issues, & all the other pieces were where they were supposed to be.  And while it's been frustrating to watch his muscling disappear, I'm just glad that it's not permanent (at least not this time).

Answers bring a great deal of peace of mind, even more so when they are not catastrophic.  We'll see how the next 30 days go, but I'll be thrilled if they are completely uneventful...  
I know he's just hatching his next plot...but at least he will do it shini-ly

October 14, 2019

Good News And Better News

The good news:

On Friday, Dr. Bob got to give me a happy report.  He did not see anything concerning stifle-wise with Echo, no signs of injury.  What I saw/felt was due to loss of condition from a month off on a leggy young horse.  Prescription:  "Ride lots to rebuild strength." 

Huge sigh of relief from me.  And that is my favourite prescription.   

The better news:

We've been working for months on easing Echo's sacrum back to level.  A lot of months (like, here's the update from May).  It's not something you can, or more accurately, should, do in one big pop.  If you try that, it will just pop right back out again thanks to sore, tight muscles who are loath to give up a habit.  Which is why it's also important to incorporate muscle work in your chiropractic regimen. 

His last adjustment was in late August & we did finally nudge it the last little bit back to level then.  Both Dr. Bob & I held our breath & he suspected it may try to sneak back out again.  I continued my focused SoreNoMore massage on the hip knots I've come to know well & kept staring obsessively at it.
You can see the last remaining bump on the left in early Aug
Under saddle, I pleasantly discovered continuing improvements in Echo's right lead canter - he could now keep the lead on a slight downhill turn without swapping behind or using a half-buck to unload the weaker leg.  Standing behind him, I could see his HQ muscling becoming more even.  I hoped, but cautiously.

After more breath-holding on Friday as Dr. Bob professionally poked that sacrum, he announced IT STAYED!  Yes, I realize Echo probably heard me type that & is hard at work to undo it, but I'm still taking the win!  Dr. Bob also said he wanted to hire me out for muscle work -- I told him that I doubt I'd get many clients who were interested in having their horses massaged for 15 minutes at a time when my arms get tired, as it'd take me a month to do an entire horse.

We're long overdue for some good luck, so I'm going to enjoy a nice long exhale for now.    

October 5, 2019

Wound Wars: The Battle Of Proud Flesh

Proud flesh:  the nemesis of wound care.  When you have any open wound that can't be stitched (which seems to define nearly all horse wounds), you have to wait for them to fill in on their own with granulation tissue.  However, this tissue has a serious overachievement problem & inevitably multiplies into a cauliflower-esque explosion of cell growth that protrudes well above the skin surface.  It then blocks the migration of healthy skin cells that would otherwise move in to close the wound.

It is particularly problematic in areas of poor blood supply & high motion, like the lower legs.  Where 100% of my horses' wounds were.  Of course.

If the wound in located somewhere you can apply a pressure bandage, like a standing wrap, you can prevent proud flesh.  When those cells can't push outward, they seem to just give up & pout, giving the good cells room to do their magic.  This was awesome for 25% of our wounds, specifically, Solo's skinned cannon bone.
You can see by mid-Sept the bone is once more covered by a sub-layer & as of this weekend, new skin has covered more than 50% of the original area.  I'm keeping a non-stick pad coated with Dr. Bob's Magic Red Sauce + standing wrap on this until it's filled in more, as one less place I have to fight the evils of proud flesh.

Solo's hock has been the primary battleground.  High motion, impossible to pressure wrap, with a horizontal cut destined to pull apart - it was inevitable, really.  The Magic Red Sauce (I don't know all the ingredients in this concoction) is supposed to help both retard proud flesh & encourage epithelial cell growth, but its magic definitely has limits.

I was scrubbing madly with my dilute betadine, but it wasn't enough, so mid-Sept, I called Dr. Bob.  He knows I do surgery on endangered species (& they live), so he gave me permission to get aggressive.  Really aggressive.  I dunked the knife & scissors on my multi-tool in the beta-water & charged back into battle.
 
