Friday, May 27, 2011

Post Surgery

Like the last surgery, the podiatrist came back every other day to change her bandage.  Unlike the last surgery, there wasn't much optimism this time.  I knew he'd be there on Saturday.  I had called my friend the night before and let her know that he'd be there at some point since she had missed the surgery.  I don't remember if she sent me a text before he came or not, but eventually I asked her what he'd thought that day. 

It wasn't good.  When he went to change her bandage, there was a clear substance coming out of her hoof.  He said it was either joint fluid or could possibly be a serum she was creating.  We all prayed for serum.

On Monday, as I was leaving work, turning onto the main road leading to the farm, I briefly caught a glimpse of the podiatrist's truck headed north, away from George.  I assumed it meant he'd already been there.  Sure enough when I got to the farm, she had a fresh bandage on.  When my friend arrived at the farm a little while later he asked me what the vet had said.  I told him I hadn't spoke to him, he was gone before I got there.  In the back of my mind, I figured I didn't want to know.  Living in oblivion for another 48 hours wouldn't be the end of the world.

Wednesday finally came.  I was supposed to be starting a new job in Louisville that day.  I re-arranged my schedule so that I could have the day off.  I took Kermit to the vet for his rabies vaccination that morning and then spent an hour or so doing a few things around the house.  At that point, I couldn't wait any longer.  I headed to the barn.  It was a warm and sunny day, I figured by the end of it, I would be quite sunburned.  I took George out of her stall and to the side of the barn to hand graze for a little while.  I had planned on it being longer than the 45 minutes it ended up being, but somebody decided to be a bit goofy.

So, I put her back in her stall and gave her the chloramphenacol she was supposed to get at noon.  I then left the farm to run an errand and get some lunch.  I took my time because I knew I'd have the rest of the afternoon with her.  Returning to the farm, I took my grooming box and camera and set them out in the catch pen, I figured I'd take her out there in case she decided to be stupid like she was in the morning. 

Of course, she was perfectly calm.  I got her a very good grooming in.  She was just as clean as she had been the night before when my friend took some pictures of her.  It just was a waiting game today.  Earlier that morning when I had been grazing her, my anxious friend had the podiatrist call me and tell me when he'd be coming out.  He was coming around 4, which I assumed since he typically tried to wait until I was off work for the important visits.  As Wednesday's was the mother of all his visits so far, and everything riding on the x-rays, I had just assumed it'd be after 4.

To pass some of the time while George was grazing and we were waiting, I tried to take some pictures...she's not the most co-operative, and in the end, settled on reading my book.  Again, this was a difficult task, because she wanted to help.  Eventually, I figured that she might like some water, so we headed back in the barn, if for no other reason then to get me out of the sun.

Of course, four came much too quickly.  My friend showed up just moments behind the vet.  Everyone tried to stay light hearted as he set up the x-ray machine, but everyone knew how much was riding on this vet appointment.  We got the x-rays, and there wasn't anything that stood out on them, which was good.  But, out of the new surgery sight, a clear liquid was draining.  Afraid that it was joint fluid, the vet said he was going to inject the joint with saline solution to find out. 

As he blocked the hoof, my friend's husband showed up.  Distracted by their boat being freshly named, it took a minute for him to come over.  He sat down and watched though to find out the verdict instead of going to clean his colt's stall like he normally would have done.  The vet inserted a needle just above the cornet band straight into her joint.  The first bad sign was that nothing came back up the needle, he said it wasn't uncommon for joint fluid to come out if the joint was fine.  Then he injected the saline solution.  It came pouring out the hole in the front of her hoof.  The infection had finally got into the joint.  I felt sick to my stomach.

The vet quickly said that he would not consider amputation for her.  Neither would I.  As a yearling, I can't imagine what that would do to her quality of life.  He said that he could put her down right then, or he was comfortable leaving her a few more days because she was still eating and looked great, he said just keep her on the antibiotics.  My friends informed me that they'd already talked to the farm manager and she could be buried next to my friend's old horse, Phoenix, and her two cats.  It was comforting, but at the same time overwhelming.  I opted to wait because I was starting two new jobs in as many days.  I knew I'd be a wreck regardless, but I figured that I had a better chance of keeping a stiff upper lip if I knew she was still alive. 

