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Discussion on Urgent Help Needed...Septic Digital Flexor Tendon Sheath of Hind Limb
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Member:
judyhens
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Posted on Thursday, Dec 8, 2011 - 1:53 pm:
Our son's beautiful six year old Andalusian mare had an accident on November 18th. She was being ridden in the desert (Phoenix) and shied, managing to impale herself on cactus spines. She developed an infection and has been hospitalized multiple times since the injury. I will include her discharge summaries if possible. She will do better following flushing of the tendon sheath and IV antibiotics. Within a few days of discharge she becomes quite lame again. We are concerned about her other legs now as well - best methods to prevent laminitis and compensatory tendon strains. Also - any other ideas re: evaluation and treatment? She has been readmitted to the hospital and is back on antibiotics (Gentocin 35 CC IV per day and Exceed 20 cc IM every 4 days). In addition she is on pain killers. On 11/19, the dx was "Imbedded cactus spine in the left hind limb and rt. forelimb" The report indicated that the mare was sedated and placed under general anesthesia the night of the accident and multiple spines were removed. Incisions were lavaged and closed. She was placed on SMZ and Bute. She was readmitted on 11/25 with a dx of Suspected left hind septic tendon sheath. She was sedated and ultrasounded again. The exam revealed thickened synovium but minimal fluid in the sheath. Centesis of the sheath and felock joint were performed No fluid was obtained from the sheath. Normal fluid was obtained from the joint.Amikacin and K+ penicillin were injected in the fetlock and sheath. The sheath was lavaged with amikacin under general anesthesia because of her severe pain.She was kept on IV Gentocin and Naxcel. Discharged on 11/29. Readmitted on 12/2 because of increasing lameness. Dx: Septic digital flexor tendon sheath. They did tenoscopy of the sheath under general anesthesia. Cactus spine fragments and hair were imbedded in tissues within the tendon sheath and were removed. She was discharged on 12/4. She was readmitted on 12/6 with deteriorating symptoms. Back on IV and IM antibiotics, having an MRI and another flush of the sheath. We are all worried sick. Any other thoughts/ recommendations Dr. O? Any help would be appreciated. Ideas on most effective ways to prevent damage to other legs/ feet?
Blessings,
Judy
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Member:
mrose
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Posted on Thursday, Dec 8, 2011 - 2:19 pm:
Oh Judy, I am so sorry! What facility was she taken to? THE best leg/foot guys on the west coast are at Alamos Pintado near Santa Barbara, CA. Do you know of them? The vet school at Davis is another. Is there anyway she could get to either one? Or, could you confer via phone with one at least. Dr. Mark Rick at Alamo is wonderful; but all are great vets. Their facility has more,and more modern equipment than any other place I know. Here is a link to their site.www.alamopintado.com
I hope your son's mare recovers. Please keep us posted. Best wishes.
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Member:
pattyb
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Posted on Thursday, Dec 8, 2011 - 8:26 pm:
I may be way out there but I do have one question... With all the work you're having done, is there anything being done for drainage at the bottom of the incision? My past experience with serious wounds left me wanting a drainage strip if the wound will drain at all..just curious.....
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Member:
mrose
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Posted on Thursday, Dec 8, 2011 - 10:50 pm:
Judy, when one of our mares severed her tendon she had surgery, wound looked good etc. but she wouldn't recover. She would start to be better, then slip backwards with pain and infection.She had numerous ultrasounds, x-rays, lavages, IV antibiotics etc. Finally, an MRI revealed infection had gone down from the injury site and bacteria had "pooled" in her sesimoid bone. Has anyone looked lower down in your mare's leg? Could a similar thing be happening? Also, in Libby's case ( I think you can still read about her here on HA) the only thing that finally cured her was hyperbaric chamber treatments as bacteria in her case was anerobic and antibiotic resistant. Hopefully, this won't be your son's mares case; but do have her lower limb checked if she isn't healing up.
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Member:
judyhens
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Posted on Thursday, Dec 8, 2011 - 10:51 pm:
Hi Sara and Patty,
Thanks for your comments. Every option will be taken into consideration. Our son is a physician in Phoenix and he does feel a drain is indicated at this point. Possibly a way to repeatedly flush the sheath without having to put her under each time. Don't know if that is possible. She apparently always feels better after it is flushed. She has not had a drain to date. There is little fluid for aspiration even for the culture. The MRI showed thickening of the tendon sheath. Really concerned about adhesions. Since this has been on-going for three weeks, they are also thinking that changing to a more powerful antibiotic may be needed. Are these things ever fungal? Your positive thoughts are appreciated.
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Member:
judyhens
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Posted on Thursday, Dec 8, 2011 - 10:55 pm:
Sara, those are good thoughts too. Are hyperbaric chambers readily available for horses? Interesting thought. Thanks!
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Member:
mrose
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Posted on Thursday, Dec 8, 2011 - 11:22 pm:
Yes, amazingly, they are. Alamo Pintado had one, and I think some of the other well known vet hospitals do also. The horses are mildly sedated and led in with a handler who stay in there with them, kind of like being in a horse trailer.