The one good thing about proud flesh is that it doesn't contain any nerves, just a zillion blood vessels.  So it will make an unholy mess when you hack (very carefully) away at it but your horse won't feel a thing.  This wasn't a super fun addition to the twice-a-day cleanings & it made them even longer, but Solo dozed patiently while I chopped off endless tiny tissue nodules, just trying to keep it roughly even with the skin surface.
Front
Looking good today (white is Corona)
Lateral side
Today's view, still a little proud flesh, but the skin will soon swallow it
After scrubbing, I would alternate between polysporin & Magic Red Sauce.  I am happy to say that after several weeks of battle, not only is the proud flesh on pouty retreat, but the front hole has finally closed, meaning no more diaper wrapping & ending the 2-roll-a-day vetwrap suffering!  There is still some fill in that hock, so it gets hosed daily, but has drastically reduced with today's cooler weather.

Echo's return to work was delayed by the fact that it took me an hour to do Solo's bandage when I got home from work, after which it was basically dark.  He is now back under saddle, though, for the past 10 days.  He is almost completely healed.  The friction burns on his chest have vanished under his new winter parka-in-progress, you can't even tell they were there.
Top is Sept 3, bottom is Sept 27
Proud flesh did rear its ugly head on his knee, so it also got the knife & is now gasping its very last, tiny breaths.  A few more Red Sauce treatments & it too will vanish.  The cut on the outside of his cannon is a small scab hidden in fur.

My knife hasn't been needed in several days.  Both boys are sound & happy.  So much so that my next story for you involves a lesson (OMG, a lesson!!?!) in which Baby Monster is making some very exciting progress.
Coming soon...

September 19, 2019

Tricks of the Equine First Aid Trade

Since I am currently using nearly all of the equine nursing tricks I've developed over the years, I wanted to share a few products I've adapted from the human world.  In many cases, this is much cheaper than buying "horse" labeled products, as we all know that's an automatic 300% markup. 

Horses & humans may both be mammals, but are NOT interchangeable, so product transference should always be done with caution.  I check with my vet before I try anything new.  And Dr. Bob himself has suggested several of them!

In my wound care kit right now:
  • Generic wound wash from CVS -- a mix of antiseptic & lidocaine, this stuff has become the first thing I grab for cuts & scrapes.  Dr. Bob first mentioned something like this when Solo got staples in his head last year, as the lidocaine reduces itching so they don't rub on everything.  I squirt on a clean cloth to apply & a bottle lasts me a long time (uh, usually).
  • Non-stick wound pads (biggest size available) -- fabulous for things on legs that get wrapped.  In the last post, you can see one sticking out of the wrap around Solo's cannon scrape.  I've found that if you leave a little sticking out above the vetwrap, it helps prevent the pad from sliding out the bottom.  They absorb without peeling off healing tissue when you change bandages.
  • Nitrile gloves (altho medium is of course too small for my giant man-hands) -- not sterile, but cleaner than my fingers & saves me from having to wipe 5 different kinds of goop off my hands.  I also like that the blue is easier for me to see when I drop it or it blows out of a trash bucket.
  • Polysporin -- a long time ago, a dr. told me that 10% of people develop allergic responses to Neosporin, so polysporin was a safer choice.  I don't know if this is applicable to horses or not, but I've used the poly ever since on full-thickness cuts & it works well.
  • Colored duct tape -- I always tape wraps/standing bandages that are worn unattended.  I try to get tape that is a different color than my standing wraps so I can easily see from a distance if it's still there, but I had blue left over from something else, so oops.  
  • Gorilla tape -- I usually only use this for hoof wrapping, for which it is a godsend, but I was about to run out of duct tape, so have also used it on standings.  It has not left a residue or caused any damage to my standing wraps.
The discolored gladware with 3 little syringes is my wound lavage kit.  NCSU vet school taught me this method when I had to clean out Solo's healing head-holes.  Add a little Betadine to water, so it's a diluted mixture, about the colour of weak tea or lighter.  Use the syringes to flush out the wound.  Syringes allow you to control direction & pressure of stream pretty well.  Because Betadine is cytotoxic, you never want to use it full strength on an open wound & even dilute, use only when needed to prevent infection/flush out debris.  It will stain whatever container you put it in, so pick something you don't plan to eat out of later.

Finally, the big fat syringe is just a dosing syringe with the tip cut off, making it easier to give dissolved stuff like SMZs without losing 1/3 of your dose stuck in the plastic tip.

