Tuesday, September 30, 2014

Just About Perfect (Pie)

Yesterday was a good horse day.  All three horses had rides, and all went very well.

Red is back to walking under saddle - yesterday was our second 15-minute walk ride.  His EPM symptoms are already abating - this is typical within five days of starting this particular medication.  His walk is good, and there's no toe-dragging.  His feet are easy to pick again and he was very good for the farrier at his recent appointment.  He doesn't have to rebalance himself any more when we're saddling or when I'm mounting. The ankle is also looking better.  There's still a slight wind puff, but every day it looks a bit smaller and we continue to ice, and he also gets arnica tablets and aspirin with his feed.  I won't do another formal neuro test until next week when we're up to 30 minutes of walking and ready to trot.  No trot work unless he's neurologically back to normal.  If there are still any residual neuro abnormalities, we may alter his medication routine a little.

But Pie is the star of this post.  Pie has had a tendency to fall on the forehand, and also cut in - a result of falling on the forehand - and almost all of this is due to my riding.  When I pay attention and ride correctly, the "problems" mysteriously vanish - imagine that!  Yesterday, I tried to focus on my riding and see if that would fix the problems, and sure enough it worked great.  With Pie, I need to keep myself off his forehand - this means staying upright and open and sitting back - it almost felt like I was leaning backwards but I expect I was just managing to sit up straight.  No pushing with seat or legs and no "trapping" with my hand.  Pie was very happy and we had a fabulous ride.  I was able to do precision bending - small circles and serpentines and other figure work, with frequent changes of direction - and he never fell in or lost his bend, not once, and he stayed beautifully soft throughout.

But the real prize was the canter.  His canter was free, open and relaxed, and the most wonderful thing of all happened on our first canter departure on the left lead.  He did the most amazing, relaxed, engaged walk to canter departure, and all it took was my thinking the 1-2-3, 1-2-3 rhythm in my head at the speed he would do it when cantering, and exhaling as his outside hind was leaving the ground in walk.  His forehand was free since I was sitting straight and relaxed, and he just stepped off into canter as beautifully as I've ever felt it.  I was delighted and told him so - he just said "well, woman, what did you expect?  I do this all the time in the pasture and all you had to do was get out of my way."

Pie's pretty wise.  A boarder who saw us cantering commented on how beautiful his canter looked, and it sure felt beautiful.

And for a nice example of listening to, instead of blaming, the horse for a "problem", read this post from Shirley over at Ride a Good Horse.  Dawn has been having some issues with softness when tracking left, and sure enough her neck is sore from all the time she spent having her head propped up while sedated for her dental work.  She has a final recheck next week, and as soon as that's done we'll be having the chiropractor out to do some work on her.

Saturday, September 27, 2014

EPM Forever (!?) and Norman Cuteness

We now have a likely explanation for how Red came to reinjure his right hind ankle.  He originally injured the ankle in July, and after 30 days off from work with icing daily, he was looking pretty good and we started slowly back to work.  After about two weeks, we were up to 8 minutes of (very nice) trot work, when one day, he suddenly tripped badly behind - so badly he almost fell down behind - and strained the ankle once again.  More time off, more icing.  He was having trouble walking down hills - dragging his hind toes.  At his last farrier visit about 6 weeks ago, he was very fidgety and hard to trim.  And picking his hind feet has become a bit difficult.

Hmmm . . .  something looks familiar . . .

We ran a neuro exam and drew blood to check for EPM - and sure enough, that's what's going on (again).  Red had EPM (phenotype 5) several years ago and made a full recovery.  He's had a couple of minor symptom flare ups (no active EPM - we tested and the results were 2-2-2 - more on that below) due to stress or vaccinations - EPM horses, even if clear of infection, can have temporary reoccurrence of minor symptoms due to these things, and a little Banamine or passage of time clears things up.

