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Discussion on Granulosa Cell Tumor | |
Author | Message |
New Member: Tonijo |
Posted on Friday, Dec 6, 2002 - 9:56 pm: Dr O - I read the story above about the unrecognized ring of scar tissue around the outside of the horses intestines that had to be put down. I have a mare(my baby) who had a very complicated Granulosa cell tumor surgery a few months ago and it was discovered when I took her for a lameness exam which has now become secondary(tear of medial collateral ligament & medial meniscal damage from trying to mount other mares). About 5wks after surgery Sierra colicked on me and on the 3rd day she became dehydrated but was still moving manure. We took her back to the clinic where she had surgery and this is what happened: they found no spontaneous or net gastric reflux upon nasgastric tubation. A rectal exam did find that there was an adhesion of a loop of small intestine to the peritoneum on the left flank close to the incisions from the previous standing laproscopy which was unsuccessful when trying to remove the tumor due to displaced organs so that then she had a ventral midline ovar. that was performed. They discovered the tumor was adhered to the body wall,sm intest/and uterus. Tumor was blindly removed w/ stapling equipment(just some background). I took her back to the clinic 5wks after the surgery to follow up on a ultra-sd on her leg and got great results as far as that healing is going but upon her return is when the colicked started and 3days later my vet and i decided she needed to go back to the clinic where she had surgery after a wk of observation and a gastro test they discovered superficial ulcers in the margo plicatus area (probably from the 35day bute treatmt for the leg and all the moving around. She has responded to the gastro guard and its now 5wks on it(Im treating for one more week)And so now I am dealing w/ a horse that lays down alot and looks at her belly and in minutes she jumps up and is alert and hungry. I watch her pulse/heartrate/gum color/and all the other colic signs but its always mild compared to the first colic or two before going to the clinic and coming home after 9days(she colicked off the trailer and I had to make a emer. call to my local vet) Ive got her on dengie hi-fi working her up to 16pd(she has lost about100+pds). On top of this shes got a yr to heal from the stifle injury. Am I being fair to her? What does my future w/ her look like? It seems that shes demonstrating the behaviors the horse w/ the 1cm scar tissue did. Is it possible(well anything is) but does it sound similiar to the other horse to you? Do I go ahead and con't to watch her through the winter and see what happens? Im so confused but my vet and the clinic vets say that I dont need to say goodbye just try to see if she can get thru these bout's of minor colic pain from adhesions or is there a way I can see whats going on inside her and repair it? Im so confused and I dont have family to talk w/ nor a significant other. Whats your opinion of whats going on and the long term effects/complications? Sorry so long. I really hope to hear back. I know this is a rare situation w/ everything shes been through. By the way the tumor was about 2grapefruits put together and it was definitely slow growing.desparately seeking answers from any that would like to also share. toni |
Moderator: DrO |
Posted on Monday, Dec 9, 2002 - 7:44 am: Hello Toni,I am afraid there is no way I can predict the future but from what you describe I agree with the other veterinarians, it does not sound like it is time. What feeding changes have you made and how often does she have these bouts and how long do they go on for. What do they say about a second surgery? Do you keep some Banamine on hand? DrO |
Member: Tonijo |
Posted on Thursday, Dec 12, 2002 - 8:22 pm: Dr.OFirst I must thank you for getting back! Sierra used to eat 2qts trotter in am/pm with 3flakes a hay am/pm/noon. I now feed her only dengie and she can have up to 16pd suggested by the nutritionist but I am only giving her about 6pds due to her behaviors after she eats. Its like every other day that she will lay down and close her eyes, look at her stomach sometimes lay laterally and sit her neck back up but I usually witness her in a fetal like positon. The vet came the other day to tube her and banimine her and she was fine. The next day she was ok too but in the evening she had about a30minute episode of laying down/eyes half shut/stretching neck to rest on stall floor and back up to fetal position looking at her stomach from time to time and acutually stretching/lifting her hind legs once or twice. She definitely has some dehydration issues and Ive now been giveing her 1/2qt of wheat bran and 1/2qt nutrena senior very watered down w/ warm water that I have to trudge to the barn. I water it down so much so I know that shes at least drinking 2gal a water a day. I also water down her hay. I hope all this water in her food is okay but Im sure half of the colicky symptoms are from not drinking. She does pass manure and urine. The manure is a small amount but often and I notice more urnine lately since Ive been bringing warm water up. I also believe that the adhesions loop near her small intestines near her left flank is also causing discomfort. She is so hungry and I really want to feed her more to fulfill her and put weight on(she actually eats her shavings til I throw a few handfuls more of dengie)but Im so afraid of even more discomfort. I do have banamine on hand that I have had for about a month now that I really am trying to hold off on because she just came of a 6wk course of gastro guard and Im afraid the pain meds will cause reoccurance of ulcers which the clinic also believed was part of her last colic. So now the vet suggested that I up her hay to 4scoops(2pd) 4xday and a mash mentioned above. I started it Monday and now its Thursday and when I go up at night to see her shes alive and spunky looking to eat but the girl that feeds in the