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Discussion on DJD in my 25 y.o. Mare
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Member:
Twhgait
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Posted on Sunday, Jun 4, 2006 - 5:33 pm:
Wonderful article on arthritis DrO! It answered many of my questions and concerns right off. My 25 y.o. TWH mare is newly dx'd with DJD. My farrier was out recently and we both noticed her acting up when he was trimming her front feet-very out of character for her. I made a mental note to add this to my list for the upcoming vet visit for spring shots. Later that same week, she decided to lay down and she couldn't get back up at about 3am (I'm so thankful for my baby monitor!). We estimated she was down at least a few hours before we found her and another hour and a half was spent with us trying to get her to rise. It was a terrible experience. When she finally did get up, she was very obviously sore, mostly on the right front. She banged up her elbow on the right pretty good. She walked out of it in about 5 minutes and was acting fine. My vet and I decided to start her on bute 1gm a day but it wasn't making much of a difference that I could see (I was going by attitude-she hasn't showed pain or been lame outside of the farrier visit and that first few minutes after getting back up). Vet was out yesterday and flexed her two front legs and said she is very bad on her right knee - possibly bone on bone - and her left wasn't much better. We did a Legend shot and she is now on Aspirin 2x day. She seems better on the left today, but still ouchy on the right (now that I know what to look for). My goal here is not to keep her ridable, but comfortable. She's very stoic. Financially and in respect to her age, I have to be conservative with her treatment. What is the prognosis with bone on bone joints? Will she ever be comfortable with this condition regardless of the course of treatment? I'm probably asking a "crystal ball" question, aren't I? That night she couldn't get up really brought home for me the fact that I better start facing the inevitable. She's getting old and I can't stop it.
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Moderator:
DrO
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Posted on Monday, Jun 5, 2006 - 8:09 am:
If she is comfortable walking around there is no reason with a little judicious use of bute she cannot be trimmed and get up and down. Next time you find her down and struggling to rise on her own give her 2 grams of bute orally and a few hours.
DrO
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Member:
Twhgait
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Posted on Tuesday, Jun 6, 2006 - 1:14 pm:
Thanks DrO, I will do that. Can she have the "as needed" bute on top of the scheduled aspirin she already gets twice a day?
Something is working with her, either the Legend or the aspirin. She seems a little perkier and much more happy to get after her grandson then previously. 
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Moderator:
DrO
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Posted on Wednesday, Jun 7, 2006 - 6:47 am:
I don't know any work on the safety of bute on top of aspirin Kim and usually it is not recommended you piggyback NSAID's. In general aspirin has well established pharmacological properties that are thought to make it a poor choice for chronic painful conditions. But I don't think the final word is in on this for more see, Equine Medications and Nutriceuticals » Anti-inflammatories (NSAID's, Steroids, Arthritis Rx) » Aspirin.
DrO
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Member:
Twhgait
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Posted on Wednesday, Jun 7, 2006 - 5:25 pm:
Another great article DrO. This information is invaluable.
Unfortunately, my mare was down again today. My neighbor noticed her down (in the sun, sweating and in distress) and called the vet we share who in turn called me. My neighbor was able to get her up on her own by yelling at her (this is an improvement from the long ordeal my husband and I undertook to get her up last time). I checked her over as soon as I got home and she doesn't seem to have damaged herself as badly as last time. I spoke with my vet and we're going to do another Legend shot this Saturday (probably a series of 3) and see where we are at. I'm at a loss with this. Her going down and suffering when no one is home to "save" her really scares me (Thank God for my neighbor).
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Moderator:
DrO
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Posted on Wednesday, Jun 7, 2006 - 7:40 pm:
Kim what makes you think your mare suffers so when she is down? Certainly she did not sound comfortable in the sun but if she chooses to lay down there and if she can get up if necessary. I am just wondering if you are not punishing yourself more over this than is warranted. Personally with such severe disease I really think the Legend injections are an expensive DrOp in the ocean. We have had many older horses with similar histories that did well on a gram or two of bute once daily for years. Usually we also would recommend an oral joint supplement.
