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  1. #1
    Join Date
    Sep. 11, 2003
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    Nuevo Mexico
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    Default Mystery illness - stroke? Please help

    I don't even know where to start...

    Horse is a 31-yo paint gelding, has been retired about 5 years. When the weather started getting cold, he seemed to be having a hard time - moving stiffly, a few mild colics. Vet said joint issues/age, and we started him on Adequan and occasional banamine when he seemed especially stiff, as he is sensitive to bute.

    About 2 months ago, found him down in the snow and it took 2 of us to get him up. He was fine once he was back in his stall, and vet suggested keeping him inside in cold weather. He'd occasionally go off his feed a little, but basically normal. But lethargic.

    About 6 weeks ago, he looked like he was laminitic - stretching both fronts out, off his feed. Vet agreed with founder dignosis - we pulled blood for CBC and Cushings test, and treated with banamine and pads on feet. However, despite the founder stance, he was negative to hoof testers, no heat in feet, and vet said maybe it was just joint pain. X-rays showed one degree of rotation in LF, but that had been there for years. Took him off the Banamine and started him on Tramadol. Also Ranitidine. Cushings test showed highly elevated ACTH so we started him on Pergolide. CBC was normal.

    He has gotten progressively more lethargic and moves VERY slowly. He also seems to be, for lack of a better word, slow in the mental sense. He takes a while to realize his feed is in his tub, and moves very slowly toward it. He has taken a couple of steps that look like he is possibly neurologic, but this is not consistent. Aloof, when he'd previously been a total love-bug. (Which may, of course, be due to all the needles and oral syringes and examinations he's dealt with lately.)

    The strangest thing? His whinny has changed. Which for some reason made me think of when my grandfather had a stroke and had trouble speaking. I immediately contacted my vet when this occurred to me and he agreed that a stroke was totally possible. I am guessing that may have been when he was down in the snow.

    In typing this, I am thinking, good lord, put the old guy down. Anyone reading this will probably think the same. But every time I think about this, he greets me with bright eyes and a nicker...a different nicker, but a nicker. To complicate matters, this horse had a mystery illness about 5 years ago, where he had multiple colic episodes, lost about 200 lbs, and turned gray overnight. Vets were stumped, he made a full recovery with tons of diagnostics that showed nothing, but no real treatment. I keep thinking he'll turn around again? And he doesn't seem to be in pain, just lethargic and dull and slow. I know it takes a while for the Pergolide to start working, and I hate to give up before seeing if that makes a difference.

    And then tonight, I noticed that his sheath was extremely swollen and hard, not sensitive though - will call vet in the morning...but I am thinking maybe his system is just shutting down? Bloodwork says no, but just I don't know any more...

    Thoughts? Advice? Awards for reading this novel?

    ETA: Yes, I have heard of the pergolide veil. The lethargy began before we started him on pergolide.
    Last edited by Vandy; Mar. 10, 2010 at 12:45 AM.



  2. #2
    Join Date
    Mar. 8, 2004
    Location
    Baltimore, MD
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    Default

    I can't help you with the medical part of your question but wanted to tell you that you will know when the time to put him down has come. Its obvious you are in tune with the horse so all you have to do is listen and be ready to act upon what you hear. Jingles for both of you.



  3. #3
    Join Date
    Oct. 26, 2005
    Location
    Deep South
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    4,598

    Default

    Oh, Vandy, this is so heartbreaking. I know you must not know which way to turn... but you WILL know when it's time. We who love our horses/dogs have that inner voice. I'll say a prayer for you and your boy.
    SPAY/NEUTER/RESCUE/ADOPT!
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  4. #4
    Join Date
    Nov. 13, 2002
    Location
    PA, where the State motto is: "If it makes sense, we don't do it!".
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    Default

    Some of his behavior may be from a stroke but I would suggest you have his thyroid level checked.

