My brain is so full of everything that has happened in the last few months that I hardly know where to begin this blog post.
About a month after our successful Oroquin treatment, Blue began showing signs of illness again. He was standing sideways at the hay feeder again, and started slipping from he sheath off and on. He also started leaning on his stall wall at night, and standing with that "kicked out" hind leg.
Dr. Ellison at Pathogens gave me a stern talking to over the phone. Blue is not "cured," no matter how successful to Oroquin treatment. A course of Levamisole (NeuroQuel) was prescribed to help shore him up. After the two week dose was over, he needed another round, then a round to every other day. Every time we tried to wean him off of it, he would relapse. I resigned myself (quite happily) to the idea that he would just have to be on an every-other-day dose for the rest of forever. At $60 a month, NeuroQuel is affordable into the forever, and it worked.
And then...
It stopped working. Well, I mean that the NeuroQuel was not nearly as effective. I don't know if it stopped working because I am too terrified to take him off of it. I called Dr. Ellison again (Blue's mom on line 2 again!) Again, she talked me down off the wall. It's chronic, sure, but manageable. Let's try dexamethasone orally and see how it goes.
Orally, the dex is not really working, either.
In the middle of all this fun and games, Blue got kicked in a pretty real way. The inside of his right hind was in bad shape - pretty swollen and with a big superficial wound. Dr. Miller (always on speed dial) set us up with SMZ and bute to get him through it, as he was injured in the leg that is already an issue. Also, dexamethasone can hinder healing in immune-deficient animals. And I'm pretty terrified of what an infection would mean for Old Blue.
So we became a hospital once again, devising a clever system of jelly jars, dry erase markers, maple syrup and a coffee grinder to get Blue to eat everything. The meds schedule was like quantum mathematics - every other day on alternating days for the levamisole and dex, every day for bute and U-guard, twice a day for SMZ and vitamin E.
After his wound had healed and he was back to walking better (yet still tilted), Dr. Miller suggested we switch to dexamethasone shots for better absorption, and I agreed.
Also, as a fun aside, dex causes gastro issues including ulcers and can cause a horse to lose weight pretty dramatically. Convinced of the worst, I bought another tub of U-Guard and ran to the feed store to get some beet pulp with molasses.
And so, here it is - Blue's medication schedule (don't tell my husband how much this all costs).
1. Levamisole tablet (NeuroQuel) every other day.
2. 2.5 ml (That's 10 mg) of dexamethasone by injection every alternating day.
3. Two scoops of U-Guard every day
4. Two scoops (10,000 IU) of vitamin E every day.
maple syrup to make the medicine go down.
5. 1 pound (building up to 2 pounds) of soaked beet pulp every day.
6. 1/2 cup corn oil once a day to maintain weight (may go up to 1 cup and may switch to an oil lower in Omega 6 and higher in Omega 3).
I also learned how to give a horse a shot and Blue, to his credit, was a very good patient about it.
He got his first dex shot last night. I am not brave enough to ask Dr, Miller what happens if the dex simply does not work. Part of me just doesn't want to know.
Monday, November 7, 2016
Wednesday, July 20, 2016
Signs of trouble
It's been a pretty blissful month at Blue Nile Farm. Blue gained strength and weight following the levamisole treatment, and began enjoying his summer days dozing in his stall and the warm nights outside with his herd. Lots of treats, lots of love, lots of flyspray.
But then...
We noticed Blue was standing sideways at the hay feeder again. And that right hind leg was kicked out again. And maybe he's more tilted than he was just a week ago.
My heart sank into my stomach and I felt sick. There is only one reason for all of this, and it's neurological.
My vet gave me some Dex shots and I'm simply beside myself. I always knew relapse was possible, but I did not know it was possible within a little more than a month of end of treatment.
But then...
We noticed Blue was standing sideways at the hay feeder again. And that right hind leg was kicked out again. And maybe he's more tilted than he was just a week ago.
My heart sank into my stomach and I felt sick. There is only one reason for all of this, and it's neurological.
Friday, June 10, 2016
Troubles linger
I decided that Blue would do well with some focused exercise, and so I let Emily ride him at the walk yesterday. I don't know what I was hoping for.
Blue was very stiff - and we didn't do anything but walk, but he seemed to get very tired, very fast. His feet were trimmed the day before, and that seemed to help with the toe dragging until he got tired at the end. I would say that Emily rode at the walk (In big figure 8's) for about 15 minutes:
Blue was very stiff - and we didn't do anything but walk, but he seemed to get very tired, very fast. His feet were trimmed the day before, and that seemed to help with the toe dragging until he got tired at the end. I would say that Emily rode at the walk (In big figure 8's) for about 15 minutes:
Waiting on Levamisole
Post-Oroquin, we are waiting on the delivery of Levamisole.
