not looking great

We had the vet out yesterday to look at Murray’s front feet. He was still lame, and TrJ had a feeling that something in that clubby RF was not right. Historically, he’s been much more sensitive on the LF than the RF, so I was surprised that the club foot was the one constantly catching her attention.

 

We took rads, and surprise! Neither one looks great good normal. In the vet’s (paraphrased) words “to just look at his feet you’d never guess that it looks so bad on x-ray.”

 

He has rotation in opposite directions in his left and right front feet. It’s changed from the rads we took during his PPE in 2015. There are other things too — The Horse says it well: Usually, a foot lameness results from a little bit of a lot of things all added up together (Dr. Alexia McKnight).

 

So. Here we are. Staring down retirement at 9.

 

It’s not great.

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well played, you sneaky mofo

This post was going to be all about how well Murray is settling in to his new barn. And it kinda still is.

We had two really nice rides last week. On Thursday after he arrived, I figured I’d get on Murray for a little hack around the indoor so we could blow some steam off. Murray was wiggling and jiggling at the tie (which happens to be right next to the kitchen where his grain is prepared) and my new trainer (J) suggested I take him to the indoor and turn him out for a few minutes.

new indoor views

In the indoor, a lovely teenager happily opted to give us the space so we could have some crazy time and she went outside for a quiet ride. Murray ran all around, rolled, shook off, snorted 3 times, and cantered around some more. J came in and watched us, laughed about Murray being “definitely a thoroughbred” and complimented his cuteness.

I was definitely worried that Murray would be too much, er, Murray for a new barn. But everyone has been super understanding, accommodating, and welcoming. It’s awesome.


isn’t it awesome, Murray?!

After a quick run around, I tacked up and got on. We cruised all over the indoor and did a little bit of w/t/c, but not so much that Murray was like “eff this place that makes me go on the bit all the time.” That evening we even got to have a little turnout so that someone wouldn’t be too bananas.

cute pony i found at my new barn! i will steal her

On Friday morning, a group of riders were headed out to the back field to ride and asked if I wanted to come with. To which I responded an enthusiastic YES. The back field is super cool — probably 20+ acres of pasture with a gallop track (about 1200m) and grass jump field. I took one look at it on my tour and was like “yeah I’m getting bucked off out here.” To add to the openness, you have to walk down the property line past a whole bunch of hoop houses owned by the neighboring nursery, and there are cows and goats in the pastures adjacent to the field.

murray is skeptical about hoop houses

Murray was a dweeb all the way out there, pushing past the other horses then trotting sideways down the lane. When he saw the hoop houses he took a hard look at them, but I just kept pushing him forward. The lane was somewhat narrow so we didn’t really have much other option, and the last thing I wanted him to do was stop and back up into another horse or the hotwire of the mare pasture behind us. Fortunately, once we got to the field Murray was much more interested in something else.

sweet nectar of Oregon

We walked around the dressage court, grazed, looked at some fences, grazed, did a little trotting, grazed, cantered, grazed, chatted with new friends, grazed.

You get the gist.

Murray was much calmer walking back down toward the barn, so I hope that after a couple more trips out there he’ll think it’s old hat!

When I was untacking, I noticed that a bug bite on Murray’s belly from the day before had pitted under the girth and made two boob lumps. Which was weird. But I assumed that it would go down, since Murray has had allergic reactions to bug bites along his belly before.

But then on Friday, the lump was bigger. And on Saturday it was even bigger.

fooooork

On Sunday we called the vet. She came first thing Monday.

Most of the lump is just pitting edema. But there was this one sensitive, firm section that she thought might have some fluid in it. So new vet gave Murray a second dose of sedation and aspirated the lump, which spat out some pus. Yay.

For those of you familiar with California horse disease, this is not looking great. It’s a tentative pigeon fever diagnosis, but the sample got sent off for culture.