    It's my personal opinion that when you have edema in places it doesn't belong and lethary, among other things, that it can be tied into the thyroid.

    He may need to have medication for the thyroid as well....

    I have gathered, from a previous thread on COTH several years ago, that Cushingoid horses/ponies can have neurological issues. I had an old pony diagnosed with Cushing's who would have trembling at one point but the vet wasn't concerned about it because it was only once or twice, and never lasted more than a few minutes....
    "Good gardening is very simple, really. You just have to learn to think like a plant." ~Barbara Damrosch~



  5. #5
    Join Date
    Sep. 11, 2003
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    Nuevo Mexico
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    Default

    Great news this morning...Scout seems perkier than he has in weeks! Sheath is still extremely swollen, but he was more enthusiastic about his breakfast than he's been in over a month. Low grade fever from last night is gone. Best of all, while he was waiting for his food, he whinnied normally for the first time in 2 months!

    Did call the vet first thing - he thinks the sheath is a side effect of the Pergolide and will resolve within a few days. He recommended continuing with the same dosage, but splitting it am/pm vs one daily dose. I am having him come out to check it anyway and pull blood again just in case, and will ask about thyroid testing.

    But for the moment, I am very optimistic! I saw glimpses of my old horse this morning that I haven't seen in a long time. He took some normal steps and was watching my every move, whereas recently he had been just standing in the back of his stall most of the time, looking depressed.

    I am reluctant to admit this, but...for the first time ever, I had an animal communicator visit Scout exactly a month ago. I know but I was desperate. She gave me a lot of info, but what really stuck in my mind was that she said Scout kept saying "a month". She didn't know whether he meant that he was going to die in a month or get better in a month or what...just "a month". I took it to mean he wanted me to give this a month to resolve, though you can bet I was worried I'd find him dead in his stall this morning...I'm not sure if I believe in this stuff, but strange that exactly a month to the day after her visit, he suddenly seems like a different horse!



  6. #6
    Join Date
    Oct. 4, 2003
    Location
    Clinton, BC
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    Your love for this old horse comes through in your posts. I'm going to rain on your parade. He's 31, and basically "failing". He's had a mild rally. He will not get "better", he will only get older. Throwing money at it won't change this reality. If you let this go on indefinately, it will end up ugly for him, uglier than it is now, and uglier than it has been so far. If you pick a day and end it for him before this happens to him, he won't have to suffer at the end. If you love him, don't wait until he is dying anyway to make your decision. Worst case scenario, your vet is away or unavailable on the day that you make the emergency call. It doesn't matter to him if he lives 31 years, 3 months and 15 days, or 31 years, 4 months and 2 days, or 31 years, 4 months and 20 days. All that matters to him is whether he suffers at the end. You are keeping him going because you don't want to lose him. You are going to lose him, and soon. Make it as easy for him as possible, not you. You will suffer either way. But you will suffer more if you have to watch him suffer. Sorry. Bite the bullet and set a date.



  7. #7
    Join Date
    Sep. 11, 2003
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    Nuevo Mexico
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    NancyM, I hear you, although with all due respect, I feel that I am making the right choices for him. I have another pony who is 41 who had an major impaction colic at 35...and returned to work afterwards - now retired, happy and sound. I feel like I have a pretty good grasp on when to let go, although like all responsible owners, I do second guess myself sometimes. The last 2 older horses I have euthanized have not been emergency situation, but rather planned events when I didn't foresee their quality of life improving and they were still fairly comfortable.

    What I would really like is for Scout to enjoy this spring/summer, so he can be turned out and take nice naps in the sun, and schedule euthanasia before the weather gets cold again. I really respect my vet, and when we have discussed euthanasia for Scout, he's encouraged me to wait to see how he does on the pergolide first. Of course, if he takes a turn for the worse, I will not wait.



