Coronet prolapse perioplic ring dead?

[Forgewizard]

Ideas? Thoughts? Prayers? :confused:
arab mare 27 yrs slightly anemic, aith melanoma cancers, foundered both fore hooves. This is her off Fore.

Already tried: Glue on Ibex with myron McLane frog support pad, easy boot plain and with frog support, lilly pads ( which seemed to work best- but horse seems to be allergic to rubber), currently wrapped in diapers and hoof slippers.

Horse has never been shod, has had excellent hooves(until now).

Reason for founder? Unknown, I suspect EMS, cushings/cancer systemic issues, vet thought weight trouble- but horse was not obese.
http://pic17.picturetrail.com/VOL855/2893929/8203912/109395674.jpg
http://pic17.picturetrail.com/VOL855/2893929/8203912/109395662.jpg

[Rick Burten]

Kim

how long has she been this way? What was in the area you resected? Has any attempt been made to identify the trigger(s)? How far has the cancer spread? What is her body condition score? how much , if at all, has it changed in the last six months?

Regardless, at twenty seven, the question seems to me to be one of quality of life. If this mare is in a lot of pain, then the euthanasia option becomes more attractive(at least to me). While you may be able to keep her going, for what purpose? to what end? Please understand that this is not said accusatorily, merely philosophically.

I once read somewhere that the one thing we can do for our animals that we cannot legally do for our species is to give them the "dignity of death". This may well be one of those times.

[Forgewizard]

Rick,
I am in complete accordance- my gut feeling is that the melanomas are at the root of her systemic insult. She presented with what the owner thought was a beginning abscess in early July. Soaking and icthammol applications did not raise any drainage, a call to her vet only said keep soaking. The vet finally came out 11 days after the mare first came up lame. They called me on day 14. HOrse still had heat in all four, bounding digital pulses and definite sinking valleys at the coronary band. I pushed for xrays and they revealed the bones already dropping.

I had noticed for several months prior to this that the mare's neck was becoming quite rigid. I relayed this info to the owner, but she chalked it up to physical condition, I suspect an EMS or cushings problem.

The vet told them she felt the horse was overweight- but the mare was certainly not obese!

The area I dremmelled out was to hopefully establish a drainage site, instead of the rupture that happened anyway. Nothing whatsoever has drained out from the resected area!

Researching my "Color atlas of the Horse's Foot by Chris Pollitt, shows a horse with a similarly prolapsed coronet band, their prognosis for that horse was not encouraging either.

I can see definite new hoof growth regenerated in her other three hooves (since it has been a total of close to 10 weeks since original onset), but this off fore is not showing any at all.

I've been tending the horse every second day for the past few weeks just to change bandages and monitor the hooves. Have her on the roster for mu first stop tomorrow morning, am afraid I will see that the near fore has finally come through the sole.

Her soles are quite thick and dense and are probably one reason this has taken so long. Ireally wish she would have started lying down as soon as her feet were sore! She's just too tough for her own good!

as far as body score she was probably originally a 6.5 to 7 but now is definitely a 5.

[Phil Armitage]

I totaly agree with Rick. Personaly I think it is inhumane to allow any animal to suffer and there is no question this horse is suffering and old. I would flat out refuse to work on the horse and tell the owner point blank the horse needs to be put down. Sorry if it comes across as blunt and/or harsh I do not mean to be, but this is what I have always believed and believe is the right thing to do. I know this is a very personal choice, however It is a very difficult decision to make especially when you have bonded with your horse. Sometimes it helps if another person recommends it and I think it is more appropriate if it is the Vet., but if the Vet won't for what ever reason (I can't imagine why the Vet won't) Then I quess another professional, horsemen or a friend should speak up.

Now I think it would be appropriate to say.......... "Now go out there and do the right thing"

[Jaye Perry]

Ideas? Thoughts? Prayers? :confused:
arab mare 27 yrs slightly anemic, aith melanoma cancers, foundered both fore hooves. This is her off Fore.

Already tried: Glue on Ibex with myron McLane frog support pad, easy boot plain and with frog support, lilly pads ( which seemed to work best- but horse seems to be allergic to rubber), currently wrapped in diapers and hoof slippers.

Horse has never been shod, has had excellent hooves(until now).

Reason for founder? Unknown, I suspect EMS, cushings/cancer systemic issues, vet thought weight trouble- but horse was not obese.
http://pic17.picturetrail.com/VOL855/2893929/8203912/109395674.jpg
http://pic17.picturetrail.com/VOL855/2893929/8203912/109395662.jpg

if one has $100k to spend, do it. Save the mare.
If one doesn't have the money, time , stomach and sterile place to keep the mare; put her down.
We have discussed this before, emotional value vs. monetary value.