morning says she is laying down and the shavings looked pushed up to the sides which makes me believe shes got discomfort after 12am in the morn. I sometimes leave that late. But she always jumps up to eat if she is laying down. Do you think the waterd down hay is okay? Do you think the watered down mash is okay? Do you think I should add any laxative/oil? Do you think I can up her feed and how soon? Should I be doing anything else? Also, do you think the colic signs she demonstrates are gonna last forever? Or do adhesions sometimes subside? The night after the tubing I witnessed her laying down like I said w/ eyes closing on and off and stretching her neck out straight to rest on the stall floor and then look at her belly. Maybe one or two rolls but I yell at her to stop and she ususally listens and settles right down. After making a emer. call to the vet and waiting for her return call w/ instructions(20min. span)she jumped up again like nothing ever happend. Whats you feeling on this? Im sorry so long but I want to be as acurrate as possible. toni |
Moderator: DrO |
Posted on Friday, Dec 13, 2002 - 7:48 am: A horse that is laying down but interested in eating is probably not colicing Toni, or if she is it is very mild. Perhaps some of the laying down times are not colic related.Yes water in the feed in OK, though I don't think watering the hay does much but wash the nutrients out. Creating a mash with pellets is a good way to increase water consumption. Feeding mineral oil as a laxative will probably not be a good idea and vegtable oil does not act as a laxative. A couple of tablespoons of Epson's salts in the mash at each feeding will keep the stools softer, but should not be combined with any other laxatives. Yes I do believe you will need to increase the amount of daily feed and the trick will be to divide it in as many small feedings as you can. Toni, I do not know if these episodes will improve. In general if the adhesion does not break down is a couple of months it scars in permanantly. DrO |
Member: Tonijo |
Posted on Saturday, Dec 14, 2002 - 10:35 am: Dr OThe orginal surgeries took place in September and when I took her back to the clinic about 5wks later for the first colic in October the vets at the clinic were contimplating whether or not to open her up and correct the adhesions but after a few conversations they decided to see how she handled the bouts of pain. First they mentioned cutting her open her then laproscopic but then decided to not do anything except treat for the ulcers which she had and that treatment ends this wknd. I do believe she had some response to that med. Anyways, It was believed that maybe they would not be that successful, they felt it(the adhesions) would either come back same place or another place and possibly be more painful for her. Is there any other options to try and repair this adhesion situation w/o being so invasive to her? I hate watching her lay down and continually look at her stomach. It saddends me to know end. Sometimes I feed her only to see her finish and a second or two go lay right back down in her stall. What other reasons could possibly cause her to want to lay down? I do know we are treating her for the stifle injury too(collateral medial tear and medial mensicus injury)w/ hyluranic injections every four wks. So todays questions: .Could the leg be bothering her to lay down that frequent? She never laid down this much before her ovary surgery? I just couldnt trot her w/o a limp or pick up her hind leg w/o almost falling back. But she was always standing. .Is there any other ailment that would cause her to lay down besides that(leg) and the adhesions that I should be considering? .Is your feeling about adhesion removal/repair the same as the vet here? .Can you suggest any other options for helping correct the adhesion situation now that 2mos+ have passed by? .Should I be investigating more to keep her longer in my life? .And do you think that these symptoms could tie in with the symptoms of the horse who had the blockage (above-first message dated j 6/23/00on this board)with the ring around the intestines that showed no blockage,normal vital signs, but continous bouts of colic? He too was treated for ulcers as Sierra is? .Think theres any similiarities? I cant express how appreciative I am to have some feedback from you. Thank you and look forward to hearing back from ya. Toni |
Member: Tonijo |
Posted on Saturday, Dec 14, 2002 - 4:51 pm: Dr. OAlso, when you say to add epsom salt to the mash feeds w/o any other laxatives, what does that mean? I also add Stressed X powder for the water issue(electrolytes). Would that be a laxative also? or is that ok to add w/ mash too? Im not sure what kinds of laxatives are out there besides mineral oil and Im not giving that, I leave that up to my local vet. thanks t |
Moderator: DrO |
Posted on Sunday, Dec 15, 2002 - 11:07 am: If it is just electrolytes then no, it would not be considered a laxative and yes could be added to the mash. Otherwise consult your vet about the effects on any medication you use.DrO |
Member: Tonijo |
Posted on Sunday, Dec 15, 2002 - 1:17 pm: --------------------------------------------------------------------------------Dr O, This info is a response, w/ more questions,immediatetly before the last one you just answered(I posted 2 on the same day because before other questions came to mind) Please read my following reply on 12/14 POST 3 from your 12/13 POST 7426 repsonse. Thanks and here it is: The orginal surgeries took place in September and when I took her back to the clinic about 5wks later for the first colic in October the vets at the clinic were contimplating whether or not to open her up and correct the adhesions but after a few conversations they decided to see how she handled the bouts of pain. First they mentioned cutting her open her then laproscopic but then decided to not do anything except treat for the ulcers which she had and that treatment ends this wknd. I do believe she had some response to that