Wednesday, July 27, 2011

It's not cushings, but she's still lame

Just got Buttercup's results back from the ATCH Insulin test. Insulin and hormone levels look normal, which mean she does not have Cushings Disease.

While Cushings Disease would have meant access to supportive drugs, this is still a good thing, the vet assures me.

Her normal insulin levels mean we've been managing her diet well and the vet said that Equine Metabolic/IR horses can have normal levels so that's still on the table.

At this time, I have no plans to have her tested for EMS/IR because the tests are prohibitively expensive (I have fancy new shoes I have to buy Bud every four weeks), can often miss the IR and even if she is diagnosed, we wouldn't be doing anything different than what we are already doing. There is no cure or treatment for EMS, other than diet management.

Buttercup hasn't improved much with her new shoes, but she does seem more comfortable from last week.

Here's the latest lameness video, which I've sent to person who is excellent at analyzing lameness to see what he thinks:

Sunday, July 24, 2011

New shoes - July 23

We had to up the ante on getting Buttercup comfortable. Forty-eight hours after getting her plain steel shoes, her comfort level dramatically decreased. So Russ came out and the new strategy is four-point shoes (also known as natural balance shoes) paired with a fake gel sole.

Her heels have been her main base of support with her soles so thin and her P3s on the ground (the breakover really hurt her). The four-point really takes advantage of her happy heels, moves the breakover back so that she isn't spending more time on the part that hurts.

The gel is copper infused so it should keep any thrush down. Normally the gel is paired with a styrofoam pad that is level with the ground. Russ filled in with the gel, but kept is just below level of the shoe with the ground, so that it acts more like a sole and minimizes impact to her tender hooves.

She is drastically more comfortable, but still not sound. Hopefully we'll see her continue to improve.

Tuesday, July 19, 2011

Lameness Update - July 19, 2011

So we had the vet out yesterday to try and determine underlying causes through new radiographs. I also had an ATC insulin test to test for Cushings. While Buttercup does not have the clinical appearance of a Cushings horse, she also doesn't have the clinical appearance of an IR horse either. Plus, we could support her with better medicine with Cushings and it's the cheaper of the metabolic tests.

What the X-rays revealed:

• No arthritic changes, so that's a good thing!
• Dramatic decrease in sole depth over the last year and half since the last X-rays
• Building up her heel then created downward pressure on her rotated P3, causing it more pain.

The vet recommended we go back into shoes to give her immediate comfort and my old farrier Russ was right down the road. He came over and shod her. While the vet recommended eggbar shoes with padding, Russ wanted to go with a plain steel shoe and then work from there. If she needs more than this, we will go to it in stages.

X-rays: (they got flipped)

Above view of the P3 looking for arthritic changes:

Vet shoeing Rx:

Freshly shod pics, left:


And while she's not completely sound, she's the most comfortable she's been in three months and that's good enough for me. Hopefully she will continue to improve.

We're still stumped as to why we lost all the sole depth. Maybe it was a triggered by a laminitic episode due to the rabies shot? Maybe it is a seasonal thing for her? All I know is that she lost it and we're doing what we can to make her comfortable.

That brings me to another point: Buttercup is officially retired. All this time I've been working on getting her back to the ring, back into showing, back into jumping, back into something. But I've known for a while now that's a pipe dream. I'll be happy to have her comfortable enough for the occasional trail ride. She may just be a pasture ornament for the rest of her days, but she may also come around to the point where she can go out and enjoy herself on trail. We'll see what she's up to. But she's retired — officially — at the ripe old age of 9.

Instead of a gold watch, she got steel shoes.

And recent video of her, still not sound, but at least comfortable:

Friday, July 15, 2011

Wound looks great ... but lameness mystery

Buttercup's leg wound looks fabulous! I don't even think the scar will be as apparent as it continues to heal. I'm so pleased!

