update on my big lad

[leanne123]

brief history big sissy boy 18.3hh irish hunter came in with a big knee and a gash and puncture wound about 2 inch above the knee. honestly never seen anything swell so much before.
called vet out was given a weeks course of antibiotic injections and anti inflamarys. vet said that because the wound was near the tendon sheath it could easily get infected. the swelling in his knee was fluid it took ages to get on top of the infection and heal the wound but he was only stiff on his leg not lame. hes had loads of antibiotics , anti inflamatrys and god knows what else in the massive syring of loads of different stuff they were pumping into him to get on top of the infection.
hes now been on box rest for 15 weeks and hes getting worse not better. nearly 3 weeks ago hes gone lame on it had vet back out he gave more anti inflamatrys and came back a week later and x rayed it.
from the x ray he said there is bone damage , vets words were that the front of the bone has come away from the rest of the bone but its not a fracture.
keep him on box rest and i will come out in 20 days time to re assess.
today his knee has swollen even more (think hes been having partys in the stable) and the size of the knee was nearly back to normal. i thought we were making progress but obviously were going backwards again. cold hosed it and then i've clayed his leg up for tonight as was my vets day off today but have arranged for him to come tommorrow.
honestly i don't know what to do for the best.
so far hes cost me £600 in vet bill and theres more to add onto that for 2 visits drugs and x rays plus whatever happens tommorrow.
and my good natured baby is getting moody to go with it not with me with other liverys tit biting him all the time.
im stumped as to what i can do to help him, can't take him out of the yard as i did try this the other week before he had x ray and was put on boxrest again, we were having a little amble through the woods which is behind our yard and he grew three feet taller and had eyes on storks looking for the scary monsters. the were loads of dog walkers too so i had to keep moving him over off the path to let them past.i was scared he'd go into a fit of rage as the further wr went the more energetic he got.
any body any idea how i can cheer my poor baby up ?
was gonna get a physio or someone to give him a massage but i can't find anyone local .
im in rotherham south yorks if anyone knows of one.

 

[Tia]

Could it be a bone infection? This sounds awfully like what one of my horse's had. It was a blooming nightmare and cost a lot of money but he did mend eventually.

 

[Patches]

I think I mentioned this the last time you posted about your lad....

Is there any chance the bone damage has been caused by infection eating into the bone? What did the vet think had caused this damage?

I know I told you before that Patches had a very innocuous little scab on her knee in January 2006 that was so minor, I almost thought nothing of it, apart from the fact that it didn't seem to want to heal was annoying. Hers became infected and for her it did settle on her tendon sheath and she did require emergency surgery. The surgery did sound like a drastic measure, but getting "in there" to clear the infection was of paramount importance. Tendon sheaths don't have the greatest blood supply, so no matter how many antibiotics you pump into a horse, you just can't get enough to flow through the blood stream and attack the infection directly.

Now, I know your lad didn't have a tendon sheath infection. However, Patches was x-rayed before surgery to check the infection hadn't spread to the bones in her knee as well.

I'd really have been expecting this to have cleared up by now. I'm surprised your lad hasn't been admitted to an equine hospital to have IV antibiotics in very strong doses to really attack the source of the infection.

Personally, I think the time has come for you to seek a second opinion. Something has to be going on in there which the treatment he's being given isn't able to resolve.

 

[Tierra]

Interesting...

My horse suffered a puncture wound about 3 inches above his knee on a front leg at the end of summer. My vet established pretty quickly that it had penetrated the tendon sheath and was concerned about the risk of infection. However, after much flushing out, he decided to give it a couple of days to see how he responded to anti biotics and if we could keep it infection free (he was concerned it was close to the knee capsule)

Now, my vet does always go on the side of caution, but it was made clear to me right from the start that IF there was the slightest sign of infection setting in, he would refer him straight to Liverpool. My vet was also very very insistant that I called him if he showed even the slightest sign of lameness.

As it happens, he healed very quickly - although he did have a bandaging that looked more like a cast than anything else and two weeks box rest with some strong anitbiotics (with the exception of being trotted up daily at the vets request).

I'd be concerned, given how long this has been going on... Who is the vet? (I used to like in Rotherham myself). I'd seriously be seeking a referal at this point.

In terms of physios - I wouldnt really have anything done until the leg situation is rectified as thats got to be priority but I know Vicky Spalding used to work round Rotherham as she regularly saw my horses. I dont have her number but it'll be online somewhere or other. Gavin Schofield also used to visit a particular livery yard in Whiston and he's excellent - although not a physio - but Im not sure he still goes there since he became so popular.

