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Elderly horse having trouble getting up
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Brandy
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 Posted: Mon Aug 10th, 2009 01:19 pm
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Hello Dr. Deb and forum,

I'm looking for insights from those of you that are experienced with elderly horses.  My 26 year old TWH/QH cross is in really good shape in most ways, but when he lays down to roll (he loves to roll), he is having a harder and harder time getting up.  He will get into a sitting position (like a dog) and then has to rock a few times to get back up.  His back legs don't fold up like they should, they aren't getting under him very well.

I've got him on what I think is a quality oral chondroitin/glucosamine supplement, his diet is as balanced as I can get it.  He has 24 hour turn out with access to a barn stall and a safe friend.  He's got some loose teeth that still have healthy gums (gets a dental twice a year) so while he gets whatever pasture and hay he will eat, he also gets some grass pellets, mostly at this point because he doesn't adapt quickly to changes in his diet and I wanted to be able to make the shift gradually for him.  He still loves to get out, so I pony him regularly from one of the others whose company he enjoys at whatever pace he choses--to keep his mind happy and his body moving.  He gets whatever kind of interaction from me that he'd like at this point: he loves to get up on a drum and do other fun things to be stimulated.  He learns quickly and loves to learn.

He went down mid-May, I found him outside in a rain storm.  He was able to get up but then coliced, I think due to the shock and being so cold and wet.  Since then he's been able to get up each time but it's a struggle.

Yesterday I came home from a ride and he was down again.  I'd been gone for 4 hours so that is the maximum time that he could have been down.  He'd obviously been struggling (was sweaty, banged his eye and rubbed the hair off the upper eyelid).  We helped him get propped up to the sternal position and after about a half hour, he was able to rise again.  When he did get up he was very wobbly but after 10 minutes or so got his feet back under him again.  He had an appetite right away this time and all the plumbing systems were fine.

So.....I know that I am facing the inevitable.  What I'd like is advice from those who have gone through this, and suggestions if you can think of anything else that I can do for him.  His mind is still so sharp and physically he looks fantastic, you would not know he is as old as he is.

He is my first horse, I've had him for 16 fabulous years, I have no words for how much I love this horse.  Whatever I can do for him to keep him happy and dignified is my priority.

Dr. Deb, I have read your paper on "Fostering a long life" several times and I really am trying hard to find the balance between inviting him to be healthy and wanting more.  I think that maybe we've reached the point where even though I am inviting him to be healthy, he's just not strong enough to maintain.  But I don't know, and I don't know how to know.  We live in the inland NW USA: the last two winters have been tough ones and I am worried.

 

 

 

Last edited on Mon Aug 10th, 2009 01:53 pm by Brandy

hurleycane
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 Posted: Tue Aug 11th, 2009 10:06 am
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Being able to give them a good dignified euthanasia is what we all want to do - but knowing when is not easy for any of us.  This pain and struggle that you feel is part of the process of letting go. 

IMO, the physiologic consequences for the horse of either not being able to lie down or get up are very severe - and eventually equal to a founder or a leg fracture in the toll it takes on the horse.  In such circumstances, you and the Vet do what you can.  And knowing the eventuality of the infirmary, I would not begrudge any moment you give him.  More importantly, know that when you decide to put him down, no moment will be too soon.

You are very lucky to have had one for so long - good relationships are very precious.


 

Last edited on Tue Aug 11th, 2009 10:08 am by hurleycane

fitz
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 Posted: Tue Aug 11th, 2009 11:27 pm
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Brandy-
my heart breaks for you, because of him being your first horse and because of the length of your relationship. i have put down several good friends in their later years and it never gets easier.
last fall, my 29 yr. old hanoverian gelding was put down. he showed the same struggles you describe as well as a diminishing appetite and a distinct behavior of removing himself from the herd (he would graze by himself not next to his favorite mare). He was becoming more ataxic behind and in Oct. i decided to put him down. There was absolutely no way he could handle another Minnesota winter. This was a decision I did not regret as we had record sub-zero weather and lots of ice and snow. He is buried on my farm and I ride around his and my old event horse's grave daily which comforts me.
My vet and dear friend told me many years ago what a wonderful thing I was doing having my horse slip into unconciousness with a mouthful of good grass on a sunny beautiful day with me next to him stroking him.
I remember that each time I've had to go thru this.