Libby has thickening of the tendon also below the injury site. In her case sadly, the tendons were unable to heal; swelling caused the tendons to pull apart at the initial surgery site and there wasn't enough of a matrix left for stem cell therapy.
If your son is a doctor maybe he could arrange for a culture for anerobic bacteria? They can't be cultured normally, and seem to be very antibiotic specific. Dr. Rick, who cared for Libby, said many times when an injury won't heal, they are suspected.
Initially they infused the leg with antibiotics. they had a small plastic "stem" going into the leg and a drain at the bottom of the wound site.
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Member:
canter
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Posted on Friday, Dec 9, 2011 - 7:14 am:
Judy, no advice, but just sending my very best wishes.
Fran
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Member:
frances
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Posted on Friday, Dec 9, 2011 - 10:12 am:
How awful, Judy. So hope she makes a full recovery.
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Member:
judyhens
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Posted on Friday, Dec 9, 2011 - 11:40 am:
Thanks everyone. She is currently functioning as a handicapped rider program horse. She seems to intuit rider needs, even though she is young. Our son just hopes and prays that she can return to that function and be able to help others. That is his goal for her at this point, with her becoming pain free of course.
How fast things can change....
Blessings, Judy
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Moderator:
DrO
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Posted on Saturday, Dec 10, 2011 - 9:49 am:
Hello Judy,
The best and perhaps only prevention for breakdown of the laminae on the opposite leg is to return the horse to weight bearing as soon as possible. I completely agree with your son that continued worsening of infection indicates a flush and drain system needs to be put in place to allow multiple daily treatments as needed to remove and prevent the return of purulence.
I am assuming cultures are running and that the horse is on NSAID's and possibly opiate pain relievers.
DrO
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Moderator:
DrO
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Posted on Saturday, Dec 10, 2011 - 9:51 am:
Judy, one other thought occurred to me. If the horse is non-weight bearing on a leg I would also consider using a sling to unload the sound legs.
DrO
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Member:
judyhens
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Posted on Saturday, Dec 10, 2011 - 11:58 am:
Thanks for your input! I forwarded every message on to our son. As an anesthesiologist, he was able to consult with what he considers some of the best human orthopedic surgeons in his area. They basically outlined the same protocol for humans as Dr. O's suggestions for horses, even down to some of the same antibiotics and need for drains/ flushing. The only significant difference being that we can stay supine in bed and our equine friends cannot. :-) Surgery has just started this morning to place the drain and flush system. Your input and support is greatly appreciated. Judy
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Member:
judyhens
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Posted on Saturday, Dec 10, 2011 - 12:03 pm:
Thanks for your input! I forwarded every message on to our son. As an anesthesiologist, he was able to consult with what he considers some of the best human orthopedic surgeons in his area. They basically outlined the same protocol for humans as Dr. O's suggestions for horses, even down to some of the same antibiotics and need for drains/ flushing. The only significant difference being that we can stay supine in bed and our equine friends cannot. :-) Surgery has just started this morning to place the drain and flush system. Your input and support is greatly appreciated. Judy
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Member:
vickiann
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Posted on Saturday, Dec 10, 2011 - 2:29 pm:
Good luck with the treatment, Judy.
I hope that you can return this lovely horse to working again.
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Member:
judyhens
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Posted on Sunday, Dec 11, 2011 - 5:37 pm:
Follow-up re: surgery. It was a little more extensive than expected. Despite worsening of swelling and lameness each time that iv antibiotics have been stopped and improvement each time she is flushed, infection wasn't evident. There was another large spine in the fat pad behind the fetlock. That might be a source of inflammation and a potential source of infection. They ended up cutting the annular ligament which apparently shouldn't cause her an issue long term. My son thinks the biggest battle is going to be against scar tissue once this elusive infection is gone. They do have daily flushing and a drain system in place now. Any experience with cutting the annular ligament?
Your support is greatly needed and appreciated!
Blessings, Judy
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Member:
pattyb
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Posted on Sunday, Dec 11, 2011 - 5:53 pm:
Hi Judy...and good day to you.
I'm so glad they set the treatment plan up to include a drain for flushing. Any time I have a wound that will drain if given access, I request one so it doesn't turn into a multiple trip problem in the long run. The fact that they also found another spine really gives me hope that this horse will finally recover with a bit more time.
Please keep posting updates....
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Member:
judyhens
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Posted on Sunday, Dec 11, 2011 - 9:36 pm:
Tonight's update: "She looks really good. Bright eyed and active. Very interested in food and us. Bearing weight on the leg as well, but obviously sore as expected." I'm attaching a picture before the injury and in the hospital so you can get to know the horse a little better. She is such a sweet girl! Thanks again for your input and support. It means the world to us.
  
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Member:
lilo
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Posted on Sunday, Dec 11, 2011 - 9:40 pm:
Beautiful girl, Judy. Best wishes for her recovery.