 

[Tia]

[ QUOTE ]
I'd seriously be seeking a referal at this point.

[/ QUOTE ]

I completely agree with Tierra - I would be feeling very concerned about the level of care your vet has given.

 

[Patches]

[ QUOTE ]


Now, my vet does always go on the side of caution, but it was made clear to me right from the start that IF there was the slightest sign of infection setting in, he would refer him straight to Liverpool. My vet was also very very insistant that I called him if he showed even the slightest sign of lameness.

As it happens, he healed very quickly - although he did have a bandaging that looked more like a cast than anything else and two weeks box rest with some strong anitbiotics (with the exception of being trotted up daily at the vets request).

I'd be concerned, given how long this has been going on... Who is the vet? (I used to like in Rotherham myself). I'd seriously be seeking a referal at this point.


[/ QUOTE ]

Yup. My vet didn't hang around. I took Patches in to them at 10.30am, he tapped the tendon which showed sign of infection, x-rayed her knee to make sure infection hadn't penetrated the bone further complicating the issue, and she was under the knife before 11am. Things moved alarmingly swiftly but it was the only way to cure her.

Had I left it, even a day, the vet said there was a good chance she'd not have recovered as the infection eats through the tendon leaving them permanently crippled. Patches was also in a Robert Jones, cast type bandage for three whole weeks post surgery.

Your vet was completely right to be so cautious. This is what I can't quite understand with Storm's big lad. It's been going on for far too long and I'd be incredibly worried if this was my horse for his long term soundness.

You need a second opinion Storm as a matter of urgency. I'm not trying to scare you but I really do think your lad needs more aggressive treatment than he's received up to now to knock this on the head.

Good luck with him. I hope he's finally on the mend for you soon.

 

[leanne123]

i have had a second opinion but the vet was from the same practise so dont know if that would count. anyway to be honest i don't think either of them have any idea whats wrong with my baby.
after i came home from the yard tonight i was already thinking about getting a different practise to send someone to have a look but i don't want to offend my vet and don't really want to pay for the other practise to take another set of x rays.
i know that the injury is worse now as you can see hes in pain moving around.
im really glad that i refused (when a few weeks ago when it looked better than it is now ) the vet said to start riding him in walk for 10 mins in stright lines.
i dont want to rush this, i want it to mend properly but i know its worse know than before.
i think it needed more aggressive treatment from the start.
hes no infection in his knee as the vet tapped his knee and took a sample to check.
will pm you the vets name
i have had the vet out 11 times to him already and still don't really know whats wrong with him just maybes.

 

[Tia]

I was so thankful that the owner of my (ex) horse was prompt at calling the vet in. My old horse almost died even with this speedy care and even after his surgery he wasn't out of the woods for many many months. Her vet was fantastic and his skill really did save this horse's life.

Storm; I would run the bone infection theory past your vet and be prepared for a large bill

......but hopefully you will still have your horse in this world. Delaying treatment could be the last thing you will do for the horse if it is a bone infection.

 

[Tierra]

I must admit I was rather shocked myself at the initial comment from my vet. The injury itself looked very small but naturally I couldnt see how deep it was which is why I called him in the first place. The minute he saw the injury, he spoke to the nurse with him and asked her to call Leahurst to see how busy they were that afternoon.

I consider myself VERY lucky that there was no initial sign of infection and my vet (like yours) bandaged him to the hilt and came out himself every other day to change the bandaging.

A couple of people on the yard commented that in their opinion, he was being very OTT but my horse healed 100% with no complications and my vet bill for the incident was lower than storm's currently is (considering my vet travels 60 miles to me also.....)

Im really really interested to know which vets she is dealing with as I do know most of them in that area. Like you, id be terribly worried about what's going on as lingering infections in those kind of areas generally dont carry good prognoses in my experience

Storm please please please either get an immediate referal or call another vet for a second opinion (they can always then refer if they think its necessary).

 

[Patches]

I really feel for you Storm.

We take what the vet's tell as gospel. Afraid to question their superior knowledge. However, you know your horse better than anyone and I think I'm right that your instincts are now telling you that he needs something else.

Get on the phone in the morning to the nearest large specialist equine practice and seek a second opinion. I know it's going to cost you more money (is he not insured?) but you have to look at the bigger picture, you've already paid out for 11 visits now and are still none the wiser with a horse that is deteriorating not improving.