Brandy
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 Posted: Thu Aug 13th, 2009 12:16 pm
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Thanks for the replies Hurley and fitz.  I guess I should have maybe been more clear.  I'm okay with a dignified euthanasia when the time is right.  I've lost two horses previously, both far before what I thought should have been their time but circumstances were that there was no choice.

What I'd like to know is if anyone has any ideas physically for what I might be able to do for him.  Mentally and physically in all other ways, he's not ready.  He doesn't even want to be retired from riding so I do my best to make up for that in other ways.

The single problem is that his back legs don't fold up like they should.  I've had three vet consultations for him in the last three days.  The first, from my primary vet who I really like but does tend to be quite conservative.  He sent me home with a couple shots of injectable banamine and the thought that sometimes when they are down and stuck, the banamine can take effect in about 10 minutes and make it possible to get back up.  So, his response was to help him get up once he's stuck down.

The second vet is also trained in acupuncture and I had her come out and give him a treatment.  We will see where that goes, I didn't think it could possibly hurt.  She also has suggested a daily dose of a gram of bute.  She is pretty sure that the problem is his hocks, that they are too stiff.

The third vet suggested that I consider joint injections.  I have read here what Dr. Deb's thoughts are on this, but wanted to throw it out anyway.  What this vet said was that at the time that he and my primary vet (they are in practice together) went to school, injections were taboo and they were not trained in it, but that the vet schools have changed their thinking on this.  If I am to go this route, I will have to take my boy to the vet school (we are a 45 minute haul from WSU so not a big deal for my excellent traveler).

So, what I'm really asking is for experience with horses who are in otherwise very good condition but stiff hind legs causing a rising problem.

erobb123
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 Posted: Thu Aug 13th, 2009 05:55 pm
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Brandy: Related to your question, I know of a mare with Degenerative Suspensory Ligament Dis(ease)/Dis(order) (DSLD). It is a sad disease, there is no cure, all you can do is try to minimize pain and hope the degeneration can be delayed. Her problem is in her hind pasterns, they are VERY slack. She was being used as a broodmare and was out with a herd of 25+ on 90 acres for at least 12 hours a day. This mare, when she laid down, sometimes could not get back up. We wondered if possibly her legs were falling asleep under her, but I suspect more likely that she just didn't have the strength to make the "jump" to her feet. And that she was in too much pain. BUT: after that foal was born, grown, and weaned, this mare went to live with another woman and is now doing so much better. The differences are that she is not in foal (that's more weight than she could handle), she is in a smaller pasture by herself (so she can walk, stand or sleep without having to keep up with others or worry that they will pick on her), she is now getting glucosamine/chondroitin (Cosequin, I think) which probably isn't affecting the DSLD but is making the *rest* of her body hurt less from compensating. She is even being ridden a couple of times a week - the woman weighs *maybe* 100 pounds, let's the horse pick the speed and is on her maybe 10 minutes in a flat area. (I personally don't think the mare should be ridden, but it's her horse not mine.) The end result is the mare is much healthier and happier, but don't be fooled, she still has the DSLD, the pasterns are better but still lax, she shifts her weight from foot to foot in discomfort. (BTW: DSLD apparently can also show up in other places, such as the hocks and, interestingly enough, in the neck.)

As to injections: they are more common in some circles than in others, as you know. All I know about it is that you definitely want it done by a vet with lots of experience with injections, and that it is more likely than not that you will need to do repeat injections, but maybe only once a year. You might actually get some insight by talking with a vet who does a lot of injections, they should have some ideas of what else can be done, what has been tried by people before they decided to go for an injection.

