Tag Archives: Banamine

What’s In Your Tack Trunk?

Equine First Aid Kit
All horse owners should have an equine first aid kit & know how to use all of the supplies. At least twice yearly, examine & replenish outdated supplies. Store your first aid kit in your home or temperature controlled space. Leaving it in a trailer or uninsulated tack room will quickly degrade the supplies. Talk to your veterinarian about customizing your first-aid kit for your horse’s particular needs.

FUNDAMENTALS
Thermometer, Mercury or Digital
Stethoscope (good quality)
Headlight (good quality)
Proper Fitting Halter & Lead Rope
Latex Gloves (12)
Watch or Timepiece with Second Hand
BASIC EQUIPMENT
Bandage Scissors
Suture Scissors
Tweezers or Forceps (smooth jaws)
Non-Sterile Gauze – 4″x4″ Squares (1 package)
Conform® or Kling® Gauze 4″ (2 rolls)
Elastic Adhesive Bandage (Elasticon®) 3″ (2 rolls)
Cohesive Bandage (Vetrap®) 4″ (2 rolls)
Non-Adhesive Wound Dressing (Telfa® pads) 3″x4″ (2) & 3″x8″ (2)
Povidone Iodine (Betadine®) Solution (4 oz)
Antiseptic Scrub, Chlorhexidine or Povidone Iodine (Betadine®) Scrub (4 oz)
Sugardine
Small Plastic Containers for Mixing or Storage (2)
Wound Lavage or Cleaning Bottle, Saline (250 ml)
Tongue Depressors (6)
Alcohol Wipes (10)
Spray Bottle for Water (1)
Paper Towels (1 roll)
Multi-Purpose Tool, Leatherman® or Equivalent
Cotton Lead Rope (3/4″ – 1″ in diameter)
Electrolytes (paste or powder)
Fly Repellent Ointment (1)
Heavy Plastic Bags (2 – gallon & 2 – pint size)

SECONDARY EQUIPMENT
Cotton, Rolled Sheets, Leg Cottons (2)
Standing Wrap & Quilt or Shipping Boots
Easy Boot or Equivalent in Appropriate Size
Baby Diapers (2) (size 4 to 6 depending on hoof size)
Triple Antibiotic Ointment (1 tube)
Extra Halter & Lead Rope
Lariat
Syringe 35 cc (1)
Syringe 12cc (3)
Syringe 3 cc (3)
Syringe 3cc with 20gauge needle (3)
Syringe – 60 cc cath tip (2)
Needles – 18gauge – x 1.5″ (4)
Needles – 20 gauge – x1.5″ (4)
Eye Wash, Saline (1 bottle)
Opthalmic Ointment or Drops (1 bottle or tube)
Magnesium Sulfate, Epsom Salts (1 package)
Duct Tape (1 roll)
Clippers with #40 Blade (good quality)
Shoe Puller
Crease Nail Puller
Hoof Pick
Hoof Knife
Hoof File, Rasp
Clinch Cutters
Farrier’s Driving Hammer
Collapsible Water Bucket
Ice Wraps
Twitch
Bute Banamine Bordered

Talk to your veterinarian about dispensing a few medicines that you may use in an emergency. In most, if not all states, a veterinarian cannot legally dispense prescription items without a valid Veterinary Client Patient Relationship (VCPR). 

• Flunixin Meglumine (Banamine®) (injectable or paste)
• Phenylbutazone, Bute Paste (1)
• Trimethoprim-Sulfa Tablets SMZ-TMP in small container (75#)

What a Difference 3 Weeks Can Make

Tilly came to me from a slaughter auction in Texas after 17-ish years as an Amish workhorse.  She was thin (she still is), sick (upper respiratory infection) had cracked hooves, had never had her teeth floated (they made a horrible grinding and clicking sound when she ate), and apparently had never been clipped or bathed or worn a blanket.  I do not think she had ever even had a treat (she still won’t take an apple or carrot).  