What I'm not pleased about is her soundness. In all honesty, this has been going on about 12 weeks now. At first, we blamed it on the rabies shot and some re-balancing work on her hooves. Then it was the Triple Crown senior we briefly tried. Then it was bran mash to get her to eat her medecine. Then it was the stall rest and lack of circulation.

She's been out of the stall nearly two weeks and her soundness has not improved. She's sounder on harder surfaces and really ouchie on soft surfaces. Scott said that's because of the pressure around the hoof.

It looks to be ouchie near the toe on the outside of the hoof. She's weighting the inside of her front left and landing heel first.

I called up my old farrier today and he agreed to come look at her tomorrow. I'm pretty upset about the lameness and I'm just not certain what the root cause is. I just want her to be comfortable.

Scott said this may happen every summer with her laminitic condition. Her being uncomfortable for months at a time just doesn't fly with me. So if we have to shoe her or take other measures to get her comfortable during these tough months, I want to explore that option.

Here are her hooves from about four weeks ago while on stall rest:

They look even better now, in my opinion. The hooves structurally look like they should be healthy. There is no bounding pulse in that front left either. She has been booted in the meantime just give her a level of comfort.

Thursday, July 7, 2011

Update on the leg injury

(Buttercup was released from stall rest earlier this week to her own private paddock)

This month was going to go so much differently in my head. Buttercup and I were going to get up early nearly every morning and walk for a short distance down the beautiful trails of our new facility for longer and longer distances until I had her walking up to 45 minutes at a time undersaddle over the last four weeks.

Instead, my mornings, that are not really busy with my new job, I am out at the barn, treating and re-wrapping a leg. Buttercup was stuck in a stall for the last four weeks. Every time she would lay down, her wound threatened to open. After the first two weeks, proud flesh began to emerge (likely a product of my antibiotic ointment — just say no to Furazone, I've learned) and location of the wound.

The wound originally wasn't under wrap but when the proud flesh was subsequently cut out, the vet wanted us to wrap tight.

Buttercup's front hooves have suffered from limited blood flow from the lack of movement — the simplest things become complicated when you have a horse suffering from laminitis. To make some matters worse, Bud went off her feed at the time she needed her antibiotics the most, so bran (super high in sugar) was introduced to get her medicine down. She's been off the bran for 2.5 weeks, but she is still exhibiting hoof soreness, likely from the limited mobility.

Her hind legs have been stocked up nearly every morning too.

The area has been difficult to wrap, nearly too long to just have a wrap around the gaskin part of the leg, requiring some wrapping of the upper part of the cannon. And the wrap itself has created sores, that also need to be treated.

Meanwhile, Buttercup, who has never taken to stall rest well, has actually made life very easy on me and her caretakers. She's been pleasant and willing and understanding. I love that horse.

She was released from her stall earlier this week into her new, individual paddock. The paddock is gorgeous and completely shaded by mature oak trees and void of any grass. With the increased movement, she is less foot sore, but it's still there. She'll probably take a few weeks to recover full soundness.

Another issue we have is that Bud appears to have lost some weight. Not too much to be concerned about. It looks like loss of conditioning rather than true weight loss. It's hard to tell right now since she's not only had the injury and stall rest to contend with, but we also switched her to a beet pulp and alfalfa cube diet since she's arrived at her new barn. (Her WellSolve L/S wasn't available at this facility, and she did not do well on Seminole's lower starch brands.) I'll have to make a decision soon to see if we need to get her on a fat supplement, or if she'll perk back up just being out of the stall.

Making Bud very happy: she has a very handsome boyfriend next door. So she gets to squeal and show off, but then leave him stuck on the other side of the fence. Bud's a tease.

Progression of the wound pics:

Week 1:

Week 2:

This shows the proud flesh emerging and the issue of keeping the stitches in such a tough spot.

Week 3:

Here you can see the wounds created by the wrapping.

Week 4:

This had just reopened prior to me getting there (Bud decided to sleep flat out that night). But pretty healthy looking!

After about another four weeks on pasture rest, I might start to think about riding her down that trail. In the meantime, Bud is fine getting her daily grooming and loving!