  8. #8
    Join Date
    Mar. 10, 2006
    Location
    Albany NY
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    My personal response would be to put the old guy down. Yes, he rallied, but it won't be for long, and he will continue to escalate odd episodes. To me, it wouldn't matter what it was that happened. I would guess a stroke.

    I think it is extremely important to evaluate a horse's time not by emotional feelings for him, bright eyes, or nickers, but by the quality of his life. If he is experiencing episodes which compromise his ability to function, in otherwords, get up from lying postition, stand without pain, eat and digest well, my personal response would be to end his life kindly, quietly, on a warm spring day like the ones we have been having, when he feels bright and chipper and can be surrounded by friends and even fun.

    There is nothing more selfish than prolonging a horse or other animal's life because of the owner's emotional needs, or because the owner used an emotional criteria to assess putting him down.

    If you are waiting for him to tell you he is failing, he's told you. Allowing him to get sicker until his eyes beg you is selfish and inhumane.

    In my opinion.
    Airborne? Oh. Yes, he can take a joke. Once. After that, the joke's on you.



  9. #9
    Join Date
    Feb. 9, 2000
    Location
    Iowa
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    1,031

    Default

    AR, I hope you posted while Vandy was because if you bothered to read her post yours was unnecessary. You and I might take the easy way out but Vandy is putting the horse first, at the vet's recommendation, and pergoglide cost be darned. From the sound of it I'd rather be Vandy's retired horse than yours.

    Vandy, I'm glad Scout is feeling better and I hope he has those happy days in the sun this summer. If it was a temporary rally and you have to face the inevitable sooner then I hope it is a peaceful passing for both of you.



  10. #10
    Join Date
    Jul. 4, 2004
    Location
    E. Washington
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    693

    Default

    If he is having neurological issues from Cushings, it can be very painful.

    I had to put my 25 yr old arab gelding down in Sept because he went neurological. He was stable in his Cushings symptoms, but in a lot of pain. After 4 grams of bute I realized how much he had been hurting.

    I made the appt, it was brutal, but necessary. He also went blind in just a day or two.

    Even though he was still perky, he had a lot of pain off the bute, and he was starting to fall from the ataxia.

    My heart goes out to you.



  11. #11
    Join Date
    Sep. 28, 2001
    Location
    Kentucky
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    Default

    It's clear that you love him very much and that your vet is very involved in his care as well. The two of you working as a team know the horse much better than all of us posting here do. Trust you instinct and your vet's advice; when Scout is having more bad days than good, it will be time to let go. I don't see why you should have to put him down prematurely just because that unfortunate day is coming.

    Good luck; I hope you have a wonderful summer with him!



  12. #12
    Join Date
    Apr. 1, 2003
    Location
    Cocoa, Fla
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    Default

    My pony is on Pergolide for Cushings. Originally vet was ordering a powder every month - but at $100 a month that was getting expensive. Found a place where Vet calls in script and they deliver a capsule of Pergolide for $15/mon (extra for shipping).

    Point is not the money but despite vet warnings that Pergolide may not be a good - my pony is actually doing BETTER on this stuff. I've heard they do a LOT of business and thus it's "fresh" (my vets concern it may not be). Pony has perked up and gotten rid of Cushing fat pads.

    Vet puts script in at vetpetsolutions.com and owner put in "oder" for Pergolide at thrivingpets.com - so a bit confusing but well worth the extrat bit of work st the beginning.

    Not sure of where you get your pergolide but the Pergolide Compound Capsule, Apple Flavor, 1.00mg is what I order.
    Sandy in Fla.



  13. #13
    Join Date
    Sep. 11, 2003
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    Nuevo Mexico
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    Just wanted to give a happy update. I was concerned about Scout's sheath today, as it was very swollen and fever was back. My regular vet was unavailable and I thought a fresh set of eyes would be good anyway...Vet said sheath is infected and put him on SMZs. He did a full battery of Neuro testing which was NORMAL. He thought the weakness I'd seen in the hind end was discomfort from his sheath, and said Scout was nowhere near ready to be put down... After vet was done with the sheath cleaning and disinfeting in the wash stall, Scout was so ready to go back to his stall that he trotted down the aisle, looking quite sound He is NOT ready to leave us.

