Sunday, June 12, 2011
And Then There Was Sophie . . .
If you remember, when Dudely returned to THE FARM he brought with him his pasture mate, Sophie. This Clyde mare had been rescued by Refuge Farms from the eastern side of Wisconsin along with The Buckskin and The Morgan. ClydeMare, as I had called her, had thrived with Dudely and in Wanda's cares. She had been delivered to Wanda very, very thin and her coat was filthy. She was difficult to handle and bossy. Everything you would expect from a big mare that had been starved and not cared for.
Upon returning to THE FARM, Dudely made it clear that the Old Barn he would not share. Nor would he share the round bale in the old barn. So ClydeMare was stuck out in the elements and if you recall, this spring was laden with cold rains, snow, and wind. It wasn't long before we moved her into the corral with a shelter and a round bale of hay of her own.
Sophie, as Wanda had called her, did not thrive here. Too many people. All alone in the corral. Too many horses around her. She dropped weight and became agitated. Her best home was a two horse setting in a quiet neighborhood. And so, I began the search for such a home for Sophie.
And then along came Deb. A gentle woman. Intelligent. Very intuitive. And extremely sensitive to the needs of her horses. Deb was looking for a pasture mate for her elderly gelding, Scout. His pasture mate had crossed a bit ago and Deb felt Scout needed a horse to accompany him. Deb visited us here one weekend and met Sophie for the first time.
Deb and I have communicated via emails and I, for some reason, have saved those emails. Now I know why. I'm going to let Deb's emails tell you the story from here. Read on if you want to read a love story. A story of devotion. A story of the perfect placement. A story of recovery. Sophie landed beautifully with Deb! You'll see! Read on and you'll see how it is supposed to be when a horse needing love and care meets her destined caretaker.
We begin on the day after Deb first visited Sophie here at THE FARM:
Sun 4/03/11 2:44 PM: I slept on it, got out some books, talked to a few people, including my husband, and decided a “gentle giant” would be a wonderful addition to our little hobby farm. So, if you still want me to foster ClydeMare, I would love to. The nesting instinct is setting in! Hope to hear from you soon. deb
Wed 5/04/11 8:57 PM: . . . the road is very straight & after almost a mile, you will go down a steep, winding hill. We are the first house on the right at the bottom. . . red outbuildings, big beige house. Excited lady in the driveway.
Sat 5/07/11 3:52 PM: Thank you so much again for everything! It has been a blast observing the horse behavior between these two! Sophie finally did go out in the pasture and Scout paced when she got too far away. She is staying very close to him, eating hay, chowing grass, drinking water and checking up on Scout as much as he is on her. I'm lovin' it Sandy! And they seem happy too! Thank you! Deb
Sun 5/08/11 9:44 AM: Isn't she beautiful? Does she wear eye make-up?
Sun 5/08/11 6:05 PM: Sophie and Scout are acting lovey again over the gate.
Mon 5/09/11 5:43 PM: I will be glad to take Scout's halter off, but with this next step thought it safe just in case. Uneventful. Sophie is very mellow! Ahhhhhhh :-)
Mon 5/09/11 8:44 PM: Scout is being really nice, no “hoof business,” even nickering to Sophie tonight over the fence while I was with her and giving her some great ear scratches and neck rubs. Scout came over to visit Sophie and me! Good night, backatcha tomorrow!
Tue 5/10/11 9:01 PM: I really will get over this, I promise. They are both in the “pen” for the night, without halters. I threw some sweet feed on her SC and she ate it. They are in love. He lets her do anything—she has mellowed him! It was 100% uneventful when we put them together later today, but beautiful to watch. I took about 75 pictures. I won’t send them all! :-0
Fri 5/13/11 7:10 PM: All is well--we're getting it! Scout did run thru a gate today though, as he was fired up w/the cool, breezy morning. Sophie just trotted behind him,totally mellow. She is so sweet Sandy! I brushed both of them early--can't wait to work on Sophie's legs! This picture is first day on roadside pasture, so halters on...just makes me feel better when they're so close to the road. Good luck with your weekend event! I'll check in next week.
Fri 5/13/11 10:30 PM: Thanks Sandy. We just love Sophie--she is so laid back… and just has to tame her new man! :-0
Mon 5/16/11 1:08 PM: Sophie and Scout are doing really well together—funny, at first he was in love, then he got bossy, and now he’s mellowed again. And what I really love is Sophie NEVER lets Scout get her riled. She’s like an older, wiser woman w/a little boy who never grew up; but at other times, they both look very much like two seniors just enjoying their old age. Scout has lots of calmness too!
