The most exciting caseous material ever

Last Saturday Ben and I went for a really very pleasant tack walk. We meandered down the road from the farm and then got a bit swarmed by yellow flies. This led to a bit of trotting down the road to lose the 10+ flies we had acquired. He was FANTASTIC and trotted politely and then walked politely.

Later that day, JT's working student texted me: 

She'd cleaned some of that white goo away before photographing, but said that when she took off his Easyboot there was a disgusting smell

Yay!!! Weird that it ruptured out of the frog, but maybe it was centrally located and so putting pressure both medial and lateral?? No clue. 

BUT! He feels sound and great! We've been adding in a bit of intentional trotting to our tack walking now. He's progressively getting his mind back in the groove too, yesterday our ride only had a middle section of flailing as opposed to Monday where it was mostly flailing. Yesterday he really seemed to respond to reassurance as well; Monday he was a tightly wound spring that couldn't relax. I'm doing 30-40 minutes of walk with 5-10 minutes of trot right now. I was trying to just do 5 yesterday, but once he spooks at something one of the best ways to get him to settle again is to put him to work for a few minutes, so we had a few extra trot circles. We're going to stick to just 30-60 minutes of walk and 5-10 minutes of trot until he gets front shoes with pads. Slow and steady to build him back up again, mentally and physically. 

Until he gets shoes back on he is also restricted to his 5-6 hours of turnout in hoof boots in the morning. It's just too hot to leave him out longer and it is just too wet to go out overnight with boots that trap ALL the moisture on his feet. But the second week of July we'll have shoes back on and can go back to full time regular turnout. A few weeks after that, I'll move him to the GY's. 

I was using the super long line/lunge line so I could stand in the shade while he grazed. He's just the most handsome <3 

Quick Update

Thus far my decision to go back to turning Ben out was absolutely the right one. He's a bit of a stress ball in the way Yoshi and Zing were not. In addition to just being really no fun for me to try to walk in hand or under saddle, it was making me cringe to see how unhappy and stressed he was. He's not a brave horse to begin with, and with all the extra... energy from being stuck in the stall, he was just about exploding in every direction. And while the lip chain kept him from exploding onto me, he clearly was unhappy about it.

Happy ears.. might've let his mane get outta control while he's been off 

Post bath, happy and grazing

Kiddo has been getting 1800mg of trazodone with breakfast then going out in his hoof boots for the next 4-5 hours. And he is soooooo much happier. Like his brain has slowed down again. And he looks happier in his body. He will stand relaxed behind instead of weird and wide (which quickly returned after his adjustment). The first day of turnout he did bounce around a bit, probably for a minute total, but with a bit of leg flinging, which seems to be his favorite move, and prancing. He rolled probably 5-6 times, no surprise, he loooooves a good wallow. He limited the sliding stops, but bounced up and down a bit. I was holding my breath some. But the next day under saddle I trotted a 20m circle both ways and he still felt SOUND. And we could just TROT the 20m circle without exploding or flailing. 

Since the first day, he has restrained himself to just a bit of trotting. Excellent. Considering we were doing some spinning in circles and bolting both in hand and under saddle, I'm telling myself this is an improvement. 

And with time working the way it does, we're now just 2 - 2.5 weeks away from his recheck appointment. Fingers crossed we get a good report then. He's still pointing one toe or the other sometimes. I don't love that. But I may also be over analyzing everything now. 

In non-horsey news, Pico cat decided to give me a heart attack this week. She had gotten progressively lethargic and anorexic over the past two weeks and really went downhill the past 3-4 days. Bloodwork just showed dehydration. Initially fluids, cerenia (anti-nausea), and mirtazapine (appetite stimulant) weren't doing anything. But this morning I woke up and she ran down the hallway to greet me! She hadn't done that in a week! I'm still keeping her abdominal ultrasound and chest x-ray appointments today, but I'm hopeful we're on the right track. 

I just adore her

WW: A familiar view

Tack walking because he struck my forearm with a flying front foot while hand walking

And turnout with sedation because even with various sedatives, tack walking wasn't going well either. Time will tell if it was the wrong decision. Mental health wise, we're both happier.

Not a horse, but look at how cute this lil gal/dude is in a blackberry field 

Cautiously...

Ben had his recheck today. He hoof tested positive lateral and medial again on the right front as well as on his left front... There was some black goo laterally on the right front that was there last time. We thought it was just leftover from his glue on shoe, but maybe it is real? 

