"Dear Santa, I'd like a new pair of shoes..."

Pookey Bear and his kind benefactor, Dr. Allen, a.k.a. 'Santa'

Pookey Bear being silly...

...we told him not to make faces at the camera!

Tex says 'howdy'!

No Pookey pics today--just a riddle, a quick progress report, and a holiday 'howdy' from Tex, who spent the morning helping me decorate!

Here is the riddle:

What do dental impression material, a dremel tool, Saran Wrap, and a blow torch have in common?

Answer: they are all part of the farrier's tool kit used to put a new shoe on Pookey Bear!

Pookey paid a visit to his friend Joe Monday afternoon, getting a big thumbs up on the condition of his three good feet, and a mixed report on his problematic right front.

The negatives: he continues to grow lots of hoof on the lateral side, but not on the medial side, leaving his bony column rather catty-wampus (not a legitimate medical term, I realize). Also, he popped up with a new area of infection, this one pretty nasty looking, which Joe had to clean out.

The surprising positive: despite his problems, he walked off after his shoeing amazingly well, and has remained pain-free and in good spirits for the past several days. He continues to walk well with very little noticeable limp, and feels great!

Hooray!

Yes, Virginia, there is a Santa Claus.

And yes, he does love little insulin-resistant horses!

That was easy!

As you can see, one of my patients is healed!

Although he is still wearing a diaper and some duct tape on one of his feet (the non-abscessed foot, which has a bad crack) he is certainly pounding around on all fours just fine.

Zippy never quite got the hang of the bucket soaking the way that Pookey Bear did, so I drew out his abscess using those wonderful Animalintex pads, and followed up for a few days with a sugar-dine solution.

Hopefully by this time next year we will be posting some bucking-and-running video of Pookey Bear!

What is wrong with this picture?

What is wrong with this picture?

If you guessed that it is Pookey Bear's hiney hanging out, then you guessed right!

Yes, somebody has outgrown their expensive winter blanket.

Of course I can't imagine that: weight gain as an adult? How shocking!

I have actually lost a few pounds this week, hauling two horses' worth of manure in the wheelbarrow. My fabulous 'machine' is in the shop, so I am hoofing it to the back pasture twice daily, dumping load after load of soiled bedding.

When I finally get my machine back, I am going to hit the Web and search for a size 80 blanket for Mr. Wonderful, to keep his backside warm.

At least his feet are doing great: he continues sound on three feet and constantly improving on the fourth. He is still enjoying his twice-daily walks, and is re-learning how to pivot in his stall--something he has not been able to do for a long, long time!

We are at the five-week mark, post-surgically, and getting better each day.

Whoo-hoo!

Zippy follows suit...

Somehow, as a horse owner, I managed to make it from 1967 to 2010 without ever dealing with an abscess.

So far this year, I have dealt with three: Pookey Bear, Rita, and Zippy, pictured above.

But being an Appaloosa, and tough as a boot, Zippy has gone from three-legged lame to nearly sound in 24 hours. A few meds and a soak and poultice, and his swelling has gone down 50%, his abscess is draining nicely, and he is feeling fit as a fiddle.

I'll take that!

A brighter future!

The sweet bay face you see in this photo is not Pookey Bear (who is fine, BTW).

But had life taken a slightly different turn for him, it could have been.

The sweet bay face belongs to a lucky horse at a sheriff's auction I attended yesterday. The dark side of the photo represents his old life; the bright side, the new.

This horse, along with 24 others, was seized from his breeders by animal control. The stallions in the group had been locked in their stalls for months, standing in piles of their own waste up to eight feet high. Their hooves looked like genie's slippers. Their coats were dull and their manes and tails hopelessly matted. They were emaciated.

The mares were found huddled together in a small outdoor enclosure, competing for small particles of low-quality hay.

I will not even discuss the young horses.

But for most of these sweet horses, the future now looks bright! Most of them were sold at auction yesterday to knowledgeable, kind-hearted horsemen who have promised to give them a place to live out the rest of their days in comfort and happiness, with clean, dry footing and full bellies.

A happy ending!

Pookey Bear is working toward his happy ending, too.

After finally getting the best of that nasty abscess, he is feeling much better! He visited the doctor earlier this week, and got a new set of x-rays and a new pair of shoes. His x-rays looked kind of funky--his bony column is kind of 'listing' in his right front. But with a little farrier magic, he is once again standing up nicely, and walking nearly sound.

Today's footage was shot of him on his morning walk.

Doesn't he look great?

His future is looking brighter and brighter!

Success!

Pookey Bear is doing better today!

It appears we were dealing with an abscess, as expected, and it is beginning to drain, providing him with some much-needed relief.

Check back tomorrow for an update.

And thank you for praying for Pookey!

"PPPPP"

Remember the 'PUSH' bracelets? Pray Until Something Happens?

I am borrowing from that tradition and making myself a 'PPPPP' bracelet--'Please Pray for Poor Pitiful Pookey.'

Yes, I am afraid he has take a turn for the worse. We suspect a bad abscess in his right front. The pain is so severe he is three-legged lame, even with the mega-NSAIDs he is now on.

We are praying that poultices will do the trick and pull out the infection--so I guess I could add another 'P'-- 'Please Pray for Poor Pitiful Pookey's Poultice'!

Thugs

No new pics of Pookey today--he is doing great!

Just a SOC (that's 'straight-out-of-the-camera') shot of a band of young thugs.

With Pookey on the mend--and thus no more hay soaking, ice-water sponge baths, or lymphatic massages--I had been wondering what on earth I was going to do with all my free time.

