Nathan
To friends who have been waiting for news, we apologize for the delay in “Nathan Updates.” Nathan has only been here one week, but it seems like we have volumes to write about him already. We’ll have to post about him over several days.
We’ll start with a few details about Nathan’s condition on arrival. A one-word description of the overall picture might be “overwhelming.”
As the trailer door swung open, the most obvious problem was his weight. Even with an abnormally thick summer coat, hip bones, ribs, shoulder blades and vertebrae were clearly defined. The heavy coat itself seemed a big bold arrow pointing clearly to Cushings. Nathan’s feet were all abnormally shaped, obviously not trimmed in some time. The biggest concern, however, was his balance. The gray gelding’s back end did not seem to be doing quite what he asked it too. He “listed” to the right, dragging his left hind leg any time he turned in either direction. There was no life in his tail, which hangs limply while the other horses’ tails swish gracefully back and forth as they graze.
Any one of those conditions, other than neglected feet perhaps, put Nathan’s future in question. Together, they seemed impossible to manage.
Once he was comfortable in his new accommodations, we stepped back to evaluate one step at a time. First…..feet. That issue seemed like it should be easiest to resolve and might bring the most immediate comfort. The problem, however, is that impaired balance meant it was difficult for Nathan to stand on three legs. When Nate finally did pick up the foot that appeared to be in the worst condition, we found it was heavily infested with maggots. The heel was virtually nonexistent accompanied by deformed bars and overgrown hoof wall headed in every direction. The smell was nauseating. Yet, Nathan looked fully weight bearing on that foot. Had he been like this so long that if felt “normal?”
The Animal Control Officer who brought Nate to Traveller’s Rest considered this a need for urgent veterinary care. We agreed and made the call. While here, the vet also documented Nate’s condition at time of arrival.
During the veterinary exam, the two biggest concerns were Nathan’s feet and his balance. Working together, the two issues made each difficult to evaluate separately. With poor balance, Nate couldn’t pick up a foot easily. Abnormal feet aggravated the balance problem. This combination of problems also made it hard to determine just how much of his lameness was pain and how much was neurological impairment. In addition, Nate had no muscle mass due to his malnutrition. Starve horses often drag their feet until they become stronger and rebuild muscle.
The maggot infested foot was addressed first. It was cleaned, flushed and poulticed with a Betadine/Epsom Salt paste, held in place with a baby diaper and duct tape. Not pretty, but functional. The hope was that the salt would kill any maggots that might still be hiding in any crevices, or hadn’t yet emerged from the diseased tissue covering the bottom of Nate’s foot. To thoroughly debride the foot, Nate will likely need to go to the vet clinic, but that’s a decision for later. At the moment he is likely not strong enough to tolerate anesthesia.
Where do we start in formulating a possible rehabilitation plan? Can we rehabilitate this beautiful old soul? Being realistic, as we continue to evaluate, it may be determined that the kindest thing we can offer our big new horse is a peaceful transition to his next life. That remains to be seen, but we’re trying to keep an open mind.
(We're very open to hearing any suggestion concerning any modality - within reason - we're not going to subject Nate to anything in the realm of "the treatment is worse than the illness")
We’ll start with a few details about Nathan’s condition on arrival. A one-word description of the overall picture might be “overwhelming.”
As the trailer door swung open, the most obvious problem was his weight. Even with an abnormally thick summer coat, hip bones, ribs, shoulder blades and vertebrae were clearly defined. The heavy coat itself seemed a big bold arrow pointing clearly to Cushings. Nathan’s feet were all abnormally shaped, obviously not trimmed in some time. The biggest concern, however, was his balance. The gray gelding’s back end did not seem to be doing quite what he asked it too. He “listed” to the right, dragging his left hind leg any time he turned in either direction. There was no life in his tail, which hangs limply while the other horses’ tails swish gracefully back and forth as they graze.
Any one of those conditions, other than neglected feet perhaps, put Nathan’s future in question. Together, they seemed impossible to manage.
