Quoth the Raven

Nevermore.

One of the reasons that I have been so quiet lately is Raven. For the past two months she has been fighting a losing battle with DSLD, and last week it became clear that she could struggle no longer. Kerstin euthanized her on Saturday morning, and she died peacefully eating an apple out of my hand. I got one one last kiss between her double whorls before her knees buckled.

Raven got to know Kerstin well during her treatment for that stupid (fucking) puncture wound, so she was completely relaxed for the final injections. Such a good girlie, as I told her many times. There is a big black hole out in the paddock now, but some friends have loaned us their two horses for a while to keep Tonka company. I have to admit that I find their presence comforting too.

The first picture was taken on September 11th 2008, two months before the stupid (fucking) puncture wound. Raven was at her healthiest and we were getting ready for some galloping along the dikes. The second picture was taken on April 2nd 2008, a week after she arrived at Farcical Farm. Back then she was skinny and scared, rarely looking directly at me and never approaching of her own free will. The last picture was taken on May 3rd 2009, at the beginning of what turned out to be the end. I am not a spiritual person, but as of July 4th 2009 I like to think that she on the moors and beneath the stars in her king's wild company.

Two Steps Forward, Ten Steps Back

Followed by another eight steps forward. On Sunday morning I woke up to the sight of Raven dragging her hind right leg past our bedroom window. The whole thing was puffed up from hock to fetlock, but without any heat or sign of trauma. If not for the swelling I would have assumed it was bad abscess, but it looked just like the pictures of a bowed hind tendon in my encyclopedia of equine veterinary medicine. I was heart broken...after such a long, slow recovery from that puncture wound (to the same hock) it came as big a blow.

With hosing and bute the swelling went down considerably over the course of the day, and Raven spent most of it lying flat out. She looked better on Monday morning, but continued to limp dramatically. By Tuesday night only the fetlock was puffy, the limp was almost gone. This morning she is totally back to normal. There is no evidence of an abscess so I have no clue what happened here. My best working theory is that the hock may be extra sensitive now and she whacked on something. Kerstin is coming this afternoon to do teeth and x-rays on Tonka, but I fear that she will be as stumped as we are.

Hock Eyes

I am an inveterate M*A*S*H fan, and have been known to ask "what would Alan Alda do?" in tricky situations. About three weeks ago Raven was finally beginning to look comfortable again after the great hock puncture of 2008. She was getting leaner and stronger, and the SmartFlex Repair seemed to be helping -- I was planning to be back on her in early April. Then we got another snap of cold, wet weather and everything went downhill. The joint looks stiff, the problematic suspensory tendons look painful, and the whole horse looks uncomfortable. She is dead lame on the hind right for a couple of minutes after getting up. She prefers to be on the dirt part of the paddock instead of the crusher dust. She is standing in the corner with her nostrils slightly wrinkled instead of joining Tonka at the feeders -- it is like we have reverted to December.

Now that the weather is warmer and drier she looks a little better again, but still very stiff and jilted on the hinds. Christina was here to trim today, and Raven was dead lame for a few strides after having the hind right on the stand for long enough to get her mustang roll (Christina trimmed the hoof with it resting on her boot). It is time for Kerstin to come out for teeth and vaccinations, and it is time to reassess the long-term plan. I think we have to give Adequan a try. It's what Alan Alda would do.

The Host with The Most

Or maybe the hostess. It could be Raven or it could be Tonka, but one of my horses is producing piles of manure that are, in turn, producing piles of tiny red worms. Of course I have them on a regular worming rotation, but it looks like we need some bigger guns this month. Over the past three days I have collected samples from both horses so that Kerstin can give me the go-ahead to hit them both with five days of Panacur (fendendazole). Here's a picture of some encysted red worm larvae just to gross you out.

Five Pillar Plan

On Sunday I very carefully watched and heard Raven moving. When she fully articulates the right hock joint it clicks, but she is not articulating it as much as the left. As a result she is pushing herself up high on the left fetlock to accommodate the slightly straighter right leg. This might explain why she looks sore on both hinds. I previously thought that the hock injury had somehow precipitated further degradation of the suspensory ligaments, but now I wonder if it is simply mechanical exacerbation of that weakness. Based on these observations I have formulated a plan.

Pillar 1: Joint Maintenance
This needs to happen with support from Kerstin, but I would like to try nutritional supplementation with MSM or glucosamine before jumping straight to something like Adequan or Legend. Any recommendations on good supplements are welcome -- there are about a million to choose from.