What about you?  Do you have favorite products you've adapted to equine use?

September 9, 2019

A Healing Update - It's Never Simple

The first week post-carnage went fairly smoothly.  The Horse Gods saw this & felt it necessary to remind me that this is an unacceptable premise.  As if I need reminding.

Both horses were wrapped for the first week & I was pleased with their progress.  Then Friday morning, I came out to feed breakfast & Solo was suddenly non-weight bearing on that hind leg.

He is a seriously stoic horse, so my panic level shot to maximum while I coaxed & pleaded him in hobbling hops back to the shed.  I took his temperature (normal), pulse (slightly elevated at 44 bpm, but not extreme), & unwrapped his bandages to check for any signs of infection.  Nothing appeared to be any worse than it had been 12 hours before.  Solo was eating & drinking & pooping with a happy face, he just did not want to move that leg.
Doing fine the first week
I called the vet & parked the hose over Solo's hock.  There was still a fair amount of swelling around the hock, but it's a pretty ugly wound, so that's not unexpected.  Dr. Bob talked me off the ledge (he's getting way too much practice at this).  He agreed infection was unlikely & thought Solo had probably just tweaked one of the many bruised tendons/ligaments sometime during the night.  He increased his SMZ dose to be cautious & if we didn't see improvement by Monday, we might try a heftier antibiotic.

I hadn't thought of that possibility, but I now think he is probably right.  Solo could have slipped or torqued it getting up.  I'm glad to say that he is improving -- he's walking, albeit slowly, as well as standing on it, including resting on that leg, which alleviates many of my concerns about the joint.  I also think, based on how he moves, all that delicate healing skin on a high motion area is pulling, especially as it dries & gets tighter, which probably doesn't feel great & he's protecting it.  I know he didn't run around, Solo is a careful guy.

The cuts are healing very well.  Everything is closed except for a small hole at the front, which is good for drainage (only a small amount now).  We're sticking with the SMZs - after Solo had TWO resistant bacteria show up while he was at the vet school in 2017, I am uber-conservative with antibiotic use in all circumstances.  Well, plus, I'm a biologist & I know better.  Only when prescribed, only when truly necessary, & the lowest level possible, as appropriate to the situation.
Front view, this morning, before hosing - WEIGHTBEARING!
Side view this morning (day 9), base layer is closed
It will take a while for the cannon bone scrape to fill in completely, but it has clean margins & it doesn't worry me.  I will keep wrapping until the hock is closed & dry since flies are still out in force.  Why not, I've already purchased my body weight in Co-Flex/VetWrap since one bandage job takes a whole roll.
This is what is under the standing wrap
Echo is doing just fine.  Well, aside from making me crazy by trying to stick his nose into every. single. damn. thing while I'm tending to Solo.  Children.

He's been wrap-free & bute-free since Friday & his last dose of SMZs is today.  The cut on the outside of his leg is pretty much closed & his chest is all healthy skin again except one stripe which will soon be done.  Nothing on his chest actually cut the skin, these were friction burns & they were not sore after the first day or two.
3 days ago; today it's now all healthy, normal skin
3 days ago, that one stripe is still healing
The scary-looking hole behind his knee filled in very quickly.  I'll have to stay on top of proud flesh since I can't pressure-wrap the area, but it's not painful at all.  No swelling & he should be back in work this week.  I just keep Dr. Bob's Magic Red Sauce on it & slather Corona & Swat on the rest to keep the bugs out. 
2 days ago, drying out & filling in
Thanks to everyone for your well-wishes, as always, they mean a lot!  I know horses are experts at mangling themselves no matter what, but I'm going to be angry at myself for a long time for missing that jumper wire.  I did a lot of modifications to the fence when I moved in & thought I had removed all of those, but I was wrong.  However small the odds that the horses would hit the fence at that corner, out of all the corners -- it happened.  Shame on me, but it won't fool me twice.   

I'm cautiously optimistic that the worst is behind us.  Thanks to Erica for helping me finish the last of the fence repairs yesterday!

Cross all the things for us & hopefully the next update will have NO ooze or vet calls. 

Hey, let me have my dream.