med. Anyways, It was believed that maybe they would not be that successful, they felt it(the adhesions) would either come back same place or another place and possibly be more painful for her. Is there any other options to try and repair this adhesion situation w/o being so invasive to her? I hate watching her lay down and continually look at her stomach. It saddends me to know end. Sometimes I feed her only to see her finish and a second or two go lay right back down in her stall. What other reasons could possibly cause her to want to lay down? I do know we are treating her for the stifle injury too(collateral medial tear and medial mensicus injury)w/ hyluranic injections every four wks. TODAY'S QUESTIONS: .Could the leg be bothering her to lay down that frequent? She never laid down this much before her ovary surgery? I just couldnt trot her w/o a limp or pick up her hind leg w/o almost falling back. But she was always standing. .Is there any other ailment that would cause her to lay down besides that(leg) and the adhesions that I should be considering? .Is your feeling about adhesion removal/repair the same as the vet here? .Can you suggest any other options for helping correct the adhesion situation now that 2mos+ have passed by? .Should I be investigating more to keep her longer in my life? .And do you think that these symptoms could tie in with the symptoms of the horse who had the blockage (above-first message dated j 6/23/00on this board)with the ring around the intestines that showed no blockage,normal vital signs, but continous bouts of colic? He too was treated for ulcers as Sierra is? .Think theres any similiarities? Ihave had Sierra on 6wks of gastro-guard and I have administered 3/4 of 1250# horse tube. How much would I administer for the last 2wks as a maintenance? I had trouble doing caluculations from the article? I cant express how appreciative I am to have some feedback from you. Thank you and look forward to hearing back from ya. Toni |
Moderator: DrO |
Posted on Monday, Dec 16, 2002 - 6:26 am: 1) Yes it is possible, but what does this mean? This question should be answered with a good physical exam.2) & 3) I think the people who did the surgery and follow up exams are in the best position to answer this question. Though surgery is the only option the rate of recurrence is high not making the decision straight forward. 4) No your horse is entirely different. Which calculations did you have trouble with? DrO |
Member: Tonijo |
Posted on Monday, Dec 16, 2002 - 6:00 pm: So "the rate of recurrence is high" makes my decision easy to say that its probably best to leave Sierra alone and hope that the pain w/ the adhesions subside and it gets better vs. worst. I cant see putting her through another surgery to have it happen again, financially, emotionally, mentally and physically for the both of us. As for the calculations, I read in the article that 6wks of gastro-g. full course and 2more wks. of maintenance had a higher percentage of nonrecurrance of ulcers so I am going the extra mile and gonna use the paste for two more wks but I am not sure how to calculate. Do I basically give half of what she was getting as a full dose? she was getting 1000# dose which is more than enough seeing that she is only about 800# from all the wt. she lost. QUESTION #1: So I think, if I am calculating right, I give her just alittle under 500# dose ea. day for 2wks? Is that correct? Im measuring from the 1250# tubes of gastro guard. Am I calculating right?I am also feeling better about hearing you say that my horse was totally different from the horse at the beg. of the thread that passed on from 1cmm ring around the intestines. QUESTION #2: So what does it mean when they say she has a adhesion of a loop of small intestine to the peritoneum on the left flank? QUESTION #3: How dangerous is it? What are the probable things that could happen vs. possible(we know anything is possible) Thanks again for your time, knowledge,and help! Toni |
Moderator: DrO |
Posted on Wednesday, Dec 18, 2002 - 7:00 am: 1) If you use a weight tape to establish a correct weight then give 1/2 the labelled dose. Some would recommend that you give 1/2 the labelled dose for the normal expected weight of the horse, not the reduced weight.2) It means a tag of fibrous tissue has attached a short segment of bowel to the body wall. 3) The danger of an adhesion is that it will not allow food to pass efficiently so a blockage might occur. We do not know how dangerous your particular adhesion is because we do not know its characteristics, principally how much of the bowel is involved in the adhesion and whether the adhesion completely surrounds the bowel. DrO |
Member: Tonijo |
Posted on Wednesday, Dec 18, 2002 - 9:47 pm: Hi Dr. OThanks again for the gastro guard info and the adhesion info. I will tell you this...If I do not force water down in a very watered mash form she will not drink in this cold weather and thats when I notice shes at her highest point of discomfort laying down looking at her belly. Im wondering if theres any relationship. Either way, I am up there every night w/ 2-3 gallons of my own warm water. QUESTION: Is there a way to see the characteristics of the bowel and how much of the bowel is involved w/ any type of equipt/technology? If so, whats involved?whats the procedure? QUESTION 2: I am giving her B&L Solution for both her leg ailment(stifle injury/arthritis) and for the help of avoiding colics. Am I hurting her stomach w/ that herbal med and going against the treatment Im using for her ulcers that has been sooo expensive and taking the chance for reoccurrence w/ that herbal stuff? I thought I read that somewhere out here. I dont want to do that if its the case. The Gastro Guard is very expensive. thanks Toni Thanks Toni |
Moderator: DrO |
Posted on Thursday, Dec 19, 2002 - 6:55 am: Depending on location of adhesion and equipment available an ultrasound might further elucidate the involvement. What is B&L solution?DrO |
Member: Tonijo |