Once he was comfortable in his new accommodations, we stepped back to evaluate one step at a time. First…..feet. That issue seemed like it should be easiest to resolve and might bring the most immediate comfort. The problem, however, is that impaired balance meant it was difficult for Nathan to stand on three legs. When Nate finally did pick up the foot that appeared to be in the worst condition, we found it was heavily infested with maggots. The heel was virtually nonexistent accompanied by deformed bars and overgrown hoof wall headed in every direction. The smell was nauseating. Yet, Nathan looked fully weight bearing on that foot. Had he been like this so long that if felt “normal?”
The Animal Control Officer who brought Nate to Traveller’s Rest considered this a need for urgent veterinary care. We agreed and made the call. While here, the vet also documented Nate’s condition at time of arrival.
During the veterinary exam, the two biggest concerns were Nathan’s feet and his balance. Working together, the two issues made each difficult to evaluate separately. With poor balance, Nate couldn’t pick up a foot easily. Abnormal feet aggravated the balance problem. This combination of problems also made it hard to determine just how much of his lameness was pain and how much was neurological impairment. In addition, Nate had no muscle mass due to his malnutrition. Starve horses often drag their feet until they become stronger and rebuild muscle.
The maggot infested foot was addressed first. It was cleaned, flushed and poulticed with a Betadine/Epsom Salt paste, held in place with a baby diaper and duct tape. Not pretty, but functional. The hope was that the salt would kill any maggots that might still be hiding in any crevices, or hadn’t yet emerged from the diseased tissue covering the bottom of Nate’s foot. To thoroughly debride the foot, Nate will likely need to go to the vet clinic, but that’s a decision for later. At the moment he is likely not strong enough to tolerate anesthesia.
Where do we start in formulating a possible rehabilitation plan? Can we rehabilitate this beautiful old soul? Being realistic, as we continue to evaluate, it may be determined that the kindest thing we can offer our big new horse is a peaceful transition to his next life. That remains to be seen, but we’re trying to keep an open mind.
(We're very open to hearing any suggestion concerning any modality - within reason - we're not going to subject Nate to anything in the realm of "the treatment is worse than the illness")
Replies to This Discussion
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Permalink Reply by Traveller's Rest Equine Elders on
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Nathan Update June 6
Nathan is making tiny improvements on several fronts. He is, by no means, out of the woods yet, but at the same time is giving us a tiny bit of hope for the future.
As we posted Sunday, we started first with Nathan’s maggot-infested foot. It appears all the nasty little critters have moved on to greener pastures.
(Sidenote……before anyone tells us we should leave the maggots to clean out the diseased tissue………it’s true that veterinarians sometimes use maggots for that very purpose. However. They use sterile medical maggots, not those from “wild” flies. )
Back to Nathan and his foot. For the first several days, when we flushed the foot with a strong Epsom Salt solution, the buggers became irritated and began to frantically wiggle around, causing Nathan to stomp his foot. With each stomp, balls of maggots would fall out of crevices and pockets we couldn’t see. It was disgusting and not something I want to see again soon, but some days you just have to hold your breath and do what you gotta do. After three days, no more maggots emerged.
The trick now is keep the flies from re-infesting the foot. Wrapping was not working since it was holding too much moisture in the heel. We want to keep out the flies, but not to promote more moisture loving bacteria while doing so. We found one style of fly boot that fits fairly well down over the heel, but not quite all the way to the ground. Adjust the boot. Spray. Pick up all poop crumbs anywhere in the vicinity. Spray. Adjust boot. Another poop crumb. By the time this is over we’ll have become obsessive about the smallest manure crumb in a stall.
Now that the maggots are a thing of the past, how do we aggressively treat the underlying infection? The former owner told the Animal Control Officer that Nate had canker. We’re not at all sure, at this stage, that canker is the correct diagnosis. We’re hoping the problem is an advanced case of thrush, which will have a much better prognosis. Another vet evaluation will determine that. Meanwhile, we’re treating it as advanced thrush.
The good news about Nate’s feet, other than the departure of the maggots, is that he was able to stand on the infected foot long enough for us to lift and examine the other front foot. Miracle of miracles, it looks pretty normal! The hoof is overgrown and badly in need of trimming, but the frog and sole look healthy.
The second portion of this update concerns Nathan’s balance problems. The vet did not think the source of the trouble was a virus or protozoal infection, but more likely trauma to the spinal cord. That could be good. That could be bad. If the damage was recent, and we can reduce the inflammation, Nate’s neurological symptoms might diminish significantly. If the damage to the spinal cord is long standing, the chances of repair are much lower.
