Friday, July 31, 2015

The positive way to spin this: another fork in the road...

When to give up?

That’s what’s been going through my mind a lot lately when it comes to Deli. Not to give up on her, because she’s going to get my care for the rest of her life whether she is a pasture puff or something else. But whether to give up on doing endurance rides with Deli. To retire her to easy-going trails without a goal other than moving along.

Endurance riding is something I’ve been trying to achieve with this horse for six of the nine years we’ve been together. Because I think she would both enjoy it and be good at it (barring the obvious soundness problems) and I also enjoy and could be good at it. I love being outside on a trail with a horse I love more than anything but the element of goal-setting (not necessarily winning a competition, but the idea that there is some mountain to climb) to endurance riding really appeals to me.

I have that one LD under my belt and that was enough to make me realize I really really want to pursue this sport. I can’t remember doing something that was so hard and yet so fun ever before in my life.

I was all set to take Deli to her first LD (Bandit Springs) at the end of June. She was doing awesome during conditioning rides. So awesome. She was getting obviously more fit and seemed to be enjoying moving out more on the trails (more forward = more fit and confident for this mare). She was ready, too. She was strong and getting stronger. The couple successful intro rides we have under our belt meant I was pretty confident her brain could handle it as well.

Just over a week before the ride I go out early in the morning to sneak in a ride before the blistering heat set in only to find her pawing in her paddock, not wanting to move. She was 3-legged, the right hind leg had a slightly puffy fetlock, and her distress was obvious. I made an emergency vet call. I found the barn owner down in the barn and asked if I could cold hose her where she stood (and create a big mud puddle), and she expressed surprise because when she’d fed Deli about a half-hour earlier she was walking around acting normal.

It was bigger than this, I kid you not. This was taken later when she was comfortably putting weight on the leg again.

I don’t need to go into all the details but as I waited for the vet Deli’s leg got bigger right before my eyes. She got a fever that kept climbing past what would be normal for a horse in pain (eventually getting to 103.7 before the vet was able to administer a nice cocktail of drugs). Concerned about the level of pain she was in – to the point she was almost panting – and knowing the vet was still at least an hour away, I called her to let her know I was giving Deli the last of the painkiller I had left from her last badbad injury.

The final diagnosis was lymphangitis, but based on the circumstances it’s likely that Deli was bitten or stung by a spider or other insect. The vet thinks a black widow bite somewhere on that leg is a possibility. We also have scorpions in the PNW, though I’ve never seen them around the barn. The weird and bad weather we’ve had this year had meant the proliferation of all sorts of insects we don’t normally get much of. 

The swelling was bad. Horrific, one might say. The whole leg from hoof to udder was grotesque.

For non-horse folks... the left leg is normal.

Deli hanging out in a stall the day after the "event".
Deli’s compromised lymph flow in that darn right-hind from her old scar and many bouts of celluitus probably contributed. As did her allergy to insect bites (a hyper-immune reaction which started after she definitely had a bad spider bite on her chest about 3 years ago – her skin melted off that time).

Lymphangitis is essentially inflammation and/or infection of the lymph system. The vessels swell enormously. Lymphangitis can be caused by many things – one of which is the introduction of a toxin. Things get inflamed, lymph gets constricted, that gets infected and… everything goes downhill from there. 

Everything I’ve read and heard now says the same thing: Lymphangitis is a frustrating condition to treat."

In all the articles I've read they end saying something like: it’s a good thing it’s such an uncommon condition. To that I say: no sir, because that pretty much guarantees my horse is going to get it.

Deli went through a long round of antibiotics, and me trying to find something, anything, that would work to abate the swelling. Her leg got huge and nothing helped. It got so huge the pitting edema (meaning you can press a finger into it and it stays like putty) was draped over her hoof. Nothing helped. 
A sweat wrap. Which helped not at all.
I played around with different things. Supplements to help cleanse lymph. Infared light therapy. Cold hosing and icing. 

Topical medication. Anti-inflammatory medications and even herbs of various sorts. Bandaging and sweat wrapping and massage. 

I'm still considering other therapies, too.

Trying some feed-through assistance.
Luckily, other than the pain of having her skin stretched tight Deli’s serious pain went away within a day. Her skin itself wasn’t hot or painful like I saw when she gets cellulitis. Up around her groin/udder area it was more painful and inflamed – there are a string of important lymph nodes in the area. The skin on the inside of her leg from stifle upward got weird bumpy skin, almost like hives, and the lymph system in the area became ridged and hot. That particular area hurt a lot when you poked it. It made me consider that Deli may have been bitten a bit higher up and the first swelling just appeared in the fetlock because of how the fluid circulates.

But I’ll probably never know exactly what happened. The spider bite is our best speculative guess based on the whole set of facts we do have. Her temperature being so elevated so quickly, for example.

I finally found that movement seemed to help a little, so she went back out in the big pasture with her buddy. I went out two times a day (meaning over two hours of driving every day for two weeks) to give medications and hand walk her. The FatLeg remained stubbornly persistent. It would go down a little, but only a little. 

She didn't seem very uncomfortable so I hopped on her to do our walking. I even gave my husband a short lesson on her one day to serve two purposes at once.

Lesson pony?
Haha... no. Only for my husband, who she adores.

When we knew we were not dealing with infection anymore, it was time to try steroids. Adding the corticosteroids dexamethasone had an immediate positive effect. She was on that for 10 more days, ending last Saturday. During which time I obsessed over watching her feet for founder – something that luckily didn’t happen (she’s pre-Cushing’s and Cushing’s horses are more prone to founder. And a side effect of steroids can be founder).