The young thugs answered that question for me.

Having just been weaned, they are all pining for mama, and are very resistant to staying inside their temporary enclosure. That electric tape works really well until a bull gets tangled up in a section and drags it across the drive, between the truck and trailer, and around the corner of the house.

Strangely, after just one such incident, the microscopic wires somehow separate, and the tape becomes more suggestive in nature, rather than punitive.

As in, 'we would really like for you to stay in this enclosure,' as opposed to, 'Z-a-a-a-a-a-p-p-p!'

So I am spending several hours each day chasing calves, much to Pookey's amusement.

He hangs his head over his stall door and watches for hours.

It's better than TV.

Learning curve...

Today, we changed Pookey's bandage.

And I am happy to report that his incision looked fabulous!

However, because this is a family-friendly blog, and graphic photos of incisions and sutures are not universally suitable for the under-18 crowd, I decided to substitute a 'pretty' picture for a more scientific one.

While searching for a 'pretty' picture I came across this head shot of Pookey Bear, in which his head looked just fine, and part of the background looked great, being naturally blacked out already, just like in those lovely TB track photos. But since this is not Hialeah, unfortunately there was a good bit of distracting debris in the background: a ladder, some old dog crates, a few gas cans, an oxygen tank, a couple of hay bales (Put away the extinguishers, boys! No fire danger here!) and at least half a dozen half-empty range cube, Equine Senior, and old fertilizer sacks.

So I gleefully imported the picture into Photoshop, where I have worked on it for the better part of the afternoon. Well, in between runs to WalMart, holding patients for The Boss, and doing laundry, that is.

I am very happy with the result! Except that I cannot quite get the line on the far side of his face smooth. When other people do these, the result looks natural. Mine looks like the poor horse's face has been gnawed on by grasshoppers.

There must be a learning curve!

Movin' out!

If your curiosity got the better of you, and you have already clicked on the little triangle and played the video, you might very well be asking yourself, 'Did they get a stand-in to play Pookey in this video?' Because given the events of the past few months, it is rather hard to imagine that Pookey could be looking so normal, so forward-moving, so frisky...

In fact, if you promise not to tell his doctors, I will let you in on a little secret...

Moments after this video was taken, he actually trotted!

Now, we of course are having none of that in the future, as it could be very detrimental to his healing. We will be walloping him with some high-powered drugs to quiet him down, or at least tying some lavender tussies around his stall. Or is it raspberry leaves that are supposed to calm them down? Or Vitamin B-1? And do they need to eat them, or can they just inhale them? I can never remember.

At any rate, we will be doing something to slow him down a bit.

What a fun new problem to have!

Not another diet!

A sight for sore eyes greeted me as I rounded the corner of the barn this morning: a bright, alert, engaged, sleek, lean, happy Pookey Bear, peering out of his stall, waiting for breakfast.

Thanks to a near complete absence of pain, Pookey is once again feeling grand. Combine that with his carefully managed diet, and it seems that the metabolic problems that led to his laminitis last June are finally under control.

Huzzah! Huzzah!

However, because of my innate cautious nature and attention to detail (okay, and my OCD as well) and thanks to the good folks at Land O'Lakes-Purina, who treated me to a lovely weekend of nutrition CE in St. Louis, I am once again reviewing Pookey's diet. And believe it or not I suspect that I might have hit upon one small flaw in my thinking, which hopefully can be rectified with one small tweak to Mr. Wonderful's diet.

(READER ALERT: If you have zero interest in equine nutrition, please stop here! Pookey is looking healthier and happier than I have seen him in ages (thanks, Dr. Wilcox, Joe and gang!) and we anticipate excellent continued post-surgical healing. However, if you just love dissecting your horse's diet, keep on reading...)

For the past few years I have been a firm believer that a 'forage first' diet is superior for horses. In their natural state horses are wide-ranging, selective spot grazers, and while researchers differ on whether to classify them as constant or intermittent grazers (or even foragers), most agree that a feral horse will graze for 16-18 hours daily, spending the rest of the time sleeping, migrating, or engaging in various social interactions. So it seems reasonable that the horse's digestive tract is designed to manage small amounts of high-fiber vegetation nearly continuously throughout the day.

Of course what most stalled horses get is large amounts of low-fiber concentrate, fed in discrete meals, often with a hay 'chaser.' It is no wonder that we deal with a lot of digestive issues in stalled horses!

Various medical conditions further complicate the picture: ulcers, PSSM, HYPP, chronic colics and diarrhea, Cushings and insulin resistance all create specific dietary needs and problems that must be addressed, often on an individual basis, given the wide variation in horses' living conditions.

I thought I had arrived at the perfect diet for Pookey.

Even a quick glance at his 'glamour shot' above and you would conclude that he is in the very pink of health.

But one of the speakers this weekend exposed the flaw in my logic, which I will now confess...

Back in August I had Pookey's hay tested, and found that it contained about 12% crude protein, which seemed perfectly adequate according to the National Research Council's nutrient requirements for horses. However, I had forgotten one small factoid, which Dr. Kelly Vineyard reminded us of: the horse does not have a protein requirement. Rather, he has an amino acid requirement, specifically for lysine and threonine. Feed those amino acids in adequate levels and the horse will thrive. Reduce them below acceptable levels, and the horse may experience muscle wasting, poor coat and hoof quality, and impaired tissue healing and repair.

Now, I would have no reason to believe that Pookey's hay was deficient in those essential amino acids, except for one small thing: for months I have been soaking his hay to reduce the sugar content. Soaking has been proven to reduce sugars by up to 30%. Unfortunately, the soaking also has an unwanted side effect: it washes away protein and possibly certain minerals as well.

