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!