A Day for Answers

I hardly slept Sunday night; between my inability to breathe through my nose and the anxiety weighing down my chest over what potential answers I may receive from the Vets, I tossed and turned for a good chunk of the evening.

Before giving you guys a recap of the visit, I wanted to disclose what sparked off inside of me to get all of this information on the table and why now I pushed for that information.

Basically, it all added up to the fact that I was tired of playing a guessing game. I was tired of the tentative answers I had received during the initial vet visit this Spring. I don't discount what the Traveling Vet said or what we concluded - but it was never "for sure". I was tired of not knowing if my little home remedies would even make a fucking difference. I wanted to see clear, concise, scientific data that showed me exactly where Suzie was and what I would have to do to make things easier. Of course, it is easier said than done to just pop over to the vets, especially if they are near your barn. For me, organizing a simple trip to the vet involved a rigorous amount of preparations, pre-planning, and a lot more $$$ (think hotels, restaurants, lay-over, gas, etc).

She was happy to see me on Monday morning.

I am willing to admit that I should have followed through with additional diagnostics and the like when Suzie was first "diagnosed". However, please keep in mind that I did the very best I could with the resources I had available, as well as the current funds I had in place.

Anyways, onto the real content of the post!

We arrived at the Vet clinic just before our appointment time - which is a relief since we got a little bit lost along the way! The receptionist was wonderful and after filling out a few forms, I walked around back to unload Suzie and wait for them to open the large garage doors which led into the equine examination room. At this point, the Boyfriend unhitched the trailer and headed off into town to toodle around the home-building supply stores (boys are weird in that they find scouring the hardware store fun).

Suzie was bright and alert. I assume we were near an industrial part of town, as there were a lot of loud noises and the high winds seemed to amplify that. She snorted as we walked in circles and meandered around the parking lot. After about 10 minutes, the Vet popped open the back door and we slipped inside to begin the consultation.

The first forty minutes were largely conversational - I went back through Suzie's entire history and tried to give a detailed recount of her medical history. The Traveling Vets were supposed to send Suzie's entire file to this clinic, but I guess the clinic's internet was down for the better portion of the weekend and the Vet hadn't been able to review the files, so I did what I could from memory. I'm pretty sure I apologized several times due to the fact my mind was super muddled and dazed from being sick and the large quantities of drugs I was taking (sorrymrsvet).

The main basis of the appointment was palliative care, with emphasis on the knee and caudal heel pain (navicular) diagnosis. And once a good chunk of Suzie's history was brought to light, I also shared another issue that had given me some worry.

When Suzie had been kinesio taped by my friend back in October, I noticed she had very uncharacteristic bowel movements - they were very loose and cow-ploppy. At first, I merrily assumed that she had given herself some stomach upset from the hauling (she sometimes will "worry poop" once or twice at a venue if she hasn't been hauled in a while). I had started her on Metamucil and beet pulp, and about a week or so later, the skies cleared and there was no more ploppy poos.

I won't gross you guys out with the actual
pictures of her butt, but this gives you a general idea.

I celebrated until I ran out to the barn the next morning - Suzie's entire back-end was slimy, as if she had literally pooped down her legs. I washed her up and for the next few days, waited to see if there were any changes. After three days, there was no indication that anything should be wrong; no feed change, poops were still normal, still drinking/eating normal, no weight fluctuation, no weather changes, temperature was normal, bright/alert... literally nothing had changed except for this persistent slimy back end that I was now cleaning every second day. In an attempt to figure out what the hell was going on, I dosed her with kaopectate and probiotics for a week.

Still nothing. Solid poops with an occasional less formed pile (but no diarrhea!).

Fast forward to a few days later when I took my nephew for a pony ride and Suzie passed gas while tied to the barn and poo water literally surged out of her! I apologize for the next haunting visual, but it was the wettest, slimiest fart I have ever seen or heard.

That's a Mare Glare if I ever saw one.

I spent the evening googling and trying to figure out what the heck this all means... I had never encountered a horse that had solid poops but slimy/wet farts before. And as most googling unveils, there were 100s of remedies to try, but none of them really seemed worth it without some clear direction from the vet. And since I was headed to the vet in under a week, I opted to wait for the appointment to see what we could find (if anything). 

So while the Vet mulled over the case of Wet Bottomed Suzie, we began a more thorough examination of her knee and hooves.

I could probably write an entire novel of information I received, but I'll try to break it down into something simple and more legible. Of course, this isn't word for word stuff and some of it is subject to error due to the fact I was high off of flu meds.

The Vet was realistic with me and spoke candidly and openly about Suzie and what her personal thoughts of my mare were. She was exceptionally happy that Suzie is in picture health - she has fabulous weight to her, bright/alert, and is in good spirits. Furthering her exam, she found no temperature, breathing issues, or heart issues.