Mon 5/16/11 7:51 PM: (Our adopted 2002 stray, "Boxster," who is a sweetheart, and rules.) A quick note to say what a wonderful day/evening I've had with Sophie and Scout. She got her meds and I think Scout has figured out I have enough love for both of them! (If only the hair we brush off our equines was worth money!!!)
Tue 5/17/11 7:52 PM: New POA: Giving Sophie her Pergolide in the early evening, with a syringe, and then all of her SafeChoice right after in a hanging bucket I bought at Fleet Farm today. Went well--I just mixed the Perg w/a little water. Maybe tomorrow night she'll spit it all out in my face :-o Don't have to tie them for feed as Scout gets the same thing, he's content and they both eat very very slowly...Just an old couple happy to be together. Sophie's halter is one I bought 5 years ago for Scout and it was WAY too big, so never used it, until now...:-) When I'm home all day, I don't halter them, but when we both are gone for awhile, I'm still keeping a halter on. They are both still learning their gates to the four pastures (Sophie teaching Scout) but they are doing beautifully!
Tue 5/17/11 10:11 PM: That little/big mare is medicine for me too…and John gets along with her just fine. I’m looking forward to he and I “ridin’ around the pastures!” Sophie has become one of my best friends. And Scout is OK with that! I’m going to keep brushing until the gleam is glamorous!!!
Wed 5/18/11 9:30 PM: Sophie was ready for me tonight, when I came with her meds. What an intelligent and sweet girl!! However, all went well, with some sweet talkin' from me. We all love her.
Thu 5/19/11 9:43 PM: I wonder when I will get over these daily updates… Scout was hilarious tonight—I was in a grooming mood and he was SO competitive and jealous of my attention to Sophie. But I have to brag that I had awesome communication with both of them, and everything went fine. It was adorable how Scout was attached at my hip, following me around to make sure I didn’t go near Sophie…but that changed after I reassured him. He really does love Sophie, and me too! This is FUN Sandy. Sophie is such a sweetie!! She does NOT like her medicine, but is letting me squirt it into her mouth, and then she gets her feed. Then they both spend at least a half-hour slowly eating their feed. So cute. Thanks……deb
Sat 5/21/11 8:01 PM: Today Sophie was laying down relaxing, then started getting up, lost her balance and plopped/fell back down. The photo I sent was right after that. She continued to lay awhile but was up grazing within 10 minutes and just fine. (she’s so much like an elderly person—who I care for in my job.) Scout IS happier w/Sophie, yet he’s changed some—quieter and more affectionate toward me. (Thanks Sophie!!!) They’ve gotten into a routine and seem very content. I wish I could see how they interact in the dark overnight hours. Sophie did a big “teethy-smile-face” yesterday when I squirted in her meds. Today she just quietly accepted. She knows the routine. Thanks Sandy and glad the sale is going well!
Sun 5/22/11 9:42 PM: Wild weekend weather for your sale—hope it still went well!!! Scout has always been riled up by storms but today he and Sophie stood calmly in the pasture with their behinds to the winds and heavy rain, just grazing. She, a wise woman, has tamed him. We just love her.
Wed 5/25/11 8:25 PM: Tomorrow is set aside for grooming! I'm looking forward to it and hope the weather cooperates and I can be outside! She is a nice horse, so easy going!
Fri 5/27/11 6:26 PM: This morning when I went out Sophie was laying down and Scout standing right next to her. Nice to see she can rest on the ground, peacefully, with her guy keeping watch ;-) They’ve hardly taken a break today from the pasture, enjoying the cool, rainy weather.
Tue 6/07/11 11:05 PM: Meanwhile…I’m just so thrilled to have Sophie here and I love doting on her. Next 4 days totally free—I’m so lucky—so I’ll be brushing. Her coat is sleek and lovely, but with the heat/sweating, needs some attention. My biggest victory is that Scout accepts and welcomes Sophie. He does have to be boss, but he’s very easy going with Sophie, which he wasn’t with his former companion, Magic, my other gelding…. (He likes his Girl!)