We cleaned out the one abscess and couldn’t find any others. And it was pretty clear what was abscess and what wasn’t — Murray was cool with you thumb printing the pitting edema all over, but on the abscess site he was kicking his belly with shocking accuracy. New vet put Murray on antibiotics, and he’s now on stall prison until we get the culture back and the abscess site closes.

He’ll be fine. If it is the pidge, we caught it super early. If it’s not the pidge, we caught it early. It’s just an abscess.

And of course, I can’t ride. Because the abscess is right where the girth goes.

Well played, you monster. Well played.

just like that

I’m hesitant to make any statements about the inevitable end of the leg hole saga, but I was quite surprised by the sudden and marked improvement in the wound this week. From the surgery date until the first of November (about seven weeks) the hole had been steadily but very slowly closing in with lovely pink scar tissue.  And I do mean slowly.  We were making 1-2 mm of progress every four days.

It even got to the point where I started lining up all of the pictures I’d been taking, scaling them to the same(ish) size based on multiple landmarks, and measuring the size of the wound with circles and lines on PowerPoint.


left to right, late September to mid November (mostly every 4 days, but with a good 2 week gap between the 4th and 5th images)

The wound was persistently puffy and open for about two weeks at the end of October (between the 4th and 5th images above), and seemed only to get angrier and threaten more proud flesh.  I hung around while my friend’s horse had a sizeable degloving wound checked out by the surgeon who treated it, and fortunately learned a good deal about granulation tissue, what it’s made of, and what it can look like. The answer: it can be made of almost nothing glued together by even less, and as a result can have a whole range of different appearances.  (Life pro tip: do not google image search “granulation tissue”).

Murray also became less well behaved during bandage changes. Despite the hand walking and the training and the increased attention, one change at the end of October was awful. And then, as I was cleaning up the wound and getting prepared to re-wrap, another piece of skin fell off. In a different location. Below the original wound.

W

T

F

I don’t have any pictures of this because I was so busy screaming NOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO that I was incapable of taking a picture.

Lucky for me, RBF was on hand and pointed out that the skin that had fallen off was very superficial and I could just use some more telfa over it and it would probably heal real quick. Even better, she was right.

wound shrinkage, as indicated by my cleverly-inserted red circle

And then — miracle of miracles — a scab appeared. Right over one of the deepest and almost-proud-flesh-iest bits of the wound, a nice healthy scab just showed up one day. And the rest of it was nice and dry and that yellow-y flesh that I’ve seen on other healing wounds. I’ve never been so happy to see a scab in my whole damn life. Scabs mean healing! Scabs mean that the granulation tissue was flat enough for … well I’m not sure what for! But a scab is a great forking sign!!

There is a tiny bit of puffiness left, which I discovered when I left the wrap off for a few hours to let the leg air out a bit.  When I came back to it, the last little bit of open granulation tissue (by the blue arrow above) had puffed up, as it has been wont to do.

Our vet happened to be at the barn during this, and took a quick look. She proclaimed us almost done, and cleared Murray for limited turnout in the round pen. Murray celebrated in the way to which we have become accustomed.

full leg replacement surgery

Remember how optimistic I was about Murary’s leg last week?  It was healing, the wound was closing, and (I haven’t written about this yet) he was working fantastically under saddle to boot.  He was gonna be healed up in no time!! JUST KIDDING.

he is starting to get that soft, fuzzy look that winter hair brings

During our dressing changes I noticed that healthy skin had stopped closing inward, and on Monday when I left the dressing off for more than a few minutes, a ring of proud flesh reared its ugly head.  My vet said she could come out on Thursday (three days later), and to keep putting steroids on and wrapping and she’d debride if needed.  So of course I put some wonder dust on it JUST IN CASE that would fix the problem for me.

I turned Murray out on Thursday before the vet appointment knowing that it would be his last shot at freedom for a while.  He galloped and galloped and galloped and galloped.  And then when I called him he galloped up to me. ❤

When the vet got there I told her about the progress/regress since she last saw the wound, and then said “and I know you said just to keep putting steroids on it, but on Tuesday I put on some Wonder Dust…”  She said “noooooo” in response, and her husband/assistant said “YEAH! I love that stuff!!”