September 2, 2019

Emergency Vet -- A Two-Fer

I was working outside on Saturday when I heard the fence wires suddenly start jangling in a bad way.  I had just put the horses in a small side paddock to munch on some fresh grass while I worked on their fields.  I whipped my head around to see Echo flailing about as the top wire dropped (it has breakaway points for this reason) & both horses took off to the other end of the paddock.

Since I only saw the end of the action, I'm not sure exactly what happened, but my educated guess is that Solo kicked out at Echo while he was up against the fence.  Solo got a hind leg over the top wire & Echo somehow got one front leg over it.

As soon as I caught them, I saw that I needed an immediate Dr. Bob inspection (of COURSE, it's a weekend, that's how horses do).  I was cautiously optimistic there wasn't anything catastrophic, as both were trotting & walking around in proper mechanical order (albeit full of adrenaline), but with ugly things - & these were definitely ugly - around joints, I am always very cautious.

To make it more fun, I don't know if you've ever tried to do first aid on two horses while trying to keep a phone in the good reception spot so the vet could call you back.  Well, it's impossible.  A HUGE thanks to Trainer Neighbour who came over & helped me juggle all the things until the vet arrived!

Both horses were really damn lucky.  Warning:  photos follow. 

Echo put a gnarly hole behind his left knee, but it is in a "safe" valley between vital structures.  We can't wrap it due to location, but it is already filling in rapidly.
Right after it happened Sat
He has a full thickness cut on the outside of his cannon, but it is just skin, I will wrap until it closes just to keep it clean as well as to reduce swelling there & below the knee.  Some wire chafes on the tops of both forelegs look bad, but no cuts there.  Thanks to youth, he's not even stiff.
Keeping Corona & Swat in business
I am so very grateful it is not Sacred Leg which doesn't like touching, otherwise I would be far more miserable.

Solo's right hind got the worst of it.  He exposed a chunk of cannon bone above the fetlock, which looks dramatic, but those usually heal up pretty well.
I really never wanted to see my horse's bones...
The front of his hock suffered two full thickness slices while pulling the wire down, but all the tendons are ok, just bruised.  I don't have fresh pics of those, we were too busy tending. 
Side view ~14 hrs later (Sun am)
A blood vessel got nicked & ruptured when I initially hosed it, so I was reminded yet again that horses have a lot of blood.  I think I could have done a transfusion when I rinsed out the initial bandages (below) in the bathtub yesterday.

This morning, those cuts were already nearly closed & all the tissue looks healthy so far.  My main job is to keep everything clean to prevent infection & try to keep the bugs off where I can't wrap.  Both will get a full course of SMZs along with bute for swelling.  Dr. Bob had me put some of the green Epsom salt gel in Solo's hock bandage, to try to draw out fluid into the diaper wrapped around it.  I've never used that on a wound before, just feet -- I'm pretty impressed!
Front view Sun am, healing up
What Went Wrong & What Went Right?

It was mostly a freak accident in just the wrong place.  My property came with hi-tensile wire fencing, which my neighbour built very well.  I have lined much of it with a strand of HorseGuard tape, but this section was not lined.  I'm glad it wasn't, because I think added tape might have made things worse in this case.

The wire itself is heavy-gauge & as I have learned during a couple other times Solo has bounced off the fence, this is an important safety feature which helps it roll off before cutting.  Unfortunately, just about anything will cut when you put an entire horse's weight on it.  I have seen horrific injuries from wood, electrobraid, PVC, mesh, thin tape -- horses are just way too good at carnage.

One of the multiple breakaway points did give when it was supposed to, which created the slack needed for the horses to get out & undoubtedly prevented much worse injury.  However, one point that should have released didn't & I found afterwards that there was an old jumper wire hidden in a bush that I had missed which prevented that release.  That's on me, as I'm sure that led to Solo's hock cuts.  I cut that off & reinspected all the other connections so it will never happen again.
It finally stopped bleeding, still tweaking my bandage setup
Despite the emergency bill & the stress of double first aid, I'm very grateful that things weren't worse.  No one needed stitches or sedation.  Both horses are sound, will heal fully, & are experienced at letting me clean & poke & wrap sore parts without kicking my head off.  After I do my penance of a couple weeks of nursing, everyone should be well on their way. 

Go hug your horses & check your fences.  Don't forget to look under the bushes.