P.S. John and I went to check on S&S right at dark and we could NOT find Sophie. Scout was in the “pen/corral.” Then I spotted Sophie all the way at the end of the pasture and John said, “That’s where the eating is the best!” Then I asked Scout, “WHERE is Sophie?” and w/in a minute Scout trotted out of the corral and loped out to the end of the pasture and joined Sophie. It was TOO cute. We are truly enjoying Sophie!
What did I tell you? Love, pure love. Devotion and gentle caring. As it should be.
Thanks, Deb! From all of us at Refuge Farms and especially from Sophie! She looks remarkable, her butt is round, and her coat just gleams! As I've told you, when I come back I want to come back as a horse in your barn.
Enjoy the journey of each and every day,
Sandy and The Herd and a very happy Sophie!
Upon returning to THE FARM, Dudely made it clear that the Old Barn he would not share. Nor would he share the round bale in the old barn. So ClydeMare was stuck out in the elements and if you recall, this spring was laden with cold rains, snow, and wind. It wasn't long before we moved her into the corral with a shelter and a round bale of hay of her own.
Sophie, as Wanda had called her, did not thrive here. Too many people. All alone in the corral. Too many horses around her. She dropped weight and became agitated. Her best home was a two horse setting in a quiet neighborhood. And so, I began the search for such a home for Sophie.
And then along came Deb. A gentle woman. Intelligent. Very intuitive. And extremely sensitive to the needs of her horses. Deb was looking for a pasture mate for her elderly gelding, Scout. His pasture mate had crossed a bit ago and Deb felt Scout needed a horse to accompany him. Deb visited us here one weekend and met Sophie for the first time.
Deb and I have communicated via emails and I, for some reason, have saved those emails. Now I know why. I'm going to let Deb's emails tell you the story from here. Read on if you want to read a love story. A story of devotion. A story of the perfect placement. A story of recovery. Sophie landed beautifully with Deb! You'll see! Read on and you'll see how it is supposed to be when a horse needing love and care meets her destined caretaker.
We begin on the day after Deb first visited Sophie here at THE FARM:
Sun 4/03/11 2:44 PM: I slept on it, got out some books, talked to a few people, including my husband, and decided a “gentle giant” would be a wonderful addition to our little hobby farm. So, if you still want me to foster ClydeMare, I would love to. The nesting instinct is setting in! Hope to hear from you soon. deb
Wed 5/04/11 8:57 PM: . . . the road is very straight & after almost a mile, you will go down a steep, winding hill. We are the first house on the right at the bottom. . . red outbuildings, big beige house. Excited lady in the driveway.
Sat 5/07/11 3:52 PM: Thank you so much again for everything! It has been a blast observing the horse behavior between these two! Sophie finally did go out in the pasture and Scout paced when she got too far away. She is staying very close to him, eating hay, chowing grass, drinking water and checking up on Scout as much as he is on her. I'm lovin' it Sandy! And they seem happy too! Thank you! Deb
Sun 5/08/11 9:44 AM: Isn't she beautiful? Does she wear eye make-up?
Sun 5/08/11 6:05 PM: Sophie and Scout are acting lovey again over the gate.
Mon 5/09/11 5:43 PM: I will be glad to take Scout's halter off, but with this next step thought it safe just in case. Uneventful. Sophie is very mellow! Ahhhhhhh :-)
Mon 5/09/11 8:44 PM: Scout is being really nice, no “hoof business,” even nickering to Sophie tonight over the fence while I was with her and giving her some great ear scratches and neck rubs. Scout came over to visit Sophie and me! Good night, backatcha tomorrow!
Tue 5/10/11 9:01 PM: I really will get over this, I promise. They are both in the “pen” for the night, without halters. I threw some sweet feed on her SC and she ate it. They are in love. He lets her do anything—she has mellowed him! It was 100% uneventful when we put them together later today, but beautiful to watch. I took about 75 pictures. I won’t send them all! :-0
Fri 5/13/11 7:10 PM: All is well--we're getting it! Scout did run thru a gate today though, as he was fired up w/the cool, breezy morning. Sophie just trotted behind him,totally mellow. She is so sweet Sandy! I brushed both of them early--can't wait to work on Sophie's legs! This picture is first day on roadside pasture, so halters on...just makes me feel better when they're so close to the road. Good luck with your weekend event! I'll check in next week.