After the vet rebandaged her hoof and pulled the bandage and Soft-ride off her good foot, we turned her loose.  Still slightly drugged, she was more than happy to graze.  Anyways, what did it matter what she did now?  The farm was hers to do whatever on.  Eventually, she wandered back into the barn looking for food.  With a little guidance, I took her down to where my friends were talking with the other two boarders.  They promptly began to spoil her with the treats they'd been feeding her and the feed for their horses and donkeys.  George followed one of them into the donkey's stall and was taken aback by it's size (it's a double stall).  I drug her away from the donkeys feed tubs, though their owner insisted she was fine.  I took George down to her stall, where my friend promptly gave her the medicine, and George promptly left after that.  I followed her back down to the other end of the barn and drug her out of one of the other horses stalls.  We then wandered outside, no lead rope, just my hand on her halter.  She saw the other two boarder's come in and said hello to them and semi-followed the donkeys.  We then walked up to see her old field buddies, two of them tried to tease her.  After that, and suprisingly little resistance when I pulled her away, I took her back to the catch pen and grabbed my camera again. 

Eventually, my friend came back from putting the boat away.  She said they were going to dinner and wondered if I'd like to go.  I went even though I didn't really feel like doing so.  I figured it was better than me going home alone at that minute.  When we returned from dinner, George was asleep in her stall (I had interupted her nap schedule that day by taking her outside).  I let myself in quietly, and sat down on her.  I figured I'd never get to ride her, so this was as close as I'd ever get.  I didn't make her get up, I grabbed the camera yet again and snapped a few more pictures.  I wouldn't have many more opportunities to get any.  I said good night to George and that I'd see her in a few days.  In the mean time, I knew she'd be well spoiled with plenty of food by everyone but my friend's husband. 

Surgery 2

Thursday afternoon, the podiatrist showed up in a good mood.  His biggest concern was to make sure he cut the hole in the right spot and didn't get too close to the cornet band.  His other concern was keeping her heel elevated since he had not let it touch the ground since the first surgery.  After using elastikon to secure her shoe to her foot he began x-raying.  First, to check the infection's spot, then with a marker on the outside of her hoof to make sure the area he was looking at was directly above the infection.

Then he took a sharpie to her hoof wall to draw out the area that he would remove to get access to the infected bone.  I'm not a big fan of the smell of burning hoof, so when he took the saw to the hoof wall, I was starting to wonder if I could actually handle all of this.  Thankfully, after a span of time that was probably much shorter than it felt like, he was done cutting and began pulling away the hoof wall.  He also ordered surgery music to break up the silence while he worked.  I remember country playing, but I'm glad I don't remember any of the songs because I'm not sure I'd ever be able to listen to them in the same way again.

He cleaned out the site, and then stuck a probe into the bone to see how deep the infection was.  He felt it was just a surface thing, but told his two assistants to take an x-ray just for the heck of it.  The x-ray showed the probe going all the way through her bone.  He grumbled that they had messed up, and told them to do it again.  Same result.  Preparing to take over the x-ray machine himself, he had one of the assistants hold just the tip of the probe (it was sterile, he had no gloves on), and George moved her foot, dropping it to the ground.  The vet said forget it, it didn't matter anyways, he needed to get to work and allow blood flow back to the foot. 

He started scraping.  A chunk of bone moved.  He ended up pulling out another large piece of bone.  He apologized for cussing his assistants in his head about not getting the x-ray right, we clearly knew now that the probe was indeed going that deep.  Immediately after removing the bone out of the front of her hoof, he looked it over thoroughly. The only thing he could say positively about the whole situation was that there was no articular cartilage on the bone, which left a slim possibility that the infection was not in the joint.  He then quickly went to work on bandaging her hoof up.

When he was done, he grimly looked at me and told me that it was getting to the point that there was little more he could do.  I didn't need to be told.  The bottom just about dropped out of my stomach when he pulled the chunk of bone out of her hoof.  I honestly don't remember much of the conversation that took place between the chunk coming out of her hoof and that comment that we'd reached the end.  I know he had some conversation with my vet student friend, but I have no recollection of what was being mentioned, all I could do was stare at my drunk pony and rub her ears.

