After two rounds of EPM treatments, stem cell injections, acupuncture, chiropractic adjustments, testing, antibiotics, ultrasounds, blood work, adding DuraLactin….Here is a video of Chance yesterday! He has gained a lot of weight back and hopefully, with the addition of the Rice Bran in his feed, he will continue to gain weight!
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!
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
Most common is Staph
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!
The 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.
* Metabolic Syndrome- Cornell
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.
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?
Me: Okay, well, what is the cause of the Lymphangitis? Did you run any diagnostics?
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.