Over the last couple weeks, I have seen moments where C looks like a healthy 8 year old, who can do anything, and other days, he looks like he did when we began treatment for EPM. The entire journey is daunting and heart wrenching…but how can I give up hope when, according to the numerous veterinarians and the countless journals, he is not in pain? And when his eyes light up when he sees me? And when he rolls around in the snow? Or is laying in the sunshine? Or when he gobbles up his food? Or when I see him close his eyes and hear him let out a sign while I groom him? Or hear him whinny? Or run around in the field? I can’t. I won’t. Not after the 15 years he gave me- doing the work, moving with me, being my buddy. I owe him. So, the endless hours of research will continue, as it has with each hurdle over the many months. Fingers crossed.
Tag Archives: hope
Yet Another Obstacle
Chance has been doing great since his Stem Cell treatment. He has not had a single flare up of Lymphangitis since he arrived in Sperryville. He no longer stocks up when he stays inside due to weather. He is gaining weight. AND he has not been on daily pain medication! He is finally happy, healthy, and pain free!
Until one day I noticed that he began twisting his back right leg inward at the walk. I figured that it was due to the long term injury to the DDFT and lack of muscle on that side. I asked Vet4 and he agreed. I called the farrier, who had previously worked on Chance when we arrived in Lynchburg many years prior, and he did a more supportive back shoe. The shoes seemed to help a bit- Chance’s twist was less extreme.
A few weeks later, I realized that I needed to find a local vet due to Vet4 being 2 hours away. I called and Vet5 came out. She watched Chance walk down a small hill and immediately said, “He is a wobbler! We need to test him for EPM.” I tried to justify Chance’s ataxia by suggesting that he was walking down a hill, after a long standing injury, and it was a bit muddy. And, to be perfectly honest, I was a bit peeved! My horse did NOT have EPM! Not after all he had already been through! He was healthy! He just needed some rehab to rebuild the muscle. I was thinking to myself, that EPM was the first condition that I had addressed with Vet1. The very same diagnosis he had shot down. There was no way….
Well, we tested him anyway. I convinced myself that the test would come back negative.
I began to do what I do best- hours of research. The journals and articles I read said, that while 50% of horses have come in contact with contaminated feed, only 1% actually develop symptoms! 1 PERCENT! The Protazia attack the CNS, eventually moving from the spinal cord to the brain. Symptoms can, and will, differ from horse to horse, but usually a horse with the parasite on the spinal cord shows lameness and ataxia on one side of the body (usually hind end). Where as horses whose brain has become infected, show anything from paralysis of the face, to personality changes, choking, difficulty chewing, etc.
A week or so later, I received a call that Chance did have EPM! I was heartbroken! And, honestly, I was angry! Angry at Vet1 for dismissing my initial thoughts about Chance having EPM! I was reassured that he was not in any pain, but in order to ensure his safety, we needed to get him on medication ASAP!
Again, hours of research…looking at the different medications (Protazil, Marquis, etc) and the outcomes and side effects.
I called the vet I trusted with my horse’s life, Vet4, and he walked me through what should be done.
Spoke to Vet4 ie EPM results:
He state there were two choices- Marque and Protazil & typically he sees an improvement with 85% of horses.
Plan:
Day 1: DMSO and Banamine
Day 2: Same
Day 3: Same
Day 4: Begin Protazil with DMSO and Banamine
After reading about my opinions, I was inundated with talk about what is referred to as, “the treatment crisis”. Some horses will begin the medication and, due to the kill off of the parasite, their body reacts with severe inflammation. Some horses will collapse and not be able to get back up, and others will have an increase in their initial EPM related symptoms. This scared me. I did not want Chance to fall and be laying there all alone for hours; I wanted him to be under 24/7 watch.
Vet4 said that If I wanted to trailer him to the hospital, I was looking at around $1500.00 for one month.
~$800.00 (1 month)
~$700 (1 month) board
Typically, the outcome of the medication, when EPM is caught early, is a decrease in 2 grades of Ataxia. Chance was deemed a 3 on the Ataxia Scale.
Stem Cell Injections
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!
UPDATE:
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!!!!
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.
Research, Research, Research
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!
Road blocks
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.








