Saying goodbye to Max. 1993-2015

It's never easy to say goodbye.  6 weeks ago when the vet first saw max and his xrays showed some rotation in all 4 hooves, she told me that sometimes they seem to get better for a while and then make a turn for the worse, and that with all 4 hooves affected, it was pretty dire, but the rotation was not horrible yet.  "Mama, I don't want the vet to put my horse down!" Said my wonderful 9yo daughter immediately as she heard us talking.  Max was 22.  His previous owner moved overseas and could not take him with her, and he had been a faithful dressage and trail partner for the last 16 years for her.  We were so blessed to have him here, even if it was only for just over a year.  

He was the perfect beginner horse, and would take care of any rider at the walk and trot.  Besides my daughter, we had friends, cousins, grandparents, aunts and uncles enjoy rides on him.  He was a total goofball when we took him to a local arena, but calmed down and worked through it with me.  He knew if I was riding that I would make him work.  He much preferred his sweet girl, and showed it in his expression of pure joy every time he saw her.  His ears would prick forward and his eyes would light up at her knowing she probably had treats in her hands.  

The onset of laminitis was rather sudden and he was very lame.  If you watch this video, when the vet first came to see him, he had the stance of a "severe sinker," although I didn't know that then.  To get the x-rays, we had to block all 4 feet so that he could stand comfortably on the cement, and then after we saw the rotation, we decided to take him to the vet hospital while he was still blocked so he could be seen daily for DMSO for 3 days and be in a sand stall for a while.  I don't know if I would do it that way again, but it is the decision we made.  Dropping him off was an emotional nightmare.  They had to temporarily put him in a stall with no windows - it was a sand stall, and he was only there for 40 minutes, but I really didn't want to leave him in that situation at all. Thankfully the kids were still in the truck and didn't need to have that information.  I was clear that I would rather take him home than have him where he couldn't see other horses, and was assured that he would be moved into the other sand stall very soon.  I was also in a bit of an emotional spot not knowing whether Max would make it home.  On our way out, I had to drive the trailer back behind the clinic near a manure pile, and ended up sinking the dually up to its rims in the muddy shavings.  A tractor pulled us out, but it was still stressful.  

5 days later, he did make it home.  He was still lame, but much more comfortable and was standing squarely. Over the next few weeks he seemed to get a little more comfortable, a little quicker in his stall to come visit you at the door.  He would go out in his paddock and scratch withers with Charlie over the fence.  But last week I noticed him seeming a little more sore, so I made an appointment for the vet to come out to do x-rays to see where we were.   I had been waiting to see that typical founder ring at the top of his hoof, and it was finally growing.  The line was so deep I worried that the hoof wall might come off.  A few days later I noticed that at the top of the coronary band, it felt strange - like the hoof had slid up on his pastern slightly - or rather, his coffin bone had sunk.  I hoped I was wrong.  For the rest of the week he got progressively lamer each day.  First I noticed his RF seemed more sore, then his rear feet one at a time. 

The day before the vet appointment, my daughter and I had a long talk in the barn about Max.  We stood in his doorway and just watched him, and then we sat down on a hay bale and kept watching and thinking and talking and snuggling.  We left his stall door open... his feet hurt too much to try and take advantage of it, at least not at first.  He did not want to put weight on his LH. We talked about all of the horses that I have helped cross over to the rainbow bridge and why we made that choice.  We talked about rotation vs. sinking.  I told her I didn't know for sure what the x-rays would show, but that how sore he was was not okay, and we have to put the welfare of the horse above our feelings.  We talked about how horses in the wild that were very lame would not survive long.  And we talked about the process of euthanasia, and that the vet always gives them a sedative before injecting an overdose of a barbiturate.

