Saturday, November 5, 2011

Hospital Zone

When I went the 45 miles or so down to Yakima to pick up Beth on the 17th, I wanted to have someone along for back-up, if I needed it.  Pat was unavailable, and hubby Al was willing, but my friend Anita offered as well.  Trouble was, Anita is recovering from rotator cuff surgery just now, and wouldn't be much physical help, if Beth got into trouble in the trailer...she came along primarily for moral support (and she had a working cell phone, which, at the moment, I didn't).  So she met me in town, and we headed south.
I wasn't sure yet if I wanted to put Beth in the regular slant stall, or leave the dividers open and let her travel loose.  The only halter I have that has the snap at the jaw was Kate's, which would be pretty roomy on Beth, but I figured I could leave the snap undone to avoid her wound if I needed to.

Beth was barely recognizable.  Her face, jaw and neck were swollen, and she hung her head above the pile of uneaten hay.  Ryan said she was hardly eating even the softened pellets he offered her--the dogs would come in and finish them off if he didn't pull the feeder out once she stopped nibbling at them.  He had given up even trying to give her the penicillin shots in her hindquarters, quick as she is with her back feet (even in her depressed state).  So there was some edema (swelling) forming on one side of her neck, and in her lower chest, where he had to move once the neck muscles had taken all they were going to take of the poking.  She had one fairly deep laceration on her right shoulder, and a few scrapes on her legs, but the obvious focus of her injuries was her left jaw bone, where she now had seven stitches.  Ryan explained that the vet had actually had to cut the wound open a little farther, to get the huge chunk of bone out.
We gingerly put the halter on and led her to my trailer.  Seeing as how the last time she loaded into a trailer was after her injury (to the vet's) and the time before that was the trip down to this place of hard work, and then pain, she was understandably reluctant to load up.  I also didn't want to pull any on her head, so Ryan brought over a lunge whip and it didn't take much more than a few taps for her to load up.  Later, Anita was to tell me that Beth gave her a look that really sunk into Anita's soul--sort of a "What the h%*# have I done now!?!" look of despair.
Hauling home was uneventful, and I set Beth up in a private paddock on the south side of the barn, with free access to a matted stall.  Kate and Maddie were in the next door paddock. She picked up one little mouth of hay, mouthed it only a bit, then let it drop back into the feeder.  I soaked some Equine Senior for her, and she showed a little more interest in nibbling at that, but seemed to dislike it once it turned to total mush.  So I tried little 2-cup portions as often as she would clean it up, or turn up her nose at it.  Ryan had given her a dose of bute the morning we picked her up, but I discontinued it at this point, somewhat worried about that much NSAIDs on an essentially empty stomach.  She was drinking decently, from a heated bucket.