In beginning the lameness exam, hoof testers gave no indication of heel pain, however the Vet noted Suzie's overall foot structure and conformation makes her a prime candidate for heel pain/navicular. Some may remember she had a verrrry strong reaction to the hoof testers in the Traveling Vet's appointment. I was pretty surprised given the fact Suzie didn't even react, but the Vet basically said that even though Suzie didn't react, it didn't mean that she didn't have navicular. (Sidenote: why is navicular so fucking ridiculous to diagnose!?)

We moved on to the second portion of the lameness exam - a brief trot in the back parking lot revealed Suzie is sound at the walk, but very lame at the trot, more noticeably on her left front leg (which is information I already knew). The Vet called for blocks to Suzie's left hoof, from the fetlock down, so we understand how much of her lameness was caused by the knee and how much was caused by the navicular/heel pain. After the block was set, we repeated the trotting and found that only about 20% of her lameness disappeared.

Choosing where to block in the fetlock.

With this information, we now know for certain that the knee is our biggest issue, which moved us on to removing her shoes and doing xrays of her left hoof and knee. I opted to not xray her right hoof, as the Vet mentioned that her left leg is the bigger issue and if there was something appalling with her left hoof, we would xray her right.

Radiographs of her left hoof revealed some black spots near the navicular bone, but the Vet basically said not too be too concerned with that. While I internally celebrated the fact her navicular bone was in good condition, the Vet again reminded me that caudal heel pain encapsulates all the bones in the hoof, not just the navicular bone. Based off of how Suzie has responded to the therapeutic shoeing, her current conformation issues (contracted heels), and a few indications in the radiographs, she was pretty confident in confirming the previous declaration that Suz has navicular/ caudal heel pain.

We discussed the idea of xraying her right hoof, and I opted not to. The left did not show any rotational change in the coffin bone or any other kinds of degenerative conditions. The Vet agreed with me that, at this point, it wasn't super pressing we get both feet xrayed.

Instead, we moved on to her knee. I was the most nervous for this, as I knew the potential outcomes I faced should the results not be in Suzie's favor.

What I can say about the knee is that it has advanced arthritis. So much that the Vet cannot even determine if a previous fracture or otherwise caused the build up or if it just happened to collect there because it just felt like it.

If you do not know how to read xrays, the front of her knee
is to the left. You can see the faint outline of the large bump
and inside the bump you will see the jagged outline of
all the arthritis.

We reviewed the xrays, chatted about the non-existent veterinary options I have at home, and started to formulate a plan.

The good news is that the Vet is confident Suzie is happy - she can still motor around under her own steam, can still get down for a good roll or nap, and is still ornery when she needs to be. The arthritis is troubling and will never get better, but thankfully the Vet gave us a plan that is easy to carry out and will bring Suzie (hopefully) a much easier, and fulfilling retired life.

Because I live so far away, the Vet wanted to give us the best possible plan to minimize our travel and to expand Suzie's quality of life. Firstly, she asked me to stop Suzie's daily dose of Previcox for a period of two weeks - her reasoning is that the Previcox may be affecting her hind-gut since she has been on the drug for the better part of the last three years and the excess water in her bowels may be from gut irritation (ie. ulcers). However, the Vet is skeptical of ulcers given Suzie's weight, appetite, and currently healthy poops. It was noted during the appointment that apparently a few horses this year are also experiencing similar issues, so it may not be related to the Previcox at all. She did prescribe sucralfate - 3x/day for 14 days to see if it would help and also mentioned that it wouldn't hurt to slather some vaseline on her legs to prevent scalding after I wash her up again.

For her knee, we agreed to put Suzie on Legend. It is the most readily available drug, and the easiest to administer since it is given IV. The Vet was concerned about injecting the joint since there is so much arthritis, that a needle may not even make it through all the crud in there. There was worry about injections as well, because it would mean I would have to travel. For Legend injections, they are IV, so I could easily get that done on my own at home. Personally, I have never given IV injections before and told the Vet I'm sure I could find someone to help me, but the Vet walked me through it and gave me the all clear to administer them at home on my own. It was enlightening to learn and I am grateful she took the time to explain to me. At the clinic Suzie received 1 injection of Legend and I took home two more doses which will be given a week apart from one another. 

And lastly, for her feet, we spoke at length about the fact she really needed some heel support (heartbar shoes) and a farrier to coax her heels to open up vs continuing to shoe them in a contracted fashion. I took her recommendations and have contacted a farrier in the area who is supposedly pretty decent with therapeutic shoes and he is supposed to be calling me within a few days to go over the xrays and set up an appointment. 

So, all in all?

All good things.

Ready to go home and get this game plan
started.

I have the confirmation and validation that Suzie is happy. I finally have the answers about what the hell was going on in her knee. I no longer have a big, black hole in my gut that rumbles around because I am scared of not knowing how to continue helping her, or if I am making a mistake in prolonging something that is impossible.

And for once I feel very much at peace with the information I have and the clear, directional path only brings me more comfort.

Some will say I am crazy for hauling an old, ornery horse 14hrs in the beginning of Winter - but crazy is what keeps me going sometimes. And sometimes, I don't really have clear reasoning behind what I do or why I do it. But no matter what, my animals are always the forefront of my life and I do whatever I can to keep them happy and healthy.