Post by jjackson7 on Nov 2, 2016 19:22:08 GMT -5
Hi there,
So this is a bit of a long story and I'll try to be as brief as possible while still giving you all the details. My weanling AQHA colt Romeo has just been diagnosed with Aquired Flexural Deformities in both of his hind legs; most commonly known as contracted tendons. So being an aquired deformity, this colt was not born with this condition. He was brought in aprox 3 weeks ago (maybe a bit longer now) to be weaned. He has spent most of his life on large meadow pasture with the rest of the broodmares and foals.
So the foals were put into the corral to be weaned with a large round bale of good quality upland hay. Timothy, brome, alfalfa mix. They were also given a small amount of dry rolled barley every day. It was 2.5 gallons split between the four weanling foals and a yearling that was with them as well. The corral that they were in is muddy....very muddy. It feels like it has rained here every day all summer so they were standing in a half foot of mud, with it getting deeper around the feeder as time went on. Normally they wouldn't be in there, but it's the safest place to wean the foals to that is where they were.
We weaned the foals right before we shipped our calves so I got really busy for a while, and didn't spend a lot of time with them. One day I noticed that they had pulled/knocked their round bale feeder over, and Romeo was limping slightly on his hind leg. As I said it was a busy busy time, so i gave him a quick overlook and there was nothing obvious going on with him. No open injuries or anything, and I just assumed he whacked his leg off the feeder when they did whatever the heck they did to it. Fast forward a couple more days, he's still limping, maybe even worse, and isn't really walking a lot, but all they're doing is standing at the bale all day anyway so this isn't surprising. After shipping and getting all our cows brought in from on range, the focus turns back to Romeo. We start re-introducing the foals to the halter and he's just not right. He's a little sore but he's not limping the way he was. However, I get him out of the muddy pen and notice one hind fetlock is being held at a weird angle. Call the vet and can't get an appointment for a week as they're short staffed and it's the height of preg testing season so they're run off their feet.
Get him to the vet and can't see my normal vet. I have to see a temp, Dr. H we'll call her. By the time we get there I am noticing that both of his hind legs are affected. She says it's contracted tendons. She tried to manipulate the joints and tells me that they are contracted to the point that he can not extend that limb back to a normal position. She doesn't really seem to be listening to me about the fact that this foal was not born with this, that he wasn't like this at weaning and that this just developed. She takes some x-rays and says that he needs surgery. That we're looking at a around $2000-3000 for surgery, but that the aftercare is soooo intensive that it will also require a couple months of in clinic care afterwords. Which obviously almost doubles that cost. They can't do the surgery in our clinic so she is going to look into a few clinics around the province and get back to me with a better estimate of the exact cost, and also show the x-rays to someone who is more specialized in this type of thing. Boom. Sends me home with bandage instructions for this little tiny dime size wound she found on the fetlock (and kinda made me feel like this was the root of all of our problems), Uniprim as an antibiotic for the wound and she also wanted his feet trimmed as they were a little long. I told her I had planned on doing them but he was sore so I was waiting. So she send me home with the biggest tub of Bute powder I've ever seen so I can manage his pain to trim his feet. I get home and called the clinic back to check on whether he should be stall rested or not. She said yes to stall rest him and to also put him on the Bute for 10 days as an anti-inflamitory. She has already talked to one vet from another clinic that was hopeful about splints but she said they would take 6 months to a year and I would have to change the bandages twice a week because pressure sores can be a problem, so it was a lot to take on and she wasn't really sure if that was the way to go and yadda yadda yadda. In my mind I'm thinking that checking splints twice a week is a heck of a lot better than surgery but.........
So I give him the Bute powder and Uniprim that night and we trim his feet. In the morning I go to check on him, and he's standing upright in both legs. What?? My heart does a summersault. As he moves around while I'm cleaning his stall he does knuckle back over, but he is still trying to stand back up. So I unfortunately didn't get pictures that day as the cows had to be moved to a new pasture (running a ranch eats up the time) but he got his Bute and Uniprim again that night. We go through the weekend and he is still standing up for small periods of time and it starts to get to when he will walk more or less normally but when he stands/rests it tends to pull him back over. I did get some pictures through out the weekend.