DrO
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Member:
Twhgait
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Posted on Thursday, Jun 8, 2006 - 3:34 pm:
Hi DrO, my fears mostly come from that night I caught her down and struggling. I'm sure when she initially goes to lay down, it's to rest or roll, but it's the getting back up that's hurting her. The night I found her laying down, she was stiff (all four legs straight out in front of her), was shaking and her breathing was very irregular and harsh (that's what had woke me up). When she did get up, she had that swollen right "elbow" (sorry, don't know the correct anatomical term), missing hair off of her head and blood in her mouth. Yesterday evening, I noticed her elbow was swelling again and it's because she was struggling to rise again. Am I punishing myself more then necessary? Yes, probably! But thank you for making me take a step back to see that.
That Legend is really expensive (just got my first bill from that visit) and if it's only a DrOp of help, yeesh. I will switch her back to the bute (then I can give PRN bute without worrying about NSAID on top of NSAID). It looks like from the articles that Cosiquin (? spelling) is one of the better choices for an oral supplement.
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Moderator:
DrO
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Posted on Thursday, Jun 8, 2006 - 9:53 pm:
Cosequin has come down somewhat in price, I think it is competitive.
DrO
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Member:
Paul303
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Posted on Friday, Jun 9, 2006 - 1:50 am:
Kim: Perhaps DMSO might help with the elbow. My mare was afflicted with this in the eighties when she began with her Navicular. She's now 26, and remains rideable after all these years, but that elbow was troublesome for awhile. It was more of a decubitus sore with her because she spent so much time down, with her elbow on her hoof or on the ground. The sores on her HOCKS were caused from her trying to rise.
Besides the DMSO, we used one of those "donuts" on her fetlock. The DMSO may have dispersed the fluid build-up in her elbow, but the "donut" helped keep it away by padding the foot that contacted the elbow.
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Member:
Twhgait
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Posted on Sunday, Jun 11, 2006 - 12:35 pm:
I went to the feed store and all the oral supplements they sell (didn't find Cosequin) would make me double up on the scoop to get the recommended dose into her. I ended up buying the stuff from the vet but that'll give me the recommended dose per scoop and the container will last me at least a few months. Thanks Lee for those suggestions! I'd like to know more about this donut. Was this something you slipped on her when she way laying down? Or did you leave it on her? I'm trying to think of something that would protect her "elbow", but obviously it would need to be something that's on all the time. I don't know if it's her hoof or the ground that's causing her damage. I was thinking DMSO for her "elbow" too, but the heat and swelling she develops goes down within a matter of 24hrs. We are then left with abrasions that peel off over a week or so.
She's much quicker in her gait today (she decided to not want to be caught for fly spraying time - the run-away is back, LOL) and I got the go-ahead to start riding her lightly to help build up some muscle. His biggest concern is that she trips and takes us both down with her. I think if I take it slow, we'll be alright. I've got to wait for her to lay down again to see if she's getting better at getting up.
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Member:
Paul303
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Posted on Monday, Jun 12, 2006 - 9:57 pm:
We left it on her. I just called the guy that loaned it to me ( twenty-some years ago ). I don't know if elbow protection was it's intended usage. He had accumulated "mystery boxes" of tack, like you do when you have horses. You know, donations from people you don't even know that DrOp them off because they don't know what to do with them.
It was an extremely well-made device about 2" thick. It had some weight to it - it was probably filled with sand and covered with a very heavyweight fabric like canvas. A cross-section would have revealed a square shape. It closed with a well-made leather strap. My friend told me that it might have been used as a weight for gaited horses ( weighed about 2-3 lbs. ). Yet I clearly remember my vet ( at the time )saying that he used these devices all the time to protect the elbow point from repetitive injury. It never did her any harm, and she wore it all the time until she stopped laying down so much. The mare probably cracked her elbow with her back hoof, it swelled, and just like when you bite the inside of your mouth, you just can't seem to quit biting it.