Fri 5/13/11 10:30 PM: Thanks Sandy. We just love Sophie--she is so laid back… and just has to tame her new man! :-0
Mon 5/16/11 1:08 PM: Sophie and Scout are doing really well together—funny, at first he was in love, then he got bossy, and now he’s mellowed again. And what I really love is Sophie NEVER lets Scout get her riled. She’s like an older, wiser woman w/a little boy who never grew up; but at other times, they both look very much like two seniors just enjoying their old age. Scout has lots of calmness too!
Mon 5/16/11 7:51 PM: (Our adopted 2002 stray, "Boxster," who is a sweetheart, and rules.) A quick note to say what a wonderful day/evening I've had with Sophie and Scout. She got her meds and I think Scout has figured out I have enough love for both of them! (If only the hair we brush off our equines was worth money!!!)
Tue 5/17/11 7:52 PM: New POA: Giving Sophie her Pergolide in the early evening, with a syringe, and then all of her SafeChoice right after in a hanging bucket I bought at Fleet Farm today. Went well--I just mixed the Perg w/a little water. Maybe tomorrow night she'll spit it all out in my face :-o Don't have to tie them for feed as Scout gets the same thing, he's content and they both eat very very slowly...Just an old couple happy to be together. Sophie's halter is one I bought 5 years ago for Scout and it was WAY too big, so never used it, until now...:-) When I'm home all day, I don't halter them, but when we both are gone for awhile, I'm still keeping a halter on. They are both still learning their gates to the four pastures (Sophie teaching Scout) but they are doing beautifully!
Tue 5/17/11 10:11 PM: That little/big mare is medicine for me too…and John gets along with her just fine. I’m looking forward to he and I “ridin’ around the pastures!” Sophie has become one of my best friends. And Scout is OK with that! I’m going to keep brushing until the gleam is glamorous!!!
Wed 5/18/11 9:30 PM: Sophie was ready for me tonight, when I came with her meds. What an intelligent and sweet girl!! However, all went well, with some sweet talkin' from me. We all love her.
Thu 5/19/11 9:43 PM: I wonder when I will get over these daily updates… Scout was hilarious tonight—I was in a grooming mood and he was SO competitive and jealous of my attention to Sophie. But I have to brag that I had awesome communication with both of them, and everything went fine. It was adorable how Scout was attached at my hip, following me around to make sure I didn’t go near Sophie…but that changed after I reassured him. He really does love Sophie, and me too! This is FUN Sandy. Sophie is such a sweetie!! She does NOT like her medicine, but is letting me squirt it into her mouth, and then she gets her feed. Then they both spend at least a half-hour slowly eating their feed. So cute. Thanks……deb
Sat 5/21/11 8:01 PM: Today Sophie was laying down relaxing, then started getting up, lost her balance and plopped/fell back down. The photo I sent was right after that. She continued to lay awhile but was up grazing within 10 minutes and just fine. (she’s so much like an elderly person—who I care for in my job.) Scout IS happier w/Sophie, yet he’s changed some—quieter and more affectionate toward me. (Thanks Sophie!!!) They’ve gotten into a routine and seem very content. I wish I could see how they interact in the dark overnight hours. Sophie did a big “teethy-smile-face” yesterday when I squirted in her meds. Today she just quietly accepted. She knows the routine. Thanks Sandy and glad the sale is going well!
Sun 5/22/11 9:42 PM: Wild weekend weather for your sale—hope it still went well!!! Scout has always been riled up by storms but today he and Sophie stood calmly in the pasture with their behinds to the winds and heavy rain, just grazing. She, a wise woman, has tamed him. We just love her.
Wed 5/25/11 8:25 PM: Tomorrow is set aside for grooming! I'm looking forward to it and hope the weather cooperates and I can be outside! She is a nice horse, so easy going!
Fri 5/27/11 6:26 PM: This morning when I went out Sophie was laying down and Scout standing right next to her. Nice to see she can rest on the ground, peacefully, with her guy keeping watch ;-) They’ve hardly taken a break today from the pasture, enjoying the cool, rainy weather.
Tue 6/07/11 11:05 PM: Meanwhile…I’m just so thrilled to have Sophie here and I love doting on her. Next 4 days totally free—I’m so lucky—so I’ll be brushing. Her coat is sleek and lovely, but with the heat/sweating, needs some attention. My biggest victory is that Scout accepts and welcomes Sophie. He does have to be boss, but he’s very easy going with Sophie, which he wasn’t with his former companion, Magic, my other gelding…. (He likes his Girl!)