The day of the appointment I researched and hoped for some sort of way we could help him further.  I didn't find anything that you could do once the coffin bone hand sunk down.  And then my daily email from The Horse arrived and the top story was about how humane euthanasia actually was...  I went out to the barn to groom Max mid-day and he was laying down.  I went in his stall and pet him and sat down and waited, hoping he would get up soon on his own.  I have walked into the barn when he has been laying down many times and this was the first time he didn't jump up to see what was going on.  He lay there for the next 3 hours, and thankfully he did get up.  I knew just by watching him that it was time.  

The vet finally arrived and my daughter and I met her out at the barn.  She rubbed her hands over his hooves one by one and said that without even x-raying him she could tell he had already sunk and that, "I think you should put him down."  As much as I knew it was coming and thought I was prepared, the tears started falling down my cheeks.  It was hard to talk.  My daughter looked up at me with worry but strength.  We asked the vet if she had ever seen a horse rehabbed from sinking in all 4 and she shook her head sadly.  She said that if it is just one hoof you could cast it and let a new hoof grow over the next year, but with all 4 the horse had no way of being comfortable on any of his hooves.  We had talked about it and I knew my daughter didn't want to be there for the actual process, but this was her horse, and she wanted to be the one to take him to his resting spot.  I told her she could feed him as many treats as he wanted.  The vet gave him some banamine to help him be more comfortable before walking out of the barn.  He hadn't been able to have any grass since he had been home.  He was so excited to get some carrots and ate more than half a 5lb bag.  He made it out onto the grass with my daughter at the lead and was so happy to have his muzzle down in the green stuff but still took every carrot she offered.  More tears fell as I watched my daughter put a braid in his mane - the same way she did for Penny, and I did for Arthur, and all the others.  And then she bravely braided his tail. Final hugs and kisses were given and the vet and I watched her and her brother run into the house.

I have helped my share of horses pass over the rainbow bridge and some times they pass easier than others.  Max, like everything else in his life, passed the easiest of them all.  He was very relaxed after the xylazine and I kept rubbing my hand on his forehead and told him over and over how much we loved him and thanked him for all he had done for us, and when the last of the pink injection was in, he bent his knees and laid down and was gone.  So peacefully.  

Arthur on Pergolide

I thought I'd try to journal Arthur's progress as a Cushing's horse. He did beautifully out in the pasture this winter, but as the spring grass came in and I started keeping him off of the grass, he started to get laminitic/ouchy feet. I may have left him out on the pasture a few days too long, but keeping him off the grass was not doing the trick, and it had worked well last year. He has a 48' x 36' paddock attached to the stall that is all dirt. He also was not wanting to eat as much hay as he used to - I ran out of my winter supply, and the quality of hay the feed store had was just pitiful. I have since found a better supply of hay that he likes, and also adjusted his feed to include supplemental salt, magnesium, and vitamin E. I also have started driving to get Ontario Dehydrated Timothy Balance Cubes that are specifically formulated to be a balanced, complete hay cube, designed for Cushings/IR horses. Arthur loves them, but I have to adjust everything slowly. But the biggest change I have made is to finally put Arthur on Pergolide. It seemed we were able to control everything with diet last year, but the diet was not working this spring, so I finally made the commitment to keep him on Pergolide for the rest of his life. He has been on the Pergolide for a whole week now, and is doing SO much better. He is finally comfortable on his feet again - moving around so much more. Although he seems a little "dopey" after his evening dosage, overall he seems much brighter and more energetic. I guess I am learning that you really have to focus on the whole picture when it comes to Cushings - both the diet and the medication, good trims, etc. When one part is off, you end up with an uncomfortable pony. I am relieved to say that Arthur is again comfortable, bright, and eating well, and I love that little pony so much.

