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Has anyone successfully re-habbed a femur fracture? UPDATE 1st Page

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  • Has anyone successfully re-habbed a femur fracture? UPDATE 1st Page

    The title pretty much says it all. I'm weighing the options and awaiting a 2nd vet opinion. Just wanted to hear from anyone else who has been there in the meantime.

    Thanks

    UPDATE - Unbelievable?

    After dinner I went out to fill water and pick the stalls and found him resting on the WRONG leg. I did a double take and had to think about it for a good 30 seconds to convince myself I wasn't confused. Closer inspection revealed the tiniest beginnings of an abscess about to pop out the top center of the coronary band. I spent the last 10 minutes soaking and am headed out for another round. My head is positively swimming now.

    The farrier was actually out the same day he went lame and of course we checked for signs of an abscess first. No heat, no sensitivity to the hoof testers, nothing. But so lame she couldn't trim because he just couldn't stand. How could I have missed this?

    I'm trying not to leap to any conclusions here or get my hopes up prematurely--I mean there is the X-ray taken by vet#1 that shows a fracture. Could she be wrong? Could it have been some artifact on the film? Is it possible to misread an x-ray like that? Does my poor horse have an abscess and a fractured femur? I can't even think straight at this point. I'm trying to just be calm and take this one step at a time. 2nd opinion vet will be here tomorrow and I trust him to get this all sorted out. I can't take this emotional rollercoaster another minute.

    He is not eating or drinking. I didn't catch the vet's overdosage of previcoxx until after he had already gotten 2 full pills (each one over 4x the correct dose) and of course merial's website indicates a high incidence of ulcers with overdose. So maybe he's developing some gastric ulcers to go along with everything else.

    The kids are in bed and I'd like to put myself to bed too, but I've got to go pick up my yard since a strong storm blew through and knocked over my trash cans and the neighbors and now there's stuff all over my yard and pastures. Then I want to soak his hoof some more, and see if I can't get him to eat and drink a little. At least the storm did drop the temperature significantly.

    What's the fastest way to get this abscess to pop? I've only dealt with the kind that come out the bottom.
    Last edited by meaty ogre; Jul. 25, 2010, 08:41 PM.
  • Original Poster

    #2
    I guess the proper terminology would be a femoral fracture. it's the femur. Off to research again...wasn't coming up with much searching for stifle but that would be the joint, not the bone.

    Comment


    • #3
      Not a femur but a humerous. My horse got kicked in the front leg, just above the knee on the outside and fractured it. We locked him up for 3 months, rode for exercise for a month and then turned him out. He got hurt in Nov and now we are jumping and showing and there is no sign of the fracture at all.

      I would think that it would be a similar situation for you. The good thing about bone fractures is when they heal they are healed totally. Unlike tendon and soft tissue injuries that can be problems for a while.

      Comment


      • #4
        I know this might be a tough time for questions but can you give us more details? Is it displaced?
        "Kindness is free" ~ Eurofoal
        ---
        The CoTH CYA - please consult w/your veterinarian under any and all circumstances.

        Comment

        • Original Poster

          #5
          It's not displaced, but a major concern is if it splits, then of course it's over. The fracture is directly above the point of the tibia. On film, the fracture goes from the joint, directly over the point of the tibia to the top of the film. Not sure how long it extends because the vet took films as high as possible. The fracture goes to the top of the film. If any of that makes sense. Vet did say surgical plates to brace it are not an option, not that I would probably go that route anyway on this horse.

          This is an aged TB who does not do well on stall rest. He's my first horse so there is definitely sentimentality there. When the vet said not to euthanize I was immediately relieved as I had been bracing for the worst, but as the vet pulled away it was nagging at me. Then of course I went online to research and the outlook seems downright dismal. The only successes I found were in foals who had surgical repairs.

          The vet left me with the dog version of equioxx (1 pill a day? Doesn't sound right for a horse and a dog to have the same dose but I wrote it down precisely) and instructions to stall rest 30 days. I'm worried to death that he's going to injure it further in the stall (stall and "rest" don't go together for him). Worried he may injure it further if I take my chances and let him out. He's completely non-weight bearing on it. My head is spinning. Thanks for listening.

          Comment


          • #6
            I am so sorry.

            I'd get a second opinion immediately. Tough on a weekend I know.

            I've never had a fracture like what you describe in any of mine but I'd be worried too. Can you sedate him until you get a second opinion? The drug dose is probably correct, it's a different type of anti-inflammatory. Is he in a lot of pain? If so that particular drug isn't going to cut it. You'll need to line up better pain control as soon as possible to hopefully avoid further complications such as laminitis and colic.

