Monday, 10 October 2016

Tonto vet history


The note I gave to the vet for Tonto's medical history
 
Summary
  • about 20 years old
  • up to date on tetanus, not on flu
  • retired since 2013
  • history of back pain, believed to be  muscular but not fully investigated
  • has arthritis in hocks
  • ringbone in front feet
  • history of being a good dooer but struggling keeping weight on in recent years
  • often has thrush infections in feet
  • has had unusually mucky sheath of late which he has found uncomfortable
  • suspected of Cushing’s but tested negative on tests
  • has some behavioural issues – needle phobic (I have aural sedation to hand for visit)
  • seems to have a very high threshold for pain
  • condition is on the decline and debating PTS due to reduced quality of life
  • owner wants to rule out all possibility of improving quality of life before deciding on PTS 
Summer 2011

Diagnosed with chronic ringbone effecting joint margins on both front feet in 2011. Was continued in light ridden work and prescribed bute as needed. Shoes were removed.
Autumn 2010 photo - the day I saw he was lame

Summer 2013
 
By 2013 Tonto was showing indications of increased pain. Some difficulty holding up right for when picking out feet and had a ‘goat-on-rock’ stance when saddle was presented to him, his back was also sore. Tried putting shoes back on, but didn’t help. We re-Xrayed and confirmed significant degeneration with damage surrounding the ligament connective tissue in front feet and arthritis in both hocks. October 2013 fully retired to field livery and on bute during winter months. Shoes removed.


 
Autumn 2014
 
2014 blood test for Cushing’s. Came back with normal result.



Summer 2015

Summer 2015 living out on lush grass field but not gaining weight the way he used to (now a healthy weight). Had some episodes of choke with his feed.

 

Autumn 2015

October 2015 started to loose weight despite good grazing, was seen separating himself from the rest of the herd, noted he seemed uncomfortable behind and had repeated episode of choke despite having wet feed. Teeth were investigated and rasped, on inspection there were some sharp edges, but nothing very significant. Tonto continued to loose condition and developed a mite infestation in his feathers. Saliva test revealed he had tape worm. Had a bit of a runny nose on and off. Bloods were taken which revealed slightly elevated white blood cell count but no other significant markers. Cushing’s re-tested with cortisone levels slightly higher than normal values but below threshold.



 Winter 2015/6

December 2015, was not coping with mud, with regular trips and falls in difficult footing so put on stable livery. He put on weight but appeared withdrawn on occasion. He started a course of catrophen to see if this could ease symptoms. A slight improvement was seen – but this realistically could have been optimism on the owners part.

February 2016, moved to a dry flat field to try and help mobility and living out. He was given an unlimited supply of hay and a daily feed and was taken off bute. Lost a little condition but not too much, occasionally seen standing with head lowered and withdrawn – but difficult to observe as field was remote.



Spring 2016

April 2016, moved to field livery at westlands. Re-tested for Cushing’s, again borderline but negative. Given a booster shot of catrophen. Continued to struggle with mobility but fairly happy in himself. Weight was healthy – but needed daily feeds to achieve this (always thinner than the other horses on similar grazing).


 
Summer 2016

June 2016, was seen weight shifting on back legs. Vet called to find he had fly strike in his sheath. This was treated but he still seemed uncomfortable behind. Seemed better after a night on box rest with limited socked hay. Pulses felt by farrier, but not by vet. Tested again for cushions, with a borderline negative result. Decided probably not lamanitic and so injected hocks with steroids (with a conservative dose for safely). When injecting vet noted there was very little space left in the joint margin (by feel). Some immediate improvement seen but not long lasting. Other bloods ran, no significant markers barring a slightly elevated white blood cell count. Weight healthy – but needing daily feeds to achieve this.



 

July – August 2016 continued issues with mucky sheath and having to work hard to keep weight on (feeds daily). Some weight shifting seen on and off behind.

Autumn 2016

September 2016 lost more condition – with some further muscle wastage and tucked up behind. Seemed depressed. Moved to rich grazing and extra fatty feed but no improvement. October 2016 moved to stable livery.

 


Ups and Downs

Operation get Tonto happy has been having highs and lows.

Two days after bringing them into the pony palace Tonto had a blip. He had been turned out in the drizzle without a rug and came in withdrawn, shaking and not eating. I only picked up the panicked calls from the yard at 10pm due to a work commitment. By the time I got down the next day he was brighter. I suspect the damp and cold of the previous day had made him uncomfortable. I was relieved he was feeling better - but it is a clear warning sign that he is very unwell. I decided to call the vet and up his bute to 2 per day.

The vet came out the following Monday - we got Pete out from Liphook who specialises in oldies. Fearing the worst I forewarned work, got my father to come along for moral support and wrote out Tonto's full medical history - I might post it here for the record. Just as I was explaining to the vet that I think it might be time for a difficult decision Tonto rallied. He buggered off during the 'trot up' dragging me into a parked car in his quest to get back to Sofie. The vet concluded that he still had fight in him, and with his case history it would be worth trying him on cushings meds as he has so many cushings symptoms.

Since then Tonto seems to be having more up days than down. We are starting a gentle introduction to try to avoid the 'paroglide veil' which is a common side effect of the meds. He still seems occasionally lethargic and a bit fussy on food - though has taken more of an interest in hay of late. I think he is putting on weight, and can now raise his front right foot - which is something he was struggling with last week.

He is still on two bute - it is hard to tell if improvement is due to new meds, or pain killers, or the extra TLC he is getting. If he continues to brighten we will try to reduce the bute to see if there is improvement without these.

I am desperately trying not to get my hopes up of a partial recovery, but it is hard to resist dreams of him making a miraculous recovery like some cushings horses have and even riding him again. But these are dreams, which are ignoring his history of arthritis chances are he will get a little better - but still be an ill horse. Probably just well enough to avoid pts, but not well enough to live out - making me entirely stressed and broke for the foresable future.