Can't think of anything to help your boy actually get to his feet once he is down, except the banamine/bute. Does he do better on a soft surface or a hard one? On one side or the other?

I like the acupuncture idea. Maybe a chiropractor could be beneficial (I've seen some great results from chiro treatments).

Good luck!

-- Erica

Tammy 2
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 Posted: Thu Aug 13th, 2009 11:54 pm
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Brandy wrote: She also has suggested a daily dose of a gram of bute. 

I am pretty sure that you can only safely give a horse bute for no more than 3 to 5 days straight.  It is very hard on their stomachs. 

 

 

Jacquie
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 Posted: Mon Aug 17th, 2009 05:39 pm
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Don't be put off using Bute - it can be a godsend for pain relief and is an anti - inflammatory as well. It is true that it damages the liver with time, - like many human painkillers do, - but the benefit of the pain relief to an older horse who is in pain may well outweigh this negative side. I worked for 10 years as a vet nurse and have heard the vets I worked for recite this fact many times.

Once the horse is not in pain, the rest of his or her life can be made to be more pleasant and if the horse has got to the point where the ability to rise from lying down is becoming more difficult, then that horse really does need pain relief so that he can function normally again. Being stranded down in a field would be very upsetting for most horses. 

The bute maybe able to be varied and adjusted accordingly but if the amounts of painkillers get too large in order to control the pain sufficiently, then of course this is when the 'decision time' period reaches the end of the line.

Bute is not the only pain killer - homeopathy, herbal pain relief and other therapies may be worth trying, but I would not drag trying all the alternative medicines on for too long. Herbal pain relief has its risks too of course, but is worth trying.

I had to administer bute to my pony, Muffin for about 1 month, on vets advice, I then weaned him off it and put him on a herbal pain relief. I weaned him off that and he  then had homeopathic treatment. The situation initially needed to be brought into control and the Bute did that for him. Sure, maybe the Bute did shorten his life a little, but he did live to be 40 and the bute was given to him when he was merely 28! Don't be scared of Bute - it can be very helpful. If I was you I would call the vet and get advice asap to get your horse comfortable about getting up.

Jacquie

Brandy
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 Posted: Mon Aug 17th, 2009 06:13 pm
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Jacquie,

Thanks, I appreciate your experience.  I have had consultations with three vets to date, and have had him on bute for nearly a week, beginning right after the acupuncture treatment.  I believe I see an improvement: I have not been able to catch him rising to see, but actually I think that is meaningful in that he's up quickly and I'm not seeing him.  I live in wheatfarming country, and harvest is in full swing so all my neighbors are out and about and are checking in with him while I'm at work--they have not seen him down either.

Saturday I watched him trotting down a hill of his own accord and he appears to be moving better.  I got a very clear picture from him that he is NOT ready to go, so I am going to be as aggressive as I can to help him out and get him through another northwestern US winter.

Tammy, I appreciate your thoughts on the bute too.  I think that I'm in a catch 22 with this: if I don't do something to ease his hind leg stiffness, I will lose him when he can't get up.  There is a chance that bute could cause stomach problems.  Right at this moment, the stomach problems seem to be the lesser of the evils.  The other problem with bute is in the relationship that we have together.  He takes the bute just fine once I get a halter on him but he's pretty sure that the halter means bute right now and is giving me his opinion of that.

Tammy 2
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 Posted: Mon Aug 17th, 2009 09:11 pm
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You are probably right.  If I had a horse of age and had to ease his pain, I would be doing the same and not worry so much about side effects.  The odd times I have had to give my horse bute, by the third day he clearly did not want to take it either.  Maybe in a syringe with some applesauce ??

Have you looked into MSM at all ??  It is more natural and I have heard great things with regards to sore joints and muscles, arthritis and stomach issues.  I believe it comes in a powder so could be put on feed.  Maybe a possibility along with the bute ??