By Tuesday night, however, she hadn't perked up any.  And probably hadn't eaten even the equivalent of one meal for a horse her size.  I set up to take the morning off and take her in to my vet.  Besides, Ryan had told me the stitches should come out on Thursday--I wondered if it was too early to have Dr. Mark take them out while we were there.
The vet's office in Yakima faxed up their notes from the original emergency visit and emailed the digital X-rays.  Dr. Mark also talked with the vet there for background.  (One interesting thing was that the vet's notes talked about Beth hitting her head on a railroad tie, and both Anita and I remembered that Ryan had said the wreck happened tied to his trailer.  I didn't think too much about it at this time--but it was later to come up.  It illustrated the difficulty of communications that continued through the next couple of weeks.)
Dr. Mark was a little surprised that Beth had finished with her antibiotics already, but the wound on her jaw actually looked pretty good.  After consulting with the Yakima vet, it was decided the stitches should actually stay in another week, but they were in a place where I could probably pull them myself, if all else was going well (and Beth would let me).
Mark checked Beth's teeth, and didn't see any cracks or bruising of the gums.  What he did see was a need for a float job--I probably should have had it done before she went down for training: there were some points, and some older sores on her cheeks from same.  Plus there was a noticeable curve developing from the jaws not lining up with each other properly.  We hated to traumatize her jaw further, but he felt that she would do better with the food she was eating with her teeth in better shape.  He also wanted me to restart giving her bute once a day.  Once the sedative wore off, I ran her home and rushed back to work.
Through the rest of the week, and over the weekend, Beth started eating a little bit more enthusiastically.  She would, however, tilt her head off the one side (usually to the right).  She still wasn't much interested in hay, but seemed to enjoy being back out in the pasture.  Bringing her in for dinner and meds, she began to greet me, and would sometimes trot in--more energy than she had shown for awhile--which seemed like a good thing.
Beth continued to eat a little better each day for the next week, but one thing I began to worry about, that I hadn't noticed prior to the vet trip, was increased swelling in her lower lip, back along the jaw into her chin groove.  It became hotter and harder and more tender as the week progressed, and Beth started to back off her feed again.
On Tuesday evening, two full weeks after the original injury, I didn't get home until after dark, and couldn't convince Beth to come in for her grain (and bute)--not totally unexpected, but something about her chin didn't look right in the dark.  The next morning she came in, but I only got a glance before she headed out again.  Now it appeared there was something caked on her chin.  That night, I managed to get her in, closing the gate behind her, and coaxed her over to me and gingerly put on her halter.  In the process I managed to smear stinky pus all over my barn coat!  She had popped an abscess right behind her lower lip!
I cleaned it up enough to find a thumb print sized wound.  I took her temp (only very slightly elevated) and called the after-hours vet's number, hoping that maybe Dr. Mark would be on call, so I wouldn't have to explain the whole situation to someone else.  Nope.  But the doc did say that since her temperature wasn't too high, there wasn't much that could be done, other than hot soaks.  I did have one dose of powdered antibiotics that I gave her, thinking to stop the next day and get more, along with scheduling a visit with Dr. Mark.  What I was worried about now was whether there might be an additional break in Beth's chin.

So.
I mentioned a dilemma in the last post, but forgot to elaborate on it.
I have a challenging young mare, who is only green broke.  She's not one I've ever planned on keeping, but I knew I needed to have her going better before I could sell her.
I've got twice as much into training than she is worth in today's market.
And now there is the prospect that she may have a broken jaw.  I've already got more in vet bills in two weeks than I have for the training.  I can't afford much more.
If there's another break, I don't think I can extend myself for surgery--do I put her down?
Even if the jaw is not broken, Beth may well become a pasture ornament.
What are my options?

Next post:  an unexpected possibility.

7 comments:

  1. Eeek! The plot thickens. Everything is becoming more complicated....or is it?

    ~Lisa

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  2. Could it be an abscess from a damaged tooth? Dawn had one of those a while ago and it eventually resolved well. Hoping that if she's eating, she doesn't have a broken jaw . . .

    Sending best wishes and thoughts to all of you.

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  3. good grief. Now what??? Write more soon, please!

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  4. You are definitely in that spot between the proverbial rock and hard place. Realistically sometimes things come down to resources, and Beth has had a lot of resources put into her at this point. Sometimes resources are unlimited, sometimes they aren't. Hopefully over time a decision about what next will be made easier, as in she heals well and you can put this all behind you.

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  5. Lisa--Complicated isn't going far enough! What's that saying? If a horse can hurt themselves, they will. Well, Beth really rose to the challenge!

    Kate--On-call vet wondered about a cracked tooth,too. She was eating, but not much (not that I want to go on that kind of diet).

    Aarene--Coming up soon...

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  6. I'm so sorry you and Beth are going through this. Like the others, I'm wondering about a cracked tooth causing an abscess. I've heard of root canal treatment for dogs, but can't imagine it would be possible for horses. Having had more than a few of those myself, I imagine it would involve huge expense. Just googled (http://www.horsetalk.co.nz/archives/2006/0610/024.shtml) and see that it was done in New Zealand in 2006, but realize it wouldn't be an option for Beth. Very strange about the railroad tie. Hoping for the best possible outcome for both of you.

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  7. Oh my! Poor poor you and poor thing Beth!
    Still on catch up so I'm not in the know on how it all....
    Pantz had a cracked molar last year from the fall in the pavement with my mare. She stopped wanting hay. Took het a long time before she could eat it well, after the tooth was taken out.

    Hang in...

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