SYMPTOMS:

  • Rumbling gut
  • Cow pie stools
  • Grinding/clicking teeth
  • Cracked hooves
  • Dull coat
  • Underweight
  • Running nose

PROFESSIONALS:

  • Farrier for evaluation and trimming
  • Dentist for power float of teeth
  • Vet for physical, blood work, and fecal

TESTING/RESULTS:

  • CBC: all in normal range aside from her creatinine and protein suggesting dehydration. These values normalized after about 1 week)
  • Fecal: Minimal

FEED:

  • Triple Crown Senior Feed (Low sugars, low starch, high fat)
  • Tons of water with Horse Quencher added
  • Salt block

MEDICATIONS:

  • Exceed injections (2 total a week apart) then SMZ for 2 weeks
  • Banamine
  • Brewer’s Yeast (Stomach)
  • BioSponge (Gut health and to tackle her loose stools)
  • Electrolytes (To help with dehydration)
  • Strongid wormer 

 

 

Top to bottom:

Tilly on her way from Texas

Tilly when she first arrived in Virginia

Her feet upon arrival

Getting her teeth and feet done

Tilly after being clipped and bathed!

“& I Will Know Your Name..”

I take naming seriously. Maybe too seriously. I feel like a name should mean something, stand for something, and ultimately, it should “fit” the person or animal or farm.

My new 17 year old Belgian Draft mare was rescued from slaughter after being an Amish workhorse for her entire life. She came off the trailer after traveling from Texas to Virginia, skin and bones. She had a dull coat, hip bones high, cracked hooves, a very runny nose, but her eyes were warm. This sweet girl had never had a moment of TLC and was noticeably sick. I walked her to her new temporary quarantine home. She was alert but considerably calm but weary none the less. The vet came out and gave her a physical. Her legs were in good shape as were her feet despite the cracking. She did not have a fever but did have congestion in her chest and her teeth were all sharp points. She had a worn down mark across her nose from what looked to be a harness and her tail had been lopped off, bone and all.

We began an round of Exceed and Banamine and let her rest. She drank gallons of water and as she ate her “draft safe” diet (low sugar, low starch and high fat) I could hear her teeth grinding and knocking against each other; it was painful to watch (and hear). I left for the evening to allow her to settle in. The following day I brought her a fly sheet (bright pink :)). I groomed her and she began to fall asleep. I put ointment on her raw nose, and sprayed her with fly spray. As I went to put on her flysheet, her skepticism was evident. I could tell she had never worn a blanket, or maybe she was skeptical of the color… but she allowed me to put the sheet over her skinny body. As I finished for the evening and said goodbye, she looked at me, straight in my eyes, and I could see that she knew the rest of her days would be carefree.

I took about a week to get to know her and think long and hard about what to call her. I thought about the small details I knew about her past… 17 years as an Amish workhorse. They shipped her off to a slaughter auction after her years of service. She was worn and ragged but still strong and relatively healthy.

I decided on the name Ottilie meaning strength in battle. Numerological, the Soul urge number is 11 which states that people with this number have a deep inner desire to inspire others in a higher cause. The name’s Expressive number is 9 and states that those with this name tend to be compassionate, intuitive and highly sensitive, but also have magnetic personalities and serve humanity. How fitting, her strength during her battle (workhorse to slaughter auction) lead her to me…still strong and able but worn and haggard. The other reason I chose the name Ottilie was due to my late aunt, MaryJane. Maryjane passed in the late 1990’s tragically. She loved animals and was the reason I began my journey with horses as a child. She had a dog named, Tilly, which is the perfect nickname from Ottilie.

So, I introduce, Ottilie “Tillie”, the 17 year old Belgian draft mare who has found her forever home.

Immune Booster Leads to Infection?

For the past 6 weeks, my horse has been receiving Ozonetherapy to aid in his chronic back leg related issues- dermatitis (“scratches”), previous DDFT tendon laceration, a history of Lymphingitis, and the residual scar tissue from his DDFT injury.  Due to his age (27), he lacks proper circulation in his hind end which does not help him fight his pastern dermatitis.  