Lilo
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Member:
mrose
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Posted on Monday, Dec 12, 2011 - 12:58 am:
As you well know, I'm an Arab fan, but I LOVE your son's mare! What an eye she has; so sweet and intelligent! Why, she could be an Arabian! LOL She's obviously a lovely girl, good and solid mind. I hope removal of the spine will solve her problem. I know the vets told me with Libby that evan a small piece of dirt could prevent healing due to the infection. Best of luck to your son and this lovely mare. What is he name, btw?
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Member:
judyhens
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Posted on Monday, Dec 12, 2011 - 11:07 am:
Thank you Lilo and Sara! The mare's name is "Barbara Maynou". She was given that name in Spain. The stud is named Can Maynou and is in Barcelona. Not sure of the significance of her name, if any. Barbara is a very sweet mare, wonderful mother, and seems to intuit the needs of handicapped riders. Thank you for your kind words! She is such a positive horse. She simply has to recover! :-) And....Sara, I LOVE the presence and inherent beauty of the Arabian!
Blessings, Judy
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Member:
vickiann
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Posted on Monday, Dec 12, 2011 - 1:44 pm:
She's lovely, Judy. Andalusians have always been one of my favorite breeds.
An Arabian horse of mine experienced a puncture wound to the tendon sheath from a wild animal bite but had a good outcome in spite of having a bout of cellulitis.
It really does seem to be true that small things can cause big troubles when it comes to the legs of horses.
It sounds like the mare is getting really good care so hope that she has a very good outcome too.
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Member:
canter
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Posted on Monday, Dec 12, 2011 - 3:30 pm:
Judy, I am so glad the surgery went well and the prognosis is good. Barbara is lovely. You may or may not remember: I have a soft spot for the breed and hope my next equine partner will be a lovely Andalusian.
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Member:
judyhens
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Posted on Monday, Dec 12, 2011 - 4:16 pm:
Yes, small things can result in big trouble when it comes to feet and legs. Sometimes I think bubble wrap would be a great thing!
Fran, isn't your mare 21 or so? Sparkles? I remember thinking she was a wonderful horse! If you ever are in Texas (Austin area) we would love to have to visit and ride an Andalusian!
Thanks for everyone's comments!
Blessings,
Judy
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Member:
canter
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Posted on Tuesday, Dec 13, 2011 - 10:43 am:
Judy, yes, Sparkles is 'mature', but thankfully, still going strong and happy to be working. Would love to take you up on your kind offer some time...but you would need to check my luggage to prevent me from smuggling one of your beautiful horses home!
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Member:
judyhens
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Posted on Tuesday, Dec 13, 2011 - 3:06 pm:
HaHaHa.... I'll really worry if you bring a trunk! :-) Seriously you are welcome any time!
Update - yesterday Barbara developed hives apparently from the sedation used to flush the tendon. However they were almost gone by evening and she was acting like herself - wanting attention and bearing weight on her leg nicely. Don't have an update yet today. Will keep everyone posted.
Blessings,
Judy
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Moderator:
DrO
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Posted on Tuesday, Dec 13, 2011 - 3:45 pm:
Hello Judy,
Check out HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Lower Limb » Annular Ligament Constriction for more on cutting of the annular ligament. Delighted to hear things are going well.
DrO
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Member:
judyhens
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Posted on Tuesday, Dec 13, 2011 - 5:06 pm:
Thanks for the information. Apparently Barbara is still doing her "human" therapy while hospitalized. I was just sent a picture of Barbara with a few people from the handicapped riding center, Camelot. They came to offer her love, treats, and tlc. The joy and radiance in her eyes is unmistakable. I have the strong impression that she gave back to those around her every bit as much as they gave her. Word is, though, that she is really enjoying the attention. :-) The great news is that her behavior is now pretty much normal - she is very interested in being around people, nickers, and savors her treats. Good indications that pain is no longer overwhelming. Will update when I get tonight's report. Blessings!
Judy
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Member:
mrose
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Posted on Tuesday, Dec 13, 2011 - 5:16 pm:
Hi Judy. It sounds like Barbara is returning to normal! Sorry about the hives. Be cautious as once the immune system gets out of whack, it can be hard to deal with. There are several of us on HA who' ve had hive problems due to one thing or another and always the hives became difficuly to get rid of. Barbara has an advantage having an MD for an owner. Please do keep us updated.
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Member:
judyhens
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Posted on Tuesday, Dec 13, 2011 - 9:15 pm:
Evening update: no significant hives. Very interactive. Vigorously grooming everyone that will scratch her. Seems slightly more sore today. We are 3 days out, and they seem to think this is to be expected. Opinion? Calm, happy, lies down to rest normally. Greatly enjoys her human friends. Am attaching pictures of her with visitors from Camelot. She ended up putting her head in his lap. Enjoy!
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Member:
pattyb
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Posted on Tuesday, Dec 13, 2011 - 9:36 pm:
 Love it! Thanks for the update!
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Member:
mrose
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Posted on Tuesday, Dec 13, 2011 - 11:22 pm:
What a sweetheart! I would think soreness would be expected.if it worsens or doesn't start to improve I'd worry and look into continuing infection just going from my experience.