Sounds like he is doing better already anyways. 

 

 

Indy
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 Posted: Mon Aug 17th, 2009 10:16 pm
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Brandy,
They sell Bute in a powdered form that is flavored. Often horses will eat this mixed right into their grain. I sometimes mix it in some applesauce and add it to the grain. Worse case scenario is I mix it with applesauce and use a syringe with the tip cut off. Also, you may want to discuss the option of using something to help protect the horses stomach. I do not have much experience with these, but I am sure if you go to a website that sells tack and supplies for endurance they will have lots of information. For what it is worth, I think you are making a good decision to go with the Bute.
Best of luck,
Clara

Jacquie
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 Posted: Tue Aug 18th, 2009 02:49 pm
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I think you are making the kindest decision you can by giving Bute to your boy. This is exactly the use it is intended for. You can get it in sachets and it is a coarse sort of powder in those sachets. Muffin had it like that and never knew he was eating it because he had in mixed into a little tasty bit of his feed. It did wonders for him and he lived a long life.

It sounds as if your boys pain has been taken away and it certainly is as you say, the lesser of two evils. A life in pain is no life at all.

Jacquie

DrDeb
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 Posted: Wed Aug 19th, 2009 04:49 pm
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Brandy, sorry I have not been able to catch up on Forum doings for the past week -- out of WiFi range due to particular location in the U.K. plus some technical difficulties.

"Hind legs don't fold up right" isn't really enough information for me to go on. It sounds, however, like the bute regimen is helping your horse. Very few horses will work through pain -- take away the pain, and they will once again move or flex joints or put weight or strain on a joint. And Jacqui is absolutely correct: this is what bute and/or other analgesics are for.

They are for temporary use, and I want you to remember that part.

Your idea may be that your horse is not ready to pass out of this life, but the day will come -- and it will not be too long now -- when no amount of bute will help him. For all it does at any time is mask dysfunction and pain that is actually still there. It does not take away pain; the drugs just dull or mask the pain. And the pain is coming from tendons and ligaments that can no longer self-repair, simply due to the age of the horse. And the pain is also coming from joints and joint-cartilages that can no longer self-repair, can no longer keep up with the damage they undergo just from walking or trotting -- they lose a little ground every day in your horse now.

At this stage, this is where joint injections are absolutely fine too. Because you aren't using those to force or squeeze another roping run, another round in the show ring, another jump out of the horse. You don't have to care whether the needle which is inserted into the joint damages the joint at the same time that it gives the injection. It does damage the joint, every time; but in this situation, that's very much the lesser of two evils.

You don't have enough time left, when a horse begins to show you that he's having trouble rising, to even worry about damage done by a joint injection. All you want to do is make it so rising does not hurt him. And the reason you want to do that is that, if he lies down and can't get up, and you happen to not be there for say a couple of hours, he'll have a good chance of dying right there, which might not be the best spot for either humane or for practical reasons. And you don't want him miserably flailing around or exhausting himself in struggling to rise. So you give him whatever drugs it takes or whatever injections the vet advises, within the limits of your budget, so that the old boy can enjoy life for the year or so that you may have left with him before it gets to the point of no return.

Brandy, you are being given the signs by the horse himself. These signs are a gentle gift that says, "Brandy, you need to get yourself ready, because pretty soon I'm going to need to leave."

So you and your horse are going to team up to do this last thing together, and you'll want to keep him as comfortable as possible and do all the fun stuff that he still enjoys doing.

And keep him on the hay pellets: and have loose or abscessed teeth removed, so that he's not having pain in his mouth. The reason he colicked was probably not from struggling because of being unable to rise, but rather mainly because he'd swallowed a quid -- they can't help but do that sometimes when their teeth no longer work very well. Nevertheless I wouldn't fail to continue to allow the horse into pasture, even though that involves the chance that he will swallow a quid. This also is part of the quality of life consideration: you let him have the most enjoyable life you can, but be prepared for him to start colicking now on a mild level more and more frequently.