Levamisole is sort of an old-school drug, used years ago by sheep ranchers to deworm the flock. So how does it help Bluehorse?
Dr. Ellison writes:
"The anti-protozoal drug deciquinate was effective as shown by a reduction in titer post treatment in this study. The marked improvement in clinical signs may be partially due to the effects of levamisole as an immune midulator or effects on other neurobiological mechanisms. One such effect is the possiblity that S. neurona or the immune response to the organism damages some upper motor neuron function that is responsive to levamisole therapy."
You can read the full paper here: http://www.jarvm.com/articles/Vol10Iss1/Ellison.pdf
So basically this support medication could potentially help Blue even more. Like I said before, no complaints about Blue's incredible improvement - but there are lingering issues that I would love to see resolved. My fears about relapse are very real. If the levamisole can clear up just a few of Blue's issues - stiffness, ongoing weakness, awkward rear-end stance - then let's do it.
We are waiting on the drug now, then it will be 14 days of trying to get Blue to eat it.
Levamisole is sort of an old-school drug, used years ago by sheep ranchers to deworm the flock. So how does it help Bluehorse?
Dr. Ellison writes:
"The anti-protozoal drug deciquinate was effective as shown by a reduction in titer post treatment in this study. The marked improvement in clinical signs may be partially due to the effects of levamisole as an immune midulator or effects on other neurobiological mechanisms. One such effect is the possiblity that S. neurona or the immune response to the organism damages some upper motor neuron function that is responsive to levamisole therapy."
You can read the full paper here: http://www.jarvm.com/articles/Vol10Iss1/Ellison.pdf
So basically this support medication could potentially help Blue even more. Like I said before, no complaints about Blue's incredible improvement - but there are lingering issues that I would love to see resolved. My fears about relapse are very real. If the levamisole can clear up just a few of Blue's issues - stiffness, ongoing weakness, awkward rear-end stance - then let's do it.
We are waiting on the drug now, then it will be 14 days of trying to get Blue to eat it.
Wednesday, June 8, 2016
Take a look at this
I wasn't going to post a video today (though I took one out of habit) but I simply had to share this: my EPM horse, off Oroquin by one day, off to join his herd in the back pasture:
Monday, June 6, 2016
Oroquin 10 - Day 10
I'm looking at a different horse than I had 10 days ago.
10 days ago I stood in the barn and cried, certain that I was going to lose my Blue, my "once in a lifetime horse" to EPM. Today he goes out with his herd at night, he gets down to roll with no problems, he trots after my kids and nickers for the apples he knows are in their pockets. He gets sassy when he doesn't want to do something. He's interested in life again.
What we have here is nothing short of a miracle.
But that leaves us with many questions still unanswered - how much damage was done to his Central Nervous System? How much of that damage is permanent? What can we do to help the healing of those nerve passageways? When can we start, and how can we start, helping him gain his strength back in his hind end?
And *gulp* what about possible relapse?
Putting all those questions aside for just one more day, we can look at the overwhelming benefits of the Oroquin and see success. Blue is no longer walking "death circles." He is straighter, for sure. He is still awkward in his hind end, but certainly no longer "tilted." He trots.
While he was never really depressed, his mood is elevated again. He is happy to see me and the children. He calls for his friends in the field. He looks through his stall door with clear, interested eyes. I texted my vet on Day 5 - "I have Blue back!"
He is bright and alert and seems happy. He is also so much "straighter" than he was. There was a time before the Oroquin when we could barely get Blue into his still because he was so crooked that his shoulder and hip had to fit through the door at the same time.
And I mean that with my whole heart.
Of course, all is not perfect. He seems to still not know exactly where his hind feet are. I catch him standing awkwardly all the time, one foot crossed over the other, standing almost clubfooted at times. And he still stands with his right hind leg "kicked out," though it is much less dramatic than it had been. The toe-dragging has not resolved, to the point where we are going to have to do something to help his hooves if it continues. He was dropped from his sheath when I walked up to his stall today.
Here are his Day 10 hind end pic:
My 10-year-old daughter and I were talking about Blue this morning. She has been anxious about his condition, and wanted to know if I thought she would ever be able to ride him bareback at the walk again.
