Wednesday, July 19, 2023

Plot Twist!--Horse Update

 It's been a wild, wild ride since my May horse update.  In fact, I posted that update, and then BAM!! Problems.  Camaro didn't greet me when I went to get him from turnout.  He seemed slow, reluctant to come in.  I figured maybe he was wanting to eat grass (which was rapidly dwindling as we entered a time of early drought) rather than work.  Typically, he comes eagerly and enjoys his work (and post-work sugar cube and peppermint).

He walked slowly, but other than that seemed fine.  He stood fine to be groomed and tacked.  But when I went to lead him to the arena, he resisted.  He didn't want to take that first step, but he eventually (after a few seconds) did anyway, because he does like to please his person.  

I began our typical walk in hand around the arena in each direction so he can see things--especially anything that's changed since our last ride--and he just didn't look right.  I tried trotting him in hand.  Uh-oh, do I see signs of lameness?

Even though we were still in the "no tight circles/no longeing" stage of his knee rehab, I put him on the longe line for a better look see of how he was moving.  And it wasn't right.  Nothing huge, but there was definitely something there.  

So I didn't ride.  I asked the barn owner how he'd come in from turnout the night before, and she said "a little off, not his normal self" and then proceeded to say that the two nights previous to that she'd had an intern bring horses in at night and the intern had remarked that he was 'slow to come to the gate, not like he usually is at dinner time'.

Oh no!  Oh no, no, no!  Immediate vet call, as this was exactly the time of year and exactly the vague way his laminitis episode in 2020 had begun.  That had taken several months for him to recover from, thankfully without permanent lameness, and hadn't been cheap or enjoyable (he'd hated being on stall rest).

The vet came (not the one I normally use, she was on vacation that week, but another one from the same practice) and confirmed that yes, most likely Camaro was in the beginning of a laminitic episode.  He was prescribed a three day course of Banamine, but not necessarily stall rest since that hadn't been quiet in 2020--and we wanted to avoid redamaging his knee if he paced and circled all day and night confined to a stall 24/7--so we put him in the least vegetated turnout (since there is not drylot paddock) with his grazing muzzle on.

And he got worse.  The Banamine did hold him comfortably until the tube was used up and he'd been off it about 12 hours.  But once it left his system, oh boy, did he look worse than before.  So, call the vet office, and they recommend putting him on 1 gram Bute twice daily.  After two full days of that, he was looking still worse, so another call to the vet office and they said up the Bute to 2 grams twice a day.

Which made him look a little better, but man, that's a lot of Bute and not good for his gut long term.  So, another vet call, and this time his normal vet came out.  She was not happy to see the condition he was in (indicative of a large amount of discomfort).

She gave him an IV round of DMSO.  She made him some 'bumpers' for the heels of his front feet to change the pressure on his coffin bones.  She took radiographs of both front feet (none of the hind although she suspected they were also inflamed this time around).  She ran a test for Cushings/PPID.  She put him on stall rest with strict instructions not to even take him out to clean his stall if we could clean around him safely.  She prescribed twice daily Bute but only at the 1 gram dosage level. She recommended we contact Camaro's normal farrier (who is the farrier for the entire barn where Camaro is boarded) and get him out ASAP to change the type of shoes he had on to ones more therapeutic for laminitis.  Specifically glue on shoes.


Amazingly not protesting his stall rest this time around.

We waited for the test results.  We followed her instructions to a T in regards to stall rest, and medication, and contacting the farrier with the shoeing change info.  The farrier couldn't come for at least 5 days, and said he would order the special shoes and would confirm with us the date he was coming to work on Camaro.

The test results came in after about six days.  Positive for Cushings/PPID.  Well crap.  That explained alot though, about the laminitis in 2020 and again now when none of the other horses on the farm had had issues with their feet.  Camaro was put on a starter dose of Prascend.  Vet bills are racking up.

The farrier came, without confirming his imminent arrival, and I didn't know until after he'd finished with Camaro, that he'd even been there.  I'm not going to sugar coat it; I wasn't happy with the situation. I had wanted to be there to talk to him in person, but had left a check for him with the barn owner in case the day he came was one of the two days I was going to be out of town that week. But it wasn't either of those days.  It was the afternoon before the day I was going to be gone; literally less than three hours after I had left the barn when I finished cleaning stalls..  I totally could have been there and had requested that I be there if the farrier was coming.  