    I understand that from my initial description, many would put this horse down. I have seen horses and questioned why their owners have not euthanized them, and insisted at one point that a boarder put a horse down that was in my care that I felt was suffering. I understand that everyone who suggested I let him go is speaking out of concern for the horse and I have no hard feelings toward you - but I am here with him, have the advice of my regular vet as well as the excellent vet who gave me a second opinion today...And I am at peace with my decision to treat his symptoms rather than euthanize. Thanks again for all the well-wishes.



  14. #14
    Join Date
    Jul. 19, 2007
    Location
    Michigan
    Posts
    10,440

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    Just...don't get your hopes up. That sounds awfully like what happened with my horse (in his case, complications from EPM.) He would get better, then not, get better again, seem happy, then the off-ness and 'slow' thing would be back or he'd be standing like he was foundering but wasn't, the vet couldn't figure out what it was (this was before EPM was the diagnosis du jour) and we ended up not having a chance to put him down. He went from being off then not to having a massive stroke and went down in the field, and died before the vet could get there from the internal hemorrhaging. I'm sure, though, you'll know if things change and it looks like they're going bad.

    41 on the other pony? Wow. The oldest horse I ever knew was 42 when he died. Worked up until a year before. I really think it was the 'retiring' that sped up the end--he was a schoolie and one of the best. If you've got oldsters I'm sure you know what you're doing, it's just, the symptoms sound so much like my boy's I can't help worrying for you.



  15. #15
    Join Date
    Jan. 12, 2010
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    379

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    Have you got him on a day in day out anti-inflammatory? You mentioned occasional banamine, etc. I've had excellent luck with my own horse (young, but bad joint) and some other "oldies" with B&L Pellets (also available as liquid), or SmartPak's Smart TLC, now available in pellets as well as powder. It doesn't cause the bloodwork changes, and it is less likely to cause ulcer issues than daily bute, but seems nearly as effective. Sure you know of some of these, but wanted to mention in case you hadn't, or wanted some anecdotal approval!
    I'm not really at the top of my game today. I'm not even exactly sure what game I'm supposed to be playing, in fact... or where it's being held...

    My horse's antics iamboyfriend.com



  16. #16
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    Sep. 11, 2003
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    Nuevo Mexico
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    Bif, he has been on Tramadol for the last few weeks for pain management, but not an NSAID. Vet today also confirmed my concern that the Tramadol was causing depression/lethargia - I have taken Tramadol myself and it certainly does that to me! So thinking about discontinuing that, and trying something different. Vet wants him on banamine for the next 3 or 4 days for sheath, but after that I'm still undecided, though I do feel he needs something. I had another sensitive-to-bute horse a few years ago who did great on the BL liquid - maybe that would be good for Scout. Thanks for reminding me about it.



  17. #17
    Join Date
    Sep. 11, 2003
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    Nuevo Mexico
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    Quote Originally Posted by danceronice View Post
    41 on the other pony? Wow. The oldest horse I ever knew was 42 when he died. Worked up until a year before. I really think it was the 'retiring' that sped up the end--he was a schoolie and one of the best.
    Molly was a schoolie too, and I was really worried about that happening with her...but to my surprise, she is thriving in retirement. She plays a lot with her neighbors and is very active, which I think helps a lot. She still loves to run, buck and rear in her paddock on a windy day



  18. #18
    Join Date
    Jan. 12, 2010
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    Yes, Tramadol is good stuff!! So's you knows, it is a morphine derivative of sorts, but not controlled (not considered a narcotic)... still is fun stuff

    So, yeah, that could kind of slow him down a smidge

    I'm in pharmacy, and like many, I think drugs often cause more issues than they solve.