“I know sometimes it eats away at the proud flesh and so I figured I’d just do it, because what’s the worst thing that could happen? You were already coming out to debride it.  So I figured you could fix any problem that I caused with it. SORRY I COULDN’T HELP MYSELF I KNOW YOU SAID NOT TO.”

At least I made her laugh?

also learned a new wrap: pressure wraps!

Linda sedated Murray (I now know that he is not a lightweight), and started examining his leg.  Unfortunately, the extensor tendon along the front of his cannon was starting to swell above and below the hole, which means there’s probably some low-grade tendonitis happening in there (probably an infection, at least one hopes).  That led to digging around in the wound.  The weird black spot that had formed in there was odd, and Linda thought it was maybe some deep necrotic tissue that formed from the outside in, and therefore couldn’t be sloughed properly.  After taking away the yucky proud flesh and necrotic bits, she pointed out to me that a couple of deep spots on the wound went all the way down to the tendon.

Ugh. Great.

But we cut it all away, and Linda applied a pressure bandage and prescribed SMZs to help ward off infection.  Bandage changes every 2-3 days, with triple antibiotic, steroid, telfa, sheet cotton, vetwrap, and elastikon to keep that puppy healing nice and flat.  PSA: Valley Vet is cheaper than Amazon for that shit.

sad sedated selfie

The super super super duper humongous downside to this whole “fixing the fucking leg wound for good” thing is that Murray has been going so well under saddle lately and we’ve been having a ton of fun and now we’re limited to stall rest and hand walking for a month.

A WHOLE MONTH. WTF.



tiny dog provides awkward comfort during veterinary procedure

There’s no shortage of ponies to ride, fortunately.  And I always said that if Murray went lame I’d just do tons of ground work and clicker training with him, and teach him all kinds of tricks so… I guess this is the perfect opportunity for us to learn some shit!

Overall, 0/10 do not recommend burning your horse’s skin off with chemicals and allowing deep necrotic tissue to form all the way down to the tendon.  (However Linda gets a 10/10, obviously.)

wordy wednesday: behavior, cortisol, and welfare in horses

I’ve always wanted to put my research background to good use on this (or any) blog; writing in-depth but accessible articles knitting together research and results from multiple sources to bring a thorough and complete view to some complicated topics in equine science.  There is a crazy (though small) world of equine science out there: studies that explore everything from the effect of specific drugs on equine osteoarthritis to the interrelation of saddle slip and back shape on lameness in the ridden horse*.

Weirdly, I don’t seem to find time for that on the reg.


too busy doing this

Every once in a while I do come across a neat article about something equine-science related that I want to bring to you guys.  Frosting on the cherry is that this particular article is open access, so you can all read it if you want to!  And, in my opinion, it’s actually a fairly well-written and understandable study — perhaps because it tackles a fairly accessible topic that doesn’t require large amounts of jargon or a lifetime of studying some very specific mumbo-jumbo at 100x magnification to understand.

Low plasma cortisol and fecal cortisol metabolite measures as indicators of compromised welfare in domestic horses (Equus caballus)

Jodi Pawluski , Patrick Jego, Séverine Henry, Anaelle Bruchet, Rupert Palme, Caroline Coste, Martine Hausberger

Read the full text for yourself here.

I was originally attracted to this study because the write-up of it claimed there was some evidence in there that high cortisol levels in horses might correlate with a positive type of stress (excitement), as opposed to negative stress (poor welfare, having the snot beaten out of them, etc.).  It doesn’t quite show that, but it does cement some interesting and important findings.

