Saturday, November 16, 2019

On Death's Door (Week 1 & 2)

She will not be 
the first I've lost,
Yet, there's still much water 
in this rock of letting go.


(Penny the day after IV fluid and plasma.  She is not sedated. When we walked in, she didn't even look up to see us. Death's door.)

A couple of weeks ago, we were riding Penny and Cowboy out on the trails...



and then tragedy hit.

I woke Thursday, November 7th, and saw Penny lying down. Never a good sign.  I was immediately off to the vet, and she was ultrasounded, fluid tapped from her belly, colic exam, & blood tests—diagnosed with severe typhlocholitis and peritonitis.

The outlook was very poor, and they pulled me aside and told me just how dire it was, but to be honest, I didn't understand half of what they were saying.  My husband is a physician, and he did.  He reaffirmed--it's dire. It's really bad. Ignorance is bliss, all I saw was the road to recovery.

They kept her at the hospital that night and administered IV fluids and plasma (her blood had lost protein and only plasma could bring it back up) and there was heavy inflammation of the GI tract--something I didn't understand then would be most difficult in the recovery phase.  They also gave her heavy duty antibiotics (Gentamicin --which is not recommended for animals that sick and weak, but we had to go nuclear on the bacteria-- & penicillin)  The bacteria, which had migrated from her colon through, they assume, a perforation (though by what, we don't know..cancer, ingesting something sharp) that bacteria had entered her gut, and worse, her blood stream.

To bring into even simpler terms--getting her past the bacteria infection was doubtful. Getting her past the secondary issues--high temperature (laminitis), antibiotics (liver & kidney failure, diarrhea, loss of appetite), primary problem (the X factor--the colon needed to heal so that bacteria didn't keep leaking out.) AND worst of all, from the inflammation--the very definite possibility of ADHESIONS.

For those who don't know what adhesions of the gut are--I won't be of much help.  My husband keeps drawing me diagrams and, of course, the vet tried her best to explain when we arrived the second day and Penny had deteriorated even further.

You can read all about ADHESIONS here.  But to put it in a way I understand, you know why most colic surgeries start out successfully, but then the horse never fully recovers--adhesions.

So to recap: when we arrived the 2nd day, Penny had gone WAY down hill.  Even without sedation, she didn't recognize us as we entered. She's at least 24 years old--so an elder equine, and the vet gave her a poor prognosis--especially because many of the secondary issues don't show up until later--but are a very likely outcome.

Vets don't tell you what to do, but when I asked mine about euthanizing--she was very supportive of that decision.

This is getting long because this has been a LONG road. I'm going to speed up the telling--

Made the decision to euthanize, walked Penny out of her confinement, the sun hit her, she perked up just a little, walked her to the kill spot with doc and tech, Penny started grazing. I started to change my mind, especially finding out she was drinking on her own. (She had gone off food at the hospital, but not water.) I asked if I could take her home, the vet said yes, but she would probably die.  I decided to give it a chance because at least she'd die at home with her buddies. Vet discharged us with all the medicine & very specific parameters for euthanization should X of Y or Z occur.

I went home and got my trailer and truck, came back to get her, (again in confinement), and she had broke out in full body sweat--(toxic episode) but I loaded her up and took her home anyway.

Upon arrival home, the sweat had dried and she was relaxed and happy.  Her temp had returned to normal, her heart rate had decreased and she was HUNGRY and eager to see her buddies. HUGE TURNAROUND!)

(That's what LOVE can do for you--the best medicine.  Horses are herd animals, and confinement is one of the worst things for them--but sometimes necessary. I always cringe to leave them behind at the hospital for that reason.)


(Penny, moments after arriving home from the hospital)

Unfortunately, that initial boost was temporary.

It has been a roller coaster, with days Penny is comfortable, but appears to be on death's door, and days where she looks like she's walking back toward life. My husband and I administered Gentamicin and penicillin IM for a week (that is a lot of poking), and her fever broke for good on the Monday following hospitalization. We discontinued half doses of Banamine ASAP to lessen the load on the kidney and liver and to speed up gut healing)  We haven't had any diarrhea yet, probably because of the BIOMOS.

But on Tuesday, following hospitalization, the antibiotics were taking their toll--she was getting weak. By the time the full course of antibiotics rolled around, she looked awful, but her vitals were still maintaining without Banamine, and she continued to drink and eat a little. We were very close to euthanizing, but I wanted to give her a couple of days to recover from the antibiotic regimen before making the decision.

I'm glad I did, because each day, she has grown stronger.  She had developed severe ascites, but since ending the antibiotics, her body is reabsorbing the fluid and she's peeing it out.  Today, she looks ALMOST back to normal.