            Sorry for all the questions, I know you must feel overwhelmed. Hang in there!
            "Kindness is free" ~ Eurofoal
            ---
            The CoTH CYA - please consult w/your veterinarian under any and all circumstances.

            Comment

            • Original Poster

              #7
              I'm e-mailing the films to another vet whose opinion I trust. It is very difficult...in my area there are not many vets who do emergency farm calls, and he's definitely not in any position to trailer anywhere. It's very frustrating. And of course this always happens on a weekend. I'm just glad it's not a holiday weekend. When I called the 2nd vet to see if he'd look at the x-rays he immediately said euthanasia was the most likely recourse (referring to femur fractures in general). That's pretty much what the nagging feeling in my gut is saying.

              I specifically asked about sedation, and the vet said it was a bad idea (from what I recall it was because if he's too sedated he could stumble and inadvertently put too much weight on it and exacerbate the whole thing). I also specifically asked about pain management knowing bute wouldn't cut it and the equioxx is what the vet said was needed. I don't know what other options there even are. I was trying to ask as many questions as possible but I admit I was all over the place mentally. I asked about the long-term prognosis and the vet said she had seen several recover to the point of being rideable. I just haven't come across the same on the internet, but of course the internet is a whole 'nother planet.

              He is still drinking and interested in food, but definitely not himself. I'm sure he's in a lot of pain, but not showing any other signs of distress aside from not putting that leg down. I just can't help but think that a femur fracture in a 180lb human is probably 6months to a year long rehab, most likely involving surgery, but somehow 30 days in a stall is going to make this OK for my horse. But what do I know. I didn't go to vet school.

              Comment


              • #8
                I am so sorry to hear this. Three legged lame has to mean pain. Listen to your gut and share your fears with the consulting vet. Lots of jingles your way...

                Comment


                • #9
                  Well, holding your cyber hand until you hear back from the second vet.

                  IME with most vets you have to push for better pain relief. I would think you'd at least need to start with something like tramadol and see where that got you. Non-weight bearing on one leg for any extended period of time usually leads to other issues, as I know you know. Horses in general don't handle pain well although they appear to be stoic.

                  Sedation... Well if he's going to be a monkey what to do? I'd do what I had to do to keep him quiet until the second opinion comes back.

                  Something that helps me during times like this is to go one step at a time. Sounds like right now the step you are in is waiting for the second opinion, so all you have to do right now is keep him quiet and as pain free as possible.

                  Did he say anything about not letting him lay down?
                  "Kindness is free" ~ Eurofoal
                  ---
                  The CoTH CYA - please consult w/your veterinarian under any and all circumstances.

                  Comment


                  • #10
                    A friend of mine had a horse fracture the femur. It took over two years for it to be healed enough for him to be a driving horse. She no longer rides him. I'm not sure what the protocol was.

                    IMHO, equiox is not as strong of a painkiller/anti inflammatory as bute. Bute is much more effective. I'm surprised that's the medication the vet left with you (plus, vets are under fire right now for prescribing it).

                    I would definitely get a second opinion, see if it's something that will heal with time or is a game ender, and see if there are better meds for him. I'd also consider a mild sedative, just something to take the edge off, not make him sleepy and clumsy, but keep him calmer.

                    I hope everything works out well for you. Sending jingles for your guy.

                    Comment


                    • #11
                      Good luck, I hope this can all work out for you and your boy.

                      From the stall rest angle though, I have a Quarab who doesn't do 'stall' and 'rest'...but being in a stall that has an open front (not just a window/front he can see out of or hang is head out of - opening the door completely and using stall chains) made the world of a difference for him, even when the rest of the stall was board ceiling to floor. He completely relaxed and wasn't trying to jump over 4' doors (successfully, I might add, haha) or pawing his weight and feet off. Another option - maybe a stall buddy like a goat or such?? Not sure if it will help or make any difference at all, but I thought I would suggest it since it made all the difference for my boy (the stall chains, that is)!! Previously he had been injured and I couldn't put him on stall rest either though it ended up working out, but I had always been worried about future injuries where I might have to stall him...with the stall chains though we are fine!
                      ....horses should be trained in such a way that they not only love their riders, but look forward to the time they are with them.
                      ~ Xenophon, 350 B.C.

                      Comment


                      • #12
                        Originally posted by EqTrainer View Post
                        IME with most vets you have to push for better pain relief. I would think you'd at least need to start with something like tramadol and see where that got you. Non-weight bearing on one leg for any extended period of time usually leads to other issues, as I know you know. Horses in general don't handle pain well although they appear to be stoic.
                        Actually, the studies that have been done on the efficacy of tramadol in horses show that it's not very effective in providing analgesia (they're not sure why yet), which is unfortunate since we could use more options for pain management in horses. Equioxx or Previcox probably isn't a bad place to start, although if the horse still looks like he's in significant pain it's certainly a good idea to discuss other potential options with the vet and see if there's any more that could be done for him.