Steroids are a magical thing in some circumstances!

Despite all these drugs and enormous time commitment on my part there is currently a residual swelling left. Longer exercise (the longest so far was an hour and a half trail ride) gets the leg looking almost normal, but I can feel a difference. There is still some pitting edema left. This is pretty common – basically the leg will be permanently FatLeg to some degree. Unfortunately this also makes the severe lymphangitis more likely to recur in a previously affected leg.

Yesterday she was stung by a bee on the neck and today the FatLeg is a little fatter. Antihistamines helped that, so now, on vet advice, we are playing with a large dose of Zyrtec that we will taper off.

A more recent shot of the problem leg before a workout, which takes away some of the puff. Much better, but some residual fibrosis (especially around her fetlock scar). Welcome to the world FatLeg.

I’m exhausted and trying to ignore the stress caused by already-substantial vet bills because there is nothing I can do about that right now. I feel like I don’t have the right to complain, sometimes, because this has been a hard summer for many of my friends (and fellow bloggers) when it comes to pet health. We all seem to be struggling. One friend of mine had to put down her old guy recently due to neurological issues.

Further conversations with my vet highlight that endurance isn’t necessarily off the table. Ride her, work her, my vet says, she how she holds up and watch how she feels. Movement is the best thing for Deli if she can tolerate it. Deli is sorta-kinda sound. If the FatLeg is fat she is a bit inconsistent. As it goes down she moves more smoothly. The stretched skin is no doubt uncomfortable, but a short period of discomfort means more comfort later. And since Deli isn't resisting being worked I know she is not really in pain. This is an advantage to sensitive horses I think: I KNOW she's not hurting if she's telling me she's fine. Not a stoic pain-hiding horse, this one.

So we head back out again to wander at a walk. Happy ears = happy me.
My vet – who also vets endurance rides – also said that having some permanent FatLeg does not necessarily preclude competing in endurance. She is not surprised edema is sticking around in Deli’s scarred fetlock or that there is some stubborn fill in the tendons on that leg. She sees horses with “war wounds” all the time during vet checks – what’s important is the horse vets in sound and stays sound, and that the leg doesn’t get bigger during the ride.


Honestly competing Deli in endurance is not something I’m going to worry about anymore this summer. It’s a hot miserable summer. I need to sell my saddle for various reasons, the main one being that I need the money. And it’s not what I want, going forward, even if non-goal oriented trail riding is all that’s in our future.

While I market my saddle (to help pay for those vet bills!) I’ve returned to my trusty Skito bareback pad. Ironically I am much more comfortable on the bareback pad than in my dressage saddle for long walks. Since my own accident my conformation in my hip seems to have changed such that the dressage saddle really pains me. We’ve been back out around the fields near our barn and Deli seemed happy about that – even asking to trot in the places we have been trotting for conditioning. The footing is still pretty terrible around the fields and I’m not that inclined to tackle it while bareback.

I have mentioned my horse is wide, right?
 My main worry right now is the management nightmare this is going to be. Deli needs movement. Lots of movement. She’d probably do better in a much bigger area than she has now (which is about 1.5 acre pasture without much grass this time of year). She also can’t be in mud past her heels due to issues with skin infections which will only be more serious now that she has lymphangitis. 

Ideally she needs 2x a day supplements fed to her (which the current barn won’t do) so I don’t need to drive out daily to ensure she gets her medications when she needs them. Since she is likely pre-cushings, her being on grass may become problematic sometime in the future. So far she seems okay in that respect, but I have to admit the grass this year was minimal compared to a normal Portland spring and summer. She has always done great on pasture in the past and I’ll likely have to juggle the grass issue with exercise issue. The more safe space she has to move and the more movement she is actually getting, the less grass is going to be an issue (probably). Otherwise, how is she going to have all the space she needs while ALSO being on a dry lot (ideally with slow feeders giving her forage access 24/7)?!

Add to those management considerations her insect allergy, her need to have a fly mask put on and taken off, and her need to have certain fly sprays applied but not others (because she's allergic to some fly sprays, too). Oh, and her social needs which always have to be balanced with the fact that she gets harassed and badly injured so easily when put in with poorly socialized equines. She’s in with two bossy brat mares right now and has never had a mark on her from them – but they are also well socialized. Boarding barns have never cared much about such things from my experience and it’s always me that ends up with the bleeding broken pony and the vet bills to boot.

I feel like I could deal with a lot of these things much more easily if she were on my own property. That has always been the dream, anyway. But life and my career are not working out even remotely as planned (so far) and I’m currently in a limbo that does not give me the option of having my own place. I also dislike driving to the barn so it’s not just a desire to work out the management issues myself that makes me want my own horse place. I’d rather commute to work than drive to the barn.

Another thing I’ve run into many times at many boarding barns is that management knows much less about horse care than I do. Multiple places feed poor quality hay or don’t feed enough of it (one place refused to feed a horse more than 10lbs of poor quality hay a day – when board was upwards of $500!). It seems to be the rule rather than the exception that herd turnout and/or pastures are managed very poorly. Overcrowding is very common as well and the land is usually destroyed and knee deep mud by the time the rains come around.

This new hitch in our plans means I am discarding plans altogether that this point. Screw you, plans. The ever-increasing problems of horse-management considerations for my Deli-pony have left me discouraged and looking for solutions I’m not sure exist. At least not where I currently live where boarding seems to be very poor quality for what is paid and the economy is very bad in comparison to the rest of the United States.

I just have to work on that moving forward thing – it’s the best thing for all of us. Even FatLeg.