So, bright and early Monday morning I get a call from my normal vet, Dr.Doug. Apparantly Dr. H has been moved to his clinic in another town, and she will be gone for two weeks as he's juggling temps around right now. So since she is gone, he's calling me to see what's going on with Romeo. I give him the rundown, and tell him of the improvement over the weekend. At this point you can now easily push on the fetlock and push the joint back into a normal position while Romeos just standing there. He tells me that with this kind of improvement in so short of a period of time he thinks we can stay with the anti-inflamiories as pain management, but he doesn't understand why Dr.H put him on Bute for long term as it's hard on their stomachs. So he switches me to Previcox which I guess is off label in Canada for horses but they use it in the US. Also he gets him on some gastroguard, and tells me to get him off the bute, wait 2 days befor I start the previcox and to keep up with the uniprim just in case there is something going on infection wise. We discuss both surgery and splints and he says that he doesn't think we need to go that far and re-iterated what Dr.H had said about splinting causing sores and things. But he also said it would not be for that length of time and that they don't wear then consistently. You put them on for a few hours and them remove them otherwise they aren't building any strength on their own. These are some things that scouring the internet all weekend had already taught me, but the grand hallelujah of it all was that he said it sounded like an acquired problem which I had also discovered over the internet. Caused by a nutritional issue, resulting in a growth spurt where the bones and soft tissue weren't growing at the same rate. Couple that with the fact that he had an injury that restricted movement during the growth spurt and also the vacuum of being in all that mud, and we've got a recipe for problems. And since this was an acquired deformity, one of the most important and immediate things for treatment is adjusting his diet and taking it back down to the bare bones. Which I had already done, because of my research on the internet, which frustrated me because Dr.H didn't want to look at the fact that this was new, and therefor never gave me any advice about this kind of situation. I wasn't excited that I inadvertently caused this but at least I have some small satisfaction in knowing that this isn't something that I overlooked since birth and never dealt with like some people were implying. I'm pretty optimistic at the end of the call. He want's me to get him weighed before he gets the prescription made up for him since he will be on pain meds longterm, and also wants a bunch of video and pictures of him as he's not seen him in person. Just the x-rays.
So we weigh him and I go into town the next morning to pick up his new meds. which cost an additional $250 from the previous $275 for the drug he only took for four days. And when i get back home, I get a call from Dr.H, in the other clinic she's been sent to. She tells me that shes talked to a few clinics around the province and she has found the cheapest, closest one for us. That the surgery is around $2500 and they will let me take Romeo home after the surgery to do aftercare, so that is an major decrease in costs. I tell her that Dr.Doug had called me on monday and said that he wants to stick with the new drugs and wait and see what happens since we are seeing improvements already. Dr.H kinda gets upset and says almost verbatim, "Well if you're just looking to have a lawn ornament or a backyard pet then it's fine to just wait and see but if you ever want him to be usable then surgery is your only option." Whoomp. The air goes out of my lungs. I'm not a fan of guilt trips. She gives me all the information for the doctors she's been speaking to and says it's my decision about whether or not she sends Romeo's file to them and that I need to call them to make an exam appointment and the schedule the surgery. I need to decide if I think he's worth the money. Whoomp again.
I hang up pretty upset and feeling guilty again about what to do. And confused as both vets have a very different approach to what is going on. Dr.Doug has been my family vet for years. I trust him and he always seems to have a pretty level headed approach to things. He's cut and dry which I like, and there hve been times I have pushed a treatment he didn't think would work but we persevered and the animals have always come out on top. To be fair, Dr.Doug has only seen pictures and the x-rays of Romeo, and he's only seen pictures of the improvements. And Dr. H has only seen him on his worse day. I don't think she has seen the pictures and videos I sent to the clinis as she's been gone.