I wish I could help you more, but I realized that I've never seen one again. It sure did the trick.
The vet and everyone else referred to it as a donut.
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Member:
Twhgait
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Posted on Saturday, Jul 1, 2006 - 12:34 pm:
Lee, I've looked around my horse community, and it appears these donuts are out of existence! It's a shame too, cause it sounds like something I could use!
Following Dr. O's advice, Maude is about as much back to normal as ever. It amazes me how bad she really was when comparing "before" to "after". Before this whole laying down business, I didn't really notice much except....she was slow....she had frequent "colics".....she acted every bit her age. Today, she is snorty, she is FAST, she has a huge appetite and she is defiant! I have my old horse back! Dr. O's recommended treatment has been a life-saver (for the both of us). I'm actually sleeping at night again instead of waking up 2-3 times to listen to the barn monitor. I know I'm still dealing with the disease itself, and laying down and getting back up are still issues, but I think this all trimmed about 5 years off her age. I think her "colics" were really her knees acting up enough to make her have too much pain to eat. We added 45 degree angles on her toes which has also seemed to help greatly. My vet didn't feel comfortable with me riding her because of the tripping risk.
I don't know how much riding her will effect her knees but I think I'm going to have to get her back under saddle to get her back to "domestic horse" mentality. She thinks she's pretty wild right now. She also still needs to lose some weight. Dr. O, will light riding be too much for her? Would I ruin the progress we've made? Can I just give her an extra dose of bute beforehand? Sorry for more questions, I just want to make sure we don't go backwards!
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Member:
Paul303
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Posted on Sunday, Jul 2, 2006 - 12:32 am:
I'm sorry I couldn't be more help......but boy, that thing was sure great. Now I am remembering, that we called the sore and the huge swelling - a shoe boil.
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Moderator:
DrO
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Posted on Sunday, Jul 2, 2006 - 6:18 pm:
Predicting the course of arthritis is tough Kim but if you go very slowly with a day between rides, you will safely find Maude's limits.
DrO
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Member:
twhgait
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Posted on Saturday, Jan 27, 2007 - 1:02 pm:
DrO (and Lee, please jump in!), I have a few new questions on my mare and I'll provide an update:
Since my last post, we never did get her back to riding. She has stayed comfortable with daily bute (from 1/2gm once a day (currently) to 1gm twice a day (our peak when she was still out with our yearling who started chasing her) and daily glucosimine/chonDrOitin supplement. We didn't do anymore legend injections after the three last summer. She's layed down several times since July, but we can get her up (80% of the time, she lays there calmly, and after giving her bute, we either roll her or "encourage" her with a whip-she sometimes just refuses to even try to rise). She is completely sound in all gaits (she still has her moments of running) and I can pick her feet without a problem (I just can't bend her right front too much). The only "exacerbations" we still have is when the farrier comes to visit. He's doing everything he can to keep her comfortable during the trim, but she's very sore after about 5 minutes of standing on her right front. She also can sometimes be sore the day after a farrier visit. She IS improved with the farrier though-early in her treatment, she moaned when he picked up and flexed her right front-now she doesn't seem to mind it at all (although he might be being more careful now too).
I watch her for soundness and I watch her attitude several times a day. My vet told me that she will always have pain for the farrier and for flexing the right front and that I shouldn't medicate her daily to try to get rid of that (he recommends 2gms of banamine prior to the farrier visits). I was actually hoping to get her off of bute completely or maybe back to aspirin, but haven't made that jump yet because since the lower dose, I've noticed she does more "shuffling" when she's standing. She'll sometimes put her right front out ahead of her left, but most often she'll shift her weight back and forth when standing. I didn't notice her doing this as much when I had her on the higher doses of bute. Should I bump her back up to say 1/2gm twice a day, considering this represents obvious discomfort? Or should I try the Legend again? That seemed to work last time (then the 4th of July fireworks started and she went back to square one from all the panicked running). I'm never sure which is the worst-too much bute or some "expected" discomfort on her end. I'm thinking I shouldn't even try her off the bute or back on the aspirin at this point. She's also decided to not always eat her bute....she's starting to leave grain behind when I put bute in.
