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  Discussion on Seriously Senior Mare and Emergency Care Response
Author Message
New Member:
modh

Posted on Wednesday, Aug 25, 2010 - 4:22 pm:

Following Dr. O's "Start New Thread" Advice, this post is copied and pasted from the start of my mare's second heat stroke and in response to those who commented (Thank you!!!)

You're all really wonderful! We can't be certain this episode was a second heat stroke since no blood work or seasoned aged horse vet examined her, but we're almost certain this was another heat stoke. She is back to "normal" which is a very healthy functioning mare despite her age.

Now that we are out of the high stress emergency mode I hope sharing the following connects with others who care for our seriously senior horses.

We don't want her to suffer, and each time (now twice) she goes into what appears to be a shut down (at least diagnosed by the E-vet two years ago, thus his diagnosis that she was dying and to put her down). As an owner, this decision is excruciating and it demands the utmost certainty and trust that your veterinarian is making the right call. The first time this happened was two years ago. The after hours emergency call vet diagnosed her as "dying... she needs to be put down." We chose to keep her comfortable and wait until her regular vet could see her the following day. We were right to stick to our instincts.

This episode took place this past weekend, Fri 8/20. The symptoms appeared to be a second heat stoke though she had been hosed off just three hours earlier showing no symptoms. We've been hosing her off on hot afternoons since the first episode of heat stroke. This time, again, we couldn't know unless she was examined because gut sounds, capillary refill and heart sounds appeared normal. Her temp was 101.

This is our dilemma: Had we hauled her to the vet on duty as he suggested, he may have decided she was dying as well suggesting that it is time to put her down. Though we would have made the choice to wait until her regular vet could see her in the morning, and her regular vet in fact decided that she was indeed shutting down, we would have to haul her back to her home.

There are so many considerations I don't know where to begin. When it's time, we don't want it to happen in the clinic. Logistically, what do we do DR O? She deserves the dignity of euthanasia where we plan to bury her. Hauling a trembling weak wobbly old lady in a trailer just to have an on call vet tell us what is their opinion given age and presenting symptoms, we would have to reload, haul her back home and wait for her regular vet to return to work, in this case the following morning, and then wait in line for an availability to come out to our barn.

What happened this weekend beat us in the head with a reality we need to address. Now we know we cannot trust that anyone will make a "field call" for her after hours. Reality suggests an unspoken protocol; viable or highly likely to survive emergencies will be seen first. So what does an owner do? Perhaps our situation is somewhat rare; care and husbandry of a horse since foaling, now in its mid thirties. Euthanasia is a decision we plan when she is ready, not when we find her care to time consuming or inconvenient.

I'm highly trained in medicine and practiced many years as a vet tech. However, even 40 years of every conceivable emergency does not give me the skill of a field tech or vet who sticks a vein 20 times a day and/or starts fluids. Even the vets have had a hard time hitting her jugular just for a coggins pull. I'm modestly successful sticking a vein easy to palpate. But I will not even attempt to stick and miss several times even in a crisis to administer banimine. So she has to wait for it to take effect IM like most of us do only as a measure to relieve pain until the vet arrives.

We don't want to put down a 30's plus old horse when they are functioning, eating, alert and happy. To do this while they are fine, like my mare today would feel to me like murder. The frightening reality of this weekend is that we are left without resources when there is a crisis, which like most of us know, happens after hours.

As owners, some of us read everything, try to be the best educated and experienced owners for our horses as well as to be prepared and knowlegable to assist our attending veterinarian(s) and we hope that we matter.

This weekend, it feels like I lost my faith and worse, trust.
Member:
scooter

Posted on Wednesday, Aug 25, 2010 - 4:52 pm:

Maureen has your mare ever been tested for cushings disease? My vet said he has a mare in his practice that has cushings disease, the only symptom she has is seizures in the summer he says. He said through the summer they have to keep her on a high dosage of Pergolide and she doesn't have these seizures. Just a thought.
Member:
cometrdr

Posted on Wednesday, Aug 25, 2010 - 6:00 pm:

hey Hang in there - geriatric horses must be tough. I have only ever owned the two I have one is 18 one is 10. these are my first babies but I love em to death do us part, and I hope and pray that will be a long time from now! send us a picture of your little old gal. loves pictures!
but you and she will be in all our horsie prayers... Muffi
Moderator:
DrO

Posted on Wednesday, Aug 25, 2010 - 8:37 pm:

Maureen, I agree I would have trouble trusting a veterinarian who said a horse was dying that was not. Maybe you should discuss with the veterinarian exactly what they based this on. If you cannot get satisfactory answers and a better understanding of what you expect from this vet you need to find a veterinarian you can trust and who is available after hours. I don't know of anything else that will assuage your feelings.

One should note that a horse with a rectal temperature of 101 prior to treatment is not suffering from heat stroke. Also important is IM flunixin (Banamine) is almost as quick as IV, it is absorbed very quickly.
DrO
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