So I call Dr.Doug's clinic and ask for him to call me when he can so we can all get on the same page about what's best for Romeo. He calls me this morning befor his outcalls, and I explain what's going on. And he sticks to his guns saying that he doesn't think that we need to look at surgery yet. That with this much improvement and being able to easily manipulate the joint back to full extension, that we should wait and see how things progress. We talk about the surgery. He tells me that it's a lot of money to spend on a horse when the end results of surgery are not always great either. That once that tendon is cut that it never gets back to it's original strength, and there is a really guarded prognosis. He also for some reason does not like the doctor that Dr.H has referred me to. For unknown reasons. I think he feels going to a clinic closer to the coast gives us a better chance at finding a specialist. Dr.H said those clinics had estimated surgery being closer to $5000+, and it's a 6 hour drive to get there. Dr.Doug said that he would look into an appropriate clinic to get estimates if we decided to go that route, but right now we should wait.
So here we are in a waiting game and I can't shake this feeling of guilt about waiting. He is doing better slowly. Both Dr.H and Dr.Doug suggested taping a heel extension on his hooves to help force him to stand better. Today's prototypes didn't work out well so I need to come up with a better plan to execute that idea. I just got a call that Dr.Doug is coming to preg. test our herd on the 15th, so he should be able to have a look at Romeo then in real life. Dr.Doug also said that as long as we're seeing improvement and not regressing that it won't hurt him to wait a while and if things don't work out to look at surgery afterwards.
I'm just wondering if anyone has any advice, or has dealt with this kind of thing and can offer some guidance. I think I also just really needed to tell me story and let some of this frustration out. Dr.Doug also said that he's hoping to hire Dr.H full time after she comes back from the other clinic. Ugggg. She's left a bad taste in my mouth and because I know the stress he's under with staff right now I didn't have the heart to tell him that she's somewhat lacking when it comes to bedside manner. I'll try to post a couple pics in a bit.
Any input is appreciated
Jen
So this is a bit of a long story and I'll try to be as brief as possible while still giving you all the details. My weanling AQHA colt Romeo has just been diagnosed with Aquired Flexural Deformities in both of his hind legs; most commonly known as contracted tendons. So being an aquired deformity, this colt was not born with this condition. He was brought in aprox 3 weeks ago (maybe a bit longer now) to be weaned. He has spent most of his life on large meadow pasture with the rest of the broodmares and foals.
So the foals were put into the corral to be weaned with a large round bale of good quality upland hay. Timothy, brome, alfalfa mix. They were also given a small amount of dry rolled barley every day. It was 2.5 gallons split between the four weanling foals and a yearling that was with them as well. The corral that they were in is muddy....very muddy. It feels like it has rained here every day all summer so they were standing in a half foot of mud, with it getting deeper around the feeder as time went on. Normally they wouldn't be in there, but it's the safest place to wean the foals to that is where they were.
We weaned the foals right before we shipped our calves so I got really busy for a while, and didn't spend a lot of time with them. One day I noticed that they had pulled/knocked their round bale feeder over, and Romeo was limping slightly on his hind leg. As I said it was a busy busy time, so i gave him a quick overlook and there was nothing obvious going on with him. No open injuries or anything, and I just assumed he whacked his leg off the feeder when they did whatever the heck they did to it. Fast forward a couple more days, he's still limping, maybe even worse, and isn't really walking a lot, but all they're doing is standing at the bale all day anyway so this isn't surprising. After shipping and getting all our cows brought in from on range, the focus turns back to Romeo. We start re-introducing the foals to the halter and he's just not right. He's a little sore but he's not limping the way he was. However, I get him out of the muddy pen and notice one hind fetlock is being held at a weird angle. Call the vet and can't get an appointment for a week as they're short staffed and it's the height of preg testing season so they're run off their feet.
