Souvie new vet and test results so far

Discussion in 'Horse Health' started by Misty H, Sep 29, 2018.

  1. CabterCrazy

    CabterCrazy Senior Member

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    Loving an animal means you do right by them. And sometimes that means letting them go. He has been having issue after issue, your love of him is clear but you need to consider what is best for him. Good luck.
     
  2. DocsLglyBlonde

    DocsLglyBlonde Senior Member

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    I'll be somewhat of a devil's advocate here. Laminitis SUCKS. When my mare had laminitis, I left the barn sobbing multiple times per day because she was so miserable and I felt so terrible about how much she was suffering. I thought she was dead a couple times in those first few days because she was so miserable, I don't think a bomb going off would have gotten her up when she was already down. She was on NSAIDs, got a small dose of sedative on her worst days, was in Soft-Rides with dense foam supports, was being iced basically around the clock because it was August and HOT, micromanaged diet... we were doing everything. She was only suffering severely like that for less than 7 days. She was on stall rest for weeks afterward, and even then I questioned her quality of life more than once. My vet and the imaging kept me positive. She never had more than a few degrees of rotation, so we were lucky. Also, severity of symptoms acutely does not necessarily indicate long term prognosis. Jessie currently has no residual effects from foundering, now 4 years later (her hooves are not what they once were, I'm meticulous with her diet, her radiographs are not 100% but pretty close... But she's asymptomatic). This was my mare at 14 years old, diagnosed IR afterward but otherwise no health complications (tested negative for PPID at the time too).

    So, while I encourage people dealing with laminitis to stay positive, because it is horrific to watch, helplessly to an extent, there are plenty of horses who have good outcomes. With that said, as noted, your horse has many complications. If it were just the IR and what seems to be PPID, I'd encourage you to push on so long as you were willing and able to put forth incredible amounts of time, implement meticulous management, and employ the best professionals to guide you medically and for farriery. However, you have to add heaves to the equation. I would not have this horse on Dex period, especially with you describing what clearly sounds like full blown laminitis currently occurring. I have to be honest, I find it sickening that both your vet and farrier sound like they are blowing off the laminitis. Heaves can potentially be managed without the use of steroids, but in your climate, with the severity of obstruction that it sounds like he has, with the quality of life he will have with everything else going on, I have to agree that from your descriptions (I could never wholeheartedly recommend euthanasia without seeing the horse in person), it sounds like the hardest decision may be the kindest decision at this point.
     
  3. Puddincup

    Puddincup Senior Member

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    I'd start icing his hooves every two hours at minimum to help his out as best you can.

    My feelings concerning this horse match the other sentiments and I expressed them in another thread as well so I won't go into that.

    Laminitis is no joke when it comes to your time. If you decide to continue trying to save him from this yet, it will consume your life for at least 6-9 months. Im talking, quit your job and forget your family kinda life.

    3 months into trying to help my heart horse, we weren't getting anywhere and she told me she was done fighting. I called my vet out that same day. I didn't want regrets. I still remember her thanking me by extending her top lip and snuffling my face over and over when they numbed her legs for the walk over to the grave. She had never done that to me before. She knew. I knew. Everyone watching knew. I have no regrets.

    Don't let him suffer so that you can hang onto him. You'll regret it later. Hindsight is 20/20 and you will realize at some point that you let this go on for too long.
     
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  4. Misty H

    Misty H Full Member

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    2472DA61-10BF-4300-8404-BF92AC2D1223.png Ok first and foremost souvie DOES NOT have laminitis. He is not foundering. I believe a equine sports medicine vet would know this. Especially a vet who has 40 years experience honed in on lameness (view photo!). A foundering horse would be shifting weight to the back of his heels not to his toes as souvie is doing. Souvie’s pain is in his heel where he is flat footed and his front legs have bruised and yes I seen the bruises today due to his extremely high insulin levels. They came back today by the way. His level is 248 where normal would be between 0-42! He is way above that. Second he is being weened off of he dex starting today we are slowly dropping his dosage till we can pull him off it. The vet feels that is the way to go. His lungs have been clear and his breathing has been normal. We will monitor as we slowly drop his dose. Not that many of you actually seem to care apparently. You guys need to not jump so fast to say a horse needs to be put down. Hell even the @ss of a vet said he didn’t need to be and as did his now current vet. Actually both very experienced vets at his new office have said the same. Here is his vets website and what they are experienced in!! Russell Equine Sports Medicine — Equine Veterinarian in Tampa, Florida He simply needs to get his metabolic under control. You guys make it sound like this has been going on for ever! He got sick like this only 2 months ago and yes there was a delay in treatment because of his last vet. He is now on Pergolide for Cushings, he is PPID and IR horse but as the vet said HE CAN LIVE A NORMAL LIFE WITH IT. He will just have to have medication, and I do believe that is my choice if I WANT TO PAY FOR THAT EXPENCE. I am financially capable of that and nobody can say yay or nay to that. I will give a horse who just recently got sick a **** fighting chance and not just put him down only after getting a diagnosis two months after he got sick!! What is wrong with some of you??? Are you really that fast to say well hell im just going to put my animal down?? I don’t believe you guys could be that ignorant. He just started treatment 3 days ago and you expect me to say screw it your life isn’t worth my dollar even though I knew a horse is a expensive investment?? He is getting everything he needs now and I will give him a bit to see if the treatments will work for him! Don’t be so dang judge mental I wouldn’t let him suffer!!! But I won’t cut his life short if there is a chance to save him I did rescue him just a year ago. And I dang sure won’t make that call ONLY 3 DAYS AFTER STARTING MEDS. Now don’t go assuming anything that you don’t have the facts on and don’t draw your own conclusions! As far as souvie goes I am done posting updates since you all sincerely feel he should be killed before he even has had a chance to get this under control!!!!!! If you want to really know how souvie is doing and genuinely care send me a message others who assume and make there own diagnoses and haven’t seen videos or pictures to draw said conclusions GOOD BYE wow people never cease to amaze me sometimes
     