He has been alternating pointing his toes, one after the other, and was doing that again this morning. But he looked fine on tight circles at the walk both ways. And then... then... he jogged sound! I'm cautiously optimistic and his vet is as well. She Rxed a full cycle without shoes to give the nail holes time to grow out. This means he is staying in his stall and going out for hand walks in hoof boots. As long as he feels great, he can walk as much as we want. I am super relieved because I was feeling not great about keeping him stalled for so long. The first or second week in July, we'll regroup, shoot some more x-rays, and then if he is still sound trim and put shoes back on. 

We did discuss the possibility of some of this being related to immunocidin - mycobacterium can trigger laminitis, could the fractionated cell wall have triggered a minor laminitic episode? He definitely started very right front off, bounding pulse, dead lame on the one foot, much like a typical abscess. But there were a few days a few weeks into the saga where I questioned if he was off in the left front at the walk as well. Interesting to ponder. Makes me glad we are at the end of that medication (for now). 

Pulling the classic dog move of going on the wrong side of the pole and hoping I'll fix it for him

His vet also adjusted him today. It really, really helped. I had been watching him lately and just feeling like he was uncomfortable all over. He would shift around in the cross ties, pointing one front foot then the other, and refuse to step over onto a hind leg. He was also standing super wide behind. 

He was very out in his lumbar area again - I had noticed that on his butt tucks he was uneven in his hips even when he was square with his feet. He was also quite sore in his withers. Again, this makes sense. In the pillar work we're doing, he will soften his brachiocephalicus, but then the rocking back to lift up in his withers a bit had become REALLY hard for him. The soreness probably came from his feet. He looked much comfier after she adjusted him and was standing more normally behind. 

He had some funny faces during his adjustment. He would look wounded when things were uncomfortable, but then make subtle signs of releasing afterwards. He's learning to be more expressive, I think. He felt GREAT afterwards and was a bit of a menace while I was trying to hand walk him. He is mostly very good about not hopping or prancing ON me, but at one point did start half rearing and striking a bit. I had stupidly come out without the chain shank, thinking that 95 degree weather and stifling humidity would keep him in line, but this heat ain't got nothing on the stalled thoroughbred. Once I fixed that mistake, he was politely bouncy the rest of the time. 

WW: Ben and Ben's sarcoid

 

Sarcoid on sheath - and a fairly swollen sheath from the Immunodicin. 

Leg sarcoid - SOOOOO much smaller than it was

Handsome, dirty pony

What is dis? Rocking his new hoof boot too. 

Sarcoid Treatment

Before Ben was mine, I didn't want to write anything about this. But now? Kid is all mine, for better or worse. And Emma's post about blogging and reading got me thinking about what else I had to share that could be semi-useful or at least visually entertaining (if you're into gross things). 

Turn back now if you don't want to see some gnarly pictures of a giant sarcoid on a sheath. 

 

Arrival in January. Large, nasty thing hanging out there. 

Treatment options offered included surgery, immunocidin injections, or a combo of both. Surgery ran the risk of incomplete removal, angry sarcoid tissue left behind, and wound dehiscence. He also would need a month of recovery time if we went that route. So his owner elected to go with immunocidin injections. Immunocidin is mycobacterial cell wall fractions. The idea is to inject the sarcoid and get an immune response. The pictures that follow are testament to that. 

Looking kind of angry, but more on a stalk after the first injection

Then the center started to get necrotic, yay! At one point it was oozing pretty steady drips of puss out of the center. 

I won't compare this to food... I won't compare this to food... 

It went through several bleeding phases too 

This was a few days before our Majestic show. His doctor had managed to put a band used for castrating sheep around the base of it. It was hanging on by a thread and smelling very, very like a dead animal. Poor buddy also had a lot of swelling above it. 

JT and I joked about trotting down centerline and then flinging this sideways at the judge as we turned at C. The morning of the show, I put a ring of suture around the base to make sure it wasn't going to bleed or hurt him, and then snipped this off. I promptly threw it in the trash because the other thing JT and I had talked about was it falling off in the pasture and a dog eating it. Also LOL at my lack of gloves, bad vet.  

Large wound left, but nice healthy granulation bed. There's another sarcoid above it. We treated the wound bed with Vetricyn Plus, which I had never used before. I've since recommended it for a number of wounds I've seen at my job. This made me a believer in it. 

Closing up so quick. But... that sarcoid brewing above became the next thing. 