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Member:
lrhughes
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Posted on Wednesday, Dec 14, 2011 - 2:13 am:
A special mare...Glad to hear about her improvement. Good luck on a full recovery.
LRH
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Member:
canter
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Posted on Wednesday, Dec 14, 2011 - 7:18 am:
Isn't Barbara the perfect example of why we all love horses so much! The pictures are wonderful and she very much looks like a happy horse in little or no distress. I hope all continues to go well!
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Member:
judyhens
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Posted on Wednesday, Dec 14, 2011 - 9:59 am:
Thanks for the kind notes. I received an email from the head of Camelot (who got permission for me to post the pictures of her crew here).
"I tell her (Barbara) everyday that she is surrounded by people that understand big fights when it comes to health issues. She can only draw inspiration from the family that loves her!"
Excellent thought!
Blessings,
Judy
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Member:
lilo
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Posted on Thursday, Dec 15, 2011 - 1:21 pm:
Judy, thanks for posting the photos. What a special horse! Wishing her all the best during her recovery.
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Member:
judyhens
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Posted on Saturday, Dec 17, 2011 - 12:53 pm:
Update... As of last night, Barbara is still very sore in the affected leg. It has been one week today since the last surgery. Nothing has grown in culture. They were doing a complete blood panel. The drain has been removed. Because the current plan is to allow healing and pretty much deal with the pain through meds to control it so that she can bear some weight on that leg, Chris is wondering about the benefit of occasional blocks to facilitate weight bearing. Questions:
(1) are repeated blocks dangerous as far as long term problems? (2) are slings available for the home? (3) Medical options to maximize pain control? Any other ideas to unload the good legs?
Thanks,
Judy
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Member:
mrose
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Posted on Saturday, Dec 17, 2011 - 1:08 pm:
Hi Judy. Is she any better at all? any worse or the same? If at all possible, I would really recommend an MRI of injury site and below the site, if this is at all possible. Again, I'm not vet; just speaking from "gut feeling" based on experience. Remember, anerobic bacteria will not show up on normal cultures. A special type of culture with special equipment has to be done for them.
I believe their are slings available;also supportive splints. Dr.O probably will have that information for you and I know he'll have his comments to ad when he reads this. Barbara is just reminding me so much of Libby it makes my heart ache. Have you read Libby's record? There's been a few other members that have had serious issues like Barbara's also. If you do a search, I'm sure you can find them.
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Member:
mrose
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Posted on Saturday, Dec 17, 2011 - 1:10 pm:
https://www.horseadvice.com/horse/messages/4/76091.html Here is the start of Libby's story.
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Member:
vickiann
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Posted on Saturday, Dec 17, 2011 - 1:48 pm:
Sorry to hear that Barbara is still having these pain issues.
I don't know much about nerve blocks other than my husband had one when surgery was done on his hand last year and it was dangerous from the stand point that he had no feeling in the arm at all (and it was flopping around if he didn't keep it in a cast). It would have been very easy for him to sustain an injury without any pain to warn him that something was amiss.
I recently had to fight some severe foot pains with one of mine to the point that a couple of times I thought that he was starting with laminitis due to bearing so much weight on the other front foot.
A farrier applied castings to his front feet and they gave my horse enough foot support that he was able to continue to get around.
There are a number of different ways to apply the castings and they can be helpful in some instances with regard to laminitis.
There were times that I used Bute for my horse's pain, but over the longer term I used the dog arthritis pill called Previcox (58 mg.) and that was very good for my horse who is prone to getting ulcers.
My Vet told me that I could keep the horse on the Previcox as long as he seemed to need it.
It is very easy to administer this drug because it is a chewable tablet that is given once daily and my horse would eat it readily along with a few feed pellets.
The Previcox builds up in the system, it seems, and in about 2 days, maybe 3, one sees the maximum resulting relief. Previcox is the same drug as Equiox, which is made for horses but at a higher price.
It might be a good idea to put Barbara on GastroGard to protect her stomach if she is on Bute.
Good luck with Barbara. I surely hope that you will begin to see some more progress soon.
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Member:
judyhens
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Posted on Saturday, Dec 17, 2011 - 9:03 pm:
Thanks for the ideas and input. Yes, Barbara did have an MRI prior to the last surgery. It showed some thickening I believe, of the tendon sheath. Maybe a couple of small shadows believed to be scars from previous surgery to get out the spines.
Barbara is back at Camelot for rest and rehab. According to the Exec. Dir., today was filled with napping, munching hay, eating grain and gazing across the desert. She says she is happy to be home. She is beginning physical therapy: hand walking 2 X day for 10 minutes for the next 60 days. I will forward your posts to Chris. Sara, I will read Libby's story. An injured horse just becomes the only thing on your mind doesn't it...
Thanks for your input and your positive thoughts and prayers!
Blessings,
Judy
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Member:
vickiann
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Posted on Saturday, Dec 17, 2011 - 9:08 pm:
Judy,
It is indeed a very demanding process taking a horse through some of these challenging injuries and illnesses.
