While the vet was out last week, I asked her to take a very close look at the bumps on Fudge’s chest that we blogged about in May. They were scars at the time of purchase, and have grown since then. After five months hematomas should have been reabsorbed. They didn’t look or feel like any sarcoids the vet had seen.
This time around Fudge stood very patiently as the vet probed, squeezed, and palpated his chest. He trusts us now not to hurt him down there, and the pain from the injuries must have subsided. She carefully examined and compared all the bumps/scar tissue/injuries along his neck and chest. These appear to be the result of deep cuts through the skin and a layer of muscle. The edge of the lacerated muscle has curled up, forming an egg sized lump under the skin, and a shallow pit where the muscle is missing. This is a much better diagnosis than sarcoids. Hopefully the muscle will stabilize during his time off for rehabilitation, and not tear further.
You’d think that if the horse had flaps of skin and muscle hanging from him, that the owner would have noticed, and then gotten him some veterinary attention to suture the wounds. Yes, you’d think.
CC JesusCM 'Carrousel' www.flickr.com/photos/jesuscm/
It’s been that kind of a week. Last weekend we noticed that Fudge was not turning on his haunches as well as he had been. When standing to be brushed, his right rear leg was cocked out almost 90°. Monday night he wasn’t really interested in dinner, so we took him out for a quick neurological test. We considered that the symptoms might be heat related, but up until yesterday it had not been truly hot here. Tuesday offered the same deficits.
The vet came out Wednesday to take blood samples, do a partial neuro exam, and to talk about a relapse. We sent the samples to UC Davis for an IFA test for S. neurona, and a Selenium test to see if he is deficient (different than a mineral profile). In the exam he had problems turning on the right rear, failed to move his right rear leg back into correct position when placed far out or crossed (proprioception), and was easy to pull of-center by the tail. She agreed that he looked worse, and we decided to order medicine without waiting for the blood test results.
Thursday morning we tried to order diclazuril. It turned out to be an all-day affair. The bottom line was that the compounding pharmacy only had enough diclazuril to make a 21-day supply, not the 60 days that we need. They did not know when they would get more diclazuril, if ever. I told them to send it, and I hoped that I would find another source in the next two weeks.
I emailed an EPM horse owner in Oklahoma, whom I knew had recently treated with diclazuril. She put me in touch with her vet, who gave me the compounding pharmacy information. Problem solved. I’ll add the compounding pharmacy information to the EPMhorse.org Treatment page.
For those wondering why I don’t just pick up a tube of Marquis, it’s about the strength and cost of the drugs. Dr. MacKay at U of FL recommends using ponazuril (Marquis) or diclazuril at 7X the FDA dose for treatment of relapses. That would equal one tube of Marquis PER DAY, for four days, then a regular dose for 28 days. Add to that a sulfa combination, and you could be talking about $2000 of drugs in the first month, likely to be repeated for a second month. The compounded diclazuril or diclazuril/sulfa/pyrimeth can be as little as $145 per month, for a 7X dose of diclazuril for the entire month. Dad was right. There is no money tree growing in the backyard.
EPM - it robs the horse of his grace and dignity…and robs the owners as well.
It has been five months since we first had the vet out to diagnose Fudge, and he is three months post treatment. So where did the three-month pasture rest get us? Fudge has continued to lose muscle mass in the rear end, although it seems to have stabilized now. He has put on a little weight in a roll of fat over the shoulder and around the tail. It is proportionately more than over the barrel, where his ribs can just be seen. This disproportionate placement of both fat and muscle will probably continue until he has feeling and muscle control back in more areas
We believe that Fudge has lowered sensitivity around his barrel, including dropping when not urinating, and a strong suspicion that his continued loose stools are related to EPM. He has had a fecal egg count, been wormed appropriately, and is on mostly forage and hay.
Fudge shows near equal atrophy in his rump, although his right rear hoof drags more severely than the left. The side view shows the flattened, un-muscled rump, which is not characteristic of a QH. Please, no comments about the grooming. We had to dodge the daily thunderstorms over the past week to get pictures.
I am talking about the tens of thousands of horses in the United States that are classified as unwanted. This week I attended a lecture on the topic. It was hosted by a PA State Senator, an officer of the Pennsylvania Equine Council, and the head of a local horse rescue.
Library of Congress, St. Petersburg, FL 1947
The panel discussion gave the opportunity to voice differing opinions on the growing problem. I listened to the sheer number of horses, the fiscal repercussions, and realities on both sides of the slaughter debate. One thing became clear. Many more horse owners must become involved in this debate, regardless of how they view slaughter. The problem is too big for you to not be affected emotionally, fiscally, and responsibly.
Being the owner of a fully retired, blind horse; a Mustang; a sick unride-able horse, and having fostered OTTB’s, perhaps you could say that I’m just a sucker for the unwanted horse. Please visit these two web sites to learn more:
I have only ridden Fudge once since his diagnosis in January. I was on him for five minutes in early April to test for deficits after two months of treatment. At a slow walk he just seemed out-of-shape. Slow trotting a wide turn, his rear end fell out and he stumbled badly. Since then we have only hand walked him, and given plenty of turnout.
We are trying to engage his mind without stressing his body, through gentle ground training and desensitizing. We have found that Fudge has had little exposure to bicycles, objects like tarps, or loud noises. He seems more balanced at this point, so we loaded Fudge and the Mustang on the trailer for a very slow, 5-minute drive to the local park. We were able to work on stream crossing, standing for a sponge bath, and wooden bridge crossing.
It became very obvious stepping down from the bridge that Fudge does not know where his rear right hoof is, in relation to his body. He hung half off the bridge, searching for the ground with that leg. It may only have been a second in length, but it was enough to tell us that Fudge is not yet safe to ride.
On the way home we heard him take a misstep into the side of the in the trailer when we made a slow turn after a stop. Fudge’s rehab is going to be much like the trip home…very slow, listening to the horse, a few mis-steps, and a lot time caring for, but not riding the horse.