I apparently got bored of photographing Ben's sheath at this point, about 2 months ago. The sarcoid above was the next target of immunocidin injections. It's almost done at this point, then we get to stop poking the poor kid in an incredibly sensitive/personal area. He has been SUCH a good boy for all of this. He picks up his hind leg in protest when I go to check or remove the scabbing to be able to get ointment on it, but he has never actually threatened to kick. His whole team at Peterson and Smith where we did the injections just loved him as well. 

I think all together we did... 4 immunocidin injections, 2-3 weeks apart. 2 injections got us to the point of banding the larger one, the last 2 injections were on the one above it that never did form a nice stalk. I did another injection myself after his dual farrier/vet appointment on Tuesday. Just trying to finish off that (non-photographed) one above it. He did tend to get sore and swollen in his sheath after the injections, sometimes to the point of not really bringing that right hind forward under saddle. We would give him some easy days with just a light hack when that was happening. Seems like motion was good for it, but obviously wanted to be kind to him. 

He has a sarcoid on his leg (that I have never taken a picture of...???) that he has had since his owner got him as a 5 year old. It's just above his chestnut on the inside of his left front leg. Also about the size of a chestnut, but raised. The one on his sheath cropped up between age 10-12 while he was on lease. He had plaques in his ears as well, I'm not sure of the time frame on those. Since we've been treating the sheath, we also did treat ones in his ears and the one on his leg. 

The ones in his ears responded to a single treatment of topical Imiquimod. They did get pretty angry and painful, so I wouldn't use that same medication again in the ears. He's SUCH a kind and forgiving horse that he has gone right back to letting me handle his ears, no problem, but I can definitely see how a less forgiving horse might very easily have become head shy/ear shy after the process because they ulcerated and kind of peeled off, leaving his ears very raw for a time. Applying or spraying anything on those was a no go, so we just put ointment on when he was sedated at the next injection appointment and then kept him covered up with a fly mask with ears. 

The one on his leg has been responding to weekly Imiquimod and then daily Sarcoid Stopper. There is a Sarcoid Stopper product that probably would have been better for his ears than the Imiquimod because it contains a steroid to try to decrease inflammation associated with treatment. His vet at Peterson and Smith said the ones in the ear can usually just be ignored as well, but occasionally as a surgeon she sees one that has grown out of control and wishes it had been treated earlier. This reminds me of lipomas in dogs. Mostly they never become a problem, but sometimes they are the type that weave intramuscularly, or they just get so big in such a bad spot that they are a problem. And then once they're that size and a problem, they're pretty hard to deal with. 

I'll snap some pictures of his leg as well as where we're at with the sheath and share those if others are interested in this journey.

Getting all the help

Ben had his dual farrier/vet appointment this morning. Since he got worse last Monday, he's been mostly on stall rest with small bits of turn out with chemical help. His vet didn't want him romping too much if this was a ligament problem.

The good news? Not a DDFT lesion because he has no sensitivity to hoof testers over his heels. The bad? No obvious gas tracks of an abscess on rads. One suspicious area though. He was positive to hoof testers medially and laterally, worst over the nail holes. Medial has been the main problem, so who knows what's up with the lateral side. We pulled both front shoes and he's in for the next week. Poultice over the foot and over the coronary band, give an abscess every route to blow. 

His vet said she doesn't send horses to MRI that are that positive to hoof testers. Recheck next Thursday.

All we've been doing these days... He finally gained the last bit of weight he needed to though with all this rest 

WW: Handsome Horse (+ words of a sad vent/rant)

Still in what we hope is bruise/abscess purgatory. He got a glue on shoe on the right front two weeks ago. He'd been slowly getting better while wrapped/poulticed and was sensitive to nails on the medial side both when the shoe was put on and when the shoe was pulled. So we figured bruise on the medial side. He hoof tested positive to the whole medial side right before we put the shoe back on. He carried on in the mildly lame category until a week later when he was gimpy at the walk. Gradual improvement again until becoming seriously gimpy again on Monday. In 6 days we have a dual farrier/vet appointment to take rads while his shoes are off. Maybe we'll catch gas from an abscess if we're lucky? If they are not exciting and his vet recommends it, we'll move to MRI. 

We're on week 5 of this. Both his vet and farrier have said they've had abscesses and bruises take 2 months to resolve. His vet is 80-90% sure it is still just an abscess/bruise based on the history, the hoof testing, etc. He's been in on stall rest though since getting worse again on Monday. Just in case.

If this is more than just a bruise/abscess that won't quit, I am actually done with horses and out. I saw a good friend recently who does a lot of mountain biking; that's the direction I'm going in if this is a collateral ligament or other awful injury. 

Anyways... 

He's just the most handsome

But can still dish out some serious side eye at weird things behind him!