Sometimes one can only take things in very small time blocks.
When you can take it a day at a time things are progressing.
All best wishes for the recovery of this grand mare.
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Member:
mrose
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Posted on Saturday, Dec 17, 2011 - 10:22 pm:
Yes, it is akin to having your child seriously ill/injured. Ann (spotsrock) also had a horse with serious tendon injury. Her mare, Danni, is back showing in dressage, but it was a very long road. It is so disheartening as they go back and forth. You think you have it figured out and things are looking up, then go out the next morning and they are lame again. Tell your son not to give up, and to explore every option no matter how far fetched it may seem. If I've learned one thing after having horses my entire life, it is that they are full of surprises. What seems the most far fetched is quite possible. (was going to put LOL, but not sure that is funny. More like frustrating!)
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Member:
judyhens
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Posted on Saturday, Dec 17, 2011 - 11:42 pm:
I forwarded your messages, Vicki and Sara, to Chris. He appreciates all input and is very open to any ideas. Sara, I read through the first part of Libby's saga, then zoomed to the end of the next section. What an amazing story. You can definitely relate to the anguish of having a great equine friend in pain. I hesitate to ask, but what ultimately happened to Libby? Is she still pasture sound?
Blessings,
Judy
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Member:
mrose
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Posted on Sunday, Dec 18, 2011 - 12:12 am:
Yes. She has her "bad" days when she's kind of sore, and on those days I give her a little bute. In the years since her surgery, her worst problem has been the foot that foundered due to stress. As you may have read, I had to trailer her down to Santa Ynez, CA area; a 10 hr plus trip. Even though I gave her bute and had her foot padded and the trailer deeply bedded, the trip was very difficult for her. Much longer and I imagine she wouldn't have made it. She developed severe laminitis in her good foot which has had ongoing problems. She is good for awhile, then gets sore. At long last, I think we are on the right track. I started a post on HA about her foot and the foot of another older mare we own, but have been very poor about following up. Just been a lot going on!
Libby looks good though, and during the summer when turned out she has days when she bucks and kicks and on her worst days she is still able to wander around and graze with her friends. Like your son's Barbara, she is one of the very special horses.
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Member:
dres
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Posted on Sunday, Dec 18, 2011 - 12:29 am:
Someone said above to take each day as it comes.. when i was rehabbing Danni i counted only MONDAYS .. as everyday was to much and could be overwhelming with the ups and downs of rehab... so only Mondays were counted as we worked thru her recovery ... I don't know .. it helped
On the first day God created horses, on the second day he painted them with spots..
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Member:
mrose
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Posted on Sunday, Dec 18, 2011 - 11:02 am:
Ann, good method. It's kind of like following the stock market; if the overall trend is upward, even a slow upward, feel good. 
As to Libby, she was bobbing her head, scolding me because she felt breakfast was a bit late. Evidently feeling good inspite of the cold.
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Member:
canter
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Posted on Sunday, Dec 18, 2011 - 2:03 pm:
Judy, I wish I had something to add that would be helpful. While I've done more than my fair share of rehab, nothing was as serious as your Barbara or Sara's Libby (knock on wood!). But as other's have said, it's a long slow haul, and taking one day (or one Monday) at a time helps. Continued healing thoughts your way and please continue to keep us updated.
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Moderator:
DrO
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Posted on Sunday, Dec 18, 2011 - 10:40 pm:
Hello Judy,
How disappointing to hear of the ongoing problems.
Repeated blocks hmmmm...no probably not but the short term efficacy is unlikely to of much help. But I wonder about using arterial infusion of pain relievers, kind of like the current use of antibiotics for distal limb infections. I have not seen any work on this but other than the unknown toxic effects it may be a possibility.
As to home slings they are available for private purchase, a search of the internet for horse slings will should reveal several sources. The last one a client of mine purchased came from Nasco.
DrO
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Member:
judyhens
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Posted on Monday, Dec 19, 2011 - 2:21 pm:
Update on Barbara this morning:
"Just finished walking her. She was happy to be out of her stall and stretching her legs. She seemed more comfortable than yesterday which is a big plus! She is weighting up when walking. She is lightly weighting it in her stall. Today after a very short bit she was walking nicely, limping, but walking well. Good flat foot on the ground (weight on heel) and bending the fetlock. And she was feisty!!"
Sounds like things are finally moving in a better direction! She is currently on 1.5 g bute two times daily.
Thanks for everyone's thoughts, suggestions, and prayers. You are appreciated! I am attaching a picture of Barbara's return to Camelot, greeting her 2011 filly, Arcelia. Yep, Arcelia is wearing a pony blanket, saddle, and a little toy monkey is riding on her. :-) She stands on a pedestal, sits on a bean bag chair, and sits in a wheel chair. She has to be watched closely or Arcelia will walk up the wheel chair ramp. She has been surrounded by love from Camelot from birth and adores her friends there. When she is actually started under saddle at 3 or 4 years of age, it should be a breeze!