    Last edited: Oct 4, 2018
  5. manesntails

    manesntails Senior Member

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    He didn't recognize your horse had heaves~!!
    *I* had to ask you and described the symptoms before you rrealized it.

    SOME Riding horse Vets want to make money and keep the owner happy. You want to keep calling them when they give you hope that they can fix the horse. They stab themselves in the foot by ending that flow of money.

    Any reputable Vet, with a client's horse suffering to this extent, would not be loading the horse up on one drug after another that he knows, FULL WELL, is detrimental to the horse's long term well being.

    So, no, 40years, 2 years, makes no difference. ETHICS makes a difference. Nothing else.
     
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  6. mooselady

    mooselady Senior Member

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    You are harsh calling ignorant here....and it is not about cash, but about quality of life. Horses do not care about the cost of treatment, they only know if they hurt or not..

    @Puddincup my mare told me as well, we had been fighting for her for days after she went down. I thought she was getting better, but I went out one morning and she just looked at me and said “i’m done, amd I let her go that day.

    A person has to divorce what they want and listen to the horse, they will usually say when they are ready.
     
  7. CabterCrazy

    CabterCrazy Senior Member

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    Everyone bases their response on what you post. Your updates have not been positive. And to an animal, 2 months sick and in pain, thats a pretty **** long time.

    People here have had to make the hard choice. We arent saying "oh kill him he is useless" we are saying to look at the quality if life. Sorry we arent babying you and telling you what you want to hear.

    Good luck. And i hope you do right by him.
     
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  8. slc

    slc Senior Member

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    I disagree with not testing for PPID - some comments were made that since it's fall, one doesn't test for PPID. In general, if you are presented with a horse that is acutely lame and he does have PPID, the test results will be so high that it is obvious that it's not just a seasonal variation.

    It isn't that the sugar 'pools in their hooves' and that 'getting the sugar out' will make him sounder. That's not what happens.

    Here's some unfortunate facts.

    With your horse having both PPID and IR, the chances are that there is damage to his hooves - damage typical of laminitis. And that putting him on the medications will not make that damage go away - the medications just prevent more damage, at least that is the hope.

    What I have to say is going to be unpleasant but truthful - the thing is that if his numbers are so high, he is quite likely to have laminitis-like damage in his hooves.

    And it is quite likely that this damage has been occurring over a long period of time, as the insulin and PPID conditions worsened. You have a period of two months as your time frame of concern, but unfortunately this could have been going on for much longer than that.

    It's quite possible that his levels have been rising for several years, and during that time, damage is done. Rarely are these initial changes obvious. That's why I would test any horse over 15 for insulin resistance and PPID.

    I'm not saying any of this to shame you or criticize you. The plain facts are that insulin resistance and PPID rarely show obvious signs until they are quite severe. I had absolutely no obvious reason to test my pony, I just did. No changes in coat, no lameness, nothing. The thing is that what happens, is that you VERY OFTEN don't see ANY typical indications at all, until boom, suddenly one day the horse gets severe laminitis or his coat looks extremely abnormal - or he suddenly has a host of other medical issues that do not seem to be related to IR OR laminitis.

    What happens in laminitis is this: The tissues that support the coffin bone are damaged. That means the coffin bone can rotate its point downwards, so it points to the ground. It's supposed to be parallel to the front wall of the hoof, but only very healthy, strong tissue will keep it in that position.

    It can even do more than pivot, it can drop downwards so that pressure is put on the sole of the foot.

    You said he can't have laminitis because he's not shifting weight off his toes.