According to the American Academy of Ozonetherapy, Ozonetherapy is described as;

“Ozonotherapy is the use of medical grade ozone, a highly reactive form of pure oxygen, to create a curative response in the body. The body has the potential to renew and regenerate itself. When it becomes sick it is because this potential has been blocked. The reactive properties of ozone stimulate the body to remove many of these impediments thus allowing the body to do what it does best – heal itself.”

“Ozonotherapy has been and continues to be used in European clinics and hospitals for over fifty years. It was even used here in the United States in a limited capacity in the early part of the 20th century. There are professional medical ozonotherapy societies in over ten countries worldwide. Recently, the International Scientific Committee on Ozonotherapy (ISCO3) was formed to help establish standardized scientific principles for ozonotherapy. The president of the AAO, Frank Shallenberger, MD is a founding member of the ISCO3.”

“Ozonotherapy was introduced into the United States in the early 80’s, and has been increasingly used in recent decades. It has been found useful in various diseases;

  • It activates the immune system in infectious diseases.
  • It improves the cellular utilization of oxygen that reduces ischemia in cardiovascular diseases, and in many of the infirmities of aging.
  • It causes the release of growth factors that stimulate damaged joints and degenerative discs to regenerate.
  • It can dramatically reduce or even eliminate many cases of chronic pain through its action on pain receptors.
  • Published papers have demonstrated its healing effects on interstitial cystitis, chronic hepatitis, herpes infections, dental infections, diabetes, and macular degeneration.”

 

After doing research and speaking to one of my good friends, we determined that Chance’s flare up of Lymphingitis, after almost 3 years of not a single issue, could possibly be caused by his immune system’s response to Ozonetherapy.  Let me explain.

Chance suffers from persistent Pastern dermatitis (“scratches”) since I purchased him in 2000.  I have tried everything- antibiotics, every cream and ointment and spray for scratches, diaper rash ointment, iodine and vaseline mix, Swat, laser treatments, scrubs and shampoos, shaving the area, wrapping the area, light therapy…you name it, I have tried it.  So, when we began Ozonetherapy to help break down the left over scar tissue from his old DDFT injury, I noticed that his scratches were drying up and falling off.  We continued administering the Ozonetherapy once a week for about 6 weeks.  The improvement was dramatic!  

However, one day Chance woke up with severe swelling in his left hind leg and obviously, he had difficulty walking.  He received Prevacox and was stall bound for 24 hours.  The vet was called and she arranged to come out the following day.  The next morning, Chance’s left leg was still huge and he was having trouble putting weight on it.  I did the typical leg treatments- icing, wrapping.  The swelling remained.  I tried to get him out of his stall to cold hose his leg and give him a bath but he would not budge.  He was sweaty and breathing heavily and intermittently shivering.  So, I gave him an alcohol and water sponge bath and continued to ice his back legs.   I sat with him for 4 hours waiting for the vet to arrive.  He had a fever and wasn’t interested in eating and his gut sounds were not as audible.  He was drinking, going to the bathroom, and engaging with me.  I debated giving him Banamine but did not want it to mask anything when the vet did arrive.  

The vet arrived, gave him a shot of Banamine and an antihistamine and confirmed that Chance had a fever of 102 degrees and had Lymphingitis.  There was no visible abrasion, puncture, or lump… I asked the vet to do x-rays to ensure that he did not have a break in his leg.  The x-rays confirmed that there was no break.  The vet suggested a regiment of antibiotics, steroids (I really am against using steroids due to the short-term and long-term side effects but in this case, I would try anything to make sure he was comfortable) , prevacox, and a antacid to protect Chance from stomach related issues from the medications.  It was also advised to continue to cold hose or ice and keep his legs wrapped and Chance stall bound.  

