Wednesday, February 29, 2012

UPDATE: Sneaky and Vince, Comrades in Stalls

We went out to the barn today, to prepare for a horse show this weekend across town. It was the first time I had seen Vince or Sneaky since Saturday. There were a lot of changes.

First, an update on Sneaky. He is feeling good, and the swelling in his sheath has gone down considerably. I walked him around the aisles today and we moved at his pace, which consisted of three steps forward and then wait a few minutes before walking three more. The fluid has settled to the lowest points, along the bottom line from sternum to rump. This causes the skin to stretch tight across the top line making the hip bones more pointed that they really are.

His appetite is still good as is his water intake. What goes in is having no problems coming out in either format. The banamine was making him sweat, so SM gave him a haircut to help with the sudden heat wave we are having here in the South. I presented him a molasses treat with rock candy in the center, which he loved, and a small carrot. That took a little longer, but when we left he had moved around in the stall and was starting in on the evening hay.

Sneakers is in for a long recovery, but as long as his spirits stay good it will be okay. He knows this time he got hurt worse than ever before and this injury is teaching him that age is more than just a number. But he also knows how much he is loved.

There is a special bond that exists between horses and humans. Our bond with them is primal; on their backs we conquered the world. Behind their shoulders have plows brought our food. They have transported us and transformed us, and if we stop long enough to listen, they can teach us. If we are smart enough to hear.

Vince is responding to his PRP injection extremely well. When he heard me come into the barn, he stopped cribbing long enough to come demand my attention. His eyes were bright and his ears were forward, two things that had been missing these past weeks as we fretted and consulted on what could be wrong. Today the goofy gelding was back, complete with a new component - love. After six long months of dancing around together, now we are a family.

Why did it take so long?  Why now? Because I took away the pain. I know, it wasn't me personally but we took him to the big scary place with needles and now it feels better. He knows at last we care about him. In human terms, all we did was take him to a doctor, but in the animal world we did something huge. In return Vince is ready to go forward and get better.

And you know what? So am I.

Saturday, February 25, 2012

Into A Completely New Day

Late on Thursday afternoon, Dr. Groover and the Neurology team referred the case to the Surgical Department. The biggest break in our case was the really bad attitude Vince had developed in the preceding weeks. Always a little head shy, he had become down right unsociable. Not even AJ was immune to his poor view on life. His behavior was more irritated than would come from pure EPM, I was informed.

Vince had lameness issues.

When he was purchased in July of 2011 from Florida his feet were not in great shape. They were bruised, dry and he was almost walking on his heels. Since then we have been slowly balancing his feet. But when he moved, ever so gradually it became apparent there was something going wrong. The Surgical team repeated all the trotting motions the Neurology team had performed but they added another component - flexation.

First the front legs and then the back were pulled and tucked and after each time, the tech would trot him down the lane, stop at the end and return. With the front legs no amount of flexing or pulling made a difference. But as soon as they came to the back legs it was a completely different story.

The resident, whose name I will not attempt to spell because it was Italian and I never got it right, believed the problem was in the hocks. As the owner of one horse with bad hocks, from a first career as a reining horse, my immediate response was, "Are you sure?" She assured me the final decision would come from the head of the Surgical department, who name I will not attempt to spell because it was strange and I never got it right.  To confirm the decision a block would be injected into Vince's hock to measure the difference in pain when trotting.

More needles! But first we had to have our hocks washed to make sure no dirt could get into the injection site. While the cleaning portion wasn't too bad, they did have to sneak a calming shot into my boy to prevent their heads from getting caved in. Waiting for the block to take hold, the Surgical head came in from his afternoon classes.

The entire parade moved outside. Between the techs, the residents, the students and us there were about forty-eleven people watching my gelding trot back and forth. After three strides, the Surgical head proclaims, "It's not the hocks, it's the suspensory ligament." So back we go into the procedure room for another shot. (Did I mention there was still blood on the floor?)

After waiting inside everyone then troops back outside for another trotting session. Another down and back and Dr. Surgical Head announces that his problem moved from the left leg to the right. Amazing - my horse is so talented. Now the call is to sonogram the suspensory ligaments in the back legs. This means more sedation and a shave for each back leg.

To make a long story short (I know, too late!), we discovered three things:
1) - Vince has a lesion on his left suspensory ligament.
2) - His right ligament is inflamed.
3) - My horse can snore and drool while on drugs.

The lesion on the ligament is not new. It can be caused by repetitive off-balance motion, especially at high speeds. Vince is a jumper. They are prone to these injuries. It is treatable. Vince received a PRP injection. PRP stands for Platelet Rich Plasma. Basically they took Vince's blood, again, and spun it inside a centrifuge to separate the platelets. These are injected into the injured ligament to promote healing. It is very successful, though he might not be as enthusiastic about jumping all the time anymore.