So in 'fixing' one problem, I may have inadvertently created another!

I am sure that most idle, mature adult horses can survive very well on minimal quality protein. However, in Pookey's case, we need to optimize nutrition to maintain lean body condition but to maximize post-surgical healing, and by all means, we need to focus on hoof quality!

So guess who is no longer getting his hay soaked, and is going to be treated to a little supplemental protein?

No Bull!

Pookey Bear is back home.

No bull!

Well, okay, a little bull.

A little six-month old bull, to be exact.

A little six-month-old bull who has been making himself very useful in Pookey's absence!

Number 66, aka 'Tuffy,' was staring wide-eyed at the trailer as we wheeled down the drive this afternoon, bringing Pookey Bear back home from La Mesa Equine. During the week that Pookey has been hospitalized, Tuffy and his buddies have been doing their part for the war effort, mowing down the grass so that possibly, hopefully, ideally one day Pookey can be turned back out in his little pasture again.

Of course when that day comes--if it comes--he will be wearing his grazing muzzle and wrapped in head-to-toe bubble wrap.

But it is amazing that I am actually starting to hope again that the day may someday come!

I am allowing myself to hope a bit because he is doing fabulously well at his one-week post-surgical benchmark, having received 'the nod' from Dr. Wilcox to head home, sans NSAIDs, to continue healing in the comfort of his cozy little barn. Pookey's good friend Joe gave his feet a good inspection before sending him merrily on his way, recommending that he return in a few weeks for a trim and a reset and, hopefully, a good scratch behind the withers as well.

Leigha: as a former monitor of Pookey's digestive health, you will be glad to know that our current Chief Manure Inspector, Tex, reports 'all is well' with Pookey's droppings. Amazingly, despite a short course of NSAIDs, he seems to be completely free of any ulcer-related pain, and in fact is no longer nipping at me when I brush his belly, as he had been doing for the past several months.

What a joy it is to see him so relaxed and happy! I am confident that his tenotomy has relieved him of the chronic pain he has been battling for months, pain that rendered him out of sorts and even a tiny bit grumpy.

Now, his expression each time we walk into the barn says, 'Oh, hello there!' instead of 'Help me!' or, even worse, 'Leave me alone!'

Tomorrow, a pic or two of Pookey on his therapeutic walk. We will be very, very careful not to take him by Tuffy's pasture--he has WAY too much Poco Bueno blood to stroll casually past a cow!

Headed home!

Another stock image from the files, this one of the lovely Miss Susannah...

No new pics of Pookey, but maybe we will have some tomorrow: he is being discharged from the horse-pital this afternoon, and will be continuing his convalescence at home! Check back tomorrow for an updated Pookey report...

Pookey Report

I would like to lie to you and pretend that I am an artist, and sketched the above portrait of Squarehead sort of absentmindedly while I was booking appointments, loading the dishwasher, or hanging the towels out to dry.

The truth of the matter is that like everyone else on the planet, I am creating an alternate reality with Photoshop, and just pretending that I am an artist.

So, behold! A charcoal 'portrait' of Squarehead! Filling up space today because I have no new pictures of Pookey, who is progressing very nicely, thank you, as he recovers from his tenotomy.

His doctor reports today that he is continuing to walk nicely, and that he is scheduled to finish up his antibiotics today, and to begin tapering off of his NSAIDs.

We are praying that he will continue to motor around well as he drops back to a half dose, and--in a few days, if all goes well--gets weaned off his meds entirely.

So far, so good!

"Bright-eyed and bushy-tailed"

Exactly four years ago today, while visiting Oklahoma State University, I snapped this photo of 'Bullet,' where he stands guarding the entrance to the equestrian team offices.

It was one of those glorious October afternoons, the kind where the warm rays of the sun bathe everything they touch in a lovely golden glow, colors look deeper and richer, and the air feels sharper and crisper--without question, a 'glad to be alive' kind of day.

Today, we had another one of those here in northeast Texas: perfect blue skies, perfect cool temps, perfect golden autumn sun. And while I was certainly glad to be alive, I imagine that Pookey Bear was even more so, having struggled for the past few months with chronic, nagging pain, and finally--thanks to his surgery Monday!--experiencing some much welcome relief.

I visited him today at La Mesa Equine, where he has been since Monday, mending under the expert care of the doctors and staff. I could hear him nickering before I even walked into the barn, and was delighted to see him looking 'bright-eyed and bushy-tailed,' as the saying goes, and very much 'on the muscle.'

With permission, I slipped him out for a short walk. And while he tip-toed very carefully down the concrete alleyway, walking sort of like I do when I am forced to wear high heels, once he hit the driveway he actually pushed ahead of me, for the first time in months.

And on the grass?

He was nearly sound!

While we realize that Pookey has a very long recovery ahead of him, and many milestones that he must achieve before we can celebrate, at this point we are delighted with his progress, and are going to do a quick little 'happy dance' before we put back on our somber founder faces.

Happy dance!

Tap, tap, tap!!!

All is well!

Believe it or not, we finally got up the nerve to go ahead and schedule Pookey Bear's tenotomy. And we are happy to report that the surgery went off without a hitch, with the patient now happily recovering at the 'horspital.'

The doctors at La Mesa Equine performed the procedure on his stubborn right front, which had experienced initial improvement after his acute founder episode, but then sort of 'stalled out' (no pun intended).

His right front had always been problematic for him. Even as a healthy youngster, he had battled club foot, and subsequent abscesses. During his show career, he had required a vigorous stretching regimen to keep that leg as supple and elongated as the left.