Get him to the vet and can't see my normal vet. I have to see a temp, Dr. H we'll call her. By the time we get there I am noticing that both of his hind legs are affected. She says it's contracted tendons. She tried to manipulate the joints and tells me that they are contracted to the point that he can not extend that limb back to a normal position. She doesn't really seem to be listening to me about the fact that this foal was not born with this, that he wasn't like this at weaning and that this just developed. She takes some x-rays and says that he needs surgery. That we're looking at a around $2000-3000 for surgery, but that the aftercare is soooo intensive that it will also require a couple months of in clinic care afterwords. Which obviously almost doubles that cost. They can't do the surgery in our clinic so she is going to look into a few clinics around the province and get back to me with a better estimate of the exact cost, and also show the x-rays to someone who is more specialized in this type of thing. Boom. Sends me home with bandage instructions for this little tiny dime size wound she found on the fetlock (and kinda made me feel like this was the root of all of our problems), Uniprim as an antibiotic for the wound and she also wanted his feet trimmed as they were a little long. I told her I had planned on doing them but he was sore so I was waiting. So she send me home with the biggest tub of Bute powder I've ever seen so I can manage his pain to trim his feet. I get home and called the clinic back to check on whether he should be stall rested or not. She said yes to stall rest him and to also put him on the Bute for 10 days as an anti-inflamitory. She has already talked to one vet from another clinic that was hopeful about splints but she said they would take 6 months to a year and I would have to change the bandages twice a week because pressure sores can be a problem, so it was a lot to take on and she wasn't really sure if that was the way to go and yadda yadda yadda. In my mind I'm thinking that checking splints twice a week is a heck of a lot better than surgery but.........
So I give him the Bute powder and Uniprim that night and we trim his feet. In the morning I go to check on him, and he's standing upright in both legs. What?? My heart does a summersault. As he moves around while I'm cleaning his stall he does knuckle back over, but he is still trying to stand back up. So I unfortunately didn't get pictures that day as the cows had to be moved to a new pasture (running a ranch eats up the time) but he got his Bute and Uniprim again that night. We go through the weekend and he is still standing up for small periods of time and it starts to get to when he will walk more or less normally but when he stands/rests it tends to pull him back over. I did get some pictures through out the weekend.
So, bright and early Monday morning I get a call from my normal vet, Dr.Doug. Apparantly Dr. H has been moved to his clinic in another town, and she will be gone for two weeks as he's juggling temps around right now. So since she is gone, he's calling me to see what's going on with Romeo. I give him the rundown, and tell him of the improvement over the weekend. At this point you can now easily push on the fetlock and push the joint back into a normal position while Romeos just standing there. He tells me that with this kind of improvement in so short of a period of time he thinks we can stay with the anti-inflamiories as pain management, but he doesn't understand why Dr.H put him on Bute for long term as it's hard on their stomachs. So he switches me to Previcox which I guess is off label in Canada for horses but they use it in the US. Also he gets him on some gastroguard, and tells me to get him off the bute, wait 2 days befor I start the previcox and to keep up with the uniprim just in case there is something going on infection wise. We discuss both surgery and splints and he says that he doesn't think we need to go that far and re-iterated what Dr.H had said about splinting causing sores and things. But he also said it would not be for that length of time and that they don't wear then consistently. You put them on for a few hours and them remove them otherwise they aren't building any strength on their own. These are some things that scouring the internet all weekend had already taught me, but the grand hallelujah of it all was that he said it sounded like an acquired problem which I had also discovered over the internet. Caused by a nutritional issue, resulting in a growth spurt where the bones and soft tissue weren't growing at the same rate. Couple that with the fact that he had an injury that restricted movement during the growth spurt and also the vacuum of being in all that mud, and we've got a recipe for problems. And since this was an acquired deformity, one of the most important and immediate things for treatment is adjusting his diet and taking it back down to the bare bones. Which I had already done, because of my research on the internet, which frustrated me because Dr.H didn't want to look at the fact that this was new, and therefor never gave me any advice about this kind of situation. I wasn't excited that I inadvertently caused this but at least I have some small satisfaction in knowing that this isn't something that I overlooked since birth and never dealt with like some people were implying. I'm pretty optimistic at the end of the call. He want's me to get him weighed before he gets the prescription made up for him since he will be on pain meds longterm, and also wants a bunch of video and pictures of him as he's not seen him in person. Just the x-rays.