Both horses spent the night, as the procedure was done on Friday morning before all the vets had to go either teach or be in class. After dinner at Ruby Tuesday's and a good night's sleep we awoke and drove back out to the Large Animal Hospital. Vince was just coming out of his sedation haze when we entered the barn. Connor had been wonderful, even feeling safe enough to lay down and sleep overnight.

With clouded skies and too warm temperatures we loaded, paid the bill and left. We ran into rain around the state line which at times was so hard you couldn't see the road in front of the car. Closer to Atlanta the sun came out and the ground dried up and at long last we were back at Blue Skies.

I confess to a large sigh of relief that our worst fears were not confirmed, but there is still a long road to rehab and recovery. For the next 30 days Vince is on stall rest with hand walking. Then we go back to Auburn for a recheck and further instructions. We could tell he already was feeling better because he was cribbing again and his sweet goofy attitude was back today. It was nice to see.

EPM is a horrible illness, and I learned so much I didn't know before. While he does not have an active case I feel for those who are going through the pain and frustration of this disease. I wholeheartedly recommend Auburn University Large Animal Teaching Hospital and its staff. The entire experience, from initial phone call through the on-site process was excellent. At times I felt frustrated, with the trotting and the shots, but most of that is the teaching aspect of the hospital. And no outrageous expense.

On a different but related note - Sneaky is going strong. The swelling to the butt and sheath are still there, but he is hanging in there. He gets walked a little every day, just to assess his movement. We take off his blanket, check the swelling, see how much he ate and how much he drank along with his poop and pee levels, which are still good. So that leaves Sneaky and Vince, two good friends, in slow motion rehab.

While originally this was going to be about Vince and EPM, I have decided to continue this blog. Sneaky and Vince still have a long road to walk and they enjoy being the subject of their own blog. Every person who owns a horse is never amazed when something out of the blue happens. I hope that we can help others who are treating their own brave and loyal companions. You aren't alone, although sometimes it feels that way. We all share the pain.

A Long Days Journey...

We left for Auburn University early on Thursday morning. Of course we were stuck in rush house traffic. Our appointment was 10:30 Central time, so we had allowed ourselves for this circumstance, but with a car as well as the truck and trailer it was nerve wracking for AJ as well as Vince and Connor.

Connor had come along for two reasons. First and foremost he appeared to have a possible ulceration on his right eye. A month previous he had injured the eye, and after the medication had cleared up the large pimple, there was a small white cloud in his lens, resembling an ulcer. Second, he had impaled himself on a fence post last June and we were never confident there wasn't something left in the wound.

I know it sounds strange that would be the lesser issue, but after more than seven months, the wound was closed and scar tissue had closed the large gaping chest piercing. The possible ulcer was more urgent - we were afraid on top of his other scar Connor would lose his eye as well. Our little rescue had already come through so much none of us could bear more loss.

Once past the morning chaos of Atlanta our trip passed uneventful. Gaining an hour when we crossed the state line we arrived in Auburn at the Large Animal Teaching Hospital at 10:20am. Check in was similar to any vet, excepted the part where the trailer drove into a gate controlled parking lot and vet techs and students descended upon Connor and Vince, separating them into two different areas: Surgery and Neurology.

While AJ went with Connor, as she was more familiar with both his issues, M and I went with Vince. The resident in Neurology began asking questions as they ran their hands over his legs and back, then began trotting him back and forth over the asphalt parking lot. The students conferred and muttered and did more trotting and then the decision was made to draw more blood for more significant testing.

Bad move - the only living thing I have ever seen more afraid of a needle than myself was my horse! As AJ was walking up to join us and attempting to tell them not to come at his face with a needle, Vince saw the offending implement. What followed could only be described as a cluster. Somehow they managed to get the needle into his neck but before they could connect the collection tubes, he took a cue from another of our horses and played "Spin A Pony"! For as long I as I live I will never stop snickering every time I think of him spinning the tech and newbie veterinarians with the needle hanging out of his neck.

Next the Surgical team came to tell us Connor didn't have an ulcer, all the while the Neurology team was attempting to load Vince into the exam chute. Another bad move - having lost all respect for everyone around him because of the needles, Vince had decided this wasn't any fun and took a page from the mule handbook and refused to cooperate further.

Taking Vince back outside Dr. Groover, the Neurology vet and AJ and I have a further conversation about Connor. The clouded spot in his eye is scar tissue, which is fusing a portion of his lens to the cornea. The eye is functional and his vision does not seem to be affected. They took a sonogram the chest area and there were no foreign bodies or pus pockets in the chest. For the first time, we are given an official okay to let Connor have a job.

Vince's journey, however was about to take a wide detour.