Posted on Thursday, Jan 23, 2003 - 12:01 pm: Dr OWell holidays are finally over a I finally have a minute to update and ask away. I am trying to make an appt now w/ the clinic to see if we can locate the size and placement of the adhesion the vet has felt during a rectal palpation at previous appts. so that I know a little more of what Im dealing with. They told me it could be possible but that gas could get in the way of the ultrasound and that the ultrasound waves dont penetrate if thats the case. Also, Sierra appears to be eating more and handling it better although from time to time she does lay down and look at her belly and at those times I happen to notice that her gut sounds are loud and shes has gas. 1.> Is there any correlation between the loud gut sounds/passing gas/laying down to look at belly? She then will eventually get up pass manure and be ok. In the past you mentioned that if the adhesions dont break down in a couple of months they will scar permanently and Im wondering if that means if they dont break down a couple months after the pain/discomfort is discovered or a couple of months from the immediate surgery? We didnt have problems w/ her surgery healing until 5wks out and thats when she demonstrated a problem and we identified ulcers and the loop of adhesion. 2.>So would you say that you could calculate the 2month period from the time of the initial surgery(when she was fine)or from the time of the discovery of adhesion (5wks out)to try to calculate the break down of adhesions period? Im trying to be hopeful and she appears to be better not 100% but she is up so much more bef/after meals and throughout the day. Also, whats your feel on insurance for her? I was looking into mortality and some companies will take on preexisting conditions and I wonder if its worth it for me or not to pay 600 a year(approx) in case I lose her. I could possibly recover some money to pay these crazy medical fees I have incurred. 3.>Would I need to mention the adhesion when the vet report says her visit to the clinic with bouts of pain(acute colic) were most likely due to superficial ulcers evidenced on the endoscope procedure(due to stress, pain from surgery, longterm bute admin. for leg injury) and treated w/ gastroguard. The adhesion is not the definitive reason for colic;they just arent sure if it played a part. I believe it could have been by watching her but who knows? Im just curious. I know the underwriters have the final say so maybe its worth a look at. Some companies are willing to accept some conditions. 4.>Do you have any experience w/ insurance stuff? And as for her secondary (initially first and foremost)issue, her leg(medial collateral ligament&medial meniscus)5.>Is there anymore I could do for that while shes at stall rest? supplements or anything? 6.>When they give her a lameness exam w/ the levels 1-5 etc, what is the level of soundness that is needed so that she may possible have someone on her back again?(trying to be hopeful again) Thats enough questions for today...thank you so much for your time and education. toni |
Member: Westks |
Posted on Thursday, Jan 23, 2003 - 7:38 pm: Insurance companies only insure for the purchase price of horse now and I do not think it would behoove you to invest in insurance at this point unless you paid more than $10,000, for the horse, if anyone would insure mortality after surgery it would cost more than horse worth in terms of economics ,in terms of sentimental value by all means spend every dime you have. |
Moderator: DrO |
Posted on Friday, Jan 24, 2003 - 7:58 am: 1) Yes, I think it is possible that there is such a connection. The increase bowel sounds may represent an attempt to move ingesta past the constricted area.2) The adhesions set following the surgery and not the onset of pain. 3) If the adhesion is part of her past medical record you will need to report it. 4) I have had insured horses before and must do insurance exams regularly. 5) We have an article on caring for horse at stall rest, see » Training Horses » Behavioral Problems » Stall Resting Horses. 6) It depends on what type riding you are doing and the nature of the lameness. DrO |
Member: Tonijo |
Posted on Sunday, Jan 26, 2003 - 10:33 pm: Dr Othanks for getting back. So you believe the gas/pain/and loud noises are possibly due to the constricted area? Im so nervous w/ this whole adhesion thing. I have a stomach ache coming and going to the barn because of the unknown of what I might see. Whats your experience with adhesions in the abdominal and the like? Ive not found many reports that give an optimistic outlook, most are very grave. Im so very tired of worrying but some how I cant give up! I want to know more about the less invasive techniques to possibly correct the adhesion. 1.>are there any types of techniques(laproscopic maybe?)or therapies? 2.>do you know where I might find more about adhesions online? 3.>have you experienced any patients w/ same issue or similiar and what was the outcome? I just wonder if I could be doing more. I definitely think shes been rolling thru the nite as her stall looks a little shuffled in the a.m.(a.m. people tell me this). I also mentioned in a prior message info about severity of lameness suitable to possibly ride after her stifle injury(medial collateral partial tear)and meniscus injury(medial meniscus). 4.> have you seen any success recuperating for pleasure riding? 5.> Is there any type of procedures available for repairing torn ligaments? torn meniscus? 6.> Any type of supplement/therapy I should do for her arthritis that has come on since the injury? I think thats enough for today. I want you to know how much I and Im sure many many others do so appreciate your time and knowlege. FYI-I looked back today at my horses medical notes and the vet documented on paper back in May of 2002"Mare is lame/injured due to mounting other mares in the turnout field". Not once did he blink an eye and think this was abnormal or if he did he never questioned it. It took me 3mths of vet visits/bills from him saying "yup" "still lame" till I got on this computer and then inquired about getting technology involved and thats finally when I acted on scheduling a clinic appt(Ipresented questions about ultrasd and the like to my vet first and gave him a few days to make the arrangements, his wish, and then went ahead myself to get the appt.after no response from him) The day I arrived for the appt they immediately were more concerned about her behavior before the injured leg. I wish my vets would have reacted in the same manner a long time ago when I first got her(5yrs). During my vaccination appts I even questioned never seeing a heat from her and mentioned that she acted like a stallion on a few occasions and it was all dismissed. As much as I like my local vet, Im dissappointed and angered. Well thanks for the vent session I just appreciate your knowledge and honesty. |
