Category Archives: History

Eyes Wide Shut

I had the opportunity to work with a “horse communicator” today.  She was recommended to me by an equine vet who, after reading my blog, felt that I would be open to the idea, and introduced me to her via email.  According to the vet, she often works with this particular equine communicator due to her ability to point out exactly where the horse’s issues are, allowing the vet to adjust/manipulate/treat the main issue.

I chatted with her at length a few days ago as she explained the process and we scheduled an appointment.

Today I gave her a call, as she explained, connecting remotely allows for the horse to be in his natural setting without the influence of an unknown person.  That way the horse could be relaxed and the owner can observe, ask questions, and engage.  So, that is what I did.  She went onto explain that sometimes the horse needs energy work in order to open up to the process and that the horse must trust the process, her, and obviously, the owner.

I was asked to have questions ready to ask my horse, along with something I would like to tell him at the end of the session.  (If you have been following this blog then you will know I had some difficulty narrowing down a couple of questions- I have a lot! 😉 ) She began connecting with Chance.

I will not be able to convey all the details of what was said, Chance’s reactions, or even mine…It is almost a blur… I wish I could.

I was asked to feel around Chance’s right forehead/eye area for a lump or bump.  I did as I was asked and didn’t feel anything abnormal…but remembered he had a gash that was healing right above his right eye.  She informed me that he had a “headache”.  She continued to move over him and explained that his “energy” was “blocked” on his right side.  This makes sense…Chance has a “swagger” at the walk- he pokes his butt to the side and has a twist on the back right leg (Chance’s swagger has gone up and down- it was worse when he had the tendon issues, resolved after stem cell injections, came back when he got EPM, went away ish, and came back with his Lyme).  While she was working on his energy, I massaged Chance’s back, neck, hip, and shoulders.  She went on to explain that Chance had some right shoulder pain. Thankfully, Chance allowed her to work on his jaw (he pretty much has TMJ), his head, his back, etc.  The energy was “pouring out” even on the hind end which, if I recall correctly, is commonly seen on horses with head injuries.

This is where my one question came in…I wanted to know what happened to Chance when he came to my college.  I didn’t give many details…I didn’t know many details but I always wondered what may have happened on Chance’s trip down to my college.

I had gone off to college in January and decided to have someone trailer Chance down (about 3 and a 1/2 hours) once I got settled and found a barn, etc.  Two months later Chance was arrived at her new barn.  Despite the cool March weather, he was covered in sweat and was visibly scared.  I didn’t inquire too much since he was in one piece and I chalked up the sweating and fear to exactly that- fear and anxiety.  However, as the months progressed, Chance began bucking and rearing while under saddle….this was really strange..When he had left home we were doing dressage and jumping and he was sound and calm.  Once again, I chalked it up to being in a new place- a barn that hosted Friday night Bullbucking no less.  I decided to switch to a different farm, one preferably without bulls, even though the show was awesome to go and see, and work with a trainer.  Still the behaviors persisted and the episodes of lameness increased.  The vet finally diagnosed Chance with arthritic changes in his back and suggested I no longer jump him.  I decided that summer instead of bringing Chance home and have him endure another long trailer ride, to board him at my new vet’s farm. Chance had the summer to recuperate while under the care of an equine vet.

Anyways, after that summer, I decided to retire Chance for good.  I would occasionally get home him to walk around, I still can and do today.  But, that was the beginning of a chronic condition that was never given a diagnosis.  Instead, Chance’s symptoms were treated as they came.  

Back to my session with my very own horse whisperer..

Chance “showed” her what happened on his trip to college- a trailer wheel falling off the side of the road.  His head hitting one side of the trailer and slamming the other side.  The pain.  The concussion.  His neck and back becoming misaligned.  His jaw coming out of position. His body compensating. He showed the decline of his once functioning body- starting with the hit on his head, to his jaw, and his neck.  Down his neck and through his back towards his hips and down his legs.  The wear and tear of his body.  Chance stated that he is still angry with the person driving the trailer; he wasn’t ready to forgive.  I have forgiven them.  I have no doubt it was a mistake and that there was no ill intent.  But, I am not the one feeling the pain that he is.  I am not the one who went from a racehorse to a jumper to practicing dressage to retirement long before I should have. And like the “horse whisperer” said, she will “hold the forgiveness for him until he is ready.”  I will do the same.  

She spoke of his time on the racetrack.  Chance was happy to hear that he was being remembered for who he once was, and will always be to me- a strong, beautiful and crazy talented 17.1 hand red-headed thoroughbred and not a “weak old man” as he put it.  When asked what his name was during his time on the track, he said, “Hot Stuff”, which could be a nickname and not his actual race name.

At one point during Chance’s session he fell asleep; standing in an odd way- hind legs spread out.  Suddenly, his body gave out and he caught himself from falling.  This entire time his eyes were still closed!  They remained closed for another minute after this.  His body reacting to something, perhaps a shift in his energies, and all the while he was a a state of peace; trusting that nothing bad would happen to him. 