After more conversation and conferences Dr. Groover decided to bring the Surgical team into Vince's case. The key to the was becoming something we attributed to the EPM - a bad attitude. What we discovered was a long step in a couple of other directions.

Wednesday, February 22, 2012

With Horses, It's Always Something.

We went over to the barn this evening to make sure everything was ready for Vince and Connor's big trip to Auburn in the morning, but if you want to hear God laugh, tell him your plans. Last night I received notice from the barn manager Vince had apparently leaned against the wall between his stall and the pony next door and had caved in some of the board. trapping Fox pony in a corner! Tonight we arrived to find a crisis of another kind, only this time, NOT with my horse.

Our barn has every type of horse - retired race horses rescued from the race tracks of the mid-Atlantic; horses rescued from various situations around the country; and our own personal animals. Once such gelding is Sneaky (registered Arabian name Sneak Preview), age 27 - one of our original herd purchased to begin Blue Skies Riding Academy. Sneaky is our grand old man, a proud Arabian with the attitude of the grumpiest of sweet old men. He is opinionated, hard headed, grouchy, and completely wonderful.

About a year ago the decision was made to retire Sneaky and let him live out the remainder of his days as a companion only. He doesn't tolerate the heat as well as he used to (he is a flea bitten grey) and too much trotting or cantering caused him to gasp for breath. Of course that decision lasted only a few months before he let us know, in no uncertain terms, complete retirement was boring. Since then he has only been ridden occasionally by his favorite person DW. They have a special bond and have more fun just being together than most any others. Until I started trying to curb Vince's cribbing, Sneaky was Vince's best and only friend.

Yesterday Sneaky was being grumpy under his usual tree when one of the other geldings started 'something'. I say it that way because only someone who owns more than one gelding knows what I am talking about. The pecking order with gelding is always fluctuating. They don't fight like stallions will, but they certainly run and snort and nip and act like boys. In the process of wanting to be left alone, Sneaky fell heavily onto his right back leg.

No one knows for sure how he fell, but he got right back up and nothing seemed out of the ordinary, until this morning when the barn manager went to check on him. He wasn't eating very much and when she went in the stall it became very apparent the fall had been worse than suspected. His sheath was extremely swollen and his right hip seemed to be at a strange angle.  Many treatments were debated, but all roads eventually led to the phone and Dr. Sue was called. After more consideration we contacted DW just in case things didn't go right.

It took a while for the vet to arrive (isn't that always the way it seems), and she quickly determine that while nothing was broken, he does have a major hematoma on the inside of his right leg into the butt causing major pain. He can urinate, just cannot 'assume the position' as geldings do. We cannot touch the hematoma due to the location; if she were to be unable to staunch the blood flow there would be no way to save him in the field. The closest hospital is either UGA or Auburn, where we are already heading in the morning.

As a family we have made the decision to give him a few days with pain meds and steroids and dmso to attempt to the reabsorbing of the blood into the system. He is drinking well and and eating wet down alfalfa but there is a long road ahead. We will give him all the help and support that we deem safe for the old man. So when you say a prayer tonight, would you spare an extra one for Sneaky? Right now - he needs it more than Vince and Connor. They can have their prayers tomorrow. Tonight I have a different gelding who needs us.

Sunday, February 19, 2012

So, What Is EPM Anyway?

As soon as we began discussing the possibility of EPM in Vince, I ran to the Internet. The daughter of a librarian, the Internet is my constant reference encyclopedia. I found a wonderful site,, which has provided me with a wealth of information on EPM and up to date testing and treatment data.

EPM, Equine Protozoal Myeloencephalitis, come from the poop of the possum. Basically the disease is caused by one of two protozoa, Sarcocystis neurona or Neospora hughesi. Almost all infections are caused by S. neurona, and both infections are treated with the same drug protocols.

The life cycle of S. neurona is dependant upon the opossum. This makes the disease naturally occurring only where the opossum lives, North and South America. A horse becomes infected by ingesting the protozoa in feed, hay, pasture or water contaminated with opossum feces.

The reason some horses go from exposure to active infection are unknown, but a weakened immune system and stress have been sited as two possible causes. After a horse has ingested the protozoa, it travels through the digestive tract, and enters the bloodstream. If the horse’s immune system does not clear the protozoa from the blood, it can cross the blood brain barrier. Researchers do not know with certainty how the protozoa crosses; however, theories include its ability enter leukocytes, and cross the barrier inside of these cells. Another theory questions if the blood-brain barrier has been damaged by disease or drugs, which allows the protozoa to cross.

The protozoa live within cells in the CNS, reproducing very slowly. The horse’s immune system is not able to detect protozoa while it is inside of other cells. A stressful event is thought to trigger rapid reproduction and the protozoa begin to break out of the host cells. They move along the CNS, and enter other cells. There the reproduction starts again.
In the process of exiting the cell, the protozoa kill the host cell. Areas of killed cells are lesions in the CNS. As the lesions grow, they impede the transmission of signals from the brain to muscles, and from muscles to the brain. Lesions in the brain can cause behavior changes in the horse. The infection also causes inflammation, or swelling, of the CNS. Inflammation of the CNS can be just as destructive to nerves as the infection.