Also, my farrier said she's gotten fatter. Obviously, this is not good! I've got her and her daughter (who paces the fence when she feels she's being "starved") on filler hay, two flakes prairie grass and three flakes alfafa/orchard mix spread over three times daily. They pretty much leave the filler hay and some of the prairie grass. I suppose I can totally eliminate the the alfalfa mix but I swear she and her daughter will starve themselves before they willingly eat the filler hay. I'm afraid to even try to work her....I think she's sitting on the edge between comfort vs. pain and any little thing will tip her back over into pain.
I've read the article again and again but I think I'm starting to second quess myself. I don't know that this shuffling is an "exacerbation" or just something she'll have to put up with and therefore not sure if I should medicate for it or not.
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Moderator:
DrO
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Posted on Saturday, Jan 27, 2007 - 7:18 pm:
If she is acutely more uncomfortable why would you not medicate her? It you are worried about the dose why not try a lower dose? And why would you use aspirin as it is not a well understood drug in horses?
DrO
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Member:
lzieman
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Posted on Sunday, Jan 28, 2007 - 11:11 am:
Or how about trying naproxen if you're worried about the bute toxicity?
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Member:
twhgait
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Posted on Tuesday, Feb 6, 2007 - 10:58 am:
The only time she is "acutely" uncomfortable is with the farrier (for which I pre-medicate her with banamine)...and her current dose of bute is 1/2gm once a day-any lower and she might as well be off of it, IMHO. She weights approx 1200lbs and I'm thinking that dose of bute for her is like me taking one advil vs. the four I usually need. She was on the aspirin many years ago and tolerated it very well. My vet would rather have her on the aspirin then the bute long-term (I don't know his rationale). Lisa, he doesn't want to do the naproxen, but I asked him to look into it.
I guess my update wasn't clear...I didn't mean to imply that I was leaving her in acute pain or that I was lowering her bute dose despite the fact that she's in pain. I would never do that to her. She seems "normal" outside of the occasional shuffling. I went ahead and had the vet give her another Legend injection last week and yesterday she "played" with the gelding (over a fenceline), and her hind legs actually left the ground in a buck AND she reared. Wonderful to see, and gave me such joy. That joy lasted about 1hr. After I gave her vet a glowing report on her antics yesterday, she ended up falling down because she fell asleep standing. I figured this because she was laying in the exact spot I left her napping in the sun in. Getting her back up was easy (although she wasn't cooperative about it, I can do it by myself vs needing my husband and a few hours). She did get wet and was shivering and had quite a few bad steps after she got up. This all after me telling her vet how well she was doing  I gave her extra bute for supper and extra bute for breakfast and blanketed her. She was fine when I left this morning, but....will she fall down again today? Tomorrow? Is the falling down from pain? Or she just slept too deeply? I don't know....
This is a new situation in her (at least new because I was able to figure it out instead of just finding her down and not knowing how she got there) If she starts falling down like this on a regular basis (vs the maybe once a month I deal with now), I'm going to have to consider putting her down. I can't be with her all day to watch her. We've been lucky so far in that she chooses to lay down at night when we're home. It's hard to consider euthanasia on a horse that is as bright and seemingly pain-free as she is.