So it was no great surprise that his right front failed to respond as well as his left, as the super-taut deep digital flexor tendon kept pulling down and back on the third phalanx, tearing it away from the laminae much quicker than the laminae could heal. The expectation now is that with continued rest and supportive care, the third phalanx (P3) can be maintained in a more normal alignment with the hoof wall and with the ground, allowing the laminae to build back functional strength.

Over time, the tendon itself will heal as well. In some horses, it apparently regains enough function (and tension) that it needs to be cut a second time. We are of course hoping that Pookey will be a one-shot wonder, and will only require the single surgery!

The surgery itself, much to our delight, went beautifully. And while considerable time was devoted to carefully positioned pre-surgical x-rays, extremely high-tech shoeing by Pookey's friend Joe, and incredibly thorough pre-surgical prep, the procedure itself took just a few minutes, the subsequent suturing not too much longer. Pookey stood through the entire event with just moderate sedation, and--thanks to the analgesic effect of his meds!--no signs whatsoever of discomfort.

Immediately following his surgery he walked easily back to his stall, sporting his newest corrective aluminum footwear on the right, and a 'normal' shoe on the left. He'll be hanging out there for awhile with his friends at La Mesa, as they keep his leg snugly wrapped and scrupulously clean, hoping to minimize scarring and to reduce any chance of infection.

Meanwhile, we are staring at his empty stall here at home, missing his frequent whinnies when we step outside the back door, his trumpeting demands for food and water, and his soft nickers when a client's child walks up to pet him.

Get well soon, Pookey Bear!

Here is Pookey, gazing out his window, minding his own business, enjoying the view...

But, wait!

What is going on out there?

What does Pookey see?

I can't quite tell who Dr. Allen is working on, but it looks like...

Uh oh, it's poor Helen!

What is he doing to Helen?

It looks like he is peering at some type of injury.

And what is he holding in his hands?

Oh my, it looks like a forceps!

And some suture material!

Oh, no!

It is suture material!

Helen has a boo-boo!

Thank goodness Pookey is safe in his stall, quietly munching that 7.6% NSC hay...

ROM?

Many years ago we had a funny friend who ran high-end horse auctions for a living. He was the pedigree man (similar to the 'color man' in broadcasting) and was all-business when he was working, but highly irreverent and funny when he wasn't.

I will never forget the time when we showed up at a sale he was working, looking for a nice Paint mare. We had been standing outside one mare's stall for quite some time when he spotted us, and came running over.

"You don't want that one," he said, shaking his head. "She's got her ROM -- in sales."

I thought about that today and silently chuckled as we watched Pookey Bear standing patiently (and a tad drugged-ly) amongst his friends at La Mesa Equine, getting ready to earn his ROM in x-rays. By my count, it was his tenth visit to the radiology room--no question about it, he now 'knows the drill' and could probably depress the plunger with his teeth!

This time, however, in addition to the usual images, he had some special pictures taken.

After a thorough clip, prep, and tourniquet application, he was injected with some contrast media, and imaged specifically to assess blood flow in his problematic right foot. This procedure, called a venogram, is a useful adjunct to laminitis treatment, as it provides information about the degree of tissue perfusion in the compromised feet that helps greatly with future decision making.

If the blood flow is decent, then subsequent treatment has a reasonable chance for success. If the blood flow is severely compromised, that usually has a negative effect on potential outcomes (click here for more info and images from The Horse: http://www.thehorse.com/ViewArticle.aspx?ID=4076 )

Fortunately, in Pookey's case, his venograms looked good. The images were crystal clear and very artistic looking--someday, when he is well, I might even ask for copies to enlarge and hang on my wall! But right now I am just thankful for evidence of decent circulation, and the generous amount of sole he is growing on his left front, and on the heel of his right.

Of course not all of Pookey's news was good.

Thanks to continuing pain in his right front, we are now debating the merits of the next logical step in his treatment plan: a tenotomy of the deep digital flexor tendon. Cutting the tendon would relieve the pressure that it exerts on the distal phalanx (P3) which, in Pookey's case, would likely relieve some of his pain. Ideally, the surgery enables the laminae to re-grow by removing some of the force that keeps tearing them apart--at least the downward/rearward force that causes continued rotation.

At least I think that's what it does. Much to my dismay, effective treatment of laminitis draws heavily on physics, a subject which I alternately slept through and sweated through, but never really understood.

Pookey Bear is just glad that Dr. Donnell, Dr. Wilcox, and Joe evidently were wide-awake during physics class, and are happy to share their expertise with him!

What's for dinner?

Back in 'the day,' I spent a lot of time at the all-you-can-eat restaurants, consuming massive quantities of carbohydrate- and sugar-laden goodies, and paying little heed to annoyances like cholesterol levels and blood glucose and insulin release.

Of course that all changed about twenty years ago when my metabolism shifted, and I started getting fat on air. Now, I read the labels on everything--even vitamins--to avoid taking in even the tiniest amount of glucose, sucrose, fructose, lactose, maltose, dextrose...you get the picture.

No sugar!

So it was a relatively simple task for me to begin micro-managing Pookey Bear's diet when we discovered that he was insulin resistant.

The first thing I did was pull him completely off pasture. This was very painful for him, as he had been our Chief Grass Inspector for quite some time, and took his job very seriously.

My second move: no alfalfa. This change, too, has proven difficult, as the alfalfa component of his diet has worked wonders with his sensitive gut (and suspected ulcers, which in many horses respond well to the buffering effects of alfalfa).