The session lasted an hour and a half.  Honestly, we could have continued because of all the “blockages” but decided to stop for the day and pick up again another day.  I was told that the effects of the energy work or Reiki, would continued throughout the week and that he would be emotionally vulnerable.  As the session wrapped up Chance apparently said that he was the lucky one because I found him all those years ago.  


Energy Work and Reiki Resources


 The Benefits of Equine Reiki

Reiki for Horses: Workshops, Training, Courses, and Resources

Reiki Related Research and Resources for Two and Four Legged Friends

Equine Reiki Academy

Amorosa Equestrian Center in Ohio

The History of Reiki

Reiki Forum on Horse and Hound

Reiki Handout: Full history, explanation, and how to pictures


Equine Communication


How Horses Communicate

How to Speak Horse

Horse Forum: Horse Communicators


Head Trauma and Headaches in Horses


Symptoms of Equine Concussions

Trauma, Concussions or Other Brain injuries in Horses

How to Handle Horse Head Injuries

Helping Horses with Traumatic Brain Injuries

Merck Vet Manual: Equine Trauma and First Aid

Do Horses Get Headaches?

Chronic Lyme in Horses: Headaches

I have a limp!

Resources on how to diagnose, treat, prevent, and handle lameness in horses

Your Horse Has a Swollen Leg – Why and What To Do | EquiMed – Horse Health Matters

All About the Fetlock

Fetlock Lameness – It’s importance… | The Horse Magazine – Australia’s Leading Equestrian Magazine

Causes of Equine Lameness | EquiMed – Horse Health Matters

 

Common Causes of Lameness in the Fetlock

fetlock lame

 

Equine Podiatry

Medical History


  1. DDFT Lesion on right hind
  2. Cervical Spine Arthritis
  3. Hip discomfort due to past fall

Past Treatments Tried


  1. Stem Cell Injections: Healed the DDFT lesion in right hind until recently the lesion began to reappear
  2. Ozone Therapy: Assists in the healing of tissues
  3. Shock Wave Therapy: Assists in the healing of tissue
  4. Chriopractic adjustments
  5. Acupuncture
  6. Supplements

Initial Consultation


Chance showed decreased movement in his right hip and a audible cracking noise at the suspensory joint.  He has edema of both hind fetlocks, Pastern, and Pastern Dermatitis.  Chance was unshawed on both hinds due to his inability to stand for long periods of time and his decreased mobility.  However, his front adorned clips.

Due to the length of Chance’s front toes and the height of his heels he was unable to evenly distribute his weight (60/40) to his front and hind ends.  This would most likely cause increased tension on the DDFT tendons and corresponding ligaments resulting in an increased likelihood of tendon and ligament related injuries.  The uneven distribution of weight could also inhibit the horse’s range of motion through his hips resulting in his body compensating for this injury and causing ataxia (balance issues), pain, arthritic changes, and cervical spine misalignment.

By shortening the toe of both front feet, the heel will rise allowing a more even distribution of his weight.


Front


IMG_3193

IMG_3196


Final Product: Front


Trimmed feet to corrected to the following specifications:

Foot   Beginning Angle & Toe       Corrected Angles & Toe   Total P.C.

L/F    47 Degrees at  3 7/8 inches   53 Degrees at 3 inches         6 Degrees

R/F    45 Degrees at 3 3/4 inches    54 Degrees at 3 inches         9 Degrees


Hind


20160604_160438


Final Product: Hind


20160609_153622

 Return visit to trim and shoe Chance’s hind feet with #2 OBRHB Wedge shoes.Trimmed hind feet and corrected to the following specifications:

Foot   Beginning Angle & Toe       Corrected Angles & Toe   Total P.C.

L/H   48 Degrees at 3 7/8 inches    54 Degrees at 3 1/4 inches    6 Degrees

R/H  46 Degrees at 4 1/4 inches     55 Degrees at 3 1/4 inches     9 Degrees

Note: Chance needed to be sedated by veterinarian to complete the trim and shoe his hind feet due to preexisting hip and DDFT issues.

Ozone Therapy


OZONE THERAPY – HISTORY, PHYSIOLOGY, INDICATIONS, RESULTS


 Judith M. Shoemaker, DVM 305 Nottingham Road Nottingham, PA 19362

717-529-0526 Fax 717-529-0776

http://www.judithshoemaker.com

Ozone therapy has been utilized and heavily studied for more than a century. Its effects are proven, consistent, safe and without side effects. Why is it not more universal in its use? Many of you have come with some trepidation about infusing a gas into a vessel because you are concerned about emboli, or have some dreadful fear about ozone’s toxicity since we frequently hear about the unhealthy ozone levels in the atmosphere. These fears do not apply to properly administered medical ozone, and the potential benefits of ozone therapy are profound and without associated detrimental effects.