When we did the neuro exam, his hind legs weren't quite normal on the turning test - he tended to slightly drag the left hind toe when that leg was on the outside, and the right hind didn't step across as far on the turning test.  His skin sensation and reflex responses were poor in his hindquarters, particularly on the right side.  And his right hind foot placement test was very abnormal - he'd leave it crossed over behind his left hind indefinitely.  The reason he tripped and reinjured his ankle is that he couldn't accurately feel where his hind legs, and particularly his right hind, were.

Here is a link to the Pathogenes web site that describes the antibody test and how its results are interpreted.  In my layperson's summary, a 2-2-2 (there are three phenotypes tested for) is a horse that is free of infection.  A number below 4 is a horse that is likely free of infection.  A horse with a number of 16 or above has an active infection and is likely to be symptomatic.  Red's results were 8-2-2.  This, together with the neuro abnormalities, indicates at the very least that his immune system has been exposed - this time to phenotype 1 (not the type he had before) and is ramping up antibody production.  Phenotype 1 apparently typically produces more acute symptoms.

I might add that this is a new test - it isn't a spinal tap or a Western blot - it's an ELISA antigen test done from a blood draw, and is very specific - a horse that has been previously exposed but didn't get sick or a horse (like Red) who'd had a previous infection and fully recovered to a 2-2-2 antibody level (essentially zero) also wouldn't test with higher numbers without a new exposure.

Now, there are some unanswered questions.  Does this mean he has an active infection?  Considering that he has real symptoms, probably yes, although the numbers are borderline - you don't get an 8 without something happening in the immune system.  As the Pathogenes site indicates, changes in titer levels are more indicative than absolute titer levels, and retesting in two to four weeks to see if the numbers are going up or down would tell us more.  It could be that he was going to fight it off on his own, but we're treating him anyway with at least 30 days of low-dose decoquinate, which will likely resolve things.  We may retest him in a couple of weeks to see if his numbers are coming down - if not, we may move to a higher dose with combined immune stimulants.

Can a horse that has had a particular phenotype get a new active infection from the same phenotype?  Not in my experience so far - Dawn has had phenotype 1 only, Pie had two separate infections with phenotypes 1 and 5, and Red previously had an infection with phenotype 5 and now appears to have an infection with phenotype 1 (the third number in the test results is for a phenotype that doesn't appear to usually produce symptoms in horses).  But within each phenotype, there are several different strains.  I don't know if the science is far enough along to answer that question, but I'm hoping that horses get some immunity from reinfection with phenotypes they've already had.

But at least it's good to have an explanation of what happened with Red, and he should improve with treatment.  His ankle is almost back to normal, and we'll be starting up our walk work again - but no trotting until he's neurologically normal.  It's also a good reminder of how common EPM really is - not that I could ever forget!

If you're new to this blog, there is lots (and lots and lots) more information about EPM on the EPM and Lyme page - see the tab under the header.

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And, on a lighter note, some Norman cuteness, with his usual girlfriend - you can see his unusual eye coloring (he's a champagne, and has amber eyes):

Saturday, September 13, 2014

Slow is Fast, Fast is Slow

Okay, it's time for a little Zen - a little Zen-like thing for you to consider:
Slow is fast. 
Fast is slow.
How does this relate to your life with horses? Your work with your horses? Your life as a whole?

Tuesday, September 2, 2014

and . . . Red Stands Up Cones

Red says that we had a lot of fun today, and he's right.  We did 20 minutes of walking under saddle today - our second 20 minute session and our 6th ride since he's been back in work.   Walking around in an arena for 20 minutes can be a bit of a bore, so before our ride, I'd set up some cones for us to use.  We rode for a while, using the cones for our figures.  And then Red, by chance, knocked over one of the cones - and I had an idea . . .

Once, a long time ago, I saw Mark Rashid's horse set up a cone that had been knocked over, by stepping carefully on the side.  Mark said that your horse can understand what you want in your mind and try to do it - and in fact be able to do it - if you pay attention and reward the slightest try.