Have a blessed day!
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Member:
mrose
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Posted on Monday, Dec 19, 2011 - 6:58 pm:
Great news! I hope she continues to improve. Such a beautiful mare. I seem to be partial to grays.
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Member:
canter
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Posted on Tuesday, Dec 20, 2011 - 7:24 am:
That's wonderful, Judy! I am so very glad things are looking up!
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Member:
judyhens
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Posted on Tuesday, Dec 20, 2011 - 2:33 pm:
Thanks for the comments. The morning walk went well today. Afterward Barbara was put in a stall next to her good equine friend, Cliffy. She was able to enjoy both the sun and her buddy. She lays down and sleeps/ naps normally, which I think gives her other 3 legs some nice relief. She is munching hay happily. Still waiting on the last cultures....
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Member:
lilo
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Posted on Thursday, Dec 22, 2011 - 11:15 am:
Sounds like she is on the mend! Good thoughts for the future of this special horse! Lilo
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Member:
judyhens
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Posted on Thursday, Dec 22, 2011 - 6:06 pm:
Thanks Lilo for the good thoughts. They continue to be appreciated! Today's Camelot update: "A.M. Physical Therapy went very well. Barbara is very ouchy when she first starts, but today she got comfortable sooner and was walking in big beautiful strides."
I read something about stem cell therapy the other day. Any experience with stem cells with tendon sheath inflammation?
The attached picture is Barbara enjoying a few quiet moments with Mary during nap time. Apparently she slurps her meds down readily. That is a real plus.
Anyway, your thoughts and prayers are needed and greatly appreciated.
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Member:
pattyb
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Posted on Thursday, Dec 22, 2011 - 6:23 pm:
So nice to hear good news Judy....and thanks for posting the picture...she looks content and happy>
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Member:
mrose
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Posted on Thursday, Dec 22, 2011 - 7:29 pm:
Lovely picture!
I haven't had any experience with stem cell therapy on horses; Libby had not enough tendon tissue to form a matrix for the cells to grow on. However, I have had stem cell treatment for myself and it was wonderfully successful. I had a non-union fracture, which even with surgery, had not healed. After a painful year, I went to a specialist who had studied at Roode and Rittle (sp?) with vets there working on experimental uses of stem cell therapy. He actually did the same procedure on horses that he did on me! ( the minute I learned he had worked on horses, of course he sounded like the surgeon for me! LOL) At any rate, he did an experimental proceedure and implanted stem cell in the fracture site. He also debraded and infused with antibiotics as I had a bone infection on top of everything else. I now have full use of my foot and no pain - so, needless to say, I'm a stem cell advocate! I know Alamo Pintado, as well as Vance Snow (now deceased) have done a lot of work with tendons and stem cell therapies and have had very good success. Maybe your son could talk with one of the docs there?
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Member:
canter
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Posted on Friday, Dec 23, 2011 - 6:25 am:
I love Barbara's sleepy eyes in the picture. So sweet!
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Member:
judyhens
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Posted on Friday, Dec 23, 2011 - 7:10 pm:
Not the best day...
The vet examined her this morning. incision looks the same, drainage the same, but pain level a bit higher. They cleaned the wound and re-bandaged this morning. Afterwards Mary took her for her 10 minute hand walk and was just about finished when she suddenly jerked her head up. Mary is not certain if she mis-stepped or if an adhesion broke loose. In either case it made her sorer. Barbara laid down to nap and at a recheck an hour and a half later was sorer. After talking to the vet they gave her more bute. Barbara spent the afternoon resting / lying in the sun. When Mary checked her later she was sweaty, with a temp of 102.3. Earlier it was windy and cold, so she was blanketed. Since the wind had stopped, they took off her blanket, sponged her off, and called the vet. Over the next 45 minutes (and a million temp checks) her temp went back in the normal range. Last check was 100.3. She is now resting (standing) and looking comfortable.
Mary says this is causing lots of gray hair and wrinkles! It is constant up and down.... You guys are models for us because you mentally survived your horse's serious injuries. I'm a counselor. I'm thinking I need counseling!
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Member:
mrose
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Posted on Saturday, Dec 24, 2011 - 11:13 am:
Hmm...fever isn't a good sing. Makes me wonder about more infection. Imo, her temp should be checked morning and night and if she shows a fever, there is still infection somewhere. I believe you said an MRI was done; did it cover below the injured area? As you know, infection traavels downward. Libby's injury was about 4" above her fetlock, but the infection had traveled to her sesimoids. Just keep an eye on beautiful
Barbara. Hopefully, she was just having an off day - very possible as they sure go up and down with these things.
Have a wonderful Christmas or Chaunaka season. Hopefully, Barbara will give your son a great gift and have a more rapid recovery.
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Member:
judyhens
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Posted on Saturday, Dec 24, 2011 - 11:23 am:
Dr. O, what opiate specifically would you suggest for pain control?
Sara, the MRI did go below the injury. Her temp is 99+ this morning. I think Mary is taking her temperature multiple times daily. The vet is reassessing her at about noon. Will keep you posted.
