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!
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