Not knowing the history of this specific issue, we began with a hefty hit of anti-inflammatory medications. Three different drugs were administered the first day, continuing one of them daily until the next vet exam.
Bring in the second wave:
Starting Monday, June 29, we invited quite a few Reiki practitioners to join Nate’s caregiver team. Seven practitioners have been offering Reiki treatments for the past week. Today, a bodywork specialist worked with Nate as well, integrating several techniques into one treatment.
Now…….whether you believe only in Western medicine, or only in “alternative” modalities, it’s undeniable that in some cases, the combination of pharmaceuticals and complementary therapies produces results that can’t be explained.
In all honesty, when Nate first “stepped” off the trailer one week ago, we did not expect to be able to do anything for him other than offer him a few days of good, frequent meals, and then help him on his way “over the bridge.”
Today, we’re thinking there will be much more to the story.
This afternoon, I watched Nate pick up the leg we thought was significantly paralyzed to stomp at a fly. Not once, but three times. And remember the lifeless tail? A week ago, it hung limply with no movement at all. Several days ago, Nate began to lift it slightly. We first noticed this when he lifted it and held it up while having his temperature taken. He could lift straight up, but there was no movement from side to side. Today, however……….Today, Nate not only lifted his tail, but moved it noticeably to the right. To his stronger side. If we see that tail move to the left, you may hear us shouting from somewhere out in Idaho.
The “listing” is also almost gone. Nate now stands more squarely on this hind end, although he does rest the left leg quite often. One more tiny milestone for today was a very (maybe only 20 seconds) short episode of bearing his weight entirely on the left hind to rest the right for just a moment.
Baby steps? You bet. Reasons to keep trying a while longer? You bet! Hope is a powerful thing.
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Permalink Reply by Nina Kraus on -
Wow, what you are doing is amazing. It floors me what people do to animals. I may have missed it, but how old is Nathan? I think you start your rehabilitation plan by trying to get some weight on him. The cushings can be dealt with. We have a 22 year old mare with cushings and she is doing great. Another mare we bred had cushings for a long time and lived a wonderful life. We do put a DNR on our older mares because we do not want them to be in any pain. We have no problem with giving them bute to keep them comfortable, but, after the age of 20, it is not fair to have them in pain which is why I ask how old Nathan is. You can only try your best which you have, but, if he is in a lot of pain, then you need to do what is in the best interest of the horse.
Some people should be shot.
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Nina,
I understand what you're saying about the best interest of the horse. Nathan is quite comfortable right now (another thing that doesn't make sense about this case, I'll admit.) We specialize in elderly horses, so have a lot of experience in keeping them as compfortable as possible, thought we don't use different "quality of life" standards for them than we do for younger horses. It's not fair to allow them to be in pain at any age.
Actually, when we first started this endeavor, we had to have a chat with our vet at the time about not being here to keep them alive as long as possible, but to keep them happy as long as possible. We're all pretty much on the same page now, and all of our vets are very straightforward about each horse's chances at good quality of life.
We don't really know how old Nate is. The previous owner said 36, but I have had several people that used to board at the same barn tell me he is no where near that age. We've run into this before.....people will tell us a horse is older than he is, believing that makes his condition more acceptable. Not here.
At the same time, we don't decide to not rehab just because of age. Each horse is evaluated as an individual and decisions are made based on that horse's condition and prognosis.
As of yesterday, the vet was very happy with Nathan's progress. He's gaining weight well, the infection in his foot is under control, his back end is noticeably stronger, he's alert, animated and shows no signs of stress. Please believe me when I say we will not allow him to suffer.
Oh, and yes Cushings is very manageable these days. Nathan will bring our Cushings "herd" to seven members.
BTW....20 year old? mere whippersnappers!! ;)
Chris
PS...people don't need to be shot, they need to be educated. (Though I've decided that's just impossible for some.)
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I promise we'll get better photos (without the huge pipe panels in the way) but when the opportunity presents itself, you snap the shutter!
In less than 2 weeks, Nate's gone from this:
June 28, 2009
To this!
July 8, 2009
Miles to go, but what's the saying...........a journey of 1000 miles begins with but a single step........that may not be the exact wording, but you get the idea.
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