Tuesday, May 24, 2011

Setback!

George can be a real pain in the rear at times.  Dealing with her feet is the prime example of this.  She's a butt-head, there is no other way to explain it.  When I arrived at the barn the Monday after the maggots were removed, I found my horse was missing!  My friend had given her some tranqualizer and turned her out in the catch pen.  After wrapping things up around the barn it was time to change her bandage.  By the end of it she'd have the twitch on.  Standing still was not in her plans. 

Granted it's her own fault it had to be changed, she'd decided to pull off the others.  When changing the bandage on her right fore, she was oh so sweet and kicked her Soft-Ride boot off.  She made me proud though, when I asked her to pick it up so that I could put the boot back on, she obliged in picking her foot up, and did not put any weight on me.  A vast improvement from when the vet had last changed that bandage and his assistant gave him crap about whining about picking the foot up when she didn't want to pick it up. 

Wednesday finally arrived.  I barely beat the vet to the barn and was putting on George's halter when he walked into the stall and remarked how great she was looking.  The plans for the day were to trim the hoof and take x-rays to check on the state of the bone.  His attitude changed immediately after she took her first few steps.  George was no longer putting pressure on her heel.

After he gave her tranq, he went to remove her bandage, and as he did, an abcess popped out her cornet band.  Well, that explained why she wasn't walking so well.  He proceeded to trim her hoof.  Initially planning to leave the old sole that was still attached to the hoof, but in the end taking it off.  Overall, he was very pleased with the growth in her sole, the new frog and the overall quality of the hoof and the way the wound was healing.  Then it came time for x-rays.  He took three and then began to look at them.

The part that disturbed him was centrally located on the front of her coffin bone.  There was a small portion that looked like infection.  He mentioned that there was a slight possibility it was the hoof laying down new bone, but he didn't sound convinced.  He said he'd compare the new x-rays with the previous ones to be sure, but likely she would need to have another surgery the following day. 


5/18/11 - New area of interest is the abnormal spot on the front of the bone, that should be a smooth, straight line.

As he further assessed the situation, he explained that this time, he would not disturb the new tissue growth by going through the original hole he'd created, but would insteadcut latterally through the hoof wall.  He planned to go through and scrape away the infected bone.  Seeing worry in my face, or just sheer determination, I'm not sure which, he proclaimed that "she's not going to die."  He also prescribed that she start on chloramphenocal three times a day, explaining that for whatever reason it was really good at treating bone issues.

 This was all determined after there had been conversation earlier that they never do surgeries by going laterally through the hoof wall.  Although, they'd also done one earlier that day. 

Monday, May 23, 2011

Maggots, Maggots, Maggots

I've seen maggots used to treat hoof ailments before.  Last summer while working on the farm we had two cases, a yearling and a mare that required sterile maggots to treat their respective ailments.  It all sounds weird, but they are truly little miracle workers. 

Much to the vet's delight, the first round of maggots took to the affected area just fine and started their work.  Maggots are tricky, they don't like water, they don't like fresh blood, but they'll fight the infection like crazy.  Each round of maggots required a bandage change approximately every two days.  For the whole first round of maggots, the vet was happy with the maggots, but concerned that the filly wasn't putting much weight on the foot.  She was certainly thinking about it, touching her toe to the ground before hopping on her good foot. 

After about seven days, the maggots have lived their life span in the wound.  The vet explained to us one day that their mouth pieces physically adapt so that they can no longer eat and they then work their way out of the injury to burrow into the ground and hopefully become flies.  So he never has to worry about leaving any maggots in the wound.  True to form, at seven days she had no maggots in her foot and it was time for round two.

Round two saw similar progress.  The maggots took and she continued to bear more weight on the foot.  At one point the vet took x-rays to see how far up the wound the maggots were going, and was pleased to see they were working their way all the way up the hoof wall where he removed the laminae. 

When he came for round three, we finally got the chance to ask him if the filly could be hand grazed.  He said of course, in fact, as long as it was dry and she stayed relatively quiet, she could go out in a round pen all day for all he cared.  Well, we don't have a round pen, but a small triangular catch pen.  He said that would work too, the important thing was that the foot stay dry. 