Moderator: DrO |
Posted on Monday, Jan 27, 2003 - 6:15 am: Taking them in order:1.>are there any types of techniques(laproscopic maybe?)or therapies? No surgery usually does not resolve the problem as the adhesion reoccurs. 2.>do you know where I might find more about adhesions online? No, I have never seen such a discussion. Try a google search. 3.>have you experienced any patients w/ same issue or similiar and what was the outcome? Yes, recurrent bouts of colic. 4.> have you seen any success recuperating for pleasure riding? Yes, the occasional colic did not intefere with the riding. 5.> Is there any type of procedures available for repairing torn ligaments? torn meniscus? All of this is pretty experimental at this time but you should check out the article » Equine Diseases » Lameness » Diseases of the Upper Rear Limb » Diseases of the Stifle for more on this. 6.> Any type of supplement/therapy I should do for her arthritis that has come on since the injury? This question is addressed in the articles at » Equine Diseases » Lameness » Arthritis, DJD, OCD, and Joint Diseases. DrO |
Member: Tonijo |
Posted on Tuesday, Jan 28, 2003 - 5:37 pm: Dr OOnce again thanks for your expertise. Im thinking about insuring Sierra because after this yr I will not have an option as she will be 17yo. One company did say that there may be an exclusion(high possibilty)on colic but can always be revisited. My reasoning is after all Ive been thru I just want to be prepared financially for the worse. If I lose her I would like to recover some costs and actually pay off some of the existing med.bills. 1.> If I lose her to colic(from adhesions complications)would they exclude me if the adhesion was discovered in a different place from what they already discovered? 2.> Do you feel its not an ideal choice to obtain this insurance? some say no way dont do it but I also think about other issues that could come about, although I think at this point if I lose her it would be to a blockage. Then again she seems so strong and its been 4mos post op and we do still see bouts of a colicky horse that brings back yucky memories of this past fall but she always seems to bounce back to herself sooner vs.later. I know too sometimes the ins.co. want you to put your horse thru surgery to try and repair before euthanism and Im not sure I want her to go down that road again especially since that area (recovering from intestinal surgery)seems so grave too. Just thought I'd get your opinion, the more theories of obtaining or not helps me. 3.> Are there any supplements to help w/ pain while food passes thru the constricted area? You mentioned that patients that you followed w/ adhesions usually had bouts of colic.4.> Was it continous surgical or medical colic and did it require always going to the clinic or was it managed at home? 5.>The patients that you experienced adhesions with, did you ever follow them long term and if so, what type of life expectancy did you see after the adhesion formed(mths/yrs)? 6.>Did they get worse as time went on? Did it eventually lead to total blockage? 7.> Any signs that would indicate either things are progressively getting better or worse other than the evident "no eating and laying down continuously"? Im hoping yyou can share a few situations that you may have encountered whether it be grave or not. Thank you again for everything! Toni |
Moderator: DrO |
Posted on Wednesday, Jan 29, 2003 - 9:02 am: 1.> You must discuss this with the particular insurance companies you investigate.2.> This would seem to me to be a decision you must make based on what the insurance company will allow and your goals. 3.> I think your best management is keeping meals small, or best have the horse on pasture. I think it is very important that changes be very slowly made. 4.> Episodic medical bouts managed at home. 5.> Years 6.> No 7.> No I think we have covered the important points Toni and don't see anything to add from case histories. Your horses problem is unique and I am unsure experiences with other cases in any way apply to your horse, but the information should be comforting, many horses have years of good use following colic surgery even if they have occasional bouts with colic, let's hope yours goes like that. DrO |
Member: Tonijo |
Posted on Saturday, Apr 5, 2003 - 1:08 pm: Dr O,I am back again for a saddend update. I lost Sierra a few wks ago and it happend so quick that I never got to really ask explanations about what happend except that she had kinks in the small intestine when a rectal exam was given. But thru all the trauma I didnt quite hear/understand it all moments before her euthanasia. Im apolgizing in advance for this long story but I feel the need to give you the details and moments up until her death to beable to try and make sense of this and possibly answer some/all of my questions, so here goes: I had made the long trip to the clinic 5days before I lost her, to try and check the adhesion (which they felt they didnt want to try and ultrasound because theyfelt it would be hard to penetrate thru gas in order to get an accurate reading of its size and the such)as well as the leg injury w/ her stifle area. I got