The following day, Chance’s legs were still swollen but his fever had broken.  The vet called to say that the CBC had come back and that his WBC was about 14,00o. She suggested that we stop the steroids and do the antibiotic 2x a day and add in Banamine. I asked her if she could order Baytril (a strong antibiotic that Chance has responded well to in the past) just in case.  And that is what we did.  

Being as Chance had such a strong reaction to whatever it was, I did some thinking, discussing, and researching…first and foremost, why did Chance have such an extreme flare up of Lymphingitis when he was the healthiest he has ever been?  And especially since he had not had a flare up in 3+ years…plus, his scratches were getting better not worse.  The Ozonetherapy boosted his immune system and should provide him with a stronger defense against bacteria, virus’, etc.  So why exactly was he having a flare up?  And that is when it hit me!

In the past when Chance began his regiment of Transfer Factor (an all natural immune booster), he broke out in hives.  The vet had come out and she felt it was due to the Transfer Factor causing his immune system to become “too strong” and so it began fighting without there being anything to fight, thus the hives.  My theory- Chance started the Ozonetherapy and his body began to fight off the scratches by boosting his immune system.  As the treatments continued, his immune system began to attack the scratches tenfold.  This resulted in his Lymphatic system to respond, his WBC to increase, and his body temperature to spike.  Makes sense…but what can I do to ensure this is not going to happen again?  

My friend suggested attacking the antibiotic resistant bacteria by out smarting them…okay, that seems simple enough…we researched the optimal enviroments for the 3 types of bacteria present where Chance’s scratches are (shown in the results of a past skin scape test).  The bacteria – E. Coli, pseudomonas aeruginosa and providencia Rettgeri. The literature stated that PA was commonly found in individuals with diabetes…diabetes…SUGAR!  How much sugar was in Chance’s feed?  I looked and Nutrina Safe Choice Senior feed is low in sugar…so that is not it.  What else can we find out?  The optimal temperature for all three bacteria is around 37 degrees celsius (or 98.6 degrees fahrenheit), with a pH of 7.0, and a wet environment. Okay, so, a pH of 7.0 is a neutral.  Which means if the external enviroment (the hind legs)pH is thrown off, either to an acidic or alkaline pH, the bacteria will not have the optimal enviroment to continue growing and multiplying.  How can I change the pH?  

Vinegar!  An antimicrobial and a 5% acetic acid! And…vinegar is shown to help kill mycobacteria such as drug-resistant tuberculosis and an effective way to clean produce; it is considered the fastest, safest, and more effective than the use of antibacterial soap.  Legend even says that in France during the Black Plague, four thieves were able to rob the homes of those sick with the plague and not become infected.  They were said to have purchased a potion made of garlic soaked in vinegar which protected them.  Variants of the recipe, now called “Four Thieves Vinegar” has continued to be passed down and used for hundreds of years (Hunter, R., 1894).

I went to the store, purchased distilled vinegar and a spray bottle and headed to the farm.  I cleaned his scratches and sprayed the infected areas with vinegar.  I am excited to see whether our hypothesis is correct or not…I will keep you posted!

 


References & Information


Effect of pH on Drug Resistent Bacteriaijs-43-1-174

NIH: Drug Resistant Bacteria

Vinegar

Lymphatic Conditions

Horses Side Vet Guide

What does my horse’s CBC mean?

th

Nutrena SC Senior feed ingredience
The American Academy of Ozonetherapy

Hunter, Robert (1894). The Encyclopaedic Dictionary. Toronto: T.J. Ford. ISBN 0-665-85186-3.

 

Fall Fever

Today Chance had swelling of his back right fetlock.  He had a fever around 104 and didn’t eat his feed.  His eyes were dull and he was lethargic.  He wasn’t limping but was walking slower than normal (he usually runs to the paddock or back to the barn).  I decided, due to the Lymphingitis flare up on his back right leg, I would give him a shot of 5 mls (or 5 cc) of Banamine and wrap his leg.  Once the medication set in, I would bring him in to give him a bath (it was 80 degrees today).  So, that is what I did.  By the time he was back at the barn he was covered in sweat.  I cold hosed him and drenched the wrap in cool water and let him roam around the barn.

