Monday, 5 September 2011

HellsBells what next!

Ella.

I am bound to get mixed up and some I still don't understand but I am in good company. The vets who Ella is assigned to ( all five of them) are stumped too.

Ella came in from the field non weight bearing on her near hind. Vet was called after me poulticing her foot thinking it may be a abscess or puncture wound. Vet then put her on antibiotics and scanned her tendon. In time a tap was taken and the tests came back as inflammation. With box rest and antibiotics she improved dramatically and started limited small paddock turn out. After one full day and night Ella came in very lame on her off hind. Vet again was called and a tap and scan taken from the the new sore leg results came back as Sepsis of the tendon sheath. It was around this time I noticed she was becoming increasingly uncomfortable with being handled which is very unusual and she started to swell.

Arrangements were made for Ella to go to Edinburgh to deal with the sepsis. Her swellings were changing and moving about. All swellings were painful.

Once up in edinburgh she was no longer 8/10th lame on her off hind and was 2/10's lame on her near hind and off fore and 3/10 lame on her off hind. Vet said impossible for her to have sepsis with such low grade lameness in that limb. The swellings were still fluctuating.

Further tests were made on that limb and it came back as sepsis. So surgery was booked. Surgery went well then she started to swell with a vengeance. Her neck was covered in abscesses ( ended up being oedemas) and there were swellings on all her veins and arteries the size of oranges in places. She had a heart rate of 60 and a fever with numerous scans it was noted she had oedemas on her lungs and on all her arteries and veins( vasculitis).

Next was colic likely due to the pain from the oedemas and fever. The colic passed with bute and sedation and she was found to reactive to numerous types of antibiotics. She was placed on high doses of steroids to try and get rid of the oedemas. This in time worked. She was then taken off the bute and antibiotics( the ones she could cope with) and bit by bit the steroids. This went well until Thursday night when she colicked again. She was sedated and put on bute. She continued to colic much of friday then by Friday teatime she was much better.

Stomach taps were taken and came back normal. Scans came back with a swollen( 10cm) ovary noted. Could be haematoma , tumour or Abscess. Abscess was presumed so Ella was to be starved for five days with very small slop given twice a day and back on antibiotics. The second scan would help with diagnosis, this happened today. It looks like a haematoma. My worse nightmare which has ended up not being a nightmare at all. A haematoma caused by an oedema would have been the end of the world as it would have meant the condition was still ongoing but it has been caused by a little vein leakage which is fairly common. A haematoma caused by an oedema would have caused a ruptured vein. So we had a kind of diagnosis. Operation to remove ovary cancelled and Ella fed. Needless to say she started to colic as soon as she was fed so we presume it is an ulcer caused by starving her.

So we now have no further vasculitis, heart rate and temperature normal. Bloods coming back normal now and she will be coming back off all meds. She will be rescanned in 48hours to see if her ovary has continued to improve and likely to be scoped to see if she indeed has an ulcer. Then we wait. And wait some more and if she continues to improve she will come home.

No definitive answer, no clean disease and cure but I am likely to be taking my little horse home and there is no reason why she can't come back to full fitness. Will it happen again? Who knows. I have a list of antibiotics that can't be used and we will have a protocol of steroids if it happens again but I can say this I ain't going through this again with her.

Now the hard part. I have found the decision making impossible. I had a firm idea of what would happen but when it comes to it I can't and didn't do it. I felt pressure and felt the disbelief yet it was all in my mind. I felt compelled to explain myself when it was never needed. The responsibility of everything….of life itself( hers) but also to Bruce, to my family and to Ella. What if I hold on for me or what if I give up and call it a day for me?

So I am leaving that all behind. I wanted her put down if it was a haematoma as it meant it was continuing yet the haematoma ended up not meaning that so I have changed what I have said. The vet asked me 'what do you see when you look at your mare?' I answered as honesty as I could….A mare who has a weakness and is bouncing from one crisis to another. What did he reply? That he saw a strong mare who fought not one crisis but three and still kept going, still greeted everyone and had an attitude that good ( food) was just around the corner. So from today I will still worry but all being well she will come home I will rehab her and we will give it our best chance.

UPDATE:

Ella is now home and seems happy and pretty settled though I think she is missing the constant companionship. I don't mind as long as she doesn't miss having a vet at her beck and call.


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