    That's possible, but since he has such high levels of insulin and has PPID and since this has been going on for some time, I would not be convinced of that very easily. Something would be needed to convince me of that - I would be dragged kicking and screaming to that. What would convince? I mean xrays, hoof testers showing where the soreness is, etc.

    The reason I'd only be dragged kicking and screaming to that conclusion is that when horses have PPID and IR, they often present with sudden lameness, and yes, lameness that shifts around. And in many cases, the vet doesn't get a reaction from the hoof testers and the 'typical signs' of laminitis are not present.

    I'm not sure why that is(I have a theory), but this is exactly what happened with my PPID horse. My theory is that PPID and IR just by their nature, weaken the tissues that should support the horse's weight and keep the hoof pain free. My theory for 'shifting' lameness is that both front feet hurt all the time, but the horse tries to shift weight off the one that currently hurts more(also, I have seen horses with laminitis do that shifting even when they had no other symptoms typical of laminitis). One leg hurts, he shifts weight to the other leg, now that one hurts more because of the extra weight on it, so he shifts weight off that leg, and so on.

    Horses with PPID and insulin resistance can get abscesses and bruises in their hooves very easily. They also get signs of foot pain that are not typical signs of laminitis OR abscesses, but it is a laminitis process that's going on - the tissues are weakened and thus laminitis occurs. Quite often they have both or all 3 - abscesses, bruises, laminitis.

    My point is this: Your horse has a number of problems that would be very manageable if they were not all occurring, all at once, in one horse. He has breathing problems. Dex would help get him over the emergency breathing issue(it is NOT a long term solution), but it can also aggravate PPID, IR and foot pain. He has foot pain. For that, he will need additional care. Medications hopefully prevent further injury to the feet, but will not address what damage exists inside those feet now. That will require more than 'boots.' I really do not see boots as a solution at all - the alignment of the bones in the hoof is not addressed by 'boots' - that will require a specific trim and potentially special shoes, and that means a farrier who works with your vet, guided by xrays, to get the horse comfortable.

    The bottom line is that this horse has problems in multiple systems. Getting him comfortable - just comfortable enough to shuffle around a dirt pen (no more grazing, ever) is going to be extremely challenging and be a big long term financial commitment. Not just medications, but continued support from an excellent farrier who works in close with your vet, based on xrays which will need to be taken periodically. Eventually his condition will worsen and the treatments will no longer work. PPID medications do not, in this sort of situation, prolong life, they only improve quality of life, and they only do so for a while, and a lot depends on when in the course of the disease, treatment is started. The horse will die of this.

    I would urge you - no I would insist - that you do not just put boots on this horse. Yes, you've had a ton of expense so far, and the farrier work - xrays, a specialist farrier(oh yes they all say they're up to this skill-wise, but few are, and even fewer will work in harmony with a vet and follow a vet's directions) is needed too.

    If this were my horse, I would be realistically very pessimistic. Oh not about him needing a lot of medical care and that costing a lot and not ever again being ridden or shown or trail ridden or pastured. I have no lack of eagerness to support an old horse through all his difficulties. No lack of desire to have him with me as long as possible, no reluctance to pay huge sums of money out just to make him comfortable - I've been doing that for years, in fact, first with my gelding, then my mare, and now my pony. All instead of riding. That's right. I have these horses to take care of, and that means I can't afford to go out and buy a ridable horse, OR keep an additional horse competing. So be it. They are my responsibility. I own them.

    The problem with all this is one thing: quality of life. Can you give this horse sufficient quality of life with the resources you have. That is the bottom line. That and can you adjust your thinking around when his condition changes and the balance starts tipping in a direction you emotionally do not like.

    You got very angry at people here for saying you should euthanize now, which you see as giving you a hard time.

    To be fair, they're wrong. They are not vets, they have never seen the horse, and you are yet early in this game of life and death. Things can be done now. But in a day, a week, a month, two years, at some point, the balance is going to start tipping in a direction you seem to be completely unable to recognize.

    As someone said when ulcers were brought up, your own feelings are the least of your concerns right now. And this horse's ultimate end is not something that you should get your Irish up about. You can't control that, and you can't pretty it up, and you can't stop this process. It's going to happen. Eventually this horse WILL need to be euthanized. The key is not your feelings in this, but his quality of life.

    That's all that really matters.

    That's all that ever should really matter.

    Horses do not stay with us forever. We are only their temporary guardians. These animals are given to us by God with only one directive: "do right by them."

    Our job is simple but never easy; our job is to do right by them. At some point, it is time for them to go to God and live in the pastures of plenty, pain free and content, for the ages. They will be there when it is our own time to walk the long uphill road to those distant pastures. Our heaven has no pearly gates and no clouds. Our heaven is a pasture with an old wooden gate, a pasture full of our old and best friends. That's where we belong. Until then, we must do what is right. For them, not us.
     