Our third change: no bagged feed. This may prove to be a temporary measure, should we check his insulin/glucose levels on one of the newer low starch feeds (such as Purina's Well Solve) and find that he tolerates it well. However the concentrate that he had been eating was very high in non-structural carbohydrates (NSCs, or the newer term, water-soluble carbohydrates) and definitely caused an insulin spike, even in small amounts.

So what's left?

Well, for starters, lots of coastal hay! For the past three months or so we have been feeding him about 18 pounds per day. The idea is to feed about 1.5 percent of his ideal body weight, which I am guestimating at about 1100 pounds. However, with an insulin resistant horse, it is critical that the hay be as low in sugars as possible. The simple way to reduce sugar is to soak the hay, for about 20 minutes in hot water or an hour or so in cold. Being summertime in Texas (still!) all of our water is hot right now, so we do about a 20-minute soak before each feeding. I then drain it, using my hay net set up as pictured above, then put the next batch in to soak in the green tub while he is eating the drained hay.

In place of concentrate, he is currently getting the following: beet pulp shreds (no molasses) as a carrier for his salt and minerals; and fresh-ground flax seed, to maintain a beneficial balance of Omega-3/Omega-6 fatty acids.

While waiting on the results of our hay analysis (Click here for testing from DairyOne/Equi-analytical Labs: http://www.equi-analytical.com/ ) we have been adding the following to his daily ration:

Table salt

Remission (contains chromium and magnesium, both beneficial for IR/foundered horses)

Vitamin E

ProBios (a probiotic)

He also is down to a single scoop of Thyro-L, which seems to be very effective at taking the weight off of fluffy horses. In just three months we have pulled close to 200 pounds off His Highness, with very little loss of muscle tone in the process.

I have been taking thyroid medication for nearly 20 years now, and have lost exactly zero pounds.

Maybe tonight, if no one is looking, I will sneak into the feed room and scarf down a horse dose of thyroid meds...

Punxsutawney Pookey

"I have a little shadow that goes in and out with me,

And what can be the use of him is more than I can see..."

-- Robert Louis Stevenson (no relation-haha)

Well, here's something we haven't seen in a long time.

Pookey's shadow.

For the past three months, while his friends have frolicked in the pasture, Pookey has been cooped up in jail, recovering slowly from his nasty founder episode. With the exception of a few short, careful walks each day, in early morning and late evening, he has been pretty much stall-bound.

And for the past three days, with all the rain and storms, he had not even ventured outside at all. Since he was tiptoeing very carefully around his stall, even with his Soft Ride boots on, I assumed that when he did get out, he would be rocked back on his haunches, barely putting any weight on those front feet.

But our Blackland soil was really soft and spongy after all the rain, and in an uncharacteristic bold move, I decided to remove his boots before his walk, to see how he would move, unimpeded.

Amazingly, he seemed to move very easily without his boots. And while he is by no means walking normally, he was swinging both front legs from the shoulder, and bearing a decent amount of weight on his right front without flinching.

It was a sight for sore eyes!

So was his cute little shadow, which he has not seen for so long.

We stood outside for a long time, listening to the mockingbirds and soaking up vitamin D.

Pressing on!

A Bad Idea...

Pookey Bear is having a good day today.

Me, not so much.

It all started with a little filing on Rita's hooves, which we had noticed were chipping badly, and which Allen thought needed a tiny touch-up before her next scheduled farrier appointment.

So we dragged out the hoof stand, rasp, nippers and gloves, and went to work. Rita stood like a champ, and Allen was able to get her ship-shape in no time.

Then he went back to his office, leaving me in the shed with the hoof stand, the rasp, and Helen.

Helen had a little chipped place on her RF too, I noticed.

Helen has been a very good girl lately.

Helen has been standing quietly every single time I have picked out her feet, for going on six weeks.

Are you seeing the seeds for the bad idea that took shape in my mind?

Surely, I thought, I can handle this one tiny little chip all by myself.

Surely, I thought, despite Helen's checkered past, she will continue to stand there, dozing quietly, while I shape this foot up a bit?

Forgetting that discretion is the better part of valor, I forged ahead, and, grasping the rusty rasp firmly in my sweaty ungloved hands, I picked up her foot and began to file.

Initially, she stood very quietly. I was quite pleased with the way the process was going. In what for me was a very uncharacteristically bold move, I decided to go ahead and slip that hoof between my knees, just like the farriers do.

A short while later, I woke up. My return to consciousness was slow, with my vision gradually clearing until, through the haze of churning dust and sand, I could just make out the shape of the rafters on the ceiling of the shed. The sight of the rafters, combined with the smell of manure in my hair and the shooting pains in my back, told me that I must be lying on the ground. My eyes traveled slowly over my torso and legs, which were splayed into an unnatural position, one foot twisted sideways. My right hand seemed fine, but my bloodied left hand was still curled around the rusty rasp, unable to let go.

As the dust continued clearing, I noticed Helen, standing a few yards away and gazing at me sweetly, looking much like she does in the photo above, only without the safety of that Priefert panel between us. It was a miracle she didn't return to finish me off.

Next time, I am going to just pick up the phone and call the farrier.

Too soon old, too late smart.

GotMeANewMuzzle!

Here's Pookey Bear, showing off his fancy new grazing muzzle.

Not that he will be needing it anytime soon. He is still pretty much on stall rest, with very brief daily walks.

But in order to keep him optimistically looking toward the future, I picked up this nifty neoprene grazing muzzle, and turned him loose for a moment to see what he would do.