P.S. John and I went to check on S&S right at dark and we could NOT find Sophie. Scout was in the “pen/corral.” Then I spotted Sophie all the way at the end of the pasture and John said, “That’s where the eating is the best!” Then I asked Scout, “WHERE is Sophie?” and w/in a minute Scout trotted out of the corral and loped out to the end of the pasture and joined Sophie. It was TOO cute. We are truly enjoying Sophie!
What did I tell you? Love, pure love. Devotion and gentle caring. As it should be.
Thanks, Deb! From all of us at Refuge Farms and especially from Sophie! She looks remarkable, her butt is round, and her coat just gleams! As I've told you, when I come back I want to come back as a horse in your barn.
Enjoy the journey of each and every day,
Sandy and The Herd and a very happy Sophie!
Sunday, June 05, 2011
" . . . remains undetermined."
Last evening, at the end of the day, I stood in the driveway to the barn and just looked. I looked out at the pasture and saw them. And yes, I cried. I looked at them. And then I carefully looked. Not just glanced. I soaked in each and every one of them as deeply as I could. The mental pictures are burned in my mind. It is good sometimes to take the time to make those pictures. To take the time to soak them in. To look at them. Not just glance, but really look.
One week ago today, our lives were shaken to their cores as Jeri-Ann became ill. With no warning and purely as a hunch, she was taken to the University of Minnesota Equine Center. During her time there, I was faced with the ungodly decision: Do we treat her? Or do we euthanize her?
What was the decision? Why, even, the question? What on earth was wrong with her? And what was the outcome?
Below are the discharge orders for our baby, Jeri-Ann. I'll let those words from her attending veterinarians tell you how dangerously close we came to not having "The Baby" in our barns .
And then the next time you are here, you, too, will look. You will pause. Take the time. And look. Really look. You will soak them in, too. And you will create your own mental pictures. And yes, maybe you will cry a bit, too.
Client: Refuge Farms (Rescue)
Patient: Jeri-Ann, Equine, Belgian, Female Intact, 2550 lb, DOB 05/01/2005
Admit Date: 05/29/11
Discharge Date: 06/03/11
History: Jeri-Ann, a 6-year-old Belgian mare, presented to the University of Minnesota Equine Center on May 29, 2011 for evaluation of lethargy and changes in behavior. She had been observed lying down more often than normal during the day. no changes in food consumption were apparent. On April 15th, Jeri-Ann was vaccinated with a a 4-way, rabies, West Nile Virus, and tetanus and dewormed with ivermectin. She has direct contact with six other horses. The latest new horses on THE FARM were between February and April of 2011, but she had no contact with the temporary horses. Her manure production during the trailer ride to the hospital was decreased.
Physical Examination: On physical exam, Jeri-Ann was quiet and dull compared to her normal personality. She weighed 2,550 lbs. She had an increased heart rate of 96bpm and an increased respiratory rate at 36 breaths per minute. Her temperature was high normal at 101.3F. Her mucous membranes were pink and moist, with a normal capillary refill time of less than 2 seconds. Her gut sounds were normal in all four quadrants. intermittent muscle fasciculation (muscle quivering ) was observed, primarily over her neck.
Diagnostic Testing:
Neurologic Examination: Jeri-Ann exhibited mild hind limb ataxia at the walk. In addition, she was observed to pivot on her inside right hind leg when turning in tight circles and demonstrated bilateral weakness while performing a tail-pull at the walk. No other abnormalities were identified.
Rectal Palpation: This was performed on the nigh of admission and daily for the next two days. Due to the mare's large size, only a limited portion of the eposterior abdomen could be palpated. Within this area, no abnormalities were noted.
Manure Sediment: No sand was present in the feces, although a small rock was found.
Urine Specific Gravity & Dipstick: The results were within normal limits, consistent with normal kidney function.
Complete Blood Count: This test is sued to identify inflammation or infection, anemia, and possible visualization of Anaplasma within the blood. Anaplasma was not identified and all values for ed blood cells, white blood cells, and platelets were withing normal limits.
Serum Chemistry Panel: Jeri-Ann had a mild increase in liver enzymes, including SDH, GGT, and AST. She had an elevated CK at 880u/l, indicating mild muscle damage, consistent with her history of spending more time than usual down. Jeri=Ann had a slight decrease in potassium, attributable to her decreased feed intake.
Abdominal Ultrasound: No dilated loops of small intestines were noted in the ventral abdomen; however, intestinal thickness, motility, and abdominal free fluid were difficult to assess due to her large size.