The vet told us to give her whatever she wants to eat: grazing in the pasture, Rice Bran, Equine Senior (with beet pulp base), and hay.  She gets to choose what she wants and needs, and everyday it is something different.  Her eating is good.  Her drinking is excellent. Her will to live is strong.  Her temperature is normal.  Her heart rate is very close to normal.

Will adhesions take her down? Laminitis?

I don't know the answers yet.  Each decision I've made has hinged on the smallest glimpse of this or that hope measured against quality of life assessments.

Time will tell if this is another miracle.

11 comments:

  1. Oh my. What a difficult road. Every animal I’ve had has told me when it’s time. You know Penny and will know when to let her go. But it’s not today and that is a good thing.

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    1. The vet said it would be a roller coaster with her chances of healing at each step--basically, a coin toss. So far, she has won all the tosses. In some ways, it would have been easier to have let her go when we almost did--the worry and work would have been removed--but ...and I need to say, I think of myself as a very practical person when it comes to my horse's health--a minimalist...but something in her kept me moving forward with all this. Yes, it's definitely not today--she is out happily grazing.

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  2. Oh poor Penny and poor you. It's always a difficult decision to know what to do whether to let go or fight for more time. I think you made the right decision to bring her home. She seems happy to be out grazing with her friends. If things change she will let you know but for now she's happy and as you say she's won all the coin tosses so far. Maybe she will keep winning. Fingers crossed being home and happy will give her what she needs to stay with you a bit longer.

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    1. Thank you for the encouragement. She’s eating a lot equine senior and rice bran today, plus grazing, so she is still improving. The ascites is almost all gone. Yay!

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  3. Oh my gosh Linda, I am SO sorry to hear this! :( Poor Penny! I'm glad to hear that you're giving her the best possible chance at recovery, and brought her home. Many people, even if they would want to accept all this responsibility, couldn't because of work responsibilities or whatever else. Be thankful that you can, and have the ability to give her the supportive care and the love and the time that she needs to heal. Whatever it takes! And don't forget the power of prayer! I will be praying for Penny! And you and your hubby as well - for strength, for compassion and for the ability to do what is right for her, whatever that means. You're in such a tough position to be in, and I will pray for her healing and quality of life. But you are so right - she has the best chance at home if care can be provided. Bless your hearts for loving her so!

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    1. You’re so right that I am lucky to be able to care for her myself. Last year, when Tumbleweed has that virus, I was so exhausted caring for him, his night in the hospital gave me much needed rest. I was the one who requested he stay and be on IV fluid. I thought he needed that hydration, and I didn’t want to risk a thing. I came home that day and collapsed into the deepest sleep I’ve ever experienced. Penny didn’t require the same amount of 24/7 care after we brought her home, but pretty close. We have a camera on her stall, so I’m able to monitor her at all times from anywhere. The app is on my phone. I have been home everyday, of course. There’s no way I could have left. The price for them to do what we did was about $2,000. So, that is what we saved. The first night was the most expensive because of all the many, many tests, ultrasound, IV and plasma. Expenses aside, I cannot stress enough how powerful being home and near their herd is to their healing. Our vet completely agreed. She said they have discussed many ways to make confinement easier on horses—mirrors, for example, but everything has a downside. They felt Penny needed to be confined due to the possibility of salmonella. Unfortunately, that stall had no windows or contact with the outside world. And, of course, no other horses. That picture above is what she looked like—so, it’s no wonder, facing what we faced, we’d make the decision to euthanize. Sunshine perked her up, but when we left to get the trailer, she fought going back into the stall and then had that horrible toxic episode where she broke out in a full body sweat. She is still not eating hay, but the ascites is gone now and she was able to lay down and rest for the first time in a week. She’s hungry for senior feed and fresh grass. I feel cautiously optimistic, as my vet always says.

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    2. The $2,000 we saved was for full care from Friday to Monday—3 days.

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  4. Bless her heart...and yours for working so diligently to regain her health. Hope she's growing stronger with each passing day. You mentioned that this is the same issue that Tumbleweed had??? Wonder why something so unusual has happened on your place within such a relatively short period of time? Do the docs have any ideas?

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    1. Tweed didn’t have the same issue. He had a virus.

      They think Penny had a tear in her colon—either from eating something sharp, like a stick, or cancer, ..those were their only two guesses, after looking at all the tests.

      When Tweed became sick, he hadn’t even been put out in the herd. He was still in a private stall getting to know Foxy.

      So, different issues, no connection for those two.

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    2. When I said “had that virus”, I meant the virus he had. Penny doesn’t have a virus. Maybe that’s what was confusing?

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  5. Oh my gosh... apparently you and I weren't seeing each other's posts- thanks Google- because I check my reading list pretty much every day and didn't see any of these posts on Penny. Will read them all and comment on the latest one.

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