It could prove to false economy in the long run to opt to stay with the same practice. I think the new vet can ask the old vet to look at the notes/s-rays which might save you some money.

The very best of luck.

 

[Tia]

[ QUOTE ]
i don't want to offend my vet

[/ QUOTE ]

Please......if you listen to any advice then NEVER every worry about this!! You do what is right for you and your horse......the horse should ALWAYS come first.

 

[Tierra]

I'm replying to your PM at the moment Storm. Don't be concerned about offending your vet - its your horse's welfare that is paramount.

 

[leanne123]

will ring church fields tommorrow and see if i can get someone else i can't sleep at night cos im trawling the net trying to find anyone else that has had anything like this happen to there horse.
if he did have infection in the bone then surely the vet would have told me so. or at last thought of something else to try.
i have explained to the vet that i don't care how much it costs to treat him just do what has to be done so he knows its not a money issue thing.
when he first looked at it he did say that there could be a chance that he would have to have surgery, but he didn't want the infection to spread further when the knee was opened up.
will let you know tommorrow what happens.

 

[Patches]

I know friend's of mine thought I was being way over the top when Patches knee ballooned as they felt I should give her a few days to "see how she goes". I'm sure that 99% of the time that theory would have worked. However I just knew that something VERY wrong was going on.

I called the vets and told them I was bringing her in. No arguing, I wanted her seeing as an emergency. Bless her she could hardly get on the trailer. I wasn't delaying it any further.

Her consult, tendon tap, x-rays, surgery, 5 days in hospital with IV antibiotics, antibiotic to have at home for a further 12 days, oodles of follow up visits and two scans all came to just £1500. As with you horse, Patches wasn't out of the woods for some time either. She developed adhesions on the tendon post surgery (not uncommon with that type of injury) that required months of daily work (alot of work) on high doses of bute to break down.

There were no half measures and I thank my lucky stars that I took her to the vets that day. I was only given a 40% chance of the op being a success as tendon sheath infections can be very difficult to cure and lasting damage is a possibility. My vet later said it was the prompt action that saved her life.

You'd not think a little scab on the back of a knee, about half the size of a 5p piece (which incidentally had healed by the time we went to the equine clinic) could have caused SO much damage and lead to a potentially life threatening complication. I'm so paranoid now about the slightest scratch.

I'm the same as you and Tia though. I don't want to scare Storm at all, but after 4 months of this problem, I too would be very worried about the long term prognosis for her big lad.

 

[Tierra]

Im trying to think of vets in your area....

As I mentioned in the PM... I used Balby when i was living in Rotherham. Although they're based in Barnsley, they have a practice in Maltby so will service all of the rotherham area as well. They certainly had a couple of very very good equine vets when I was living in the area. If you do use them however, make sure you specify on the phone that you want an equine vet as they did send me a small animal vet once who was useless.

I use http://horsevets.co.uk/ but sadly they won't quite cover your area.

In terms of referals, Im 99% sure they would refer to Leahurst if they went with that route ( http://www.liv.ac.uk/equine ). You can *insist* on a referal from your own vet but that would be upto you.

There is also ashbrook ( http://www.ashbrookequinehospital.co.uk ) and while Ive heard good things about them (we've had a horse on the yard go there for diagnostic work on a miscellaneous lameness), ive never dealt with them personally (mine have always gone to leahurst)

I really would be pushing for a referral and as I said, you can insist on this from your own vet if you dont want to go through another.

 

[leanne123]

im deffinatly gonna get someone else to come out.
everybody on the yard already thinks im going ott about it and i should just wait and see. but as you've said hes my horse and i don't want him to end up crippled for life just cos we were told to wait and see.

 

[Tierra]

Which yard are you on out of interest storm?

 

[leanne123]

it was a private stud but has a couple of liverys on now its in swinton on warren vale

 

[Patches]

[ QUOTE ]
im deffinatly gonna get someone else to come out.
everybody on the yard already thinks im going ott about it and i should just wait and see. but as you've said hes my horse and i don't want him to end up crippled for life just cos we were told to wait and see.

[/ QUOTE ]

Bang on Storm, you have hit the proverbial nail smack on the head!!!!

I really didn't want to seem as though I was scaremongering, as I'm sure Tia and Tierra would agree as well. Personally I feel that the time for waiting and seeing has long since passed.