Penny's Fractured Coffin Bone

When I first looked out the window this morning and saw Penny lying down in the hay remnants by the barn, I thought she must be enjoying the warm sunny morning with a nice nap. The rest of the herd wasn't too far away, and she was laying flat out like possibly in a deep sleep and hadn't noticed when they began to meander away from the barn. But after I had put out grain & hay and let the horses in, I looked out the end of the barn to see Penny still laying there, on her belly, not even trying to get up. She was looking at me, but not getting up. She wasn't struggling, wasn't rolling, just looked comfortable where she was. I walked out to where she was laying and could see that her breathing was elevated, but she started nibbling on some old hay remnants. I leaned over her and laid my head to her belly and listened for gut sounds, and there were plenty! Lots of gurgles and pings, plenty of noise. Which was good news - probably not a colic - but left me confused. So I ran 20 yards back to the barn and grabbed her halter and came back and put it on. I clucked gently and Penny looked at me, but didn't offer to get up. So I twirled the end of the lead rope and tapped it on the ground behind her, and she stood up. I didn't notice that she did the whole dance without putting her left front hoof down, but as she stood, she held her left leg off the ground and would not put it down. I gently lifted it up to look at her hoof and I could immediately see drops of blood slowly oozing from the middle of the bottom of her hoof - about a centimeter away from the point of her frog. There was no obvious culprit - no foreign body sticking out to give me more information, but Penny was clearly in a lot of pain.

20 yards does not seem far, but for a horse to hobble on 3 legs, it seems like forever. We took it slowly and stopped several times as she hobbled into her stall - not once letting her hoof touch the ground. She was happy to nibble on some hay when she got there, (I took her handful of grain away just in case) and I ran inside to call the vet.

I didn't want to haul her anywhere in her condition, but the mobile vet I knew did not have access to an x-ray machine this week, and after telling her about the location of the injury, she urged me to take her to Elgin Vet so they could treat her right away. I knew that she needed to be seen right away, but hated to trailer her. By the time I had the trailer hooked up and backed up right to the barn, Penny was already laying down in her stall, still breathing heavily.

By the grace of God, Penny hobbled down the aisleway and into the trailer without incident or hesitation. I drove slowly and carefully to the vet, and to my amazement, she was still stand ing up after the 20 minute ride to the vet clinic. She had put her hoof down flat for balance, but when we unloaded her, she again would not let the hoof touch the ground. We got her as close as we could to the barn, and slowly walked to a stall bedded deeply in soft shavings.

Within two minutes, Penny laid down in the stall to rest, and she spent most of the next hour or more laying down while we waited for the vet seeing other emergencies. Even after resting for that time, her heart rate was still elevated at 60bpm, and her respiration rate was 40. Those numbers to me were typical of a surgery-bound colic.

Penny hobbled to the x-ray room, and within minutes after some pain medication and sedation and x-rays, it was obvious that she had fractured her coffin bone. There seems to be a "track" that goes nearly if not all the way to the bone, and you can clearly see where the bone has cracked all the way through - with more than one possible fragment. The good news is that if your horse is going to break a bone, this is the one to do as it heals eventually on its own. But there are many possible complications.

The first and most serious is she might get laminitis in her good, supporting leg (like Barbaro did) and the pain and bone rotation from founder after laminitis (pain in the hoof) sets in would probably mean the most humane thing at that point would be to euthanize her. The good news is that Penny has been very smart about laying down - she knows she's hurt and she's smart enough to take care of herself - and she needs to lay down as much as possible. The bad news is that Penny already has a small amount of rotation in her "good" hoof, and thus will be more prone to laminitis than a horse who has never experienced it before. Other things in her favor are that she is muscular ("stocky") and small-framed.

Another complication would be if one of the bone fragments "dies" and causes an infection deep inside the hoof. The vets can surgically go in and remove the dead piece of bone, but infections inside the bone like that can be difficult to cure. Or even just having the tiniest of openings (like the one that she has) that goes all the way into the hoof to the bone could lead to an infection. Cleanliness is of highest importance.