    In a similar vein, with your vet's blessing, I wouldn't vaccinate this guy this spring. He probably would titre fine on everything, and his immune system doesn't need the assault of more "invaders", when he's been having off and on temperatures anyway.

    I wish Scout the best of luck! I've known quite a few upper 30s mid 40s horses, God bless all you owners of the "oldies"!
    I'm not really at the top of my game today. I'm not even exactly sure what game I'm supposed to be playing, in fact... or where it's being held...

    My horse's antics iamboyfriend.com



  19. #19
    Join Date
    Mar. 10, 2006
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    Albany NY
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    Quote Originally Posted by Vandy View Post
    Just wanted to give a happy update. I was concerned about Scout's sheath today, as it was very swollen and fever was back. My regular vet was unavailable and I thought a fresh set of eyes would be good anyway...Vet said sheath is infected and put him on SMZs. He did a full battery of Neuro testing which was NORMAL. He thought the weakness I'd seen in the hind end was discomfort from his sheath, and said Scout was nowhere near ready to be put down... After vet was done with the sheath cleaning and disinfeting in the wash stall, Scout was so ready to go back to his stall that he trotted down the aisle, looking quite sound He is NOT ready to leave us.

    I understand that from my initial description, many would put this horse down. I have seen horses and questioned why their owners have not euthanized them, and insisted at one point that a boarder put a horse down that was in my care that I felt was suffering. I understand that everyone who suggested I let him go is speaking out of concern for the horse and I have no hard feelings toward you - but I am here with him, have the advice of my regular vet as well as the excellent vet who gave me a second opinion today...And I am at peace with my decision to treat his symptoms rather than euthanize. Thanks again for all the well-wishes.
    Well, despite the passive agressive suggestion, not all are well wishes. Some of the thoughts are ciritical. If you think the horse is so healthy as to warrant another 10 years of treatment, what did you post for.

    A horse in the condition you described in your OP deserves serious consideration for euthenasia. You, pointedldy, said you "saw the look in his eye" and decided to continue going back and forth with his infirmities with him.

    Don't marginalize or shame us who disagree. I think you're doing your horse a disservice, Just announce your intent, and be done with it. What is your interest in having a discussion? Just looking to collect those who have "jingles" and rainbows to throw your way?

    That's not what you said in your OP.

    And Vandy, I too was writing from what the interest of the horse is. You're making decisions based on your emotionas and hopes. You do your horse a disservice.
    Airborne? Oh. Yes, he can take a joke. Once. After that, the joke's on you.



  20. #20
    Join Date
    Jan. 12, 2010
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    If the horse has to live inside 23.5 hours a day, can't enjoy eating or can't enjoy interactions, 100% euth. If his personality change is from a medicine, and he turns around to going outside, being/interacting with others, and is still leading a fairly good quality life, then the euth wasn't needed. Acceptable, understandable, yes; Vandy seemed to be hoping in her OP that others had similar incidents of stroke/symptoms, and have advice or stories, positive or negative.

    I've seen horses with strokes that recovered fairly well by three or four weeks. However, I know one who is 37 or 38 and can only go out to hand graze for the hour or less his owner can take him out in evenings. He staggers a lot when walking. It bothers me no end that horse hasn't been euthed. So we all know there are lines, we all want our guys with as long as possible, and we all have an easier time deciding what others should do. Vandy has multiple vets saying it isn't time to euth. But neither would anyone think her out of place if she euthed.

    And anyone who says, "Well, he's still eating"- you can see a starving horse or a horse with a broken leg laying on the grass and they will eat! I think the animal's ability to derive a sense of "fulfillment" in herd life and interaction is more important than "is he still eating"? I also agree it is better to euth a month too soon than a month too late.
    I'm not really at the top of my game today. I'm not even exactly sure what game I'm supposed to be playing, in fact... or where it's being held...

    My horse's antics iamboyfriend.com



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