great news about her leg! they sent me home w/ instructions to starting walking her up to 40minutes under saddle and if no complications or signs of discomfort to come back in 8wks for a reeval. and to just continue doing what Im doing w/ the adhesion situation by giving her the 3gal water a day and bananmine if needed as last resort. While she was there she produced many manure piles and urine and she was alert and her coat was shiny and her vitals were fine so the vet felt she was handling the adhesion okay. Five days later it was a windy night and she was sorta spooky in her stall and she was eating her hay but would spin around and rear a little from the frightful feeling of the wind thru the barn and I was worried so I stayed w/ her. The next day was the day I decided to get on her back after being afraid for 4days of possibly hurting her. And plus it had been so long that I just wanted to do everything possible to keep her going comfortably, I almost didnt want to even get near her or put weight on her w/ the fear my whole 115pds would be too much weight. I came up to see her and gave her the usual pampered water treatment mixed w/ molasses to get her to drink and at this point she actually looked forward to me feeding it to her daily. Also at some point in Dec.I had purchased a heated bucket so she was drinking from that also. She appeared aleart and happy to see me as she always welcomes me w/ her knickers apon my entrance to the barn. After I gave her water I noticed that her bucket was full of hay and that she hadnt touched it and it was about 5pm and it was given to her about 4:45pm but sometimes she picks and that was normal for her so I didnt think about it too much. I groomed her and then I made the decision to get on her back and go for a walk. I got on her bareback and it was for only 10minutes. For a horse not being under saddle for one whole year and not ever being turned out in this timespan she was a dream. She pranced around as I tried to resist her and keep her to a walk. She seemed so proud to be out there w/ me. I did notice as I was putting the bridle on her she was a little wiggly but didnt think anything of it. When I got off we walked another 5minutes and then I put her in the aisle while I cleaned her stall and gave her hay w/ a few handfuls of grain. She did eat a little at that point but even w/ the grain on top of the hay she started to get wiggly again and I hurried to clean the stall (knowing the signs of discomfort that we have dealt with)as quickly as I could. I put her away and that was about 7pm at night. She started to have that look of discomfort and that lasted throughout the nite. She picked at her hay a little bit earlier in the night till I decided to take it away. I watched her lay down get up and lay down continously through the night w/ a roll a roll or two here and there until I reprimanded w/ my voice. She had that blank look on her face and by 12midnite I knew I couldnt let it go on any further so I banamined her with paste and used the reg dose that had worked in the past. I waited one hour and 15 minutes and saw no difference inher comfort level and by this point it was about 1:30am so I gave her another half of the regular dose and waited till about 3:30am. At this point I didnt know whether to call the vet or not but I had normal vitals and heard gut sounds and she wasnt thrashing so I shut the barn lights down and sat awhile to listen to see if she would settle. I also noticed that she had only one manure passing(small) after 7pm that evening and a little urine and no interest in any more of the water after I fed it to her. I left about 4am knowing that I had work in 3hrs and there would be someone there at 6:30. I dont know if I was in denial but also remember it was my first sick horse Ive dealt w/ in my life and she always seemed to pull thru. I recvd a call at 10am from the worker at the barn w/ an update and she said she had taken Sierra for a walk and Sierra was not trying to lay down and eager to go but the minute she went back to her stall she would lay down and it was a lateral position. She also came into the barn w/ her in that position in the a.m.. and the girl also noticed that she also had no interest in food or water. So I called the vet and made arrangements for them to come out after I got out of school unless something came up sooner w/ her behavior. I got a call at 1pm to get to the barn because Sierra was laying down and groaning and clinching her teeth and the girl couldnt get her up. She felt I needed to be there and I think she knew it was bad but didnt want to tell me strait out. I called the vet on my way and the girl at the barn did too. I got there and I saw her laying down and when she saw me she put her head up and when she did I saw fluid coming draining out of her nose. It continued every so often and more often than not. In the meantime I called for the vet again to get there immediately and she arrived 20min after me. I tried to get her up and her first attempt she fell back and then got up and I knew it was bad. I let her lay back down and while she layed there she had a little tremble in her legs which I thought, oh god! shes heading towards shock too?When the vet arrived she immediately gave her a mild sedative and then I gave her the whole nite history up until this point. We got her up and she took her into the aisle as I took along side of her on a lead chain and the vet tubed her and as we did all the reflux came up and the vet asked if that was what I saw from her nose and I responded w/ yes. She and I knew it was not good and then she gave the rectal. She explainde that she couldnt even feel the adhesion but what she did feel was a four or five kinks in her sm intestines which I think she said was distended enough to feel immediately during the rectal(Im assuming that you dont feel the intestines immediately on a healthy horse?) She made a call to compare notes w/ the other vet that is her partner and has seen Sierra too. She came back and said