As I've said before, the very best of luck.

 

[Patches]

Ashbrook are good vets. Alot of local vets here refer there if they don't refer to Nantwich.

 

[leanne123]

thanks will let you all know what happens tommorrow.
looks like im not gonna get much sleep over the next few days.

 

[Tierra]

Omg Patches that sounds awful.

Which hospital did the surgery? Im aware the % chances of that particular op can be a bit dodgy as we had a horse referred to Leahurst from our yard after a hunting accident. He underwent surgery but they never managed to get ontop of the infection and he was eventually PTS.

I agree with you 100% though. If there is any doubt I would much sooner refer to somewhere that have the full facilities to deal with something very quickly if need be. My vets are fantastic thankfully and tend to refer if there is any doubt over whats going on. I'd much sooner have them in the hands of qualified 24 hour carers than to "risk it" and keep them at home.

 

[Patches]

Tell me about it, that's horses for you.

It's been going on since the beginning of November though if I remember correctly hasn't it? I'd think you've had a fair few sleepness nights already!

What a shame. New year, new approach.

 

[Tierra]

Please please please please keep us posted Storm - will be thinking of you tomorrow but dont let the vets intimidate you. I know its hard but if you want a second opinion then get one.

If you'd prefer an immediate referral to one of the clinics - then tell your vet tomorrow to get on the phone and get it sorted out (this would be the option I would be going for if it was my horse by the way.)

 

[Patches]

I'm registered with Nantwich Veterinary Practice, Home Farm Equine Clinic. Wonderful facilities and plenty of vets - very large unit. It's part of Reaseheath College and they do many equine courses there as well.

The only referrals I've ever known them to make from there (as in things they can't treat themselves) are the very intricate colic surgeries. They tend to refer to Liverpool.

 

[Tierra]

Aaaah. My first dealing with liverpool was when a mare of mine was referred there in need of colic surgery.

Sadly, my mare was PTS on arrival and the vets at Leahurst said it was because there had been too much delay on her being referred. In my defence, i was only in my teens and as with Storm, I trusted the vets in question who were initially called to my mare. They eventually chose to refer and by which time, it was too late to do anything for her

I learnt two things from that incident... 1) I ONLY have equine vets near my horses. Im still surprised at home many people will use general vets but they just dont have the exerptise for horses. 2) If in doubt - refer

 

[Patches]

I hear you, I agree.

I only have equine vets to my horses too. I did used to have the farm vets for routine jabs when they were out to cows though....didn't see the point in a call out for an injection. The farm vets sold off part of their practice and now all equine care is handled by Ashbrook anyway.

Nantwich are perfectly well equipped to handle most cases. Not really sure why they refer the colic cases though. Must be a reason why they feel they can't handle them.

Storm, just an incidental, when Patches knee was x-rayed they were looking for dark spots on the bone. Healthy bone shows up nice and white whereas infection looks dark on the x-ray, more transparent. Did you see the x-rays at all?

 

[dunc_n_toby]

sorry to hear about alfie, If i were you I'd get him straight across to either herds at halifax way or up to Rainbow at Malton, he needs to be seen by the specialists. You can ring your vets and ask them to refer you to them, then get him boxed up and across to them.

 

[GreedyGuts]

Hi,
This all sounds pretty worrying and distressing. I second the others, it sounds like it's time for referral and further investigation, at least then you will know that he's in the best hands. He shouldn't be deteriorating this long after an injury. Once you lose confidence in your vet then it's time to go elswhere I think. I would go for Leahurst if I were you.

Best of luck with him, I hope you get to the bottom of the problem and the outcome is good.

 

[LoneRanger]

Hiya hopefully a second opinion will help you out. I had a 17.1hh horse who mysteriously damaged his knee in the stable overnight. There were no noticable cuts or punctures but his knee was enormous (more swollen than I could imagine possible).
He had IV antibiotics for a couple of weeks but that didn't make any difference. X-rays were clear. We tried box resting him, then we tried putting him on the walker for 30 mins a day. None of it worked so we turned him away for 2 months. Still no improvement so vet suggested an arthroscopy. We went ahead with it and they found some damage to the cartilege. Vet scraped away the damaged cartilege and after a few months the horse recovered. He's still hunting three years later and hasn't been lame since. There is hope! I have my fingers crossed that you find out what the cause is. Ask your vet about an arthroscopy if you've tried all the other options.