  1. Horse behavior can give us good insights to their welfare (duh, but read on a bit): horses that had an ears-back posture more than 50% of the time had lowered cortisol^ levels associated with hypothalamic-pituitary-adrenal (HPA) axis down-regulation (fancy way of saying their hormone pathways were messed up), which matched other studies. This means that both the behavior/posturing and testing of cortisol levels can be useful to equine welfare scientists in the future (within reason, of course).
  2. Riding horses don’t think their lives are total shit, even when being ridden by amateurs.

In my opinion, one of the major strengths of this study is that the researchers used riding school horses in an active program (in France). Often, study subjects are kept in near hermetically-sealed conditions, in an attempt to control all external variables.  So an “inexperienced” person riding a horse in some studies is really someone who isn’t a legitimate professional, though can still course 3’6″.  While this is great for control — you know the rider isn’t likely to hurt the horse and can do exactly what you want them to do — it just doesn’t exhibit a lot of external validity — most horses don’t live their lives being ridden only by people capable of coursing 3’6″.  For the most part, being flopped around on by rank amateurs is a lot more like a horse’s experience.


floppy reality

So, what did the researchers actually find?  (In reverse order, because I’m trying to be confusing). #2 — horses did not experience a significant rise or fall in plasma cortisol or fecal glucocorticoid metabolites (FGMs).  This means that being ridden in a school program by kids who bop and pull and bounce and kick is not a significant positive or negative stressor for these horses.  Not enough to cause an acute or long-term rise or drop in FGMs or plasma cortisol. (Many caveats exist of course: these horses have been established in the lesson program for a while, meaning they didn’t flunk out so they must not hate it anyway; also, these horses had pretty astonishingly high levels of chiropractic issues — so many collinear factors here. You be the judge.)

And finding #1 — When we see horses with withdrawn behavior (in this study: ears back during feeding time, but in other studies: non-responsive behavior, facing a wall, reclusive in stall) we can pretty reasonably question whether or not their welfare might be compromised.  Just because a horse is a bit cranky doesn’t mean they have poor welfare, but it might be worth looking into.  The authors also looked into physiological measures (anemia and chiropractic issues), and there is definitely a feedback loop between psychological health, physical health, and welfare.  So we might consider that a horse who demonstrates a change in behavior, from generally perky to generally withdrawn or low-affect, might be experiencing something physical as well.

Interesting to note is that the researchers didn’t report anything about stereotypic behaviors like cribbing, weaving, etc.  I have done a lot of reading (in both horses and other species) about how stereotypic behavior might indicate welfare, and the literature is vast and, ultimately, equivocal: sometimes it means bad, sometimes it means nothing.

So there we have it. I really encourage you to read the full article if you have time, and tell me what you took from it!  We can start a little blogger journal club!

poor welfare or drugged?

* I have full access to these so please drop me a line if you’d like to know more.

^ Cortisol is often referred to as a “stress hormone”, but it really does and indicates so much more than that.  Cortisol is upregulated any time glycogen is turned into glucose to provide easily accessible energy to the muscles.  So obviously, this could be associated with both awesome exercise (like sex! or just running, I guess) and un-awesome exercise (running the fuck away from a lion). I will actually just direct you to the paper for more on this, since I feel that the authors did a really excellent job of explaining some of the complexity surrounding cortisol in the introduction.

Official stuff:

Article Source: Low plasma cortisol and fecal cortisol metabolite measures as indicators of compromised welfare in domestic horses (Equus caballus) 
Pawluski J, Jego P, Henry S, Bruchet A, Palme R, et al. (2017) Low plasma cortisol and fecal cortisol metabolite measures as indicators of compromised welfare in domestic horses (Equus caballus). PLOS ONE 12(9): e0182257. https://doi.org/10.1371/journal.pone.0182257

disgusto leg wrap-update

When it left you last, Murray’s disgusto leg was your standard level of disgusting keratosis leg, but nowhere near cancer-leg.  Since then, it has become so much more disgusting before getting better.

looks like it’s healing, right? WRONG

First, the adhered scabby bits fell off with a little encouragement (I know, we’re not supposed to encourage that kind of thing, but it was seriously holding on by like 2 square mm and I couldn’t get the ointment underneath otherwise!)