So we weigh him and I go into town the next morning to pick up his new meds. which cost an additional $250 from the previous $275 for the drug he only took for four days. And when i get back home, I get a call from Dr.H, in the other clinic she's been sent to. She tells me that shes talked to a few clinics around the province and she has found the cheapest, closest one for us. That the surgery is around $2500 and they will let me take Romeo home after the surgery to do aftercare, so that is an major decrease in costs. I tell her that Dr.Doug had called me on monday and said that he wants to stick with the new drugs and wait and see what happens since we are seeing improvements already. Dr.H kinda gets upset and says almost verbatim, "Well if you're just looking to have a lawn ornament or a backyard pet then it's fine to just wait and see but if you ever want him to be usable then surgery is your only option." Whoomp. The air goes out of my lungs. I'm not a fan of guilt trips. She gives me all the information for the doctors she's been speaking to and says it's my decision about whether or not she sends Romeo's file to them and that I need to call them to make an exam appointment and the schedule the surgery. I need to decide if I think he's worth the money. Whoomp again.
I hang up pretty upset and feeling guilty again about what to do. And confused as both vets have a very different approach to what is going on. Dr.Doug has been my family vet for years. I trust him and he always seems to have a pretty level headed approach to things. He's cut and dry which I like, and there hve been times I have pushed a treatment he didn't think would work but we persevered and the animals have always come out on top. To be fair, Dr.Doug has only seen pictures and the x-rays of Romeo, and he's only seen pictures of the improvements. And Dr. H has only seen him on his worse day. I don't think she has seen the pictures and videos I sent to the clinis as she's been gone.
So I call Dr.Doug's clinic and ask for him to call me when he can so we can all get on the same page about what's best for Romeo. He calls me this morning befor his outcalls, and I explain what's going on. And he sticks to his guns saying that he doesn't think that we need to look at surgery yet. That with this much improvement and being able to easily manipulate the joint back to full extension, that we should wait and see how things progress. We talk about the surgery. He tells me that it's a lot of money to spend on a horse when the end results of surgery are not always great either. That once that tendon is cut that it never gets back to it's original strength, and there is a really guarded prognosis. He also for some reason does not like the doctor that Dr.H has referred me to. For unknown reasons. I think he feels going to a clinic closer to the coast gives us a better chance at finding a specialist. Dr.H said those clinics had estimated surgery being closer to $5000+, and it's a 6 hour drive to get there. Dr.Doug said that he would look into an appropriate clinic to get estimates if we decided to go that route, but right now we should wait.
So here we are in a waiting game and I can't shake this feeling of guilt about waiting. He is doing better slowly. Both Dr.H and Dr.Doug suggested taping a heel extension on his hooves to help force him to stand better. Today's prototypes didn't work out well so I need to come up with a better plan to execute that idea. I just got a call that Dr.Doug is coming to preg. test our herd on the 15th, so he should be able to have a look at Romeo then in real life. Dr.Doug also said that as long as we're seeing improvement and not regressing that it won't hurt him to wait a while and if things don't work out to look at surgery afterwards.
I'm just wondering if anyone has any advice, or has dealt with this kind of thing and can offer some guidance. I think I also just really needed to tell me story and let some of this frustration out. Dr.Doug also said that he's hoping to hire Dr.H full time after she comes back from the other clinic. Ugggg. She's left a bad taste in my mouth and because I know the stress he's under with staff right now I didn't have the heart to tell him that she's somewhat lacking when it comes to bedside manner. I'll try to post a couple pics in a bit.
Any input is appreciated
Jen