Thankfully, the vet was able to meet me at her veterinary practice so that I could pick up Baytril and more Banamine.  Since Chance just had Lyme Disease (and had finished his medication less than a week ago), we are not 100% if this is a Lyme reaction or something else.  The plan is to administer 25 cc of Baytril either orally, in his feed, or via IV for 6 days and Banamine 10 mls (or a 1000 lbs) twice a day for 3 days. The vet suggested that I do 5 cc of Banamine if his fever remains between 101-103 degrees and 10 cc if his fever is 103 degrees or above.   During this time I will begin Prevacox- one 1/4 of a tablet once a day.  After 3 days, I will discontinue the Banamine and continue the Prevacox.  If his fevers are not down in two days, I will continue the Baytril but start the doxycycline as it maybe a Lyme disease symptom.

While researching Lyme Disease, I found that many people do two+ months of doxycycline instead of 30 days to ensure the disease has been erraticated completely.  However, since Chance had shown such improvement after 30 days, I decided to not do another month.  Maybe I should have…

However, Chance had similar symptoms when we found a small laceration in the DDFT tendon of his back left hind- swelling, Lymphingitis, fever, lethargy, no appetite, etc.  If he does have an issue with his tendon I will most likely do another round of Stem Cell treatments which proved to be helpful last time.  Thankfully I stored his stem cells in a Stem Cell Bank (via Vet-Stem) and can easily have them shipped.

 

“Let Me Clear My Throat..”

My poor guy was eating the other night and began to choke.  Scary doesn’t even begin to cover it.  I immediately removed his feed and began to rub his neck to feel for any lumps (feed stuck in his esophagus).  I administered 10cc of Banamine into his butt cheek, which helps the horse’s muscles to relax, thus allowing the food to move through.  I called my vet who said to call her back in 20 min (once the Banamine had time to take effect) if I felt that he was still having issues.  Well, me being the overprotective person I am, I called and asked her to come out to check on Chance and make sure he was okay. The vet came out and flushed his mouth twice with water and said that she felt that he was okay and had passed whatever feed had been stuck.  Thank God!

(Below is a picture of Chance drugged up and waiting for the vet).

IMG_1545


Resources on Choke


How To Tell If Your Horse Is Choking and How You Can Help

When Horses Choke

 

Other EPM Therapies

The below research was found athttp://www.epmhorse.org/Treatment/Other_Therapy.htm

Veterinarians should discuss other drug therapies, in addition to the protozoa killing drugs, to address symptomatic problems that may occur during treatment.  Limiting inflammation of the cerebrospinal column, stimulating the immune system, and anti-oxidants are three things that the owner should be prepared to handle during treatment.  If the veterinarian does not discuss these, ask about them.

Inflammation

An active S. neurona infection in the central nervous system (CNS) will produce both temporary inflammation and permanent nerve damage. The inflammation can get worse when the protozoa start to die during treatment.  This can happen as the treatment drug level builds in the CNS, and is known as a ‘treatment crisis’.  Watch for symptoms to get worse 7 to 14 days after the start of treatment drugs.

Inflammation by itself can cause permanent nerve damage, so treating it is important.  Veterinarians report that horses with higher neurologic deficiencies, and possibly higher levels of protozoa, tend to get treatment crises more often that horses with a Mayhew score of 1.  Some veterinarians will place a horse on anti-inflammatory drugs immediately, to prevent additional damage to the CNS.

Banamine   Many owners already have the non-steroidal anti-inflammatory drug (NSAID) Banamine at the barn.  Even if your horse is a 1 on the Mayhew scale, you may wish to have Banamine on-hand to deal with any worsening of the symptoms. Banamine can cause gastro-intestinal side effects such as ulcers when given in high doses, or longer than five days.  A January 2009 cost was $35 for 5 doses.