i cut lots of bits of dead skin off per veterinarian advice
my hand is in most of these pics both for scale and because it helps my dumb phone camera focus

The last little bit revealed some pretty deep… wound or whatever it was underneath. But it got on with the business of healing over through secondary intention.  Ya know.  Standard healing mumbo jumbo.

looks like it’s healing right? WRONG

The above picture is from 8/8.  The next one is from 8/28.  During Camelot I wrapped the mostly-closed-and-dry wound with a little triple abx, telfa, and vetwrap before putting boots on.  It was a little yucky after because it, predictably, ripped off the scab, but after Camelot it seemed to dry up and close over nicely afterward.  I was like, this is totally healing and normal!  Look it’s all closed over!

Except what’s what weird edema-lump?

I started to wrap again at this point, which I’d been neglecting for a few weeks because I’m part of the “let it dry out” school of wound healing.  I bought this pack of vetwrap knockoffs earlier in the ordeal and started working my way through the ugly colours (red and lime green, obviously leaving purple and teal and pink for a more glorious time).  Murray didn’t seem to care if we poked, prodded, pulled, or wrapped the lump, so we continued with vetwrap+telfa as before.

I finally got the vet out after the WSS show because the lump wasn’t going away. She poked and prodded it a fair bit and managed to pull off a deceiving scabby bit that was hiding some fairly angry skin underneath.  In her words, it wasn’t proud flesh yet, but it almost wanted to be.  Weirdly, Murray didn’t give a shit that the vet had poked and prodded his leg and pushed off the scab.  The middle of the wound, however, was kinda puffy and pink and angry.

Ugh. Gross. Proud flesh, which I had been trying to avoid the whole time.  The next pic is blurry and shitty, but you can see how angry the middle of the wound was — and this was after a day of topical steroids.

The vet prescribed a week of steroids, wrapping with vetwrap + standing wraps to avoid any weird swelling stuff, and no turnout for a little while.  Five days in, the steroids have done a magnificent job and I’m kinda wondering why I can’t put steroids on every little booboo?

So that’s where we’re at with disgusto leg.  Still not lame, still not painful, just disgusto.

To add insult to injury, of course, almost all of the keratosis on the other legs has come back despite gentle and frequent currying.  So… it’s time to try some of those other ointments to break that shit down.  I cannot believe that last year, when I basically didn’t groom this horse for three months other than a brief brush over the saddle area, I got almost no keratosis build up, and this year it’s a legit problem.  Ugh. Why.

reconsidering pentosan

Since Twin, I’ve been thinking about what I might be able to do for Murray to make him more comfortable and extend our competition career.  A part of what inspired me to start thinking about it more seriously was his super-stardom at Twin, but I also have a lot more income than I ever have in the past. This makes entertaining the idea of spending/potentially wasting money on my horse’s well-being possible — I literally* did not have the money to pour money into joint maintenance before.

* The actual literally, not the millennial “literally” that really means “figuratively” or “maybe”

I first heard about Pentosan on Amanda’s blog (like, where I hear about most things apparently), and after following the trail of evidence she left, I wasn’t terribly convinced.  Use of the drug was based mostly on anecdotal reports of improved movement and comfort after IM/IV injections among Australian horse owners, and there wasn’t a ton of peer-reviewed evidence to back up using Pentosan IM/IV for joint maintenance.


murray is a skeptical walrus

Pentosan, if you’re unfamiliar, is a semi-synthetic polysulfyated xylan (don’t know what that really means? me neither!).  It is used for several purposes, including treatment and prevention of osteoarthritis.  The most interesting thing, to me, about pentosan is that it is used during open-joint surgery to help heal the joints after they are put back together.  Literally, surgeons squirt the stuff all over the open joint to help avoid cartilage break down and improve synovial fluid viscosity.  edit: Austen pointed out to me this important clarification: joint lavage (which is done both surgically or arthroscopically) works by helping to wash away debris that accumulates in the joint and may cause pain (at least in humans).  Therefore, the pentosan may not be having as much of an effect as might be reported — the lavage process itself is extremely helpful in this case.