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Moderator:
DrO
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Posted on Wednesday, Dec 28, 2011 - 7:46 am:
Judy,
I don't have any specific recommendations for opiate pain relievers in horses. Butophanol may be too sedating and Tramidol too short an action. There is certainly little material published on this and part of the problem might be the effects opiates have on the bowel, slowing down transit. But I wonder if there may be a useful alternative...I would try consulting a veterinary pharmacologist.
DrO
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Member:
judyhens
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Posted on Saturday, Jan 7, 2012 - 11:10 am:
Update - Finally making positive progress! :-)
Barbara started walking more comfortably during the past week. She is now much more perky and willing to walk. Although she is still short striding, she is moving MUCH more normally. It seems she is finally on the right track. I am not sure what her pain meds are right now, but I do know that she was/is on an opiate pain killer, Surpass for the enlarged fetlock (maybe from the cutting of the annular ligament?), a Lidocaine patch around the leg (tendon sheath), antibiotics, probiotics, bute, and maybe something else. The goal is good pain control allowing her to weight the sore leg for the protection of the other legs. Looking at periodic videos (and we have a live camera feed), she is really moving around much better now. She still has an iv catheter. They took a culture the other day and results are still pending. The incision is almost totally healed and the drainage is now almost non-existent. Getting control of the tendon sheath infection has been a nightmare. Anyway, again we wanted to thank everyone for their support! :-)
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Member:
mrose
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Posted on Saturday, Jan 7, 2012 - 11:33 am:
Happy New Year! I hope it turns out to be a very happy new year for all of you and Barbara as well! Being able to weight her foot should help her a lot. She looks good! And, boy do I hear you on the controling the tendon sheath infection being a nightmare!
How far is she from Scottsdale? I will be going to the Scottsdale Arab show mid-Feb. If she isn't too far from there I thought I might swing by and meet her in person and give her a carrot and a pep talk. :>)
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Member:
dres
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Posted on Saturday, Jan 7, 2012 - 12:12 pm:
CHEERS ! sounds like she is on the mend .. and i second Sara, healing the tendon sheath IS a nightmare ... wow .. all three of us have mares that have / are recovering from such a horrid accident .. remember my mare completely severed her DDFT and wore a cast then the kemzie brace and i am riding schooling her 2nd level ... SO HUGS AND HOPE are in ur favor..
On the first day God created horses, on the second day he painted them with spots..
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Member:
juliem
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Posted on Saturday, Jan 7, 2012 - 2:59 pm:
Three recoveries that wouldn't have happened without committed, brave owners!
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Member:
judyhens
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Posted on Saturday, Jan 7, 2012 - 6:37 pm:
Hi Sara, Ann, and Julie!
Thanks for the posts. Knowing that others have gone through this, experienced the ups and downs and agonizingly slow recovery, yet stuck with it and ended up with a positive outcome, offers hope to all of us. What amazing horses we have been blest with! Congratulations on your mare's recovery, Ann. Wonderful!
Sara - She is actually IN Scottsdale at Camelot.
I know that my son and the director there, Mary Hadsall, would love to have you meet Barbara! She loves people and would love a pep talk. Actually she loves any "talk" as long as a treat is involved! And that treat can be edible or just good scratches! If you are able to visit, just let me know the date and possible times and I will let Chris know. Hopefully he will be able to meet you there.
Thanks you guys again!
Blessings,
Judy
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Member:
vickiann
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Posted on Saturday, Jan 7, 2012 - 7:02 pm:
Patience and tenacity is something that we horse owners must have to best care for our equines.
So happy to hear that Barbara is doing better!
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Member:
mrose
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Posted on Saturday, Jan 7, 2012 - 10:52 pm:
Judy, it will be between the 17th and 21st or something like that. I'll let you know. I look forward to meeting her! I love her already from her pictures and story. She reminds me a lot of another lovely gray mare I happen to know.
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Member:
canter
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Posted on Sunday, Jan 8, 2012 - 1:05 pm:
Oh, I am SO glad, Judy, that progress is being made. Great news!
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Member:
judyhens
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Posted on Sunday, Jan 8, 2012 - 5:14 pm:
Sara,
That should work. Mary Hadsall, the director, said mornings are better because she has lessons in the afternoon. Chris may be able to work something out too.:-) Mary is the best! She pours her heart and soul into Barbara's care. I can't imagine Barbara being in better hands! She has been a true God send in Barbara's recovery.
Blessings,
Judy
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Member:
judyhens
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Posted on Tuesday, Jan 10, 2012 - 3:02 pm:
Sara, Mary has penciled you in on their calendar! Just let us know if you are able to go!
Blessings,
Judy
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Member:
mrose
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Posted on Tuesday, Jan 10, 2012 - 6:42 pm:
Wonderful! I will let you know closer to date. And, will have to get address too.
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Moderator:
DrO
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Posted on Wednesday, Jan 11, 2012 - 6:57 pm:
Having thought before you were out of the woods only to back track I have held my breath but this does seem more sure this time. Congratulations.