                        OP, I'm so sorry that you're having to deal with this. I hope that the second opinion is something encouraging when you hear back.

                        Comment

                        • Original Poster

                          #13
                          I found some ace and a syringe in my trailer. I think it's expired but I hit him with a few cc's anyway. I went through stall rest with this same horse after a surgery a few years back, and I exhausted every idea back then and never did find one he was happy with. I just went ahead and put everybody up...figured misery loves company so they can all commiserate tonight.

                          I tucked him in with his favorite mash--alfalfa cubes and beer. Gave him every beer I had except the one I saved for myself. I'm gonna finish that off now and put myself to bed, and wait for vet #2 tomorrow. I think that's about all I can do for now.

                          EqT, the vet asked about tying him in the stall to keep him from laying down, but that will make him insane. He's pretty smart as far as horses go so I'm just trusting that he knows laying down isn't an option.

                          Thanks for the cyber support. I'll check in tomorrow with any news.

                          Comment


                          • #14
                            Originally posted by lizajane09 View Post
                            Actually, the studies that have been done on the efficacy of tramadol in horses show that it's not very effective in providing analgesia (they're not sure why yet), which is unfortunate since we could use more options for pain management in horses. Equioxx or Previcox probably isn't a bad place to start, although if the horse still looks like he's in significant pain it's certainly a good idea to discuss other potential options with the vet and see if there's any more that could be done for him.

                            OP, I'm so sorry that you're having to deal with this. I hope that the second opinion is something encouraging when you hear back.
                            Bummer..what other options are there? Trying to think of things that are not controlled substances like torbugesic. IME Equioxx is about the same as bute, I would think that's a drop in the bucket, but surely each horse will respond differently to it. Always hard to deal with acute pain in horses.

                            OP, the beer sounds good. Hope the other vet gets back to you soon. Wishing you as peaceful a night as is possible.
                            "Kindness is free" ~ Eurofoal
                            ---
                            The CoTH CYA - please consult w/your veterinarian under any and all circumstances.

                            Comment


                            • #15
                              Jingles for you MeatyOgre.

                              I've typed and erased things for the better part of 20 mintues now because I want to have something useful to say, but I don't.

                              Just know that we are jingling for you and your boy.
                              If i'm posting on Coth, it's either raining so I can't ride or it's night time and I can't sleep.

                              Comment


                              • #16
                                Not a femur fracture, but a success story anyway... My trainer's horse was kicked by his turnout buddy years ago and had a fractured radius. Somehow they got him into the barn, but like your horse he was in no shape for a trailer ride and he was not a surgical candidate.

                                He was kept on crossties in his stall for quite a long time, but was thankfully very sensible about it and made a full recovery. He was already semi-retired at the time so was only doing flatwork for fitness prior to his injury, but after his leg healed he was able to go back to that level of work without difficulty.

                                Hugs to you and to your horse at this difficult time. I hope Vet #2 has some answers for you.
                                **********
                                We move pretty fast for some rabid garden snails.
                                -PaulaEdwina

                                Comment


                                • #17
                                  Been thinking of you and your horse since I first read this post. What a rough situation to go through. My heart goes out to you both. I have nothing to offer in the way of suggestions - sounds like you are doing everything possible to make the best decision for your boy.

                                  Comment


                                  • #18
                                    Oh no! I am so sorry to hear about this meaty ogre.

                                    Glad you are getting a 2nd opinion. I would imagine the 30 days of stall rest was so that a new x-ray could be done to see how much/if any healing had taken place, then determine the next step.

                                    It's so hard to do stall rest on a small farm. Are there any lay-up facilities close to you? I think some of the standardbred training farms offer that. The extra activity could serve as the mental stimulus he needs during the convalesence.

                                    Keep us posted! And, take care of yourself.

                                    Comment


                                    • #19
                                      Hugs to you. I'm so sorry.
                                      Full-time bargain hunter.

                                      Comment


                                      • #20
                                        oh jeez. I would ask for fentanyl patches. I've read on one of my equine DVM lists about several DVMs using them for fracture pain relief.
                                        Michael: Seems the people who burned me want me for a job.
                                        Sam: A job? Does it pay?
                                        Michael: Nah, it's more of a "we'll kill you if you don't do it" type of thing.
                                        Sam: Oh. I've never liked those.

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