But I wasn't notified he was on his way, or even after he arrived.  Instead, I got a text with a picture of a special shoe on the right front foot, many hours after the fact.  It wasn't what the vet had prescribed, but I was told "that was going to take too long to come in and he (farrier) didn't want to make Camaro wait longer so he'd made a special shoe that was similar."  Well, I wasn't sure, based on the picture and the fact that the shoe was nailed on, not a glue-on, that it was the right thing to do.  But, the text had told me how much relief Camaro seemed to feel after the shoe change, and that he'd 'walked out sound'.

When I saw it in person, about 68 hours post-farrier, after getting back from out of town, and after texts from the barn owner as I was driving back into town that Camaro seemed "a lot more uncomfortable than he had been right after the farrier put on his shoe", I was so shocked.  His toe looked chopped off, and only one front foot had been done (the vet had wanted both fronts in the special shoes) because the farrier had 'put hoof testers on the other front and didn't get any reaction, so didn't feel that one needed changing; he'd be back in a week for the normal six-week appointment anyway and do the rest then'.  Camaro looked flat out miserable.  Through this whole stall rest situation, he'd been quiet, not like his unhappiness on stall rest in 2020, but at least his demeanor had been perky.  Now his eye had a very very stoic look to it, and he didn't greet me when I walked up the barn aisle like he'd always had.  He wasn't even looking out the door of his stall; he was standing in the back with his head down.

I called and scheduled the vet for a recheck in a couple days, when she had availability in her schedule, because I wanted her (not the first vet from this episode) to be the one to come assess him post shoeing.  And I had a bad, bad feeling as to Camaro's potential to pull through this laminitis flare up as successfully as he'd pulled through the one in 2020.  

Well, given that those radiographs had shown some rotation of the coffin bone in the right front (the now chopped and mangled hoof with the custom shoe) when compared to the radiographs taken back in early February at the time of Camaro's knee injury, and seeing the new shoeing job which in her words "wasn't the same effect as the shoe she'd prescribed and sure didn't do Camaro any favors", and now knowing that Camaro has Cushings (which makes horses very prone to laminitis) the vet and I had a very in-depth conversation as to the prognosis.  I brought him out of the stall and she watched him walk (this was about the middle of the day, so peak time between doses of Bute, when he was pretty comfortable) and also showed her a video the barn owner had taken and sent me the night before, shortly before the dinner time Bute dose, of him being walked a short distance (why was he out of his stall?!?) and obviously incredibly painful and reluctant to move.

We talked about where in the recovery process he was, how it differed from 2020's laminitis, what additional treatments we could do, what medications he could be given to make him comfortable (and what the dangers/side effects were of those meds), how many months it likely would take for him to reach comfortable without being on meds, the special shoeing he would require forever more, and the likelihood he would ever be sound again.

In her professional opinion (which matched my gut feeling having seen him myself), because of the rotation of the coffin bone and the severity of the laminitis this time, the likelihood of him ever being rideably sound again was very low.  He could, possibly, recover to be what is known as 'pasture sound', which means a horse can hobble around fairly comfortable in turnout, but never comfortable with weight on it's back (as in riding).  However, with the Cushings, he should not be on grass turnout, only on dirt lot turnout.  And he would hate being able to see grass, but never allowed to eat it.  

In order to reach that 'pasture sound' level, though, he was going to have to endure many more months of pain as the inflammation in his feet slowly subsided, and then would come hoof abcesses, which are a typical part of the healing process in laminitis (he'd had a big abcess in 2020 once he'd started getting better), and in themselves cause a great deal of pain as they build.  We could keep him on high doses of pain meds, all of which are known with long term use to cause ulcers and kidney damage.  All of this in the hope that he'd be able to kind of shuffle around outside of his stall for the rest of his natural life.


I decided, and the vet concurred, that it was not fair to put him through so much agony.  And so I made plans for how/who/when to have his body hauled away and set a vet appointment to have him euthanized early in the morning less than three days later.  

The vet and I both cried as we put Camaro to sleep.  But, we first took him outside and let him graze the grass for about 15 minutes, then administered the drugs to stop his heart, and he died happy, with a mouthful of grass.  It was a somewhat comforting, and fitting, end to a bad situation for him.


Chewing away happily


Now that I'm crying again, and maybe you are too, reading this, let me say

BUT WAIT, THERE'S MORE!  Yes, the plot twist isn't over. . . 

(to be continued)


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