EHV-1/EHV-4 Test: A nasal swab was submitted for virus isolation of Equine herpes Virus-1, a viral disease that can cause neurologic symptoms including ataxia. This test was negative, indicating that her clinical signs are unlikely to be caused by Equine Herpes Virus.
PSSM Test: A blood sample was submitted for genetic testing for Equine Polysaccharide Storage Myopathy, a genetic mutation causing an inability to properly store and utilize glucose. This disorder can cause weakness, trembling muscles, and increased amounts of time lying down and is common in draft horses such as Belgians. We will contact you when the test is complete.
Cardiology Consult: An ECG was performed the day following Jeri-Ann's admission; no abnormalities were noted aside from an increased heart rate. Although her heart rate declined somewhat over the course of the following week, it remained above 60 beats per minute throughout her stay. Dr. Tobais' examination on 06-03-11 revealed no murmurs or other abnormal heart sounds; aside from the elevation in heart rate no specific evidence of cardiac insufficiency or failure was noted. Peripheral pulse quality was normal. Dr. Tobias attempted to perform an echocardiographic examination, but due to Jeri-Ann's size it was not possible to obtain a satisfactory image of the heart. Dr. Tobias reviewed the mare's ECG strips, and concurred without assessment that the trace was consistent with sinus tachycardia, with no evidence of a pathological rhythm disturbance.
In-Hospital Therapy:
Fluid Therapy: An over-the-wire catheter was placed in Jeri-Ann's right jugular vein and she received intravenous fluids to maintain hydration and provide additional fluids in case her symptoms at admission were due to a colonic impaction. Her packed cell volume and total protein were monitored throughout her stay to asses her hydration status and remained normal for the entirety of her time in the hospital.
DMSO: In view of Jeri-Ann's neurological deficits at presentation, she received three doses of DMSO through a naso-gastric tube. This is an anti-inflammatory and antioxidant agent.
Electrolytes and Mineral Oil: 8L of electrolyte water was administered by nasogastric tube twice to help with hydration as well as maintain electrolyte balance. Jeri-Ann also received one dose of mineral oil to assist with gastronintestinal motility and act as a marker for GI transit.
Flunixin (Banamine): Jeri-Ann was given Banamine the night of presentation to help reduce pain and provide anti-inflammatory support.
Phenylbutazone (Bute): Jeri-Ann received two doses of phenylbutazone to address the possibility that her elevated heart rate was due to pain. When little effect on her heart rate was noted, this medication was discontinued.
Oxytetracycline: This is a broad-spectrum antibiotic, used to address the possibility of Anaplasmosis. Jeri-Ann received two doses daily by intravenous injection for a total of five days.
Vitamin E: As vitamin E deficiency can play a role in muscular weakness, Jeri-Ann received treatment with this vitamin during her period of hospitalization.
Assessment: At the time of discharge, Jeri-Ann was bright and alert; her attitude has improved dramatically since the time of her admission. Her appetite has improved and she has been eating hay and Nutrena Senior feed in small rations throughout the day and night. In addition, her hind lib weakness and ataxia has resolved. The precise cause of her illness remains undetermined. It is possible that she had a mild colic episode (e.g. colon impaction) that resolve with oral in intravenous fluids. Her heart rate remained elevated during her stay but gradually came dot to 60-66 bpm by Friday. There was no change in her heart rate while she received treatment with anti-inflammatories such as bute or Banamine, and her heart rate did not increase after stopping these medications. We have not identified any evidence of musculoskeletal pain. It is possible that she has a higher than normal resting heart rate, or that she has some abnormality in her heart itself that causes her increased rate. However, she is not showing any other signs of cardiac dysfunction at this time.
Recommendations: As the precise cause of Jeri-Ann's illness remains uncertain, please watch her closely over the next 2 weeks. We recommend that you monitor her heart rate daily for the next week, followed by once a week to every other week. Please give us or Dr. Kersten a call if you notice any recurrence of symptoms following her discharge.
Please monitor her water intake. She should be drinking approximately 2.5 five-gallon buckets of water per day, and even more under hot conditions.
Signs of heart failure to watch for include lethargy, coughing, difficulty breathing, development of fluid (edema) along her belly, and stocking up. Please give us a call immediately if Jeri-Ann develops any of these problems.
Thank you for bringing Jeri-Ann to the University of Minnesota Large Animal Hospital. She is a lovely mare and was a pleasure to work with. Please do not hesitate to contact us if you have any additional questions regarding her care.