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Member:
lzieman
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Posted on Tuesday, Feb 6, 2007 - 3:10 pm:
I've thought about euthanasia lately, and basically how it equates to humans. Think about the elderly. Most people before they pass away, have lousy vision, don't get around well, and I bet have a heck of a time getting out of bed in the morning, or out of a chair even. And those are probably the lucky ones. Think about the ones that are in diapers, and no longer talk, etc. Yet, we don't usually think to ourselves that they would be better off dead. If she seems happy and pain free, it seems early to discuss the idea. As Dr. O said, she probably isn't really in distress when she can't get up. Hopefully she won't have any more instances of hurting herself when that happens. Of course the falling down thing sounds a little worrisome. Perhaps she's purposely going down that way (I know, not likely)? I think personally if I thought that the end was near, I'd medicate more, because the long-term toxicity is probably a moot point. Have you tried Capsacin (sp?) on the knees? Maybe when she goes down, apply that, along with giving her the Bute to see if that would speed it along. Or daily application of DMSO, maybe with some type of topical analgesic, before work and before bed maybe. Or I know Dr. O somewhere mentioned a once a week application of DMSO mixed with cortisone.
I feel for you. Like I said, I've been thinking about it myself, but hopefully it will be years before I have to make that decision for any of my animals.
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Member:
twhgait
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Posted on Tuesday, Feb 6, 2007 - 7:47 pm:
Lisa, you must have been listening to our conversation at work today! I'm a nurse and was gathered with some other nurses and we were discussing Maude. We decided what I am doing is "Palliative Care".....keep her comfortable, keep treating her, but no life-saving heroics. I guess Hospice care will come when "the time" comes. I think she is starting to fall now.....I've caught her almost falling while sleeping once before (I think I started a thread on it somewhere). She hardly ever lays down anymore just to rest. I'm sure she's exhausted.
I put alot of thought into what DrO said originally-that if she can get up on her own, she can get up on her own. And she can. After I get to her and start yelling and/or prodding at her, she'll make two or three attempts and UP she goes. Sometimes she'll fall back down halfway up and go right back to laying there until I prod at her again. Seems like she just gives up when she's laying there. My vet said that it will get harder and harder to get her up over time. He carries a cattle prod that he uses on horses that refuse to get up. He even recommended we buy one and have it handy (but of course call him first before we use it). He said if they dont' get up with a cattle prod, they won't get up anymore and it's time to euthanize. I'd so hate for that to be her last memory of us. So, yes, I wonder why she needs me to stand there and go thru the motions when she and I both know she WILL get up. I honestly believe she won't try though if I don't make her. On a good note, she has not been injuring her shoulder or stifle area anymore. She does have a capped hock from about a month ago when she was down, but I think that's because she hit a rock that was coming up out of the ground. I have no problems using the max of bute for her to keep her comfortable, but like I said, if this falling down thing becomes too frequent, I'm going to have to really make some decisions. Especially if she shows no interest in getting herself up without my help. I saw that thread on Capsasin and thought it sounded pretty interesting and I'll go back and read it! Thank you Lisa for your concern and suggestions!
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Member:
scooter
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Posted on Tuesday, Feb 6, 2007 - 8:06 pm:
Hi Kim I am going thru this with my mare also, hers is in the rear legs instead.
I know exactly what you mean by the shuffling, my mare does this also. I had a post last year about it, I called it weight shifting. She puts the front foot forward, then the rear. It's like they are taking little steps forward while "standing still"
I still can't decide if it is a sign of great discomfort, and nothing really makes it better, so I have chosen to ignore it! There are times she doesn't do this and times she does. If she seems to be "shuffling" alot I give her a high dose of bute until it stops, then take her off the bute again. Sometimes she won't shuffle again for mos. and sometimes it starts right back up. Sometimes she runs around like nothings wrong and sometimes you'd swear she was on her last leg! I think they are just old and like my 80 yr. old mother they have good days and bad and we just can't fix them, just help them when they need it. It took me awhile to except I couldn't fix her and it depressed me for awhile. Now I try to except her for the old very wise girl she is and it's been alot easier on me and her. She can still throw me into a panic once in awhile.