I’m won’t rule out a treatment or medication as ineffective simply because it doesn’t have veterinarian or peer-reviewed evidence.  I know that it takes time to conduct studies and gather data, and that what is currently being studied may not be what is in vogue with horse owners at the time.  Joint pain and comfort is terribly hard to quantitatively evaluate, especially when you want to look at more than just the articulation of a specific joint (how far that joint can flex/bend), and supplements/drugs for joint pain in companion and production animals aren’t necessarily at the top of the research ladder.  Particularly in equines, the amount of scientific inquiry into the efficacy of drugs or supplements is quite sparse.

All that said, I’m not going to rush out and spend a lot of money on a product that is anecdotally reported by horse owners to make their horses “feel better”.  The placebo effect*, even among animal caregivers and owners, is a real thing.  (Also in 2014 my horse was five, not actually mine, and it wasn’t the time to think seriously about maintenance.)

* Have just realised this could make an incredible horse name!!

placebo effect is sooooo good at canter poles

When I started thinking about and exploring joint maintenance for Murray this year, pentosan popped up both on the interwebs and at the suggestion of a friend.  I took some time to look into the drug more seriously, and found that in the last three years, enough evidence about the efficacy of pentosan in prevention and treatment of OA has accumulated to convince me it’s worth a try.  If you’re interested in my research, just hit me up and I can share the details with you.  But here are some of my more general findings.  (Links here may be behind a paywall.)

First of all, pentosan appears to be safe to use in  horses both intra-articularly (i.e. joint injections), as well as IV and IM.  That’s great, because it means that you don’t have to pony up for expensive IA injections just to get the drug, an if you can’t do IV, you can safely go IM.

There is also good evidence that IM pentosan actually makes its way into both the plasma (blood) and intra-articular spaces (joints).  And in dogs, pentosan has been used to successfully treat chronic osteoarthritis.  If you want to dive a bit deeper into the cell-biology literature (exposing oneself to some serious jargon at the same time), there’s at least one proposed method for pentosan to treat osteoarthritis by acting as a chondroprotective agent (cartilage protective agent).

unrelated puppy throwbac pic

Pentosan was demonstrated to modify the healing of experimentally-induced OA in donkeys and horses.  In these studies, donkeys and horses with experimentally induced OA were given IV pentosan (treatment) or saline (control).  At the beginning of the treatment period, all animals were lame, and their levels of lameness, synovial fluid, cartilage damage, and the levels of certain elements (Mg, Ca) were tracked over time (among other factors associated with joint health).  All of the above mentioned factors improved significantly in treatment animals, i.e. synovial fluid was decreased compared to controls, cartilage damage was less.  Most importantly to me, lameness score in treatment animals decreased to baseline (which I believe was 0) after pentosan treatment, whereas in control animals lameness score decreased, but never achieved baseline levels.

Certainly, this is a pretty extreme way to check the utility of pentosan.  And it doesn’t necessarily speak to the maintenance side of the drug, or how pentosan interacts with joints that might have mild-moderate OA. Notably, a similar study using pentosan and hyaluronic acid was inconclusive and demonstrated no improvement with treatment.  So there is still plenty of room for skepticism.  However, if the proposed relationship between increased synovial fluid and cartilage degeneration in osteoarthritis is correct (an extremely reasonable and supported assumption), and pentosan really does decrease synovial fluid and help decrease cartilage damage, then it seems reasonable that pentosan may help prevent or mitigate osteoarthritis (by mitigating cartilage damage and preventing the forces that result in increased synovial fluid).

There are still lots of “ifs” here.  But I’ll definitely be talking to my vet about pentosan in the coming weeks.

shut up and take my money