Pillar 2: Consistent Work
Joints are supported by the muscles around them, so we need to work on building up her legs and her quarters. On days when the footing in the pasture is good I will probably lunge her (she was fine after Sunday's session) to encourage more flexing of the joint by working in a circle. On days when it's wet I will hand walk her through some of the uneven parts of the pasture to encourage use of the leg under more varied conditions than she gets in the paddock. We'll do something every Tuesday, Thursday, Saturday and Sunday (when I am not in the office).

Pillar 3: Weight Loss
Thanks to everyone who commented on how good Raven looks. Because she came to me in such poor condition I take pride in keeping weight on her, but this isn't about my ego. Leaner is always better when it comes to joint injuries, and it wouldn't be unhealthy for Raven to lose 50lbs. I have started by dropping the high-fat pelleted feed from her diet, which accounts for about 1000 calories daily.

Pillar 4: Pain Management
No pain, no gain? More work might mean more pain for Raven, and I need to accept that using bute might be a short-term evil necessary for achieving our long term goal. Bute is dangerous because it can mask a real problem, but half a gram after a lunging session can also offer real relief.

Pillar 5: Attitude Adjustment
Mine, not Raven's. When I'm honest with myself I can admit that I have been pessismistic about Raven's recovery, which is unusual because I am hopelessly optimistic about most things. Am I just lazy? Or looking for a reason to feel sorry for myself? Or an excuse to avoid ever riding my crazy horse again because I'm skeered? Whatever. It ends here and now.

Tonka Update

Seven weeks ago I mentioned that Tonka seemed desperate for the kind of medical attention that Raven was receiving at the time. Could I have brought this upon myself?

On Friday morning Kerstin came out to check on Tonka and she feels 95% sure that we are dealing with a contact allergy -- either a continuation from the original itchiness, or something that was on my hands while I was treating him (i.e. obsessively poking and prodding him) for that. At this stage he is slightly less swollen and all of the outer skin is peeling off in sheets. His temperature is normal, but we are keeping him on the antibiotics as a precaution against infection of the torn skin. His appetite is somewhat diminished, probably due to the antibiotics and the pain so he is getting a gram of bute with each meal. His urine is an alarming shade of orange, but I assume that is from the drugs (I am waiting for a call from Kerstin to confirm). Otherwise he seems comfortable, and he *really* enjoys his zinc oxide treatments in the mornings. Horn dog.

Turgid Tonka

Tonka's sheath was so swollen this morning that the skin was beginning to split up the middle and along the sides. An emergency call to Kerstin got him an antibiotic prescription from the human pharmacist, and he seems happy to down 15 crushed pills in his feed when a little molasses is added. It would never work for Raven, so I will count my blessings wherever I can find them.

I didn't have the heart to take pictures, but imagine this about 3 times worse. He looked like this yesterday, so something is raging away in there. The outside is totally slathered with 37% zinc oxide in hopes of preventing any secondary infection along the torn skin. All the men around the house seem to get uncomfortable when I talk about this.

Willy Willy Itchy

A few days ago I saw Tonka kicking at his belly through the bedroom window and my heart sank. Cold weather colic is a worrisome reality under these conditions, as dear EvenSong knows all too well. His blanket straps seemed a bit snug when I investigated, so I loosened them and didn't observe any further discomfort until yesterday when I found him kicking more fitfully and swishing his tail as if he had a fly on his belly.

His sheath appeared slightly swollen and when I gave it a scratch he was instantly in heaven, lifting his rear legs like a dog to give me better access. Other than the swelling and itchiness there was nothing unusual -- he wasn't particularly dirty and there was no bean (rude of me to check without lube, but he didn't mind in the least). I scratched for a good 10 minutes and wondered how to proceed.

This morning he was kicking with even more agitation so I decided to call Kerstin. She figures it is a bug bite some minor infection, and she was able to drop off some topical "Special Formula" this morning, which is indicated for treatment of mastitis in lactating cows. Tonka doesn't mind -- he is feeling much better already. David and I made the best of Tonka's misery while we were waiting for Kerstin by getting some funny pictures.

While I was applying the "Special Formula" Raven wandered up to see what was happening and Tonka squealed with fury before trying to bite her. I have NEVER seen him show any aggression towards her (despite her frequent and vicious attacks on him), so I take that as some indication of how uncomfortable he was. Afterwards I went about my chores and Tonka followed me around begging for more willy scratching. He was so persistent that I finally had to chase him off with the manure fork.

And one of the rebuffed Raven in her new blanket. It is up around -1C here today, so she might be back into her shell soon. The propane truck did make it up The Hill, so we will be warm for Christmas.

Coon Foot and Fancy Free

Three posts back I mentioned that Raven is moderately affected by DSLD (degenerative suspensory ligament desmitis). This anecdotal diagnoses was independently made by both Christina and Kerstin not long after Raven arrived. To be absolutely sure we would need to have a tissue test done to assess the degree to which collagen has been replaced with cartilage in her ligaments. The results of a veterinary flex test and ultrasound have been inconclusive.