that it was definitely time and she would go find a spot to put her at rest while I said my goodbyes. She in the meantime made arrangements for the burial guy to come pick her up but she didnt want to wait for his arrival as they usually do, to take her on the trailer and do the procedure there, and Im assuming again its because she felt Sierra was in lots of pain and she didnt want Sierra to suffer anymore than she had to. I waited for her to come back to take her from me after she found a spot outside the barn and before she did Sierra started to shake alot and I asked why and I think she said that it was signs of shock? I think she said that anyways. So I just have a few questions. _1- did she endure alot of pain thru the nite if she wasnt thrashing? _2-Was it a bad choice on my part not to call at 3am? maybe it could have been corrected? _3-when do you think this all started? bef or after I rode her? _4-could the ride for 10min have done something? _5-how did she get kinks in the sm intestines? _6-did the kinks have to do w/ the adhesion? _7-could it have been the storm the previous nite that caused her to jump around? _8-how many hours or days did it take for this type of medical issue to happen? _9- did she have the block while i was on her back and just not show me signs? _10-why did she start to shake/tremble minutes after her sedation? was it a drug reaction or was it shock or low temp or maybe something else? _11-I am feeling so guilty that I made her go thru the nite in pain and didnt act on calling the vet before the morning. I forget to mentiont to that I heard her burp 2x during the early part of the night which I thought was very odd seeing that horses dont have reflux up their throat. But again I think I was in denial and I dont know why I didnt do anything when I revisit this whole situation in my head day after day. Could you possibly explain your thoughts on how it happend and when it started? Im feeling so terrible that I didnt do anything sooner. I actually thought she was improving and we were gonna get past this nasty winter, which is what I prayed for. I did, however, make the decision at one point that I would never make her go thru another surgery after that tumor removal since it was such a traumatizing experience for her to be out of her environment and hooked up to all those I.V.s and just being sick and in pain on and off while recovering. So the decision was already made not to have her go thru a colic surgery if it were necessary. _12-If I had acted sooner would it have changed the diagnosis from surgical to medical and maybe be cleared by a tube w/ mineral oil or would it have not? _13-I just keep revisiting the whole nite/day and wonder if I could have done anything else? And if surgery was the only option that nite, like i said I made the decision to not go that route after evreything shes been going thru these last six month. I dont regret anything I tried to do and I would do it again but not the surgical colic. I jsut couldnt watch her through that from what I experienced already. I will try to attach some pics i coincidentally took the night she got sick but earlier in the evening after and during my ride. You would never know there was a problem lying ahead of me. Well I wouldnt have not being an expetise in equine behavior and medicine. |
Member: Tonijo |
Posted on Saturday, Apr 5, 2003 - 1:12 pm: Please read my message before these pics, hope the pics came along too.Toni |
Member: Hwood |
Posted on Saturday, Apr 5, 2003 - 1:51 pm: Hi, Toni,The pics didn't come through. Please, please, don't feel guilty about Sierra. Colic happens . . . it just happens . . . and you did so much to try to ensure it didn't happen, but it did . . . and that is that. . . and it is my bet that the ride and the excitement of the wind and anything else had nothing to do with the twists in the small intestine . . . You can't keep horses in glass boxes . . . we have to let them live and be . . . and Sierra got to be a horse on her last day . . . she did feel some discomfort, no doubt about it, but you did what you could to relieve it . . . and you were there at the end. Cherish the good times and memories and don't let guilt tarnish them. Life on this earth is accompanied by sickness, pain and death . . . but there is also health, comfort and life . . . and Sierra experienced all of it. Be good to yourself today. You are not alone . . . and it is also my bet that you will see Sierra again . . . healthy, happy and full of life. Holly |
Member: Cassey |
Posted on Saturday, Apr 5, 2003 - 3:11 pm: Toni, I am so,so sorry for your loss. It sounds like you are really being hard on yourself, and worrying that you did something/didn't do something that could have changed the outcome. Please don't second guess and question what transpired that night. You did everything you could for Sierra, and don't doubt for a moment that she knew that you were trying to help. Everything you did was reasonable, including taking her for a ride; if anything, the walking could have helped a bit. Besides, it meant she got to spend time with you, and that could never be a negative. I would imagine it was a surgical colic from the get-go, and you had already made a firm decision to never put her through that again. You did right by Sierra by making that most difficult decision on her behalf; you did your friend the ultimate honour. Cry and grieve all you need to, and know that there are many people who really understand how you are feeling.Dee |
Moderator: DrO |
Posted on Sunday, Apr 6, 2003 - 8:42 am: My deepest condolences Toni. I think these points answer most your questions:
DrO |
Member: Sunny66 |
Posted on Sunday, Apr 6, 2003 - 9:52 am: Toni, I am so very sorry for your loss, how difficult for you! I'm quite the novice horse owner, but it sounds to me as if you did everything you could and then some! Please take care of yourself and be easy on yourself....and know that all horses DO go to heaven!!!Aileen |
Member: Paul303 |