Oxygen, in its several forms, cycles through the atmosphere and life processes just as water does. Ozone is produced in the upper atmosphere when UV light strikes the oxygen rising from plants, plankton, and algae in our forests and seas. It then falls back through the atmosphere, as it is heavier than air, combining with pollutants and water, cleaning the air and forming peroxides that benefit plants. Ultraviolet light breaking down pollutants and nitrous oxides also can produce ozone at the ground level, which is the eye and lung irritant in smog.

Medical ozone, used to disinfect and treat disease, has been around for over 150 years. Used to treat infections, wounds, and multiple diseases, ozone’s effectiveness has been well documented. Ozone has been used to disinfect drinking water since before the turn of the last century. A text on medical ozone therapy was published by Dr. Charles J. Kenworth in 1885! The best technology for producing ozone gas was designed and built by Nikola Tesla in the 1920’s. Heads of leading medical institutions in the U.S. contributed to a 1929 book “Ozone and Its Therapeutic Actions” describing the treatment of 114 diseases using ozone.

In 1933, the AMA began its systematic suppression of all modalities of treatment that did not complement its liaison with the emerging pharmacologic and diagnostic industries. Ozone therapy, along with many other useful therapies, were methodically eliminated from the educational process and exposure to the public in the U.S.

Less suppression has occurred in Europe and other countries, especially in Russia. Today in Germany, and other countries, ozone therapy is commonplace. Over 7000 doctors in Germany use it daily. In fact, in Germany, ozone generators are in ambulances for treatment of stroke victims. The incidence of permanent paralysis in these patients is much less than that in similar patients where ozone is not used.

Ozone generators are relatively simple and inexpensive. The equipment used to handle ozone is readily available but needs to be relatively non-reactive. Glass, Teflon, Kynar, silicon, and gold are completely non-reactive. Equipment made of other substances can contaminate the ozone or just deteriorate rapidly using up the ozone and becoming nonfunctional.

 Generators use several technologies to produce ozone

  • UV lamp – makes small amounts of ozone and is unreliable in making accurate concentrations. They burn out easily.
  • Corona discharge – dual dielectric sealed systems produce ozone but also lots of heat which is both destructive to ozone and to the machine.
  • Cold plasma generators – which produce ozone using low level current passed in 2 tubes of a noble gas between which an electrostatic plasma field forms that ionizes the oxygen.Ozone concentration is measured in u/ml or gms/L of oxygen, 5% or 70 u/ml is usually the maximum concentration used in clinical medical applications. High concentrations will damage red cells and inhibit growth of healthy cells.Dosage and frequency protocols vary widely. Initial high dose treatments may “jumpstart” the immune system followed by lower doses. Those who are fearful have been “starting slow and going low” with dosage and still have good results. Concentration must be carefully controlled with accurate flow rates, requiring pediatric regulators for the needed slow flow rates to produce high concentrations. Therefore, home made machines and lesser quality nonmedical devices are not appropriate.

    Ozone poteniates free radical scavenging substances and systems in the body, inducing the production of superoxide dismutase, catalase, and glutathione peroxidase. If ozone administration causes any respiratory irritation from out-gassing through the lungs, a bolus dose of 1 to 5 grams of vitamin C can be given and will eliminate any coughing instantly.

    Oxygen/ozone mixtures cannot cause emboli when injected at reasonable rates as they dissolve and diffuse very quickly in body fluids, unlike air (predominantly nitrogen) which is what forms emboli and causes the bends or decompression disease.

    The physiologic actions of ozone are many, the simplest of which is to provide sufficient oxygen to allow complete oxidation of sugars and other fuels to produce sufficient and efficient energy and to “burn clean” to CO2, water, and inert end products. If not enough oxygen is available, then incomplete oxidation occurs, producing carbon monoxide, lactic acid, and partially oxidized toxins that inhibit further oxygen metabolism and “clog the system”, tying up hemoglobin, water, and the mechanisms for function and elimination.

    Administration can be through any route with modifications:

  • Direct IV infusion – Ozone slowly administered into a major vessel.
  • Major auto-hemotherapy – Anticoagulated blood is mixed with ozone and is infused into a vessel.
  • Rectal/vaginal insufflation – Humidified ozone is administered by catheter.
  • Minor autohemotherapy – Blood mixed with ozone is injected intramuscularly.
  • Limb or body bagging – Body or parts are bathed in humidified ozone.
  • Ozonated water – Dissolves easily in water to be used topically or consumed.
  • Ozone in Saline or LRS – Can be used topically or given IV or SQ.
  • Intra-articular administration – For joint healing and prolotherapy.
  • Prolo/Sclerotherapy – Very good, less painful than other agents.
  • Acupuncture – With ozone, more effective than B12.
  • Ozonated olive oil – Ozone is bubbled through oil until the oil is thickened. This will produce ozonides that are not irritating and thus is applied topically even to eyes.
  • Inhalation – Ozone that has been bubbled through olive oil and humidified will not irritate respiratory epithelium.
  • Subconjunctival injection – For ulcers and keratitis sicca.
  • Gingival and tooth apex injection – Can eliminate infection.
  • Urinary bladder insufflation – For chronic inflammation.
  • Disc protrusions – Prolotherapy, which can be injected at interspinous space and around facets, stabilize joints and accelerate healing.
  • Auricular – Can be direct, humidified, or bagged with a homemade device made from IV bags and tubing (á la Margo Roman).As an anticancer, antiviral, antibacterial, and ant fungal agent, ozone is unsurpassed, especially since there are no appreciable side effects.Oxygen deficit is key to the development and progression of all disease processes. Dr. Otto Warburg’s work, confirmed by others, shows that this deficit and subsequent toxin buildup is the fundamental cause of all degenerative disease, especially cancers.