So the next day we gave it a shot.  I don't trust the filly.  My friend was gung-ho about just letting her loose in the catch pen.  I've known her a long time, so I kept her on a lead rope for awhile.  She dug into the grass and dirt, happy to be outside (for something other than the vet) for the first time in around three weeks.  Since she was quiet, after about 10 minutes, I let her off the lead rope and hopped up on the fence.  My friend suggest that we go throw up her stall so that the mats got a little time to dry (we'd nicknamed the filly "waterfalls" by this point).  Leaving her in the catch pen, three feet outside the gate, we turned to look at her. 

She'd walked herself into a corner and got herself stuck, this made her mad.  She kicked the fence with her hind foot, then somehow managed to wheel herself around and attempted to run to the other corner.  Here she got mad again and thought about rearing.  By this time I was in the catch pen again.  She tried to bolt to her original corner, but I blocked her way, so she ran to the third corner.  Here, my friend was thankfully able to grab her by the halter, because otherwise I would have had an interesting time catching her, considering all I could see was her hind end, and I now knew she felt well enough to kick with that.  She spent the rest of her time outside that day grazing with me on the end of the shank. 

The best part of the third round of maggots was that she was finally putting weight evenly on the hoof, including the heel.  She was still walking funny, but that was because the vet had placed her in a special shoe that elevated the heel to prevent her coffin bone from rotating.  The vet was essentially treating her as a foundered horse.  Day five of round three of the maggots rolled around.  The initial call from the vet was him calling to ask if he or my friend was changing the bandage that day.  I told him I was unsure, to check with my friend.  In the end, the vet changed it.  I got a call later that afternoon, all of the maggots had worked their way out of the wound, she was walking well, applying full weight to the foot, and as the vet said "she's not out of the woods yet," but he was pleased.  X-rays would be taken Wednesday, and we'd go from there.

Thursday, May 19, 2011

Post-Surgery

About a half an hour after I hung up the phone I started shaking.  What had I just done?  The prognosis if she made it out of surgery was a 50/50 chance of survival.  Thoughts such as these raced through my head, along with: I need to study!  Focus on Property!!

An hour came and passed.  With each minute over that hour time estimate the vet gave me, my anxiety increased about two-fold.  Worrying about the possibility of complications, how the heck I was going to pay for it all (at this point I didn't even have a summer job!) and how this would affect my finals grades had me on the verge of tears.  To add to everything, I was supposed to go to a friend's birthday dinner in a few hours. 

Finally, the vet called.  Everything went as he had planned.  He x-rayed post-surgery and believed he had got all of the infected bone out.  He removed about a 1/3 of the coffin bone and scraped almost the entire way up the hoof wall and removed a lot of the laminae.  Some of the laminae may grow back, but the bone was gone.  He also used a whirlpool boot to circulate CleanTrax through her hoof.

4/26/11 - post-surgery x-ray
The plan was set that he would allow the wound to clot and see her in two days to check on it and CleanTrax it with a whirlpool boot.  After that it would be multiple rounds of sterile maggots.  As planned, he showed up two days later and everything went as planned.  And the first round of maggots went in two days later.  George was on the road to recovery and becoming more of herself each day.  In the meantime I had two finals in between surgery and the first round of maggots.  I'm happy to report that a few weeks later I passed both with little problem.  As for the first round of maggots, the vet came back the next day to check that they took to the wound, otherwise he would inject the hoof with a powerful antibiotic so that at least something was directly attacking the infection in addition to the Baytril and penicillin she was currently on.  The good news was they took to the infection and tripled in size over night.

Wednesday, May 18, 2011

The First Few Months

George left us in complete wonder many days.  The antics she pulled were like nothing we'd ever seen out of a horse.  My foreman recently remarked to me that her all time funniest moment is due to this horse.  She wishes she could insert a memory card in her head, remove the memory and submit it to America's Funniest Home Videos or the like.  The memory she's referring to came when it still required two people to pick her feet.  It actually happened after they were done.  She and one of the guys in the barn walked out of the stall and a few seconds later all I heard was laughter.  Apparently the filly had thrown herself on the floor and thrown such a temper tantrum that it caused the guy to remark "That looks like my 2 year old!"  Attention issues much?