[calshoer]

Even though some horses have regenerated new hooves when they looked like that on presentation, they had the underlying prioboems completely under control ,and were younger and hardier to begin with. In the best of cir***stances, if she could regenerate the hoofwall, at her age is it not likey she has the time or overall fortitude left anyway to do that. It would take a year or so ,IF everything went perfectly. So given her age iand probable metabolic isues, and the cancer that could be anywhere inside by now , it is probably time to give the owners a gentle ,caring nudge in the right direction to end her suffering.
Patty

[balazsborbely]

Hi Kim
Completely hopeless indeed because of her age and the cancer. If they insist on doing something, walk away, you wiil get into trouble and not even get paid in the end.
Keep the good spirit.
BB.

[Forgewizard]

Well,
I can appreciate your views, and have the same thoughts about salvageability of this horse; but I cannot just walk away and leave them in the lurch. On Monday morning I went out and I did express to them that if this were my horse, I'd put her down. I was teary eyed and heavy hearted,- I've done this mare's hooves since '97- she's a sweet horse. Ideal manners, great hooves and as willing as anyone could wish for. Her vet had called her that SUnday after viewing the pix I sent.The vet recommended euthanasia also.

But the owners are opting to try longer. I told them I'd do what I could to help, but was not guaranteeing any kind of outcome. I also told them we were grasping at straws at this time, and were searching for a miracle. soooo....

The mare's bony column has descended in both fore hooves. The sole has opened on her near fore and the off fore, as you can see, has split open at the coronet band.

Just came back from working with her tonight. Dremelled off about another 3/16 inch of heels from fore hooves. LAst week I was able to rasp a bit more off her near fore toe. I have NOT touched her soles- preferring instead to leave them as intact as possible.

I resected a good portion of the wall directly under that prolapsed coronet- which appears to actually be proud flesh. There is definitely necrotic tissue at the germinating coronet. I was able to dremmel the wall without any sedatives or local analgesics for the mare, as she laid down- apparently the tissue is dead as well as the nerves being non responsive in that area. As she was laying down I was NOT able to dremel away the wall for the entire length of the split. I believe that removing this wall (which is already obviously detached) will relieve any "jamming" upward of the hoof capsule into that coronary tissue, further aggravating it.

As her patience waned thin, I quit and then applied "sugardine" and wrapped the hoof with diapers and put on a hoof slipper. The mare got up but was unable to stand so she laid back down immediately. SHe has large bed sores on her off side now. I am pushing the owners to bank her stall deeper in shavings, as well as getting some peat moss for her to lay in. Then I had a wild thought on the way home- how about styrofoam peanuts? You know- not actual styrofoam- but the "ECO" peanuts - biodegradable kind? What do you guys think?

The near fore hoof I just irrigated with peroxide and diapered it then put it in a slipper.

The mare now is down more than she is up.

I can manipulate the hoof capsule on her off fore and see it swivel slightly. She does have some new growth from each heel bulb to each quarter, but nothing yet at the dorsal coronet band.There is some new tissue beginning to build at the edges of the proud flesh.
There was very little drainage during the resection. I did NOT remove her entire dorsal wall - just about a half inch down from the split coronet band.

I did not have time to take pix this trip.

I also suggested they look for a sling of some sort, they way she flails around getting up and then spins before dropping back down, any healing that has happened while she is off her hooves gets torn apart during this movement. Anyone know where to find a portable horse sling?

Have you guys heard of TLOPs? Some sort of pads used for foundered hooves?

[Phil Armitage]

Kim, I am impressed your hanging in there and helping them, however I am sitting here shakeing my head and feeling bad for this horse. Why don't you direct the owners to this thread or print it out for them. Very sad and just not fair to this horse. I understand they love the horse, but the only thing they are doing now is fullfilling there needs not the horses needs and that is not right. :(

[Rick Burten]

I am in complete accord with Phil.

You have expended a tremendous amout of time and effort and have given the owners the benefit of very wise counsel.

they are being selfish and while you have gently told them so, now its time to be quite blunt. It appears from what you have described that she is now penetrating both soles , can't stand and has developed bed sores.

I know you said the vet told them to euthanise the horse, but it really is his place to be the lead dog on this team. He needs to be emphatic. And if that doesn't work, perhaps Animal Control needs to become involved.

Perhaps if you point out to the owners that because they "care" so much, they are not caring enough. For if they cared enough, they would end this horse's suffering.

[Forgewizard]

Well,
I hung in there till the end with this old girl. Her owners sent her on to that grand paddock up yonder this past Saturday. Yeehaw look at her run now! Nose high, tail flipped up and mane just a flyin! :)

This has been the worst case I have run in to and I pray it's the last one too! This is such a frustrating disorder to watch. I definitely look forward to any new information at this year's Laminitis Conference in West Palm Beach,FL!