    Antioxidants help the body to protect itself from excessive oxidative damage caused by multiple free radicals, many of which are inactivated by ozone. The support of free radical scavenging systems is important but only oxygen can improve the deficit that makes cells vulnerable to oxidative damage in the first place. Long-term ozone therapy can be augmented by supplementation with antioxidants, but normally they should not be administered within 4 to 12 hours of ozone therapies.

    Ozone produces the same effects as exercise, which produces significantly more free radical oxygen than can be administered in any ozone treatment. Ozone equals ”exercise in a syringe” without doing joint damage.

    Ozone potentiates more complete oxidation, helps to maintain more normal body temperature and increases the effects of most hormones, vitamins, herbs, homeopathics, and drugs. Concurrent ozone administration reduces the amount of chemotherapeutic drugs needed to achieve effect by 1⁄4 to 3⁄4. It complements chelation therapies and frequently improves the affect and sense of well being in patients.

    Continued therapy will allow Herring’s Law to manifest “Healing from inside to outside, top to bottom, front to rear, and in reverse chronological order of the insults to the body.” Healing crises, however, may occur. Ozone therapy facilitates the rapid resolution of these crises.

    2005 Judith M. Shoemaker, DVM

Treating Cellulitis in horses

A common and potentially hazardous infection that can be helped with combining antibiotics, cold hosing, and exercise.

Liz Goldsmith's avatarEQUINE Ink

Freedom's left knee was very swollen. You can see the scrape on the outside of the knee.

On Monday night I showed up at the barn around 7:00 p.m. to ride once the day cooled off. To my dismay I found that Freedom’s knee was hugely swollen. I had wrapped his legs because he’d felt a bit stocked up the night before and because the swelling had no where to go except the knee, the effect was horrifying. Visualize a grapefruit.

Almost immediately I saw the cause: a scrape less than an inch long. Before I called the vet I scrubbed the wound to make sure it wasn’t a puncture wound (didn’t look like it to me, but a puncture would where a joint is involved can be very serious). Normally I would also shave the area around the cut but I had sent my clipper blades out to be sharpened!  My guess was cellulitis but since it involved a joint I wanted to makes sure I…

View original post 499 more words

If You Experience Worsening Depression…

Chance began another round of Excede to get his scratches under control- it is a never ending battle.  A while back, I had a skin scrape of Chance’s scratches due to their chronic nature.  The scrape results showed a number of bacteria, all commonly seen with this type of infection, that were resistant to most antibiotics.  Thus why we decided to try Excede.

Administering Excede is pretty straight forward- 1 shot IM every 4 days for about a month.  Easy enough….or so I thought.  The first shot was administered by the vet when I was not present.  The second shot the vet also administered while I was there.  Thirty minutes after the shot was given to Chance I noticed he seemed off but not in his “normal” post-acupuncture relaxed state. He suddenly became lethargic, he wouldn’t eat his dinner, and the gut noises became almost nonexistent. I commented to the vet my concerns and she came over and reexamined him.  Sure enough something was wrong.  She proceeded to administer 10cc of Banamine (just in case it was colic) and told me to walk him around outside for about 20-30 minutes.  Then see if he would eat 2 cups of feed only.  We walked and Chance began to act like his normal happy go lucky self.  Once inside he started to eat!

Part of me felt that his reaction was a fluke.  However, the third dose proved me wrong.  Four days later, Chance received his shot and went outside to enjoy the first beautiful, warm day.  I sat in the field watching him.  He was sluggish, lethargic, stiff..he looked 10 years older and barely moved from one spot under a tree.  He wasn’t eating grass nor did he run around and play- he didn’t even run up to me like he normally would. I decided to bring him inside and give him a warm bath since it was in the high 70’s.  He was non responsive to his bath- no playing with the hose or even accepting peppermints.  I placed a cooler on him to ensure he stayed warm until he was out in the sunshine.  I figured after a bath he would perk up- again, I was wrong.  At dinner time I went to bring him in and typically I will open up the gait and he will canter into his stall- he slowly walked instead. He wouldn’t eat his feed (he normally whinnies and makes a fuss until he gets his feed and devours it) or his hay…I stayed and watched him for a while and he just slept.  I spoke to John, the guy who helps me with Chance and Lucky, and he confirmed that Chance hadn’t been finishing his feed and wasn’t running when he brought him in for dinner.

My concerns grew and I decided to do some research on Excede. That strange thing is I usually do extensive research before changing or administering anything with my animals.  But, for some reason I did not do so this time and I wish I had.

According to a number of reputable websites, Excede can cause significant and dangerous side-effects such as; diarrhea, severe acid reflux, blood coming from mouth, loss of appetite, lethargy, muscle and gait stiffness, and more.

The most troubling of everything that I read wasn’t what was posted on the Pfizer (the manufacturer) website but from the countless statements given by horse owners and the studies done by outside companies.

According to drugs.com, “in the PK study, several horses developed clinical signs consistent with foot pain (stiff in the front limbs when turned in tight circles, and increased pulses and heat to the front feet). One horse in the NAXCEL group and one horse in the 6.0 mg/lb (2X) EXCEDE group were euthanized due to laminitis. Clinical signs of foot pain (stiff front limbs and increased heat and pulses in feet) affected more horses, for a longer period of time, in all EXCEDE-treated groups as compared to the NAXCEL-treated group. The study housing (multi-horse pens on concrete slabs) and diet (free choice alfalfa/grass mix and once a day pellets) may have contributed to the development of foot pain. The prevalence and severity of injection site reactions in EXCEDE-treated horses may also have contributed to the development of a stiff gait. A causal relationship between ceftiofur and foot pain could not be definitively determined.”

The research has revealed that Excede should be used with caution and the horse receiving the medication must be monitored. Make sure to weigh the benefits and risks before starting Excede.  This drug can be lifesaving for many horses but for others, it can be life-threatening.


Excede Resources


Straight from the Horse’s Mouth: Antibiotics, Antifungals, Antivirals

Excede Study

Equine Product Catalog: In depth understanding of equine medications

FINALNewMexicoEIBPetitionExhibits2908-1407_pdf

 

Pain in the Neck

My old guy has always had issues with his cervical spine/neck.  Throughout the years he has developed arthritis which has caused symptoms which mirror EPM such as; ataxia, difficulty bending, hind end weakness, difficulty going up hills, lethargy, difficulty balancing when foot is lifted, muscle atrophy, sore back…you get the picture.

When his symptoms first came on I had the vet test for EPM.  The test was positive.  I did my research and found out that about 50% of horses will test positive for EPM but only 1% show actual impairment from the virus.  I went ahead and completed two rounds of EPM medication therapy and still his symptoms continued.  So, I sought out another vet who practiced eastern and western medicine.

After some chiropractic adjustments and acupuncture she felt that his issues were actually due to the cervical spine and not EPM. The vet also showed me how, when looking at Chance straight on, one of his eyes was lower then the other- a classic sign of cervical and jaw issues. We continued with the chiropractic and acupuncture therapy and have continued for over a year and the change has been remarkable.  Along with these therapies, we upped his feed, added supplements, began stretches and different exercises, and had him walking and running up and down hills whenever he was outside.  The dentist has also been of great help by floating Chance’s teeth every few months instead of once a year.  This helps with the alignment of his teeth because he tends to ware one side of his teeth down more then the other; ultimately straining his jaw and neck.

He has rebuilt the muscle on his hind end, put on around 100 lbs, and is able to do stretches while someone is holding his foot up.  He runs when he is outside and is no longer on pain medications (except on the rare occasion).

Here is some useful information on a horse’s back and cervical spine.

Diagnosing A Horse’s Neck Problems

Main Causes of Ataxia in Horses

Arthritis of the Spine in Horses

Back Stretches

Exercises for Spinal Issues in Horses

CHRONIC PROGRESSIVE LYMPHEDEMA (CPL) due to Scratches

Chance has always been fighting “scratches” on his back legs.  Frustrating, painful, and never seem to completely go away.  Could scratches have caused this?  My thoughts- scratches allowed bacteria to enter the leg, the infection settled on the DDFT sheath and caused the current flare up.  Below is some research I found on possible conditions due to scratches that caused similar symptoms Chance had been experiencing.

CHRONIC PROGRESSIVE LYMPHEDEMA (CPL) due to Scratches

A condition characterized by progressive swelling, hyperkeratosis and fibrosis of distal limbs has been characterized in Shires, Clydesdales and Belgian Draft horses and unfortunately affects numerous horses within these breeds. The disease has also been recognized in Gipsy Vanners; however, only a few horses have been evaluated at this point of time. This chronic progressive disease starts at an early age, progresses throughout the life of the horse and often ends in disfigurement and disability of the legs, which inevitably leads to the horse’s premature death. The pathologic changes and clinical signs closely resemble a condition known in humans as chronic lymphedema or elephantiasis nostras verrucosa. The condition has therefore been referred to as chronic progressive lymphedema (CPL). The lower leg swelling is caused by abnormal functioning of the lymphatic system in the skin, which results in chronic lymphedema (swelling), fibrosis, decreased perfusion, a compromised immune system and subsequent secondary infections of the skin.