MicroLactin   This supplement is gaining recognition as an overall, mild anti-inflammatory.  This non-prescription supplement is a derivative of cows milk, and is known as Duralactin, or the ingredient ComfortX in Equinyl.  MicroLactin does not have side effects, so it can be used over the entire course of treatment.  It is possible to supplement with Banamine during a treatment crisis.  March 2009 price was $50 per month.

Dexamethazone   (Dex) This steroid suppresses the immune system, so it should not be used as an anti-inflammatory for EPM horses except in an extreme neurological case.  Used longer than 5 days, it can cause Laminitis.

DMSO   Dimethyl sulfoxide given intravenously, can be useful when the horse has extreme neurological symptoms.  The veterinarian should administer this drug, it should only be used for short time periods, and it can interact with other drugs.

Immune System

In many regions of the U.S. more than 50% of the horses have been exposed to EPM. Researchers do not know why less than 2% of them get an active infection in the CNS.  Studies on blood of EPM horses indicate a change in the immune system response and cells.  Relapse rates for EPM are high, often with the same symptoms. Some researchers believe that the relapses are latent infections which were never completely killed, and the immune system does not recognize.  Immune system stimulants have been suggested to help the horse fight the infection.

Levasimole   This drug has been used as part of a wormer, and anti-inflammatory.  It is known to increase immune response.  It has not been clinically tested specifically for use with EPM, but is being used for it.

Transfer Factor    This supplement has been around since the 1940’s for human use. The older studies on humans suggest it increases the cell-mediated immune response.  It has not been clinically tested in horses.  The supplement is suggested to increase the cell-mediated immune response (see research below).  It WILL NOT kill the protozoa; it is only an immune booster.  It is made from cow colostrum, eggs, and mushrooms.  At least two companies produce this for equine use, and while the main ingredients are the same, there are differences.  4 Life Research and Nutrition Horizons USA offer this at March 2009 prices of $150 to $200 per month.

Vitamin E

Vitamin E has been shown to relieve inflammation, promote regeneration of nerve cells, and is an anti-oxidant protecting the CNS.  This vitamin is suggested by many veterinarians for supplementation during and after drug treatment for EPM.  It crosses the blood-brain barrier to work in the CNS.  A deficiency in Vitamin E is thought to impair the blood-brain barrier.  It is suggested at therapeutic rates from 5,000 to 10,000 total IU per day.  Add the total Vitamin E content of all supplements and feed to reach the target rate.  Research has shown that natural source vitamin E (D-alpha tocopherol) is absorbed by the body better than manufactured E (DL-alpha-tocopherol).

Recent Research

A 2006 study published in Veterinary Parasitology indicated: “Our results demonstrated that naturally infected horses had significantly (P < 0.05) higher percentages of CD4 T-lymphocytes and neutrophils (PMN) in separated peripheral blood leukocytes than clinically normal horses.  The product MicroLactin has been shown to limit neutrophil activity thereby reducing the inflammation process in the CNS.  The study goes on to say, “Leukocytes from naturally infected EPM horses had significantly lower proliferation responses, as measured by thymidine incorporation, to a non-antigen specific mitogen than did clinically normal horses (P < 0.05).  Cell-mediated immunity is lowered in EPM positive horses.

An ongoing study by Dr. Bello, Journal of Equine Veterinary Science, vol. 28, issue 8 (2008), uses Marquis, MicroLactin, and transfer factor in a protocol.  The initial study involved 28 horses, and 8 more have been studied.  This study was presented at the AVMA conference in 2007, and was published in 2008. The full text article is available below with permission from Dr. Bello.

Continuing research by others indicates controlling inflammation is a large part of the treatment process, and immune system stimulation is critical to avoiding relapses.

January 2012

References:

Veterinary Parasitology 138 (2006) 200–210

J Appl Res Vet Med 2003;1:272-8.