So I decided to see if I could ask Red to set up cones that had been knocked over . . .

Now, Red and I were using the big orange - but soft plastic, not hard - cones, which make things a bit more comfortable.  I took Red up to the fallen cone, and we stood there.  If he tried to move away, I redirected him towards the cone.  If he did nothing, I asked him to move across the cone.  Perhaps just by chance, he pawed at the cone and stood it up.  I praised him effusively, and we went for a walk.  A light bulb started to come on . . .

Within a few minutes, we were knocking down cones and setting them back up all over the arena.  Sometimes Red knocked a cone back upright with a hoof, and sometimes he gently pushed it back up with his nose.  He thought it was a mighty fine game.

Red's very curious, and very intelligent, but seeing how quickly he caught on to what I wanted was just plain amazing - and fun, too!  I think this is just a small example of how much our horses are willing to listen to us and respond, and how capable they are of this sort of communication.

Face Crud, and Red Says "What About Me?"

If it's not one thing it's another.  In the ever-ongoing veterinary saga that is my life with horses, both Pie and Dawn are currently battling a nasty case of what I refer to generically as "face crud".  Both of them had a nasty fly bite (?) - in Pie's case on his cheek and in Dawn's case on the point of her jaw - which just refused to heal despite treatment with Neosporin.  All of a sudden, Pie's bite got inflamed and infected and then just blew up - the whole side of his jaw - an area bigger than my palm - was marked by inflamed, oozing circles of infection.  And within a day, Dawn's fly bite had started oozing and seeping and then there were crusty infected areas all down the side of her jaw, and today even behind her throat latch onto her neck - and she has a whole set of hives from mosquito bites to go with that.

We've been having very hot and humid weather, which is perfect for this sort of thing to happen.  Pie's had scratches before, and this seemed a lot like that.  And Dawn has had various types of skin crud and reactions to insect bites and stings before - once resulting in cellulitis all down her neck.

After some ineffective treatment in both cases with Neosporin, I'd started treating with silver sulfadiazine topically and SMZs orally once a day.  And both horses had a swollen knee last evening, with little pustules and some seepage - they'd apparently rubbed their faces on their legs and transferred the skin infection to their leg.

Things weren't improving, so I called the vet.  She said silver sulfa can keep wounds like this too wet, which can make bacterial infections (which these likely are) worse.  She prescribed Quadritop ointment - a broad spectrum antibiotic with antibacterial and antifungal properties and also a corticosteroid to reduce inflammation.  And we upped the SMZ's to twice a day (14 pills each time) - oral antibiotics to deal with both the skin infection and also the subcutaneous stuff that is going on in their knees and also in Dawn's neck.  She said to wash with plain water when needed, and dry, and then apply the ointment once a day.

How did they get this?  It could have been spontaneous, but the guys use the same halters to bring in all the horses, and there are two horses in Pie's herd with face crud.  The halter may have transferred the bacteria to Pie's open wound.  And in Dawn's case, I expect it was my shared grooming tools that infected her.  In Dawn's case, it could be an abscess from her tooth surgery - the timing's about right - but there's not a lot of puss and she's eating normally and has no mouth odor.  And the fact it's spread to her knee and neck also makes me think face crud rather than an abscess.  But if it were an abscess, the treatment with SMZs would be what we'd be doing anyway.

All three horses now have their own sets of grooming tools, and Pie's set - the old set - have been disinfected with Clorox.  I use separate natural sponges to clean Pie and Dawn, and separate clean towels to dry them - the sponges go into a water/Listerine bath to disinfect and the towels go home to be washed in hot water.

If things aren't improved by the end of the week, the vet will make an in-person visit.

More horse veterinary stuff - it never ends . . .

But Red says:  "What about me?  You have to tell everyone what I did today!"

And I will, in the next post . . .