The clinical signs of this disease are highly variable. It is often first addressed as a marked and “therapy-resistant” pastern dermatitis (scratches). The earliest lesions, however, are characterized by skin thickening, slight crusting and possible skin folds in the pastern area. While readily palpable, these early lesions are often not appreciated visually as the heavy feathering in these breeds covers these areas. Upon clipping of the lower legs, it becomes obvious that the lesions are far more extensive than expected. Secondary infections develop very easily in these horse’s legs and usually consist of chorioptic mange and/or bacterial infections. Pigmented and non-pigmented skin of the lower legs are affected. Appropriate treatment of the infections (pastern dermatitis) is not successful as underlying poor perfusion, lymphedema and hyperkeratosis in association with the heavy feathering present perfect conditions for repetitive infections with both chorioptic mange as well as bacterial infections. Recurrent infections and inflammation will enhance the lymphedema and hence, the condition becomes more chronic. As a result, the lower leg enlargement becomes permanent and the swelling firm on palpation. More thick skin folds and large, poorly defined, firm nodules develop. The nodules may become quite large and often are described as “golf ball” or even “baseball” in size. Both skin folds and nodules first develop in the back of the pastern area. With progression, they may extend and encircle the entire lower leg. The nodules become a mechanical problem because they interfere with free movement and frequently are injured during exercise. This disease often progresses to include massive secondary infections that produce copious amounts of foul-smelling exudates, generalized illness, debilitation and even death.

TREATMENT/MANAGEMENT

Please keep in mind that none of these treatments listed below will “heal” chronic progressive lymphedema (CPL). However, a rigorous management following our suggestions below will assist you to slow down the process and even make some of the nodular lesions disappear. Your horse will need this management the rest of its life.

• Clipping of the feathers
Long and dense feathering makes management of lymphedema more difficult. We highly recommend clipping the feathers and keep them short, if horses are not presented at shows. If you have a show horse, we still recommend to clip the feathers to initiate a rigorous treatment. As the skin condition improves and the edema is reducing – you may have a better chance to keep the horse’s legs in better condition by. careful repetitive treatment, while the feathering is growing back. The feathers are usually back to their original length in about 10-12 months.

• Treatment of skin infections
Progression of lymphedema is also associated with deposition of fibrous tissue and formation of fibrotic nodules.. As a result, these horses have a poor blood circulation and immune response in the skin of their legs. They tend to built up a thick keratin layer. The long feathering further occludes the skin surface, which then remains humid. These factors provide the perfect culture environment for infectious pathogens. This explains why horses with CPL constantly battle recurrent infections with mites (Chorioptic mange) and bacterial infections (Staphylococcus, Dermatophilus).

Horses with CPL should consistently be treated against reinfestation of mites and bacteria:

Topical treatments:

• Careful washing, cleaning and drying of the legs on a routine basis is essential. Horses with long feathering may require blow-drying of their legs. We recommend using a product manufactured by HydroSurge Inc. ( http://www.hydrosurge.com ) called Apricot Sulfur Skin Treatment Shampoo.

• Frontline spray to treat chorioptic mange (do not use Frontline on pregnant and nursing mares)

• The best and most economical topical treatment is to find a source of wettable sulfur powder (“flowers of sulfur”). This can usually be found through a vineyard supply or at your local nursery (certain “rose dust” preparations). Mix this powder with mineral oil in to form a creamy paste. You can mix a moderate amount in a plastic lidded container or glass jar so that you have enough to last 2-4 weeks at a time. Apply this mixture to the ulcerated and/or affected areas of skin daily. This preparation is the best and most economical topical treatment we have found. You can use it indefinitely. Sulfur is safe to use in pregnant mares.

Systemic antiparasitic treatment: Frequent ivermectine treatment will also assist to keep the mites away.

• Exercise
Regular exercise is crucial. It will increase the circulation and the lymph drainage.

• Manual Lymph-drainage
Manual lymph-drainage is regularly used in humans with lymphedema as long as there is no inflammation present within the tissue. MLD has been successfully used in horses with more acute lymphedema, but has not been established yet in horses with progressed CPL. A massaging coldwater stream may assist a massage. It is important to dry the skin before applying anything else after massage and rinsing. If the feathers were not clipped this may take a long time and you may have to use a hair dryer. Your horse may become more compliant to this treatment as swelling reduces over time

• Bandaging and stockings
We have some limited experience with using special bandages developed for people with lymphedema. For horses, which always move around, “short-stretch” bandages should be used (example: Rosidal ®). Short stretch bandages have been successfully used in three horses with clipped feathering; but bandaging was not as successful on horses with long feathers. Of course it is crucial to have very good padding and keeping the bandages fairly tight. If tolerated, the best results will be achieved by keeping the bandages on 24/7. Of course they need to be redone at least every other day – better every day to control the legs. At first, there will be oozing from the lymphedema through the skin – so the bandages will get wet and have to be changed every day. With the reduction of the edema – this will stop. If the horse is only walked quietly the bandages can be left on for the exercise; very likely the legs have to be rewrapped after the exercise as the swelling will somewhat reduce. For more exercise it may be better to take the bandages off, use working bandages and then switch back to the short–stretch bandages after work. Again make sure the skin is dry when you rewrap.