Posted on Monday, Apr 7, 2003 - 11:30 pm: Aaahhh...Toni....What you lack in experience, you more than make up for in heart. The world of horses needs more owners like you. Pay tribute to your mare by offering your gift of ownership and love to another horse...there are so many who need someone like you. |
Member: Tonijo |
Posted on Tuesday, Apr 8, 2003 - 7:42 pm: I want to thank all you wonderful people out here giving me the support that you do! I know someday I will beable to give my heart to another horse but I just dont see it now. I loved Sierra more than life and I still do and wish so badly that I could have her back. I just want to touch her, kiss her, see her. My heart aches sooo badly and I know theres others out there feeling the same way and I try to remind myself of that but its soo damn hard! The tears continue to flow and I pray for the day theyll stop. Its been 6wks and it feels like forever. Again, thank you so much for all your support. Iwant to believe I did everyhting I could but I wish there was more. She was a strong mare and I truly believed she stuck it out after her first surgery for me, cuz I really needed her but she just couldnt go on anymore due to the fact it was out of her control this last time. I love her for that!!Thank you for your kind words and support! If you have been thru this please do let me know theres light at the end of this dark dark lonely tunnel and share your experience. |
Member: Hwood |
Posted on Tuesday, Apr 8, 2003 - 8:33 pm: Hi, Toni,I have been to where I couldn't see any light . . . and thought it was the end, but it was a lie . . . there is always a light there . . . sometimes our pain keeps us from seeing it, but take it from one who knows and who thought there was no hope . . . . and who can now say, "Hold on and believe that there is ONE who loves YOU more than life itself" . . . and that will give you hope to go on and to grow strong enough to be able to give love again . . . . . for now . . .just rest and remember the blessings . . . and believe in LOVE . . . and you will come joyfully into the freedom of light again. Honest. Holly |
Member: Tonijo |
Posted on Saturday, May 17, 2003 - 10:13 pm: Dr OIts been a few months and I received a report w/ findigns from the vet referencing the last visit w/ Sierra. On the report it did state her vitals and they were as follows: heart rate 48bpm temp 99 respiratory rate 16 breaths/min. Abnormally low gut sounds in all four areas mucous membrane was pink w/ crt less than 2seconds but appeared depressed and uncomfortable. All the research I did to prepare myself for colic signs and symptoms suggest that Sierra's vitals during that particular event were of a normal and typical horse (which, of course, we know for fact excluding that info she was not typical that nite onto the next day)w/ the exception of her min. gut sounds and the fact that there were several gallons of reflux after tubing her. 1. Is this common for horses that have experienced the same form of colic ,involving the multiple loops of distended sm intestines palpable on rectal and reflux, to typically show these same vitals(witnessed w/ Sierra)? And have the same reactions that she did thru this whole evenT? 2. Or is it usually much more easily noticed w/ heart/respiratory being higher and more thrashing w/ pain? 3. And why do you suspect or think her vitals didnt elevate and react as a typical colic horse would have? Im happy if she was able to avoid such pain or did she? I just dont understand why the typical clinical signs were not present? 4. Any theory? ideas? 5. Have you experienced this w/ other horses in your career? Or is she out of the ordinary or do you find this common? Without a doubt I know when we saw the reflux, in combination w/ her other behaviors thru the nite (laying down getting up/min manure output/not eating/depressed) but not the elevated vitals. It was either surgery or putting her to rest and I dont question any of the choices I had. I made that decision beforehand knowing what could be ahead of me after her first colic and reasons behind it. Would like to hear your input. I know we dont have definitives because I didnt do necropsy but w/ your expertise and experience I thought you might have educated guesses from experience and knowledge along your career path. She appears to be an exception to alot of rules from my experience w/ her. I await your response. thanks again, toni |
Moderator: DrO |
Posted on Sunday, May 18, 2003 - 8:47 am: Mild colics or serious colics early in the course may have fairly normal vitals like this. It all has to do with the amount of pain at the time.DrO |
Member: Tonijo |
Posted on Sunday, May 18, 2003 - 10:24 am: Dr OThanks for getting back. So its possibly that they dont experience such bad pain sometimes when things are really bad? I did forget to mention that the evening before the next day that we put her down I did administer 2 doses of banamine paste within a 3hr peroid. Could that med have kept her pain thrash down noticeably? I dont believe that she was at an early stage when the vet arrived(it had been already 18hrs and she was slipping fast, very fast). Im also pretty sure she would have not made a trailer ride to a clinic if that would have bene the choice (because she was starting to tremble,cough,nose reflux) and I would think...heading toward shock? so maybe the meds helped mask and thats why its recommended to not give them a dose so easily when a colic comes about. But in her case Im glad it helped keep her more comfortable while she waited the time out. sorry I didnt add that part to my data from the last email, it was probably an important peice to the understanding of the puzzle. Question: Do you think I masked the pain and kept the vitals down with administering the doses of banamine from the evening before? Does it keep pain down that length of time?(18hrs) Again, thanks for your input. toni |
Moderator: DrO |
Posted on Monday, May 19, 2003 - 5:51 am: I don't think your Banamine administration had an effect on the outcome, Toni.DrO |