Nobody can say when the last day is going to come, but since you have gone through this before with losing old friends, then you probably do know how that is: you know you'll know when the last day is. And when it is the last day, you just call the vet, and you help the horse through it. You keep your hands on them the whole time, even when they're falling down from the euthanasia injection. And you know also that you'll be seeing him on the other side, when you get there too. Meanwhile, while he's here you just see to it that he's got a good life that's as pain-free as possible. -- Dr. Deb

 

Brandy
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 Posted: Wed Aug 19th, 2009 05:24 pm
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Dr. Deb, thank you for your thoughtful reply.  I knew you were out of the country and busy.

Sorry about my unclear 'hind legs don't fold up right' statement.  What happens is that when he props himself up in the front to get ready to rise, his weight is too much on his backside and the hindlegs are straight out, and not folded underneath him.  His hind legs don't do what I see in my other horses, which is to fold up pretty tightly in both the stifle and hock when they rise.  I still don't think that makes much sense but I don't know else to describe it.  I can't tell if the stifles aren't folding enough, or the hocks aren't folding enough, or even if that is the problem to begin with but that's what it looks like.  What he has to do is rock forward a couple of times in order to shift the weight into the right spot so that he can push himself up.

I know that he is giving me signs, he has been for a couple of years.  Every day I ask him, and when I said he was giving me a clear picture that he's not ready, what I should have said is that he wasn't ready THAT DAY.  He's not ready today either.  We will just go day by day.

About his teeth, other than the couple loose ones, the rest are in good shape and he still is eating mostly forage.  At night, when the others are in their 'pig pen' (drylot to prevent them from getting overweight), he has pasture access plus his barn stall which opens to the pasture.  He is the only one who gets hay at night and it's always gone in the morning.

I am doing everything I can do keep him happy, and right now I believe he is.  I haven't seen him struggling to get up since last week when I started bute and he had the acupuncture.  He is definitely moving better, for how long remains to be seen.  When the day comes that he cannot be in the pasture, that will be the day that I will call the vet.  I will not deny him that, ever.  I will not deny him access to his best friends, either.  They are 15 and 19 and are very, very good to him, have been with him for 7 and 12 years respectively.

I very much appreciate the responses that I've gotten here.  I plan to keep doing what I need to do for him and will make the decision when it's time.  I am fortunate to live where I do and have the ability to bury him at home.  For myself, I have picked out his spot and made arrangements with the neighbor to come with his backhoe when it's time.  Now, we enjoy each other.

Last night, I went to the pasture to spend time with the horses, I'd been building fence and was too tired to do anything else.  He came over with his two best friends and accosted me for scratches.  I was sitting on a bench, he backed up to me and folded up his right hind leg and literally put it in my lap to allow for better scratching access.  He's so funny...some horses do tricks for treats but he does them for scratches.  I got a kick out of him stretching his leg that way.

 

 

 

Last edited on Wed Aug 19th, 2009 05:34 pm by Brandy

DrDeb
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 Posted: Wed Aug 19th, 2009 06:06 pm
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Brandy, OK, now I'm clear on the hind legs. As horses get older and their joints stiffen up, and their tendons and ligaments get less supple and kind of inflamed or sore all the time, the animal becomes reluctant to bend the joints sharply or to put too much weight or pressure on them. You'll see this initially not so much in getting up, but that the animal doesn't squat down very low in back when he goes to lie down; instead of squatting down low before they go ahead and roll over, they sort of fall over from higher up, like the Dirty Old Man on Laugh-In with his tricycle.

And yeah -- my old Painty used to come over to me and lift up his hind leg like a dog peeing when he wanted me to clean his sheath. They get so they know they have a person they can trust, and then they show you that they think you can be of some use to them. Age brings wisdom. Sounds like you'll be doing just fine with all of your horse friends. -- Dr. Deb

Last edited on Wed Aug 19th, 2009 06:12 pm by DrDeb


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