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...

Setting Up the Hospital Stall

Sunday morning: Pookey was in a good bit of pain as he had spent nearly 24 hours without NSAIDs, having switched to a once-a-day dosing regimen with the Banamine. After a nice breakfast of low-carb grass hay, a few supplements, and his morning GastroGard, he was more than ready for his daily dose of Banamine, which almost immediately provided him enough pain relief to stand up and munch his hay well into the afternoon.

Configuring his stall to make it patient-friendly was relatively easy, as we were able to open both doors to allow good airflow, and to position three fans (each at a different level) to supplement the very welcome Texas breeze. To keep his body temp at a reasonable level, I bathe him with ice water four or five times a day. The moving air passing over his damp coat provides good convection cooling, and unless it gets significantly hotter, we think we will be able to keep him quite comfortable.

Regarding bedding, we are keeping 10-12 bags of shavings in his stall at all times, making him think he is one of Ted Turner's show string! We are also helping to keep pressure off his forefeet by elevating all of his feed: his hay is placed in an elevated tub, his water is at chest height, and we hand-hold his morning and evening rice-bran meals. We also are keeping him well doused with Pyranha to keep him from feeling the urge to stomp his feet. This is in direct opposition to our usual policy of letting him 'deal' with the flies, so that they do not bother him when he is showing!

Something new we tried today: placing a towel under his head when he stretches out to rest.

I am very bothered by the shavings-in-the-eye look, and don't mind hovering a bit to make sure he doesn't develop irritation in the eye, or, worse yet, ulceration from a stray pine chip.

He will thank me for it later :-)

"We interrupt this broadcast..."

With special thanks to Tex, who 'owns' this blog, and to John Garner for the use of the title...

We are pre-empting news of Tex's latest adventures to report on the current condition of Pookey Bear, aka Absolutely Impulsive, Mr Nickers, The Wonder Horse, etc. We will be using this space to post daily updates of Pookey's condition for a bit so that we do not have to 'ding' in to interrupt family and friends at work to tell them, "Pookey just took a step!" Here is a bit of background...

Nearly a week has passed since Pookey first foundered, a sad sequela to what we suspect was likely insulin resistance syndrome, or just an acquired inability to handle carbs. At any rate, it has been nearly seven days since we last saw him prancing around the pasture: today, he stands quietly in his 'hospital' stall, munching low carb hay and watching the world go by.

After spending several days with his new friends at La Mesa Equine Lameness Center, under the expert care of Dr. Alan Donnell and his kind staff, Pookey is back home in his familiar stall in our backyard, hopefully to heal quickly and thoroughly. While he has experienced some rotation in both front feet, with the right foot more affected, we are praying that his condition will stabilize and that corrective shoeing will make him almost as good as new.

This morning he was lying down when we went out to feed, but was able to stand with little effort and immediately began to nicker for his breakfast. Upon initial assessment his pain rated about a 6 on a 1-10 scale, definitely better than yesterday morning, when he was at about a 7. He was able to move carefully around his stall to drink, eat his hay, and hang his head out the front door, which we have placed a stall guard across (okay, it's a lead rope).

Dr. Donnell had immediately placed Pookey in a pair of Soft Ride boots, which seem to greatly ease his pain and help him stand quite normally. Here is a photo of one of his trendy black 'tennis shoes':

I am a real believer in these boots! They feature a tough-gripping urethane sole, a comfortable nylon upper, sturdy velcro fasteners, and a soft but durable gel insert that supports the sole and helps relieve strain on the deep flexor tendon. For Pookey, they have been a real God-send: he could barely take a step on concrete without them, but with them, he is able to motor around relatively normally when needed.

Of course the only place he is going right now is from water bucket to feeder to window. I do worry about his circulation being impeded with so little movement, but right now it is important to keep concussion and strain to a minimum, so he is staying in a deeply bedded stall at least until Monday.

Tomorrow, more pictures, and some particulars about his care.

Until then, thanks for caring about Pookey Bear!