Spotting Lameness: The Game Plan
— Read on horsenetwork.com/2018/10/spotting-lameness-game-plan/
Spotting Lameness: The Game Plan
Spotting Lameness: The Game Plan
— Read on horsenetwork.com/2018/10/spotting-lameness-game-plan/
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;
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
During my horse’s recent Lymphingitis flare-up, the vet advised that we run labs to test for Lyme and EPM due to his presenting symptoms (hind weakness, twisting his back leg at the walk/walking sideways I refer to it as Chance’s swagger). As previously notes, Chance’s Lyme test revealed that he was at the beginning stages of an acute infection…yay Cornell University for their amazing ability to give you more than a positive or negative!
A little history before getting to the EPM Tilter results. About 2ish years ago, Chance was diagnosed with EPM (and one of the reasons opossums and I are not friends since they host the disease as do a few other culprits). Chance immediately began EPM treatment- he received Protazil in his feed for one month. I chose Protazil, although extremely expensive (if you order from http://www.drfosterandsmith.com they sometimes have promotions where you receive store credit for every $100.00 you spend…they did when I ordered and I got a “free” dog bed that my dogs adore) after hours of research due to the less likelihood of Chance experiencing a “Treatment Crisis” (worsening of symptoms) and the ease of administration (other brands require the drug being administered 1 hour before eating or an hour after and so on). Typically EPM treatment is done for 30 days and, depending on residual symptoms, some may require subsequent treatments. While Chance’s symptoms improved, I wanted to ensure that we annihilated the disease and did another round of treatment but this time with Marquis. At the end of two months, Chance’s ataxia was gone!
Fast forward to September 2016…Chance, just having a Lymphingitis flare-up, has been tested for Lyme and EPM. Lyme came back positive. And….so did the EPM test..well, kind of. Wonderful. (See why I loathe opossums?)
Chance’s EPM test #2 on 8/30/16 (the 1st one was 2ish years ago) showed the following:
“Combined SAG 2,3,4 Tilter on serum= 1:2000”
What does this mean? The test revealed that Chance had “positive, specific antibodies” detected in the blood work. This means that he had EXPOSURE to S. Neurona, a causative agent of EPM. Serum tilters range from <1:250 (negative) to >1:4000 (high positive). S. Neurona (SarcoFluor) is one of two protozoa found in EPM infected horses, the other protazoa is N. Hughesil (NeoFluor). S. Neurona is most frequently seen, whereas N. Hughesil is not as common.
The vet ran another EPM test to confirm the findings in the 8/30/16 test. The results showed that Chance had “Combined SAG 2,3,4 Tilter on serum= 1:1000. Again, Chance showed EPM protozoa in the positive-ish range.
I initially had not seen the results but was told by the vet that he was EPM negative. So when I asked for the test results to be emailed to me and saw the numbers I sort of freaked out…I emailed the vet to ask for clarification. She explained,
“The EPM test shows that he was exposed to the organism in the first test we did which is why we did a follow-up test. Since his exposure level dropped from 1:2000 to 1:1000 this shows that he does not have the disease. There is no good one time test for EPM once they are exposed which is why we had to do the repeat to compare the two.”
While this explanation offered me comfort, I was confused…why does he have any protozoa in his blood if he doesn’t have EPM?
I spoke to another vet and she explained it in a bit more detail…I am hoping I am summarizing what she said correctly..
When a horse tests positive for EPM they either have an active disease or they may not. However, when the test does from 1:2000 down to 1:1000 this typically means that the horse’s immune system is working correctly to fight the disease off- active or not. EPM testing typically provides you with a % of the chance your horse has an active EPM infection, or at least if you send it to Cornell University. For instance, lets say a horse gets the results back and it shows that they are “positive” or have been exposed to S. Neurona (one of the two EPM protozoa)…their results are 1:647. This means that, after doing a bunch of adding and multiplying that this vet kindly did for me, the horse has a 60-70% chance of having ACTIVE EPM. Meaning, he most likely would be symptomatic (ie: behavioral changes, ataxia, weight loss, difficulty eating, changes in soundness, and a bunch of other neurological symptoms).
My hunch is that Chance’s immune system was boosted because I started him on Transfer Factor (amazing stuff… more information can be found in some of my older posts) again as soon as his results came back positive for Lyme.
Resources on how to diagnose, treat, prevent, and handle lameness in horses
Common Causes of Lameness in the Fetlock
What type of shoe should I use on Chance’s back feet?