Amazingly, he began walking quietly around his little pasture, far more fluidly than he has been walking on the lead rope, with me.

It was good to see him moving around a bit!

Hangin' in there!

Considerable time has passed since we last reported on Pookey Bear's progress. The primary reason for that is my concern that we have made very little progress over the past month or so.

However, a recent visit to La Mesa Equine, Pookey's home away from home, has left me hopeful that we soon we be able to see a glimmer of the light at the end of the tunnel!

Pookey's most recent set of x-rays had shown that the sinking and rotation of P3 had apparently stopped, but that he had formed a serum pocket along the front of the hoof wall that was growing in size. This type of pocket often forms when the laminae lose their attachments to each other, and the tissue begins to devitalize, both from lack of circulation and from inflammation. Yesterday, a new set of x-rays showed that the devitalized area reached almost to the sole near the toe, so the team at La Mesa opted to remove a portion of the toe to allow for drainage and relief of pressure.

Amazingly, this was not a painful procedure --other than for Allen and I, who both got a little weak-kneed at the sight of Pookey Bear's bloodied hoof! But the procedure seemed to have an immediate effect, establishing drainage of the trapped serum and providing some immediate relief of pressure in that foot. Of course Pookey has to be a little complicated, and it looks like he might have an abscess as well, possibly attempting to blow out of the interior aspect of his coronary band. So his treatment plan is as follows: keeping the toe scrupulously clean and relatively dry, while keeping the coronary band soaked (with epsom salts or povidone iodine solution) to try to draw out the possible infection there.

As an adjunct therapy, he is once again on dimethyl sulfoxide (DMSO) IV. One of those underrated drugs that has been around for ages, DMSO is often used to fight inflammation of many different kinds, and is administered either IV or topically. As a topical agent, it carries whatever substances are on the surface of the skin down into the deeper tissues, which makes it helpful in treating various forms of arthritis and arthralgia. As an IV drug, it often works wonders in reducing inflammation (possibly by scavenging free radicals) but it does have a downside: almost immediately, it causes the patient to begin smelling very, very funny. In equine patients, because of their large surface area, it is not unusual for the entire stall to start smelling bad, or even, in some cases, the entire barn.

Our barn does not smell very good right now :-(

However, it is a SMALL price to pay for a little relief for our beloved 'Mr. Nickers.'

As we were able to run the DMSO at home this time, he was able to enjoy some quality time with his good friend, Dr. Meow, while he 'chilled out' on his IV drip.

Pookey also is enjoying his fancy new shoes. His friend Joe made them for him, cutting and hammering on an aluminum sheet until he got it just right, providing Pookey a bit of frog support while relieving direct pressure on his sensitive toe, just distal to the frog's apex.

We were also very cheered to see the smallest beginnings of new hoof growing in, hoof that hopefully will be aligned with his new coffin-bone angle.

It will take the better part of a year to before his new hoof will actually touch the ground.

When it does, you can bet we will have a party!

Today, Pookey lost one of his oldest and dearest friends.

His favorite mare, Snooty Tooty, crossed the Rainbow Bridge at the age of 30 years.

Born in 1980, during the Carter presidency, she was sired by Mr Denero APHA out of Lady Debra Sue, a QH granddaughter of The Ole Man. Snooty, a ringer for her great grandsire conformation-wise, wound up with a single plate-sized spot on her right side, which--aside from a pretty blaze--was her only white.

She enjoyed a brief but glorious show career before coming to live with our small family of Paint horses in the early eighties. I remember mucking out her stall when I was pregnant with both daughters. Both of them learned to ride on her chubby little bay back (after struggling with the pony!) Years later, she took eventual horse-trainer daughter to her first show.

She was always there for all of us: always patient, kind, gentle, and dependable, the ideal babysitter for both horse and human.

Never sick or lame a day in her life, she suffered a sudden-onset neurologic problem that made it clear it was time for us to put her down. Fortunately she was able to spend much of her last morning grazing and hanging out with Bunny in her favorite pasture. She also had a bit of alfalfa, her favorite treat, and then she gobbled up her entire breakfast of Equine Senior, not dropping a single morsel of grain (thanks to excellent dentition) and licking the platter clean!

Snooty, RIP--you will be missed by all of us!

Bay is so b-o-r-i-n-g...

Bunny, the blond, here, bringing you a brief note about The Little Bay Horse...

His feet continue to improve: he goes on short walks two or three times a day, and has been turned loose briefly in his grazing muzzle, which he has enjoyed greatly.

That is the good news.

The bad news is that he colicked last night, and today he has decided to stop eating his hay and grain and drinking water. So we have spent the entire day begging, pleading, coaxing, cajoling, wheedling, needling, and even forcing him to eat and drink. On the outside chance that his ulcers are acting up again we have re-upped his Gastrogard to one tube daily, and are waiting with bated breath to see if the fix is successful.

Check back later!

Walking again!

Oh, happy day!

We are walking again!

It's not real pretty. But at least he is putting one foot in front of the other, and covering some ground!

There is no question that his spirits are better now that he is getting out a couple of times a day for short walks. However, the siren song of the ankle-deep, verdant bermuda grass is hard to resist...

One step at a time

July 8, 2010.

Pookey took a normal step today.

One normal step!

Hooray!

On his feet all day...

Yesterday, for the first time since he foundered, 'Mr Wonderful' would not lie down.

On one hand this is a good thing, as it indicates he is no longer in the acutely painful phase of his condition. Additional confirmation of this is the gradual diminishing of those bounding digital pulses, and his increasing ability to move around his stall for food, water, and companionship.