From my perspective Raven has three symptoms of DSLD -- she (1) is coon-footed on the hinds, (2) is uncomfortable holding them up to be picked/trimmed, and (3) will sometimes dig holes so that she can stand with her toes pointed into them. Raven does not:

• have a particularly post-legged conformation
• trip or stumble with any regularity
• spend an unusual amount of time lying down
• have lumpy wind-puffy "sweet potato" fetlock joints
• lean on fences or rock when standing
• drop weight quickly or have unusually loose skin
• refuse to canter (this is her preferred gait)
  
• come up lame after riding or refuse any gait under saddle

It's possible that Raven merely suffers from poor conformation -- coon-footed thoroughbreds are not uncommon. I believe that she probably does have DSLD (because of the hole-digging) but I do not believe that it is serious or degenerative at this time. So far we have seen nothing but improvement in symptoms (2) and (3), and it was almost a non-issue until the hock injury. Assuming that she recovers to her pre-injury condition it will continue to be a non-issue until I see further evidence of symptoms or a real deterioration in the quality of her joints.

Good News and Better News

Good news: David and I are off to Hawaii tomorrow for a week. We'll spend four days in Honolulu with some friends and three days in Hilo to do some volcano watching. It will be more expensive than we originally expected (the Canadian dollar was at par with the US dollar when we booked the tickets) but it won't be any less fun.

Better news: Kerstin can't see any smoking guns on Raven's x-rays. After walking and trotting her up and down the driveway Kerstin feels that Raven's moderate suspensory desmitis (a post for another day) is responsible for her unexpectedly slow recovery. Because Raven has always been sound on the hind fetlocks/pasterns I never worry much about those dropped tendons, but it makes sense that they would be bothering her now. Melissa will give her a gram of bute each day while we're gone, and we'll see where things stand in a week.

Leave Without a Trace

We were out all day, but Kerstin was obviously here to do Raven's x-rays because she left her extension cord in our garage. I'm glad it got left behind because it is contained by a completely ingenious invention and I now know what to get my brother-in-law for Christmas. No news on Raven so far...hopefully that means good news.

La Cuenta

Before tomorrow's x-rays Raven's vet bill comes to $1300 and change. (Only our cat Spike holds the dubious distinction of incurring an even larger bill against a more mysterious affliction.) I'm not telling you this to garner your sympathy, merely to satisfy any curiosity you may have about largish equine expenses. A couple of months of juggled finances will see this paid off, for which I consider myself truly lucky. In honour of yesterday's news I finished the last manure bin with recycled nails instead of going out to buy new ones.*

*Actually, I am just lazy.

Hardworking Henry

With the ambient temperature at 5 degrees Celcius and the relative humidity at 80% it is hard to get turnout sheets dry without bringing them into the house (which I try to avoid -- we don't need the smell of wet horse layered over the smell of wet dog). This morning I washed Tonka's 1200D sheet and draped it over the conveniently-horse-shaped Henry to dry with the assistance of two oscillating fans.

Meanwhile Tonka looks like a private school girl flirting with skirt length rules in his new sheet, which is considerably shorter than his other two.

Raven was feeling better today, moving well and eating like she had never eaten before. Kerstin spoke with best leg vet in the Fraser Valley and he agrees that her symptoms are consistent with bone and/or cartilage damage. He recommended that we put her back on one gram of bute per day and Kerstin will come do the x-rays later this week. We recently got a newsletter from her practice saying that they had purchased a digital machine, so I should have news for you in near-real-time.

Up and Down

I'm on campus today, but David called to say that Raven is very stiff. She was quite lame this morning until she got going, and then she seemed more comfortable. Kerstin was emphatic that Raven should remain stable or continue to improve, and that anything otherwise would probably indicate damage done to the underlying bone. I did palpate the joint quite assertively last night, and there is no suggestion of continued infection -- it is smooth and dry, with just a little nub of tissue around the wound itself. My fear is that my not-so-tender ministrations aggravated a bone chip that is responsible for her continued pain. Hopefully Kerstin will be able to get some x-rays tomorrow.

Little Miss Sunshine

Christina Cline has been trimming the horses every month for nine months and it has never rained while she was at Farcical Farm. On a couple of occasions I have cleared out the garage just in case, but it appears (to me) as though she travels in a pocket of dry weather (she assures me that she does not). Today it was chilly and sunny when she arrived (not in a goat van VW, but it seemed like a good excuse to promote one of my favourite movies).