This mare was a sweety to work with until the end. Cheers to you Mon Ami! :)

[Dave Purves]

Sorry Kim, I know how hard it is, even when it's a clients horse, and even when you know it's better for the horse in the end.

But I think this thread brings up good question:

Do we as farriers have some type of "moral obligaion"? Let me clarify that, I read a couple posts stating that they (the post-er) would refuse to work on this horse. Would it be better for the horse if a competent farrier refuses to work on the animal, so the owner goes and finds some hack that doesn't care either way, or know better? I believe it was in the best interest of the horse to be put down, however, who is to say that I'm right, or the owner was wrong? I just wonder if we really have the right to tell a client in this situation what is best for thier horse and refuse service.
Not trying to argue, just a thought that I had. I for one would offer my opinion on life or death, but if my opinion differs from the owner, I think I would stick with the horse just for my own piece of mind, knowing that I'm doing everything I can to keep it comfortable.
Dave

[Forgewizard]

Yes that's exactly why I hung in there with them. I've done this horse long enough to consider her one of "my herd". She was a horse with enough good points about her that I'd gladly put her in my barn.(If I was in a position to add another horse to my one horse stable).

All my clients know that I don't hold punches. Although tactful, I tend to tell it like it is, because I feel that a well informed client is easier to work with and has more realistic goals than one that is molly coddled or given sugar coated answers. She had asked several weeks back, what I would do if she were mine and I told her I would put the horse down.

It was not an answer I knew she wanted, but it was a truthful one. My main focus was that on her worst hoof she was NOT regenerating any new wall for at least 2/3 of the hoof! Without this regeneration there would be no real hope for the mare to even become pasture sound.

After telling her this I assured her that I would abide by whatever their decision was. If they wanted to keep trying and have a chance for at least a little while longer to see if regrowth would start; I would help the. They opted for this and I committed to an every other day visit until the end.

In their minds I understand that they at least are comforted by having tried to offer her the best they could. In my mind I believe the best interest of the horse was finally brought forth- as hard as it was for all of us.

They'd had Mon AMi for 20 years and I knew her for close to 50% of that time. It's hard to say good bye to a long time friend.

There is no way I could in good conscience walk away from this horse just because they didn't agree with my opinion at the time I gave it to them. That would have been rude and inconsiderate. It isn't in my book to leave a friend hanging when they are crying out for help!

Was there any monetary gain in this situation? No! Certainly not! I spent way more time there than I got paid for- but was there a moral gain in this? Certainly yes! I know everybody (including the horse) tried their best; it just wasn't in the cards for this horse to come through this. Which seems to be one of the huge mysteries of founder- why some horses survive and others do not.

Answers I hope that will be found with the research being done on this problem!

[calshoer]

I am glad they finally made the best decision for her.I have had some of those long term horses as cients too, and they become like one of your own family. PS I am going to Palm beach too. Looking at the lineup, it is a can't miss event. Anyone who wants to be working on laminitis horses should get there. PS if anyone knows a cheaper hotel that is walking distance to the convention center let me know. Patty

[Roy Amaral CJF]

Did you get the feet?

It's hard to ask sometimes, but taking them appart helps you understand what you're seeing next time.

[Forgewizard]

No, Roy, I did not get the feet. I wanted to but didn't have the heart to ask them. All I have is the pictures. They actually put her down earlier than they had originally told me. I caught a yucky summer cold and spent this past weekend getting rid of it; when I left them on Friday night we'd talked and they were going to put her down on Monday, but they called me on Sunday to say they'd let her go on Saturday. SO she was already buried by the time I knew she was gone. I couldn't really ask them to disinter her just to remove her feet.

What was interesting about this case was that the liquified pus(?) that was present in that worst hoof. Reading through Dr. Pollitt's Hoof Book, it says that a creamy colored fluid is actually bone demineralizing. It doesn't mention the smell of that fluid. The colore was just a shade lighter than that "putty" color of office filing cabinets. It was fairly thick too. And horrible smelling!

Only during the last two visits was she exuding a similar fluid on the hoof that P3 had penetrated the sole.

On the ripped coronet hoof- P3 never did come through the sole! My suspicion (without actual scientific data) is that in this case the toughness of her "bare hoof" and density of sole actually backfired on her and contributed to the separation of the hairline. I realize that the original sinking caused the hairlinge to turn under and strangulate- but if P3 had pushed through her sole like it did on the other hoof- which WAS actually generating new hoof at the hairline; then maybe this hoof might have had a chance? I don't really know. And in reality I doubt it would have made a difference in the outcome- considering the mare's age and metabolic issues she already had.