    Last edited: Oct 5, 2018
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  9. slc

    slc Senior Member

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    DocsLglyBlonde, post: 8220078, member: 58675 I'll be somewhat of a devil's advocate here. Laminitis SUCKS. ..... But she's asymptomatic). This was my mare at 14 years old, diagnosed IR afterward but otherwise no health complications (tested negative for PPID at the time too).

    In fact, many cases of laminitis do come out fairly well. However much the horse reacts to the initial pain, the recovery depends on the resilience of those tissues. And with PPID and IR, especially as severe as with the OP's horse, that tissue is compromised. That MAY make a big difference. As my vet said, 'Laminitis cases can go very well, except when they go badly.'

    So, while I encourage people dealing with laminitis to stay positive, because it is horrific to watch, helplessly to an extent, there are plenty of horses who have good outcomes. With that said, as noted, your horse has many complications. If it were just the IR and what seems to be PPID, I'd encourage you to push on so long as you were willing and able to put forth incredible amounts of time, implement meticulous management, and employ the best professionals to guide you medically and for farriery.

    Again, I'd like to stress that this is not something where you just put a boot on a horse. This horse needs xrays (they really are not that costly these days) and a farrier working as a TEAM with your vet... and obviously the vet needs to prescribe sensibly for the laminitis.

    However, you have to add heaves to the equation. I would not have this horse on Dex period, especially with you describing what clearly sounds like full blown laminitis currently occurring.

    Aha, though. The OP is sure that the horse does not have laminitis. She believes all she has to do is get the 'pooled sugar out of the horse's hooves.'

    I have to be honest, I find it sickening that both your vet and farrier sound like they are blowing off the laminitis.

    I reserve that type of comment unless i was standing there and heard the vet say that with my own ears; I don't condemn a vet til I hear his or her side of the communication. Because there is an awful lot of crossed signals between vet and customer. I doubt that even the worst vet in the land would say, 'Yeah, naw, this horse can't possibly have laminitis.'

    In this case, the OP is convinced the horse does not have laminitis. That is going to affect the vet's comments to her. The vet only treats what the owner allows him to treat. If the symptoms are not reported accurately (because of the owner's belief the horse hasn't got laminitis, so the owner sees the symptoms only through the lens of his own preconceptions), the vet may be quite skeptical that an IR/PPID horse with this high a numbers doesn't have laminitis, but the owner is making the decisions here.


    Heaves can potentially be managed without the use of steroids,

    Just to play devil's advocate here, sometimes vets know more than owners, especially when it comes to doses and types of medications. I've read a great deal of 'oh no you can't ever do that' advice here and seen vets do exactly the opposite, and it worked out - not just worked out but really made a difference, really helped the animal, plus directly contradicted the strenuously firm statements made here. And yes, there is a dose of steroids and a type of steroids one can give a horse with heaves, and help that without aggravating the other issues. The steroids also may be a temporary management of acute symptoms rather than a long term management plan.

    but in your climate, with the severity of obstruction that it sounds like he has, with the quality of life he will have with everything else going on, I have to agree that from your descriptions (I could never wholeheartedly recommend euthanasia without seeing the horse in person), it sounds like the hardest decision may be the kindest decision at this point.

    I agree that the situation is very bad. But I wouldn't be sure that euthanasia is necessary at this point if the horse starts responding to the medication and is more comfortable.
     
  10. LoveTrail

    LoveTrail Senior Member

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    Actually anything above 10 for insulin is IR. Most labs just don't recognize it because they use more of an average and most people tend to not test until there is an issue like laminitis occurring so the average is quite high. The lab my vet uses says under 20. My horse is under 20 at 17.43, but he is definitely still IR with his cresty neck.

    I wonder if Souvie is actually getting laminitis in his back feet instead based on your description of how he stands. Tried to look at your previous photos, but they tended to be taken at awkward movements so can't really tell anything.

    I would check his digital pulse like three times a day. My friend's horse she only checked for heat when he already was getting laminitis. It actually took something like three weeks before he actually had heat. She told just recently she realized he actually got the laminitis from his first injections. Just the second second set on his hocks was what pushed him completely over. He was only nine. At ten he still has some issues with abscesses and his bad left isn't normal looking.

    Actually if you look up other threads of horses that got IR/Cushings and/or laminitis they had signs too, they just didn't realize it. I only tested Foxy because of the above horse and another horse that got advanced Cushings and laminitis on all four legs, he couldn't stand up, and was put down at the same age as Foxy this year, 16. Changing Foxy diet really helped him. I've had dozens of friends notice how much better he is now in looks and movement. Just last weekend at show I got another compliment on how good he looked in our riding classes. She hadn't seen him since last year which was about a month before I had made his first diet change. His IR had made him extra sensitive and tense and of course that affected how he moved and his whole riding profile.
     
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