Both horses are getting better about being trimmed. Tonka used to fuss and pull and sink and wriggle, but now he prefers to nap. Raven used to kick out randomly with her hinds but today she stood like a statue. In both cases I think that their improved behaviour follows from their improved health and circumstances. Poor Raven was stiff on the right hock when Christina put it down, and strained to hold herself up for work on the hind left, but she did it like a trooper. After a conversation with Kerstin this morning I will hold off riding her for another week at least, but we are supposed to start trotting sets up and down the pasture on Wednesday. I think this means I have to trot too.

Raven Update III

When the alarm went off at 06:30 Raven and Tonka were munching at one of the feeders -- she has been down in the soft dirt at the top of the paddock every other morning. She lifted her head in greeting when I stepped outside, and I could see that she was feeling perky and troublesome -- her usual self.

There was no swelling under the bandage and the joint is cool to the touch. The best possible outcome imaginable. Kerstin wrapped it again to keep it clean, and we will stay with 2g of bute and 20cc of Excenel each morning for the next four days. Any backslide at this stage will be a bad sign, but Kerstin was visibly pleased with how well things have turned out. I was trembling with relief -- so much that I needed to sit down for an hour before I could trust myself to inject the Excenel safely.

Raven took herself for a trot around the paddock after the vet left, tossing her head and kicking up her heels. Then she hung her head hopefully over the gate to the pasture, but she's going to have to wait another few days before that happens.

Raven Update II

Both vets (Kerstin and her partner Abigail) came out this morning to treat Raven. Miss Thing *cantered* away from me when I went to catch her, which I take as a good sign. Overall the vets were very pleased with how things look. Inflammation has gone down around the joint, and they were able to detect two pockets of fluid with the ultrasound. The fluid appears confined to the joint and is not affecting the tendon sheath -- I am rapidly learning more about hock joints, and this is good news. Both pockets of fluid were drained, flushed and infused with antibiotics again. Raven got another 350cc of Excenel (about $100 worth -- eek!) and 2g of bute. More bute tonight, more Excenel and bute tomorrow, and Kerstin will be back on Monday morning to see where things stand. I remain cautiously optimistic.

Still no sign of the culprit despite much searching. Abigail suggested that I get a metal detector, which is a really good idea. Raven now has a big edema under her chest, but I can't say whether it's from stress or trauma or maybe just her blanket binding around her when she's down. The good news is that Kerstin examined Tonka this morning and thought that I was crazy for worrying at all about strangles. Daun will be pleased to hear that we decided against further vaccination.

Raven Update

Just a quick post to let you know that Kerstin made it out first thing this morning. She confirms that the puncture is clean and deep into the joint -- probably a nail or a piece of wire. She drained off fluid, flushed with saline, infused with antibiotics and wrapped it up. She also administered 3g of intravenous antibiotic (Exceden or something...brain not really working) and 2g of bute. She will be back to do the same tomorrow, and she left me with a shot of Banamine for this evening as well as oral bute. She prefers the Banamine so that the exact dosage is known, as degree of lameness is an important indicator of how things are going. Raven was a total star throughout the treatment.

Kerstin feels we have a 50/50 chance or preventing a primary infection. If the joint does get infected I will be forced to make a difficult decision. Hock joint infections are notorious for being difficult to treat and for leaving their victims only pasture sound. This has not been a great day so far, but I am cautiously optimistic given that we caught it so fast. All good wishes welcome!

Down to the Bone

Today I picked up Tonka's x-rays from Dr. Kerstin Schwichtenberg in Agassiz, and so far she is my kind of vet -- straightforward, knowledgeable and kind. The images clearly show some rotation in both coffin bones, though it is more severe in the right. Both heels are underrun. The vet, the natural trimmer and I feel that we can give this guy a decent chance at a sound, barefooted life by feeding him appropriately, reshaping his hooves, designing a good paddock, and riding him out in hoof boots. It will not be a short process, nor an easy one, and there is no guarantee of success. The way I see it Tonka will have three options, and he can't loose in any case:

1. Rehabilitation to soundness, in which case he will become our beloved trail buddy and pasture pet.
2. Stabilization at semi-soundness, in which case he will become a beloved pasture pet.
3. Degeneration into discomfort and pain, in which case he will leave this world humanely as a beloved horse.

Without our intervention at this stage Tonka is likely headed to the meat yard, either directly or indirectly. I cannot stomach the thought of such a good, sweet and willing horse going to slaughter, and I feel nothing but relief about making the decision to give him a more noble end, whenever it may come.

For the curious amongst you, here is a healthy horse foot. Notice how the triangular coffin bone sits parallel to the hoof wall at the front:


Here is Tonka's right foot. Notice how the tip of the coffin bone is rotated away from the hoof wall.


And here's the left side, which is still rotated by the separation is not so pronounced: