When it’s hot outside and you are getting your feet done, it’s imperative to have an ice pack on your head.
Resources on how to diagnose, treat, prevent, and handle lameness in horses
Common Causes of Lameness in the Fetlock
Chance is continuing to gain weight, although as I said in the previous post, he still needs to put on a good 50-75 lbs. As the days continue to get warmer, Chance’s arthritis seems to become more manageable for him; his stride is longer and he runs around (mostly after Lucky) more frequently.
Unfortunately, when the farrier came out about two weeks ago Chance was too stiff to get his back right shoe on. The farrier decided to come back out to try and re-shoe him and, during that time in between, Chance must have tweaked it…AGAIN!
While Chance did not have a shoe on his back right I kept it wrapped to provide some protection and also even out all of his hooves. However, when I arrived I noticed that Chance was significantly twisting his back right leg inward at the walk & it had some swelling. The swelling was not horrible but it was noticeable. I cold hosed his leg for about 45 minutes while I groomed him & gave him a dose of Equinox (pain medication) and Ulcer Guard. I put on his back leg wrap to help with reducing the swelling and provide some extra support. Chance did his neck stretches effortlessly and was baring weight on his back hind.
But as I was grooming him I noticed, on the left side his chest, he had patches of hair loss and dandruff. The area did not look red or inflamed, nor did it seem itchy or painful. So I continued grooming him and decided to put a call into the vet to come and check his leg and the hair loss.
Of course, I turned to Google to try and find out what exactly could be the cause of the patches of hair loss.
According to a handful of sources, there are a few possibilities for hair loss- mites or Lice, a vitamin deficiency, rain rot or crud, or even just his natural shedding tendency. A skin scrape would help to confirm what may be the cause.
As for the swelling of Chance’s back right leg, I decided to call our previous vet who collected and injected Chance’s DDFT with stem cells to heal the hole in his tendon. We have some stem cells left over and I wanted to see if injecting his leg again would be of any benefit. I also would like to get an ultrasound recheck to ensure that there is not another injury to his DDFT tendon sheath again.
The twisting of his back hind leg is worrisome as well.
Everything I have read about EPM states that horses can have a relapse in symptoms after treatment is complete. My concern is that the twisting are due to the neurological symptoms coming back since Chance’s EPM treatment has been finished for a little over two weeks….
Our current vet believes that Chance’s ataxia and twisting is not due to EPM but his cervical spine instead. Could the twisting be worse due to the swelling of his hind leg? Or is the swelling and the twisting two separate issues all together?
We decided to go ahead with the Stem Cell injections through the company Vet-Stem. Though expensive, they carry virtually zero risk, aside from a site infection, in comparison to the surgery.
Vet4 will gather the cells from his rear and stitch up the incisions made. From there, if there are enough cells, the culture will be sent to the lab, and in about two days, they are able to be injected into the leg!
There were enough Stem Cells to inject! Chance is doing extremely well and is able to come home in a few days!!!
I asked if Vet4 could get Chance supportive back shoes before he left and he said he would.
Time to set up a trailer and get his stall ready in Sperryville!!!!
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!
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!
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!
Vet4 came out immediately. I was beyond grateful!
He did an ultrasound of the back right leg and called me. He found that Chance has Chronic Cellulitis and that there was Vascular constriction, and masses on the tendon sheath between the superficial and deep tendon sheaths. The Doppler showed good blood flow and a thickening of the synovial lining. Hoof testers- Negative
We spoke about my opinions- MRI, Arthroscopic surgery, Regional Diffusion, Cold Compression Therapy, Nerve Block Injections, Steroid Injections
We decided to try the Steroid Injections into the 3 Synovial masses to hopefully reduce the size and thickening. Thus allowing us to see behind the masses to see what is actually happening.
Injections were into the Proximal Digital Flexor Tendon Sheath with 6mg Betamethasone and d100mg of Amikacon. Leg was covered with SSD and DMSO and bandaged.
Once injected, cold compression therapy for about 5 days twice a day and stall rest. Banamine daily.