On the other hand, this is a bad thing. By lying down, a foundered horse takes the weight off of his inflamed feet, and consequently reduces the chances of further insult. That insult can result in additional rotation or sinking, should he still be in the acute phase of laminitis. In a case where one limb is more severely affected, it can result in damage to the 'good' limb. (In fact, many equine athletes who suffer a serious injury to one forelimb wind up with 'contralateral' laminitis from bearing too much weight on the healthier limb).

In Pookey's case, we believe the rotation and sinking have stopped, and are hoping to reduce pressure on the laminae so that they can begin to heal and regain their structural integrity.

Last week, at La Mesa Equine, farrier Joe Bear worked his magic on Pookey and began the process of derotation by applying a pair of rocker shoes to his front feet. He and Dr. Donnell then outfitted Pookey with a new pair of 'sneakers.' These were the Soft Rider boots he had been wearing for two weeks, but a smaller size to fit his foot after much of the flare and part of the toe had been pared down.

There is no question about it: the combination of judicious pain meds, farrier 'magic' and the boots definitely seems to be working! In an effort to encourage him to lie back down, we have been keeping the barn quieter (classical music on the radio, no rock) and have closed him back up in his 12x12 stall at night.

Oh, and scratching all of his favorite spots when he is stretched out in nap mode...

Expanded borders...

I have always envied people with those quiet little horses that stand peacefully in their 12 x 12 stalls, munching on hay, delicately sipping from their water buckets, and happily watching the world go by.

Pookey Bear has never been one of those horses.

At best, when stalled, he has sniffed, licked, gnawed, paced, banged and whinnied. At his worst, he has made it necessary for me to pound, screw and glue preventive objects around his stall and its openings, a la Wylie Coyote, futilely attempting to minimize the amount of damage his razor-sharp teeth, quick hooves and big ol' body inflicts upon his stall.

Of course his illness has changed all of that. Early in the course of his founder, he did very little but lie quietly in his stall, occasionally standing up to peek out the door at mealtime. Next, he went through a brief 'feel-good' spell, in which he began loudly protesting his confinement. Finally, for the past week or so, he has been back on his stall floor, sighing a lot and looking somewhat bored and sad.

In an effort to keep him interested in life and to eventually encourage a little movement to enhance circulation, we decided to 'super-size' his stall, removing the divider between him and his neighbor. We bedded the resulting 12 x 24 deeply, then opened up the second exterior dutch door so he could hang his head out over the chain and pine over the grass.

I had hoped that this would give him a little mental boost.

Unfortunately, it gave him a huge mental boost, so much so that he has been on his feet for much of the past 24 hours. Since one of our primary goals is to keep him off his feet as much as possible to help minimize further damage to the laminae, this worries me a bit.

On the other hand, it is great to see him up and around!

Limiting carbs

Pookey is looking longingly out the window at the green grass, which is fast drying up in the hot summer sun.

Thanks to his probable insulin resistance, grass has been strictly off-limits for the past few weeks, as have grain products, Oreos, Sonic green apple slushes, alfalfa, beet pulp, molasses, peppermints, sugar cubes, etc.

Anyone who has ever suffered through a low-carb diet can relate: he is growing increasingly bored with tasteless dry hay.

In an effort to spice up his diet, and to find something to mix his supplements in, we have turned back to an old favorite: ADM's Healthy Glo Nuggets and Healthy Glo Meal. Comprised primarily of rice bran, these products are relatively low in non-structural carbohydrates (NSC) and provide most of their energy in the form of fat. The best part is, Pookey loves his rice bran, and considers it a special treat!

Doctoring Pookey

Gee, this looks suspiciously like a photo of Tex...

Wait, it is a photo of Tex!

Tex was getting a little jealous of Pookey getting all the attention in our household, so I have started taking him with me each time I go out to the barn to doctor Pookey.

Since I am making about 20 barn trips per day, that means that Tex's short little legs are having to carry him quite some distance.

As you can see, he is very, very tired.

Pookey has certainly enjoyed the diversion. He is finally starting to feel well enough that he is resenting his captivity, and looking for things to do. That means banging on his stall walls, rattling his water bucket, chewing on his boards, and rubbing his tail--all of which are activities we frown upon.

He currently is in a holding pattern, until we repeat his x-rays a week from tomorrow. Friday's x-rays at Dr. Donnell's revealed no significant additional rotation (yeah!) but evidence of sinking of the third phalanx within the hoof capsule (boo!). Sinking complicates the treatment picture but we have not given up hope that we can get him reasonably sound again, as long as the rotation and sinking stop where they are and his condition stabilizes at this point.

Stability! That's what we're working toward!

Thank goodness Tex is on the job now, keeping Pookey entertained and distracted while he chills out in his stall.

Poster Boy

Horses don't go to school.

But if they did, and if they sat for yearbook photos, and if they kept those yearbooks on a coffee table in the barn, and IF they had opposable thumbs, I'll bet that every now and then Pookey would leaf through his yearbook, and would come across this picture of himself when he was at his absolute athletic peak, and would say to himself, 'Dang, I looked good!'

Today, of course, he is starting to look a bit moth-eaten from spending so much time lying on the shavings. I gave him a really good grooming this afternoon, currying really hard to loosed all of the dust and scurf, and going over him three times with the horsehair brush dipped in coat conditioner. I am concerned that the MVP products I love might no longer be available: tomorrow, when we haul up to Pilot Point to visit Dr. Donnell, I will stop at VetLine to check and see.

Today's x-rays looked reasonably promising, as it appears that he has not had significant rotation since last Friday. He was able to stand quite still while we shot them on the floor of the barn with the cat x-ray machine...