My vet said he don't think she is in "pain" but gets uncomfortable standing in one spot for a long time and that is one of the reasons it is USUALLY worse in the winter when they stand in the lean-to
23 hours out of the day by choice. He said the "shuffling" bothers ME more than her (so did Dr.O. pretty much) and I think they are right.
Given your situation with her not being able to get up,I think I would up her bute until she could then taper back and see what happens. Good Luck I know how hard it is. I sang "If I could turn back time" to the old girl the other day and she seemed to enjoy it.
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Member:
lzieman
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Posted on Tuesday, Feb 6, 2007 - 8:34 pm:
Kim, now I feel dumb! You know much more than I do being an RN. At least the more comfortable you get her with meds, the easier it will be for her to get up, and the easier it is to get up, the more she'll sleep lying down, and therefore, she won't be sleeping standing up, and falling over. Or so I hope. Plus, as Diane mentioned, the cold weather is tough, so if you can get through the next couple of months, maybe things will improve, at least until next winter.
I just had a weird thought--do horses get ear infections that can cause balance problems?
Another stupid thought, is she starting to figure out that if she lies down she gets yelled at, or prodded, (obviously only if she's having problems getting up) and prefers to avoid that? She might view it as a punishment.
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Member:
twhgait
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Posted on Saturday, Feb 17, 2007 - 10:27 am:
Sorry about my delay in getting back here!
Diane, thank you so much for sharing that! It helps alot. Maude does alot of those same things. I used to think the gray hairs on my head where from my children, but they are probably all from Maude. I just hope that I'm doing all the right things...it's hard as I feel like I'm guessing most of the time. I will follow your wonderful advice though!
Lisa, I love your idea! I think the laying down to sleep would totally eliminate the falling...she just won't do it anymore, at least not willingly! She hasn't layed down since the 6th, but I think the next time she does I'm going to proceed as if she can get up on her own and I'm expecting her to. Basically, ignore her and go about my business around her, as long as she's quiet and not in freak-out mode. Maybe, just maybe, she'll figure out she doesn't need me to help her. I don't know and I could be reaching!
Another owner of an old horse brought to my attention (in a thread I started about her near-falls) a study done by a vet on "sleep attacks". It fit both our mares to a "T". Here's the video link:
https://equisearch.com/horses_care/health/behavior/sleepdisorder_121506/
I'll have to buy the magazine to get the whole article, but it explains alot about her falling. We catch her doing this at least weekly now (usually after breakfest, standing in the sun). The scary part for me is the fact that no one is home during the day, so if she happens to fall, she'll be stuck until we get home.
I am curious as to the long-term effects of REM sleep deprivation. Does the falling over just continue? Or are there ill-effects to this over time that will shorten her life span OR make her quality of life worse.
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Member:
lzieman
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Posted on Saturday, Feb 17, 2007 - 1:12 pm:
Kim, that must be weird to watch. So you've upped the meds, and she's still too uncomfortable to get up from lying down? That's too bad. Well, hopefully some warmer weather will help her feel better.
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Member:
scooter
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Posted on Saturday, Feb 17, 2007 - 1:42 pm:
Hi Kim, Flashes front legs buckle when she is sunning also, I haven't seen her do it much this year. Last winter when she was doing poorly it seemed to be much worse.
This winter other than not being able to trim her back hooves well, she is doing better than she has in quite a few years, I'd have to say this is her best winter in five years! She is moving better than the geldings and fighting with them again.
She gets legend shots every 90 days approx. But I started her on 2 different supps for her arthritis (I've tried millions) this one seems to really help, her cracking and popping are gone and her shuffling is greatly diminished. Here's the supp. maybe Dr.O. can comment on it, but it seems to have everything and the price is VERY reasonable.
https://www.coxvetlab.com/products/acti-flex4000.htm
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