Sincerely,
What a grand gift we have been given! Our baby, Jeri-Ann, has returned to us - elevated heart rate and all. We are watching her very, very closely and will not hestiate to re-admit her should the symptoms reappear. But today, whenever the thought crosses my mind, I look up. And I look. Not just a glance, but a look. And I treasure all of them. Every last body of them. And I rejoice for the gift of more time with them all.
Enjoy the journey of each and every day,
Sandy and The Herd - especially Jeri-Ann
One week ago today, our lives were shaken to their cores as Jeri-Ann became ill. With no warning and purely as a hunch, she was taken to the University of Minnesota Equine Center. During her time there, I was faced with the ungodly decision: Do we treat her? Or do we euthanize her?
What was the decision? Why, even, the question? What on earth was wrong with her? And what was the outcome?
Below are the discharge orders for our baby, Jeri-Ann. I'll let those words from her attending veterinarians tell you how dangerously close we came to not having "The Baby" in our barns .
And then the next time you are here, you, too, will look. You will pause. Take the time. And look. Really look. You will soak them in, too. And you will create your own mental pictures. And yes, maybe you will cry a bit, too.
Client: Refuge Farms (Rescue)
Patient: Jeri-Ann, Equine, Belgian, Female Intact, 2550 lb, DOB 05/01/2005
Admit Date: 05/29/11
Discharge Date: 06/03/11
History: Jeri-Ann, a 6-year-old Belgian mare, presented to the University of Minnesota Equine Center on May 29, 2011 for evaluation of lethargy and changes in behavior. She had been observed lying down more often than normal during the day. no changes in food consumption were apparent. On April 15th, Jeri-Ann was vaccinated with a a 4-way, rabies, West Nile Virus, and tetanus and dewormed with ivermectin. She has direct contact with six other horses. The latest new horses on THE FARM were between February and April of 2011, but she had no contact with the temporary horses. Her manure production during the trailer ride to the hospital was decreased.
Physical Examination: On physical exam, Jeri-Ann was quiet and dull compared to her normal personality. She weighed 2,550 lbs. She had an increased heart rate of 96bpm and an increased respiratory rate at 36 breaths per minute. Her temperature was high normal at 101.3F. Her mucous membranes were pink and moist, with a normal capillary refill time of less than 2 seconds. Her gut sounds were normal in all four quadrants. intermittent muscle fasciculation (muscle quivering ) was observed, primarily over her neck.
Diagnostic Testing:
Neurologic Examination: Jeri-Ann exhibited mild hind limb ataxia at the walk. In addition, she was observed to pivot on her inside right hind leg when turning in tight circles and demonstrated bilateral weakness while performing a tail-pull at the walk. No other abnormalities were identified.
Rectal Palpation: This was performed on the nigh of admission and daily for the next two days. Due to the mare's large size, only a limited portion of the eposterior abdomen could be palpated. Within this area, no abnormalities were noted.
Manure Sediment: No sand was present in the feces, although a small rock was found.
Urine Specific Gravity & Dipstick: The results were within normal limits, consistent with normal kidney function.
Complete Blood Count: This test is sued to identify inflammation or infection, anemia, and possible visualization of Anaplasma within the blood. Anaplasma was not identified and all values for ed blood cells, white blood cells, and platelets were withing normal limits.
Serum Chemistry Panel: Jeri-Ann had a mild increase in liver enzymes, including SDH, GGT, and AST. She had an elevated CK at 880u/l, indicating mild muscle damage, consistent with her history of spending more time than usual down. Jeri=Ann had a slight decrease in potassium, attributable to her decreased feed intake.
Abdominal Ultrasound: No dilated loops of small intestines were noted in the ventral abdomen; however, intestinal thickness, motility, and abdominal free fluid were difficult to assess due to her large size.
EHV-1/EHV-4 Test: A nasal swab was submitted for virus isolation of Equine herpes Virus-1, a viral disease that can cause neurologic symptoms including ataxia. This test was negative, indicating that her clinical signs are unlikely to be caused by Equine Herpes Virus.
PSSM Test: A blood sample was submitted for genetic testing for Equine Polysaccharide Storage Myopathy, a genetic mutation causing an inability to properly store and utilize glucose. This disorder can cause weakness, trembling muscles, and increased amounts of time lying down and is common in draft horses such as Belgians. We will contact you when the test is complete.