I am looking for something that is glue-on, provides support and comfort, that has good grip, while providing protection for his hoof from the rocky terrain.
After some research, I found GluShus- a company out of England. Their shoes sound fantastic. They have an aluminum shoe set in rubber that glues onto the hoof. Read more about these shoes by clicking the link below.
I’ll let you know how it goes!
Today was not the greatest of days….but I will say that we had the luckiest unlucky day ever! And, of course, it was a full moon tonight which means I should just stay inside.
Today we met with a new farrier. I have been doing some research on shoes that provide comfort, support, and do not mess up Chance’s hooves like nails tend to especially when a horse is on rockier terrain. I spoke with my vet who suggested to, “put shoes on all 4 hooves with a 1 degree wedge pad on both hind shoes. Set all 4 shoes back from the toe of the foot by at least a 1/4th an inch.”
I went to the farm a bit early and gave Chance a bath, some Equinox for pain, and got ready for the farrier. The farrier arrived and Chance was great! He stood on the cross ties and ate hay like a champ. For some reason I decided to lengthen the cross ties. I am not sure why exactly but thank God I did.
My dad and the farrier were with Chance while I went to feed Lucky his dinner. Well, after I fed Luck, I turned the corner and saw that Chance was on the ground! Yes, you read correctly, he was on the freaking ground…all 17.1 hands of him! The moment I saw him our eyes met- I know it sounds like the beginning of a love story- and he immediately took a deep breath and calmed down. I walked up to him and he slowly got up and stood there right in front of me with his head resting under my arm- breathing heavily and he had the beginnings of sweat covering his body.
I stood there and just spoke to him- calmly- telling him he was okay. Once a few minutes had passed, and he was calm, I walked him forward to make sure he was okay. Sure enough, he was fine…aside from some surface scrapes. I cleaned his scrapes up and walked him outside to eat some grass. After about ten minutes, I walked him back into the aisle for the farrier to finish up.
According to both my dad and the farrier, Chance was having his back left shoe nailed in when the nail hit a nerve and he flinched. I guess the farrier didn’t realize this because he hit the nail once more. That was when Chance reacted and went down. Thankfully, the farrier got out of the way & removed the nail midair (so that Chance wouldn’t go down on the foot with the nail and drive it deeper). Think of a splinter going under your nail…and then hitting it again, deeper under your nail….ouch!
However, he landed somewhat gracefully, but due to the cross ties not being break away and the concrete not allowing Chance to gain any “grip” with his newly shod feet, he began to panic. Upon seeing me, he calmed down, and he was able to get back up. I can’t help but thank my lucky stars that I had lengthened the cross ties so that he had some slack, and that I came back inside when I did…had I not, he would have kept flailing. Had I been in there when the nail hit the nerve it may not have happened because I would have said something to the farrier. However, had I been in there when it occurred, things may have also been far worse…since my dog, Sadie, is always right by Chance’s or my side at all times.
We ended up deciding to forgo putting hind shoes on until later (a few weeks) and the farrier removed the one evil hind shoe and trimmed up the other hoof. Chance stood quietly and allowed him to complete his job. I was so impressed with my old guy!
I have emailed my vet to see if she is able to come check on Chance tomorrow just in case…hopefully, Chance will just be a bit sore in the morning and nothing worse….:(
Over the last couple weeks the rain has been unrelenting. And with rain comes scratches (Pastern Dermatitis). In a previous entry I spoke about an amazing treatment for scratches that actually worked…however, when it rains like it has recently, once again the scratches got out of control.
A handful of months ago I got a skin scrape on Chance’s hind legs to determine the bacteria that was causing the scratches. Sure enough there were three types of bacteria growing which was why I was having so much difficulty getting them under control.
Below are the results:
As you can see above, the bacteria shows resistance or no interpretation to all but 7 antibiotics. I spoke to my vet and she suggested beginning with Gentamicin and go from there if he does not respond to the medication. Chance has been receiving an injection of 30 mls of Gentamicin in his muscle once a day for about a week now. He obviously does not enjoy this, nor do I for that matter, but his scratches are showing improvements! He is also on the topical cream, Silver Sulfadiazine, once a day.
Fingers crossed that I will get ahead of the scratches and they will go away forever!
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?
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!
While Chance’s hind-end is still sunken, especially on the right side, he is looking much better than he did almost a year ago. In the last year, he has gained a significant amount of weight (and still needs to keep gaining) and muscle mass. This was achieved by upping his feed to 4 quarts and adding hay stretcher with each meal, along with Chance walking up and down small hills during the day.