My words caught in my throat when I told her how sick Blue has been, and how I know we almost lost him. It gives me a healthy dose of perspective. If this is our final result, I am overwhelmingly grateful.
Here is our Day 10 video:
And for reference, here is the video of Blue doing circles the day before treatment started. What a difference!
10 days ago I stood in the barn and cried, certain that I was going to lose my Blue, my "once in a lifetime horse" to EPM. Today he goes out with his herd at night, he gets down to roll with no problems, he trots after my kids and nickers for the apples he knows are in their pockets. He gets sassy when he doesn't want to do something. He's interested in life again.
What we have here is nothing short of a miracle.
But that leaves us with many questions still unanswered - how much damage was done to his Central Nervous System? How much of that damage is permanent? What can we do to help the healing of those nerve passageways? When can we start, and how can we start, helping him gain his strength back in his hind end?
And *gulp* what about possible relapse?
Putting all those questions aside for just one more day, we can look at the overwhelming benefits of the Oroquin and see success. Blue is no longer walking "death circles." He is straighter, for sure. He is still awkward in his hind end, but certainly no longer "tilted." He trots.
While he was never really depressed, his mood is elevated again. He is happy to see me and the children. He calls for his friends in the field. He looks through his stall door with clear, interested eyes. I texted my vet on Day 5 - "I have Blue back!"
He is bright and alert and seems happy. He is also so much "straighter" than he was. There was a time before the Oroquin when we could barely get Blue into his still because he was so crooked that his shoulder and hip had to fit through the door at the same time.
And I mean that with my whole heart.
Of course, all is not perfect. He seems to still not know exactly where his hind feet are. I catch him standing awkwardly all the time, one foot crossed over the other, standing almost clubfooted at times. And he still stands with his right hind leg "kicked out," though it is much less dramatic than it had been. The toe-dragging has not resolved, to the point where we are going to have to do something to help his hooves if it continues. He was dropped from his sheath when I walked up to his stall today.
Here are his Day 10 hind end pic:
My 10-year-old daughter and I were talking about Blue this morning. She has been anxious about his condition, and wanted to know if I thought she would ever be able to ride him bareback at the walk again.
My words caught in my throat when I told her how sick Blue has been, and how I know we almost lost him. It gives me a healthy dose of perspective. If this is our final result, I am overwhelmingly grateful.
Here is our Day 10 video:
And for reference, here is the video of Blue doing circles the day before treatment started. What a difference!
Oroquin 10 -Day 9
Not much to say today either way. Blue looks no better or worse on Day 9 than on Day 8. There are certainly plenty of things to worry about, but I'm really just trying to stay positive.
I am thinking a bit about rehabilitation. I wouldn't usually worry about this (Blue is a pasture puff, and that's all he needs to be) but he still drags the one back toe pretty badly, and strengthening his hind end (especially in case of a relapse) is especially important. I'm not sure how to even start this. I don't want him trotting circles, and we live in flat Ohio - no hills to walk up.
He goes out all night with his herd and gets a bit of exercise that way. My daughter, Emily, has volunteered to walk him bareback in figure eights in the arena to build him up a bit. To be honest, Emily's imagination is fueled by my stories of jumping and competing on Blue, and her eyes got wide when I showed her our box of show ribbons and photos of us in our younger days. She is desperate to ride Blue, even just bareback at the walk.
As for Bluehorse, he is happier and healthier than he has been in nearly a year. I have some big decisions to make to keep him that way. Vaccinations, worming, season changes, herd changes - all can cause enough stress to throw him into relapse. Constant vigilance.
Here is our video of the day
Here's that parked-out stance that has me so worried:
I am thinking a bit about rehabilitation. I wouldn't usually worry about this (Blue is a pasture puff, and that's all he needs to be) but he still drags the one back toe pretty badly, and strengthening his hind end (especially in case of a relapse) is especially important. I'm not sure how to even start this. I don't want him trotting circles, and we live in flat Ohio - no hills to walk up.
He goes out all night with his herd and gets a bit of exercise that way. My daughter, Emily, has volunteered to walk him bareback in figure eights in the arena to build him up a bit. To be honest, Emily's imagination is fueled by my stories of jumping and competing on Blue, and her eyes got wide when I showed her our box of show ribbons and photos of us in our younger days. She is desperate to ride Blue, even just bareback at the walk.
As for Bluehorse, he is happier and healthier than he has been in nearly a year. I have some big decisions to make to keep him that way. Vaccinations, worming, season changes, herd changes - all can cause enough stress to throw him into relapse. Constant vigilance.
Here is our video of the day
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