So, the vets have started by soaking the hoof with a betadine solution to kill the bacteria, and wrapping the hoof until a hoof specialist farrier can come out (Monday, we hope) and put a special shoe on her hoof - that will have a plate at the bottom of it that you can unscrew to treat the area, and otherwise will support the hoof and stabilize it. It will have a rim that goes all the way around the hoof to keep it from the constant expansion/contraction that the hoof normally goes through with every step. Stabilizing the hoof will be key to helping the bone heal, and making Penny feel more comfortable. The shoe will have to be reset every 3-4 weeks for the first month or two to keep it fitting well and secure. Oh, and it will cost more than any pair of shoes I have ever owned (hiking boots included).

The other key is pain management - to keep Penny happy, and eating/drinking normally so that she doesn't have digestive issues as well, and also so she doesn't break down on her good hoof. They have a special boot with pads in the bottom to support her good hoof, and hopefully prevent the dreaded laminitis from occurring. When she comes home, it will be my job to monitor her carefully for any change in pain levels, as the sooner we catch issues, the less severe they become.

She will be confined to a stall for at least 6 weeks. But for now, I've got to take it one day at a time. Sammie and I will be going for a visit tomorrow morning to groom her and give here lots of carrots. So please, say a prayer for Penny, for we have a long road ahead of us.

Arthur - Laminitis Management

After such a long drought, Texas is finally receiving a ton of rain! We actually have moved into an excess amount of rain for the year, although we still have not caught up for the last two years. So, as you can imagine, the grass has been growing like mad - and has been for about 2 months now.

Arthur was being kept up in a small paddock by the barn to keep him off of the grass as it first started growing after the drought. He has been doing really well with the emergency diet from the Equine Cushings Yahoo Group. Now, the group is of the opinion that you should never, ever let a cushings horse/pony out on any kind of grass. Hard core, no grass at all. But I have been struggling with that idea - and I can tell very quickly when Arthur is getting owie. I know for certain that when the grass grows either after a drought or first thing in the spring, that it is too much for Arthur. But he was eating the grass all last summer without trouble (when it was dried and brown). I have also read that the fall grass is actually the safest grass (lowest in starch). That combined with the consistent rain we have been getting made me feel that our grass is not stressed at this time, and I wanted to give Arthur the opportunity to be out with the herd (not to mention his paddock had become quite a muddy area, and I wanted to get his feet out of that situation as well). So I started letting Arthur out on the grass at night (when the grass is lower starch than during the day) for over a week and saw no sign of laminitis, so we started letting him out both day and night about mid-October. Actually, it was Oct. 10 to be specific, since that was the Horse Expo, and I had to use the panels that make his paddock for the Expo. Arthur has been out on pasture (coming in for 4-5 hours a day over 2 feedings of beet pulp and hay) for over 2 weeks now, and he is SO Happy to be a horse out with the herd again! My main concern are his feet, which I have been watching very carefully for the first sign of soreness. But so far, so good. I will continue to monitor him at every feeding and will keep him up again if I need to. But it appears we are to the "safe" time of fall grass, and soon it will all die off and then we will be home free until next spring.

So, I know that the wonderful ladies at the Equine Cushings group would probably admonish me for letting him have any grass at all, but I feel it is important to look at each horse individually. In another situation (a severely foundered horse/pony), I would be much more careful. But for our Arthur who has had mild laminitis a few times that we were able to clear up quickly with a change in diet & keeping him off grass when it was dangerous/starchy, I feel confident that with close monitoring of his comfort, I'll be able to make changes accordingly. At his age (25), quality of life is also important, and I want him to be happy. Not to mention that moving around with the herd all the time helps keep his arthritis from bothering him. In the last two weeks, on several occasions, I have seen him trotting and even cantering to come up for feeding time, which I have not seen in a while. To me, that's what being a horse is all about - feeling well enough to be out there running with the herd, free as can be.