DrO
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Member:
pattyb
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Posted on Wednesday, Jan 11, 2012 - 8:19 pm:
Me too DrO, me too.... Congrats and good luck Judy!
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Member:
judyhens
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Posted on Saturday, Jan 14, 2012 - 12:27 pm:
Update: 1/14/12 - Continuing to move in the right direction, slowly but surely. She is walking better, and Mary, Chris, and the vet are pleased. Was allowed in the round pen for awhile for the first time yesterday. Continues to have a positive attitude. Just pray that no infection returns. Still on meds.
Thanks for your continuing support and positive thoughts! :-)
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Member:
vickiann
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Posted on Saturday, Jan 14, 2012 - 2:27 pm:
Happy to hear that things are going forward in a positive manner and hoping for steady continuing improvement
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Member:
judyhens
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Posted on Wednesday, Feb 1, 2012 - 4:29 pm:
Update 2/01/12 - Barbara continues to improve day by day. She is able to go into the round pen periodically and now bucks and rears for joy at times. I saw a recent video of her walking, and she looked great! What a massive relief. Barbara is still one happy camper! Loves to snuggle up with her humans to nap! :-) We anticipate months of rehab, but that is a ok. Hopefully her recovery will offer hope to others experiencing a similar tendon sheath infection. But then, the goal would be that one one else has to go through it! :-)
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Member:
vickiann
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Posted on Wednesday, Feb 1, 2012 - 6:38 pm:
Wonderful news, Judy!
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Member:
frances
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Posted on Thursday, Feb 2, 2012 - 1:06 am:
Fantastic!!
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Member:
canter
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Posted on Thursday, Feb 2, 2012 - 7:26 am:
That's awesome!
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Member:
judyhens
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Posted on Thursday, Feb 2, 2012 - 5:50 pm:
Thanks for the kind words! In your cases, once the positive movement began and the infection was eradicated - which I know took months for some of you - did you still experience a lot of back sliding? We are all beginning to breathe a sigh of relief for the first time. We pray every day that she continues to heal. Just wondering how common infection recurrences are once everything is negative? Thanks for your support!
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Member:
lilo
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Posted on Thursday, Feb 2, 2012 - 9:07 pm:
What a great photo!! Lilo
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Member:
mrose
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Posted on Friday, Feb 3, 2012 - 10:53 am:
Love the picture! I'm looking forward to meeting Barbara in person in a couple of weeks. I've fallen in love with her without ever meeting her.
No, once Libby got on the right track and we discovered the right way to get rid of the infection, she made steady progress. She did have good and bad days; bad days usually caused by her feeling too good and jumping around too much either in her stall or in hand. She would be a little sore, then get over it.
Of course, remember, her injury was the severing of both flexor tendons to the point she has no flexor tendon left; a lot different than infection alone.(Barbara's case if I remember right.) The problems Libby has now stem from her foundered foot. She has bouts of soreness depending on the weather,when she was last trimmed, and from overdoing at times. Her injured leg is fine.
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Member:
mrose
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Posted on Friday, Feb 24, 2012 - 8:00 pm:
Hi Judy. I'm sorry but we had to cut short our trip to Scottsdale so I didn't get a chance to meet Barbara. My nephew was in a motorcycle accident so my sister-in-law was unable to meet me, and Lonnie isn't one to hang around horse shows on his own very long! ( Normally, Lonnie and my brother go out on their motorcycles while Kathy and I spend our days at the show.) I'm sorry I missed meeting her. She is so lovely. Maybe next trip down I can. I hope she is continuing to do well.
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Member:
judyhens
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Posted on Sunday, Feb 26, 2012 - 12:31 pm:
Hi Sara,
How is your nephew? Motorcycle accidents are so frightening! Our prayers are with you guys.
Barbara is continue to improve. Her walk videos actually look virtually normal. They are working with her slowly re: walking on a lunge line. She is such a sweetheart!
Absolutely let us know the next time you are in Phoenix or Scottsdale and Chris will probably be able to meet you! :-)
Blessings,
Judy
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Member:
mrose
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Posted on Sunday, Feb 26, 2012 - 7:51 pm:
Nephew has one crushed leg and another broken. Thank God he had his helmet on or he would be dead. He's young, and I'd have to say stupid (as the young can often be) He went out drinking, then hopped on his bike to drive home. Stupid! I feel bad for his mother and dad. But, he is now released from the hospital and has a hospital "room" set up at home, and has started P.T. As with some of our horses, it's going to be a long, long haul. Could have been worse though.
Such good news about Barbara; able to work on a line and walking normally.
We will make another trip to AZ in the fall if not before. Husband does a long bicycle ride down there every year. I'll let you know.
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Member:
frances
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Posted on Monday, Feb 27, 2012 - 12:50 am:
So sorry to hear about your nephew Sara.
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Member:
vickiann
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Posted on Monday, Feb 27, 2012 - 10:51 am:
Hope that he will have a complete recovery, Sara.
And that Barbara will too, Judy.
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