After the edema has been reduced by using bandages – stockings are used for people to maintain avoid recurrence of lympedema. The use of such stockings in horses are currently under investigation.

It should be noted that horses suffering from CPL often are susceptible to reapeated bouts of “Thrush”. Consequently, thorough and routine foot trimming care is an essential part of the health care management for these horses.

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Research, Research, Research

Tendon Injury Handbook

After I left the barn, I drove home and went straight to my computer.

What was happening?  What are the masses? Scar tissue?  Nothing was able to be extracted out of them…How can I get rid of them in order to see behind them?

Again, I stayed up until the sun came out the next morning.  I already had two binders full of research and now I had a third.

Research made me believe that C has an infection in the Synovial Tendon Sheath that was being masked by the masses on the outer lining of the SS. The masses could be scar tissue from his MANY past Lymphangitis flare-ups. Perhaps, his immune system was not able to fight last attack and the infection settled in the SS and was walled off.  Thus his CBC & WBC were normal and no fluid was extracted from SS masses due to the large size of the scar tissue.
C has a major hx with his RH and “flare-ups” and lameness. I never realized this until I took the time to study his past records from the first 5 years I owned him.

Symptoms are similar to an infection- what if we proceeded as if it were?
Lack of a positive culture does NOT mean that there is not an infection in the sheath!

Current Symptoms:
1. Swelling decreases after being active
2. Fails to extend fetlock
3. Lame- exasperated by flexion
4. Positioning for fetlock flexion

Septic Synovitis: Cartilage degradation ischemia, Fibrin deposition lead to lameness to pannus form and adhesive form

Entrobacteriacaea
Strep
Staph
Most common is Staph

Treatment: 

Systematic Procaine Penicillin 22000 iU/kg or Sodium Benzyl Penicillin & Gentamicin 6.6 mg/kg for 2-9 days

Then change to oral potentiated sulfonamides 5mg.kg Trimethoprim and 25 mg/kg of Sulphadiazine

Other potassium penicillin w/ Amikacin Cectiofur or Enrofloxacin

IV antibiotics for 7-10 days switch to oral for 2 weeks

Regional limb profusion or placement of impregnated Polymethyylmethacralate or PMMA

I immediately called Vet4 and told him my theory.  He said that it was possible and that we should begin treatment asap.  He was still out of town so I called Vet3 to order Baytril. Vet3 felt my theory was legit and immediately ordered the antibiotic!

“Ask him what he wants…you will know what to do from there.”

When I arrived at the farm I was greeted by those familiar big brown eyes and a whinny.

I brought him out of his stall and gave him a bath.  He has always loved to be groomed and bathed, even if he is apprehensive to walk into the wash stall. After his bath, we went outside for him to graze and get some sunshine.  When we walked inside the barn, I stopped him and looked into his eyes and asked him, “do you want to keep trying to get better or are you ready to give up?”  He just looked at me.  A lump immediately formed in my throat.  He nuzzled me and rubbed against me.  I said again, “Do you want to keep fighting?”  He shook his head up and down! I swear to you!  This actually happened!

The decision was made, we would keep on fighting as long as we were able to keep him comfortable.  There was nothing I wanted more than to bring him home with me, let him live out the last days of his life pain-free, and with me by his side.

This was his turn.  He had always done what I asked of him- lessons, moving stables and even cities, and he was patient while I was in school- and it was his turn for me to make it about him.  For Chance to get every ounce of my time and for me to fight for him!

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Road blocks

 

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The first round of injections provided Chance with some relief, in his ability to move around and the swelling went down a bit, but that only lasted about a week.  At about day 8, Chance was swollen again and 3 legged lame.  Thankfully, a family friend of the farms owner called me.  She explained that the farrier was out shoeing one of the horses and saw Chance’s leg, and when he arrived to shoe her horses, he expressed his concern.  I immediately contacted Vet4 an he was out the following day.

Vet4 injected the masses again as a temporary fix, until we could make some decisions.  The ultrasound showed that the masses were the exact same as they were in the first ultrasound- they hadn’t increased or decreased in size.

Later that evening, Vet4 and I had a lengthy conversation about where to go from here.

We discussed the options again, at length.  We could do an MRI to gain more insight into what is happening with that leg, go in with an Arthroscope and clean it out, or look into Stem Cell Therapy.

Well, I wasn’t comfortable putting Chance under anesthesia…he was too old and too frail.  Plus, he could break a leg or a hip going down.  So, that ruled out the MRI (unless I could find a standing one) and the surgery.  The Stem Cells would run about $3000.00, plus he would need to goto the hospital to have the procedure done.

I took the night to think it over, and stayed up until sunrise reading as much as I could on leg issues, the different options vet4 and I had discussed, and other potential causes.

That next morning, I received a call that Chance was worse.  Vet4 was out of town due to an emergency, so I called Vet3.  She got out to the farm immediately.