Cushings/Laminitis & Diet

As you can read from my last post, we were so excited to get in some fresh hay for the winter! It feels so good to know that my stash is about half full, and know that the other half will be here in a few weeks. But the new hay had some unexpected consequences for Arthur, our 25yo pony. A few days after we started feeding the hay to him (he is up in a dirt paddock because he tends to get owwie feet when the grass comes in after a drought), he started showing signs of laminitis again. I had not made any other changes, and it seemed surprising to me that the hay could cause his feet to be sore. It wasn't grain overload or a ton of green grass - just hay? A very smart lady said it sounded like cushings - and I spent some time researching it. My best source by far was this group: Equine Cushings Group

I quickly learned that the hay could very well be too high in sugar/starch for Arthur, especially since it was grown during a drought time in Texas (although it was well irrigated and fertilized). So the solution was to soak the hay for 30 min (hot water) - 1hr (cold water) before feeding it to him. I was also advised to discontinue any grain, and use soaked/rinsed beet pulp instead, supplemented with vitamin E, flax seed, salt, and magnesium.

Within one week, this change in diet took him from a very ouchy laminitic pony who had started laying down for a few hours in the afternoon to get off his feet, to one who looks completely comfortable again, and has even been trotting around! He also seems much brighter, and the gook in his eyes he has had for the last year has completely cleared up. Amazing what diet can do!

I feel silly for not thinking of Cushings earlier - I knew Arthur had foundered in his past, and that he tended to be laminitic sensitive, but always thought "old foundered pony" - not Cushings. And then I remembered how hairy he had been this winter, and how he continued to shed (blankets!) until almost June before his coat looked nice, short & shiny.

My next steps will be to get a baseline ACTH, insulin, and glucose. And to have my hay analyzed so I can do a more specific diet balancing. Right now, though, we are through the hardest part of getting him stabilized and knowing what to feed him to keep him healthy and happy! I am so glad I found the Equine Cushings group and I am learning as much as I can for Arthur's sake.

Spontaneous Healing

Wow - it has been far too long since I last wrote on here! Vacations, busy schedules, have kept me away.

I rode Sweetie briefly last weekend - she was very good - we just walked around in the field a bit. And I rode Rocky this morning - lots of trot circles/figure 8's. He was also very good. Sammie has ridden Arthur a handful of times - our new favorite thing is to walk him down to the pond/"tank" and back up to the barn.

The good news is that Penny has been on her treatment, "Marquis", for EPM for about 2 weeks and I can already see the difference in her demeanor! She is much perkier and happier in general. Her hind end seems to be moving more naturally - not such a hesitation when we go in/out of her stall. I played with her a bit this morning. Only about 10 minutes of "work" if you can call it that - I played some Parelli games with her, and then asked her to go both ways on a circle, first at the walk and then at the trot. To the left seemed a bit harder on her. (Her "lame" leg is her LH). You could also tell when moving her hindquarters around that she would not cross over her back legs to move that way like she would to the right - a clear sign of lameness. But she finally did cross just barely one time and we quit there.

I also need to get Penny ready for Sammie to ride, and so I practiced mounting/dismounting a few times with Penny. She was so good, let me lean over her on my belly and scratch her everywhere before swinging my leg over.

And then the good news about Arthur's facial paralysis - over the last two weeks, I have started to see some improvement! His ear is now moving with the other ear at about 85% capacity it seems, and his nostrils are now about even instead of the right one drooping down lower, and his lower lip on the right is only drooping the smallest amount now in comparison. I'm so glad I didn't attempt to put him through an expensive treatment/surgery to correct this and that things are improving so well! It really is amazing to see. I was so worried about him for a while.

The other thing that has happened is that about a week ago, we finally got some rain here in TX. So the drought grass full of sugar has started to come up, and I have had to keep Arthur & Penny up in a dirt paddock so that their laminitis issues don't flare up. Thank goodness they keep each other company so well! They are enjoying all the hay and their feet are not aching, so I know I'm doing the right thing. In a week or two, I will start letting them out for a few hours in the morning, and work up to being out at night again. All for now!