J Eq Vet Sc, vol. 28, issue 8 (2008) 479-482
An Intensive Approach in the Treatment of Clinical Equine Protozoal Myeloencephalitis 

Am J Vet Research, June 2008  Vitamin E

J Eq Vet Sc, vol. 25, issue 9 (2005) 380-382

TheHorse.com articles # 12025, 4829

DDFT Lesions

Text from Vet4 after ultra sound #3:

“I can see that he has a deep digital flexor tendon lesion and the medial side of the tendon sheath has improve but lateral side is about the same. The DDFT may the cause of all this in the first place and everything else is secondary. We will re ultrasound in 10 days or so just to confirm my findings. If they are correct, it would help to treat that area.”

Conversation with Vet4 :
So far, Chance has received; shock wave therapy, compression therapy and laser therapy.

Chance has a hole in his tendon. Vet4 believes that this is due to an infection/bowed tendon and severe lameness. The ultrasound, done yesterday, shows no change in size of the tendon hole after the previous two rounds of injections.

“Lymphangitis is a symptom rather than a cause and the cause was never treated.” Vet1 continued to treat it like a disorder rather than a symptom!

The swelling and infection have dissipated, as has the severity of the lameness. Though still lame, he is running around in the pasture.
Pain meds were started again due to increased discomfort and soreness.

Vet4 suggests doing one of the following:

1. Stem cell- which can take about two days if sample drawn has enough stem cells. If not, it could take about 4-6 wks to culture. Once injected he can move home. He is to be hand walked for a few days and then can go out as normal. Vet4 will come out in about a month to do another ultrasound and, depending on the size of the hole, may need to do further injections.

2. Surgery to clean out but NOT repair the tendon. This was not discussed in detail.
Payment plans may be an option. I emailed the office for payment options.

Time to make another decision!

100% Turn Around!

Spoke with Vet4 today. He said Chance has made a “100% turn around”. He trotted him today and Chance was putting full weight on both hind feet! Swelling is disappearing as well!

We spoke about further treatments aside from the Baytril.

I asked about potassium penicillin- He is apprehensive to do potassium penicillin due to horses on antibiotics having DNA changing effects. That it is best to stick to the Baytril and do an ultrasound tomorrow (Friday) to view any changes to the masses. He suggests to have Baytril on hand when Chance leaves to begin immediately if swelling occurs again, which he believes will not be the case after this hospitalization.

I asked about Hydraulic acid: He also is hesitant to inject the SS with the Hydraulic acid due to it’s effects on certain bacterial strains- often allowing the bacteria to hide from the antibiotics. He does agree that another round of injections would probably be helpful and will know more after the next ultrasound.

When asked whether scratches can lead to Lymphangitis, thus leading to the infected SS, he said it is hard to tell but certainly possible.

Chance is currently receiving laser therapy and cold compression therapy along with Baytril, pain meds, and supplements.

Vet4 believes that Chance should be able to leave within a week to two weeks depending on progress!

Going, Going…..

GONE!

Chance’s fever is still at bay, the swelling is almost gone, he is sound, eating, and the light has come back into his eyes!!!

I quickly tried to set up a trailer to haul Chance to the hospital where he would begin further diagnostics and treatments.  I would have taken him soon if I felt that he was stable enough to withstand the haul.  But he was too unsteady until now!

It took a few days, there was a trailer and someone to haul him (thanks to Vet3) and we had him on his way to the hospital!  I was there waiting for him to arrive.

IMG_1842

Waiting Games

We began Baytril on 8/16.  The next day Chance came in from pasture with NO fever, NO trouble walking, but also NO appetite- eating a little grain, hay stretcher, peppermints and the swelling worse.

Chance got Compounded Baytril- 2 scoops with feed previous pm. Vet3 advised us to give another dose of Baytril but Chance won’t eat (most likely due to the taste of the Baytril in feed previous night. But Vet3 believes it is due to his pain). So, we gave another dose of Banamine/10 cc (am and pm) and Tridex- 1 packet. Iced 2x/kept in/ wrapped both hind legs with boots.  And the waiting game begins!

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!

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.

 

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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