Tomorrow we will be rising early and shooting some video of him moving before he gets his pain meds. Then, after his Equioxx has had some time to kick in, we will attempt to load up and start our haul while it is still reasonably cool.

Wish us luck!

Yet Another Head Shot of the Little Bay Hoss

I hope I am not boring everyone to tears with head shots of the Little Bay Hoss. In this case, I couldn't resist, because his ears were UP, and his expression so happy and contented and peaceful, which all spells 'the pain reliever is working,' which makes us all very, very happy!

I woke up this morning to the sound of Pookey nickering for his breakfast, and flipping over his feed tub, which he hasn't felt well enough to do for some time. He has been on his feet for much of the morning, even during the hours when he was filling his belly with hay, then receiving his GastroGard in preparation for today's dose of Equioxx.

Either yesterday's Equioxx finally kicked in and has provided him some pain relief, or he is transitioning out of the acute phase of this founder episode and into the chronic phase.

For those who are not familiar with laminitis in horses, it is a very strange beast indeed. While those of us who have had heel spurs or plantar fasciitis can relate somewhat to foot pain, the type of pain experienced in laminitis is really much more akin to a severe toothache--it is overwhelming, and unrelenting.

Laminitis can have many root causes, or triggers. Even most city kids know that a horse can founder from breaking into the feed room, or drinking too much cold water on a hot day, or pounding too hard on the pavement for too long. But recent research points to a number of other more subtle causes as well.

No matter the cause, the process, once set in motion, is usually the same--inflammation begins to occur in the hoof capsule, and when it does, it has no place to go.

It usually strikes the front feet, causing incredible pain. Over time, as the pain builds, the horse will tend to rock back on his hind end to support his weight, and to stretch his front feet out in front of him, in the classic founder stance.

Inside the hoof, the pain is intensifying as the laminae (the interwoven structures that hold the pedal bones stationary inside the hoof) begin to separate and lose their attachments. As separation progresses, and the horse continues to bear weight, the deep digital flexor tendon pulls on the third phalanx. Freed of its laminar attachment, eventually it will rotate downward. This is the dreaded 'rotation' that horsemen speak of. It is never a good thing; hence the lay term for P3, the 'coffin bone.'

Most treatment efforts in the acute phase are designed to reduce inflammation and pain, to prevent or minimize rotation, and to prevent collateral damage to other supporting structures. Treatment in the chronic phase usually involves corrective shoeing, pain control, and addressing various contributing factors.

More about that tomorrow!

Until then, Pookey's pain is at about a 5 today, down from a 7 yesterday.

For a special treat today, I am headed to the Sonic to get him a sugar-free Green Apple Slush!

Happy Days

Thought I would post an old photo of Pookey from his 'Happy Days' scrapbook.

Here he was, sailing around the pen at his favorite showgrounds (Athens), gliding along on happy feet, carrying his lithe little body, and his lithe little rider's body, with absolutely no effort at all!

Here's hoping that he will once again be able to sail around the show pen someday. I have already promised him that if his feet get better, I will stop drinking water and swallowing air so I can shed these last sixty or so stubborn pounds I have hanging on, and maybe he can pack me around someday!

Hopefully, if he does, he will remember all those times I sat in his stall and sponged water over his brow, and massaged his legs, and rubbed his back, and scratched his withers--and maybe, just maybe, he won't dump me...

Today, a loading dose of Equioxx at 10 a.m. He is still pretty ouchy this afternoon, and his stomach seems to be bothering him a bit. I took his boots off for a bit today and hosed down his feet and legs with cold water, then towel dried everything before putting the boots back on. He seemed to really appreciate the water on his hooves, holding each one up as I sprayed them. Thank goodness a front moved through last night and dropped the temps down into the eighties--the cool breeze this morning felt great! Perhaps tonight will be cool as well...

Ears up!

Oh, my.

I do so hate to post twice in one day.

It just seems so...well, so obsessive...

But I had to report that Pookey had a very good afternoon and early evening, and has been on his feet with his ears up pretty continuously for much of the latter part of the day.

We wound up giving him Banamine in the morning and half a dose at six, with our revised plan calling for him to start the Equioxx first thing in the morning, so that we can better monitor his response (meaning while we are awake, as opposed to asleep, or half asleep).

I am convinced that the GastroGard is helping his gut. My evidence is as follows: normal manure (for the first time in a long time), a bright expression, no more nipping at his flank, and no teeth grinding or head banging.

Today, when we gave him his tiny tube of the pricey paste, he spat out just the tiniest little bit. We immediately fell to our knees in the stall, scooped it up, and stuck it right back in his mouth. The two-second rule! Especially valid when the little dollop was worth nearly ten bucks!

Did I mention that I wished I had Merial stock?

I 'heart' Merial

Yesterday we passed the one-week mark since Pookey first foundered. He seemed to pass a comfortable night, spending most of the evening hours slumbering peacefully on his side, but this morning he had a hard time getting up, and was very much in need of his pain meds.

After a morning dose of Banamine, we will be switching over this evening to firocoxib, in an effort to protect his sensitive gut and to keep the pain somewhat under control.

Pookey has tried the Equioxx once before for osteoarthritis, as he has never been able to tolerate Bute. The drug did seem to agree with him, so we are crossing our fingers and hoping that it will once again prove efficacious and free from side effects.

Of course, between the Equioxx and the GastroGard, which he has been receiving daily to try to combat the development of gastric ulcers, I am wondering why I did not have the foresight to take out a bit of Merial stock...