Cardiology Consult: An ECG was performed the day following Jeri-Ann's admission; no abnormalities were noted aside from an increased heart rate. Although her heart rate declined somewhat over the course of the following week, it remained above 60 beats per minute throughout her stay. Dr. Tobais' examination on 06-03-11 revealed no murmurs or other abnormal heart sounds; aside from the elevation in heart rate no specific evidence of cardiac insufficiency or failure was noted. Peripheral pulse quality was normal. Dr. Tobias attempted to perform an echocardiographic examination, but due to Jeri-Ann's size it was not possible to obtain a satisfactory image of the heart. Dr. Tobias reviewed the mare's ECG strips, and concurred without assessment that the trace was consistent with sinus tachycardia, with no evidence of a pathological rhythm disturbance.
In-Hospital Therapy:
Fluid Therapy: An over-the-wire catheter was placed in Jeri-Ann's right jugular vein and she received intravenous fluids to maintain hydration and provide additional fluids in case her symptoms at admission were due to a colonic impaction. Her packed cell volume and total protein were monitored throughout her stay to asses her hydration status and remained normal for the entirety of her time in the hospital.
DMSO: In view of Jeri-Ann's neurological deficits at presentation, she received three doses of DMSO through a naso-gastric tube. This is an anti-inflammatory and antioxidant agent.
Electrolytes and Mineral Oil: 8L of electrolyte water was administered by nasogastric tube twice to help with hydration as well as maintain electrolyte balance. Jeri-Ann also received one dose of mineral oil to assist with gastronintestinal motility and act as a marker for GI transit.
Flunixin (Banamine): Jeri-Ann was given Banamine the night of presentation to help reduce pain and provide anti-inflammatory support.
Phenylbutazone (Bute): Jeri-Ann received two doses of phenylbutazone to address the possibility that her elevated heart rate was due to pain. When little effect on her heart rate was noted, this medication was discontinued.
Oxytetracycline: This is a broad-spectrum antibiotic, used to address the possibility of Anaplasmosis. Jeri-Ann received two doses daily by intravenous injection for a total of five days.
Vitamin E: As vitamin E deficiency can play a role in muscular weakness, Jeri-Ann received treatment with this vitamin during her period of hospitalization.
Assessment: At the time of discharge, Jeri-Ann was bright and alert; her attitude has improved dramatically since the time of her admission. Her appetite has improved and she has been eating hay and Nutrena Senior feed in small rations throughout the day and night. In addition, her hind lib weakness and ataxia has resolved. The precise cause of her illness remains undetermined. It is possible that she had a mild colic episode (e.g. colon impaction) that resolve with oral in intravenous fluids. Her heart rate remained elevated during her stay but gradually came dot to 60-66 bpm by Friday. There was no change in her heart rate while she received treatment with anti-inflammatories such as bute or Banamine, and her heart rate did not increase after stopping these medications. We have not identified any evidence of musculoskeletal pain. It is possible that she has a higher than normal resting heart rate, or that she has some abnormality in her heart itself that causes her increased rate. However, she is not showing any other signs of cardiac dysfunction at this time.
Recommendations: As the precise cause of Jeri-Ann's illness remains uncertain, please watch her closely over the next 2 weeks. We recommend that you monitor her heart rate daily for the next week, followed by once a week to every other week. Please give us or Dr. Kersten a call if you notice any recurrence of symptoms following her discharge.
Please monitor her water intake. She should be drinking approximately 2.5 five-gallon buckets of water per day, and even more under hot conditions.
Signs of heart failure to watch for include lethargy, coughing, difficulty breathing, development of fluid (edema) along her belly, and stocking up. Please give us a call immediately if Jeri-Ann develops any of these problems.
Thank you for bringing Jeri-Ann to the University of Minnesota Large Animal Hospital. She is a lovely mare and was a pleasure to work with. Please do not hesitate to contact us if you have any additional questions regarding her care.
Sincerely,
What a grand gift we have been given! Our baby, Jeri-Ann, has returned to us - elevated heart rate and all. We are watching her very, very closely and will not hestiate to re-admit her should the symptoms reappear. But today, whenever the thought crosses my mind, I look up. And I look. Not just a glance, but a look. And I treasure all of them. Every last body of them. And I rejoice for the gift of more time with them all.
Enjoy the journey of each and every day,
Sandy and The Herd - especially Jeri-Ann