George also had special hind shoes at one point.  They were a hard plastic that were glued on and had an extension off the back to help get her off her heels.  The aisle is blacktop.  The added noise would spook most horses, especially a young foal.  Not this one.  She figured out that she was making the noise, and to her, that was the coolest thing ever.  From then on, all you'd hear going down the aisle when she was being turned out was "click, click, CLACK!"  She'd be walking normally down the aisle and then throw her hind end in the air, slamming her feet down to make as much noise as possible.  Once you got outside on the wood chip path, she'd stop.

George's mother wasn't so sure about this whole motherhood thing.  She really was a good mother, she let the foal nurse, wasn't aggressive towards us.  She just had a habit of walking up to her sleeping baby and kicking her with her front foot to get the baby up.  She did this outside or in the stall, in fact, she still does it with her '11 filly.  Well, George didn't always tolerate it.  We were working in the aisle one day and heard a commotion down the aisle.  We figured one of the babies was cast against the wall.  When we reached the end of the aisle, we saw the filly in the middle of the stall, kicking at her mother with both hind feet while the mare ran circles around the edge of the stall trying to escape the filly.  My foreman called the filly mean, I said she was getting payback for her mother interrupting her naps.

George slept a lot.  She also was very lazy about getting up.  It would have been nice to have a cattle prod most days.  The babies occasionally cast themselves against the wall, it happens, no big deal when they're small enough to flip back over so they can get up.  Usually the flipping of them can be quite dangerous because they will start kicking.  One day, George cast herself in the door.  My foreman grabbed her hind feet and another co-worker grabbed her front feet.  Midway through flipping her over, my foreman lost her grip on the filly's hind feet although the filly wasn't fighting it.  Still, the filly didn't fight, she laid there flat on her back all four legs in the air.  Casting herself on the wall would become a favorite trick of hers for awhile.  Because she didn't fight, it usually meant that only one person was needed to flip her back, but she quickly became an annoyance in the barn because of her little trick.

I didn't just choose George, she chose me too.  I had the short-shift of night-watching on the farm and that involved checking on every horse on the farm hourly.  By the end of the summer, the majority of the mares and foals were out in one big field.  Usually, they found their way to a spot in the field that could not be seen from the road.  So, I'd trudge my way out into the field, usually with an idea as to where they were because I could see one mare from the road.  It was after I finished checking on them that I had to be careful, because I typically ended up with a four legged shadow.  If I wasn't careful, this crazy little filly would follow me all the way back to the gate, out of sight of the herd, out of sight of her mother, she didn't care. 

Surgery

Any text message that says "Can I call you in a few minutes" or something like it, is never good when you know the vet is at the farm.  That was the text I got the night before my first final.  At this point, I had not seen the filly in two days and had very little idea of how she was doing.  My friends were great in taking care of her and not letting me get too distracted by her.  How they don't hate my guts at this point, I don't know.

I eventually received that call.  The bad news was that the infection had spread, and aggressively.  Apparently the vet had not brought an portable x-ray with him, but sent his assistant back to the clinic for one once he saw her.  He wasn't happy with what he saw.  The verdict came down that she had to have surgery, there was no other choice if she was to live.  As my friend explained costs and other details my mind raced.  My little yearling might not ever be anything but my little yearling. 

After running through everything, she asked if I wanted to talk to the vet.  I said yes, and tried my best to articulate questions to him.  It didn't help that the call dropped multiple (I think 5, it felt like at least that) times.  I now only remember bits and pieces of the conversation.  Important details like payment and cost.  The random ones like how he's seen horses with as little as a half a coffin bone be competitive, and that she'd need special shoes until she fully healed.  And most importantly, that surgery was the only option, and I could have up to 24 hours to think about it but the decision had to be made.  He said there was a large enough piece of bone to be removed that they could send her to the clinic and lay her down on the table and really clean out the infection, or he could do it there on the farm with her standing up.  He said he felt confident that he could get it done there on the farm and she was already blocked.  He also said that since he'd x-ray post surgery and make sure he got it all cleaned out.

I gave the go ahead and he said they'd talk to me to expect a call in about an hour when they were all done.