As the damaged areas of the CNS increase, the horse generally finds ways of compensating for the loss of feeling in a muscle. The immune system may fight the disease for months, with the only outward sign being a slight tiredness or occasional stumble. The outward signs become apparent to humans when the horse can no longer compensate, and the neurological symptoms appear.

The infection in the CNS requires remedies that can cross the blood-brain barrier to combat the protozoa. Currently there are four drugs listed under treatment which have this ability. Other drugs or remedies may be able to kill the protozoa in the blood, but leave the active infection raging in the CNS. From my reading most people use a combination of drug treatments to cleanse the horse of all life cycles of the parasite.

Horses are dead-end carriers, they cannot infect other horses. Not every horse exposed develops an active infection. Now we are moving forward to help Vince and bring to more people this debilitating and often hard to diagnose disease. Tomorrow, more on blood tests, spinal taps and other diagnostic tests.

For more information, check out:

Saturday, February 18, 2012

Not With a Bang...

Today was the first Winter Schooling Show. Before the world turned upside down it would have been Vince and my daughter's debut in the Jumper Ring. That didn't happen.

We tried to put on happy faces but when I walked in the barn and saw his freckled face, ears back, nibbling at his hay net, it was obvious he didn't feel well. Bravely, M tacked him up and walked into the ring to warm up, our barn manager close at her side in case Vince had a stumble. After only two laps at a trot (with Vince walking the corners) it became apparent to all of us this wasn't going to happen.

I took Vince back to his stall, brushed him down and turned him out while M transferred to our mare Penny. For a long time he just stood at the gate, cribbing on the rail next to the water trough. After retrieving the DARE collar from his stall, I loosely buckled it on and turned to leave the pasture. Suddenly Vince was at my shoulder pushing me, a touch of loneliness on his face.

The only two other horses out at the time were two our of OTTB rescues, Big and Bailey. Usually the OTTB's form their own group and don't really invite the others to share on their round bales. I call them the original discriminators. I walked toward the two, Vince hanging right at my shoulder.

Big is a grey gelding, Bailey a chestnut mare. Both turned to look at Vince and me as we walked up. Vince stopped a little behind the other two, while I walked up to the round bale. "Vince would like to share the bale with you. I promise he won't be any problem." Both returned to munching from the center of the bale. Permission granted.

Slowly Vince joined the circle, the new kid in the cool group on a trial basis. The three of them continued in blissful peace, even when another OTTB, Katie, joined the circle. Only when the fourth TB came to graze did Vince get pushed out. Even then it wasn't mean. He just walked away and back to the gate, ready to come in for the day.

I filled his Nibble Net, great for keeping him occupied and not cribbing in his stall, then brushed him down again and talked about our big trip this coming week. I assured him it would be alright and we would be with him every step of the way. He seemed better than in the morning, more at ease with himself. I loved on him some more and then it was time to go.

After today I am more determined than ever to get this big lovable goof back to normal, whatever normal might be. He deserved nothing more than the most I can give. That's what I intend to give him.

Friday, February 17, 2012

My Horse Is Sick

So my horse has been exposed to EPM. What do I do now?

EPM stands for Equine Protozoal MYELOENCEPHALITIS. It is a parasite that attacks the central nervous system in horses. It come from possum poop.  Here in the South, most animals tested would be positive for exposure. I mean, possum is like the national animal of the South. So to say if he has an active case means more testing.

Next week Vince and his friend Connor will be taking a road trip to the University of Auburn vet school for neurological tests, with a possibility of x-rays or a spinal tap. Connor will be going for moral support and to have his old wound which refuses to close sonogrammed.

I am nervous. I have been doing a lot of reading about EPM and here is the rub - there is no positive test for EPM. You can only eliminate other possible problems and when everything is exhausted then it probably is EPM. Catching the parasites before they have the chanch to cross the blood barrier into the brain is key to a successful treatment and rehabilitation.

Vinny is too bad right now, at least in my untrained opinion. Tomorrow will be his first and last show of this season. He does trip and he has a hard time telling his left from his right, but those could be from an old injury. Only the testing at Auburn will tell.

This is my diary of Vince's big Adventure. I will keep my notes and thoughts and observations. He will have good days and bad days and here is where I will organize his journey. He is a big goofy gelding, and I love him more than I knew. While I know this is going to be a long, and probably expensive, road I cannot imagine not helping him. His goofiness makes my day.

I hope along the way to educate others along with myself about this puzzling and sometimes fatal illness.