Vet3 gave Chance Surpass topical to put on the leg, Banamine, Ulcer Guard, and continued with the Prevacox to keep him comfortable.

I asked her what she thought about the options- she felt, as I did, the surgery wasn’t a good idea and that an MRI should only be done without sedation.

I called Vet4 and we spoke about the current situation.  What else is going on? He suggested changing the course and trying different diagnostics.  He explained that TSMs (Tendon Sheath Masses) can cause swelling and pain, but they are usually relieved by the injections.  The ultrasounds showed that his suspensory tendon and ligaments looked good.  Could this be an infection? Soft tissue damage? A bone issue?

I asked him if he felt moving forward with more tests was a bad thing…was I being cruel keeping Chance alive like this?  Something that had been weighing on me from the start.  And what Vet4 said, empowered me to continue down the path I initially felt in my gut to be the right decision.  He said, “I am not the kind of person to ever give up on someone or something.” I asked if we were able to manage his pain adequately and make sure he was comfortable and he said, yes.  He advised me to “make a decision based on the horse” and “not to listen to the opinions of everyone else”.

The next day, I cleared my schedule, and headed to the farm.

 

Coming Home to Love & Peace

Chance was able to come home a week later.  Sam & John went to pick him up at the hospital. However, upon arriving, they soon found out that Chance did not want to get on the trailer.  Sam later told me that one of my sweatshirts was in the truck, so she brought it out and let him smell it- he finally loaded.

I got his stall ready- tons of fresh shavings, hay, a new water bucket…

The moment he got off of the trailer he was shaking!  I gave him a warm bath and let him out in a small, flat paddock so he could be in the sunshine.

This is what happened when I let him out!  He did something he had not been capable of doing for months and months, if not longer.

The Guessing Game

IMG_7563The month passed by slowly….I kept hitting a brick wall over and over again…with each diagnostic test we ran.

Vet2: This was Chance’s vet for many years and where Chance lived the summer I moved home.  Vet1 was used because of connivence and due to being the vet of the owner of the farm.   I called Vet2, desperate, and she came out to see him.  Vet2 had always been amazing with Chance- kind, calm, and seems to act on intuition in conjunction with science.  She ran a CBC, tested for Cushings, Lymes, an did x-rays on the back right leg.

RESULTS:

* Metabolic Syndrome- Cornell

GLUCOSE: 10mg/dl

LIPEMIA: 8mg/dl

HEMOLYSIS: 1mg/dl

ICTERUS: 2mg/dl

*Endocrinology

ACTH endo 21.4 pg/ml

INSULIN 15.22 uIU/ml

THYROXINE T4 baseline 0.77 ug/dl

*Lyme Mitpix- Cornel

OspA Value 1253- Equivocal

OspC Value 79- Negative

OspF Value 592- Negative

Temp: 99.1, HR: 42, RR: 12, No murmur

Received Potomac Rabies and Stanozanol 4ml 7 vit B12

The X-rays of his back right showed nothing that could cause his flare-ups.  While his thyroid was a bit low, it was not clinically significant.  He was negative for Lymes and Cushings.  Next step, aside from pain management, is to call Vet3- the holistic approach.

Horse's Leg

Tendon Injury Handbook

The Call

One day I received a call that I needed to come out and see Chance because he wasn’t doing well and, according to Vet1, he needed to be put down.  I quickly canceled my appointments and got on the road.  The 4 hour drive was excruciating…once we finally arrived, my heart broke.

My old guy was skin and bones.  His back right leg was swollen and he wasn’t able to bare weight on it.  His eyes were dull.  He could barely walk, and when he did, he wouldn’t put any weight on the right hind.  There were even times when he would do this “neurologic dance” (coined by the farm’s owner and C’s other mom) where he would lift up his back right leg and hop!

But when he saw me pull up, he whinnied.  He was excited to see me.  He ate the pureed carrots but refused the apple puree (only my mom would make this for him).  He wasn’t ready to die.



I called the vet who said that Chance should be put down to see what his thoughts were.

Me:   What do you think is going on with C?

Vet1: I think he is ready to be put down. 

Me: Because of what?

Vet1: Lymphangitis

Me: Okay, well, what is the cause of the Lymphangitis? Did you run any diagnostics?

Vet1: No

Me:  I would like to manage his pain and run a few tests before making that decision.  (I reviewed the research that I had done and asked where to go from there.) Could it be EPM?

Vet1: “It’s not EPM”

Me: How about Cushings? Or Laminitis? Lymes?

Vet1: Nope. Just old age.

Me: The journals I read said that some of the symptoms…(I was cut off)

Vet1: “I don’t care what journals you read!  It’s a bunch of…”

Me: One was from VA Tech actually…



Well, that was that! Vet1 did not completely lack compassion but he was more “old school” I guess one could say.  He was well respected in the horse world and up until this point, he did the job I needed. But I will say I was disheartened by our conversation.  

I decided to contact the other vets that I had worked with in the past, who also knew Chance, and get second, third, fourth opinions.  

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