I guess we are now graduating from the roller coaster to the Merry-Go-Round where one day you are up and the next day you are – not up.
The first few days at the hospital were not so good.
Our girl had therapeutic shoes put on her feet and then she had to stand on those feet to have her backs trimmed.
She did it without a nerve block so that was good… but, she was very sore from the ordeal and suffered the next few days. It had to be done, but it was painful.
However, yesterday, she seemed to brighten considerably.
Unknown at this time.
Our goal is to bring back health to her necrotic soles. If we cannot re-supply the blood flow to her toes, she cannot be helped. It was surprising to me to know that her sunken coffin bone was not the worst thing… it was her dead soles.
How did she lose blood flow to her toes? Well… it was because the trim she was given put her soles as the lowest point on the ground. This created intense pressure that did much damage but also cut off the main blood flow (which is on the bottom of the foot – Horsegods must have done that for a reason but it escapes me now…) to her toes. Hence, her soles are half dead.
WHY THE NEW SHOES?
The idea of ‘reverse shoes’ is very controversial – which really only means support everywhere except the toe so the horse has breakover and doesn’t load the sensitive toe. (However, the toe should be supported by padding.). And, there are many reverse shoes out there…
Here is why we are using a reverse shoe –
As we all know, Tess suffered a ‘traumatic trim’ which left her sole/frog as the only surface making contact with the ground. Her walls and heels were cut away. This was very bad and created a cascade of pressure, pain, inflammation, infection, sinkage and irreversible damage to her hoof capsule. It also compromised the vein carrying much needed blood to her toes.
It was very, very important to A) Find the root cause of the Founder and B) stop the pain cascade.
To stop the pain cascade, we had to get her sole off of the ground…
These shoes support and elevate the sole – as if she had walls and a heel. She is also wearing a hospital plate. A hospital plate is a sliding plexi bottom that allows the DR to medicate/harden and protect her necrotic sole – and when he is done, he can cover all that up so she can stand on a surface without fear of infection.
Also, her sole is protected by foam material which molds to the bottom of her foot and gives support. The DR has added purple pads to her toe (which was trimmed back so she cannot bear weight on her sensitive toes) for comfort and support.
Surprisingly, the DR re-applied the HOOF CINCHES (hoofcinch.com) as he agreed that they seemed to help her pain by pulling the hoof wall back towards the lamina.
Tess’ foot is treated often during the day so that they can clean and attempt to harden her soles and stimulate the blood flow to her toes – hoping to bring the tissue back to health.
I have been visiting our girl almost every day and she is receiving excellent care.
Not only are they tending to her very sick feet, but they are being faithfully regimented on her soaked, low calorie feed (better than I was because they are there around the clock).
They can also keep her pain meds and anti inflammatories on board at exacting intervals which is much better for her.
Anyway, today, when I visited her she was very bright! We had her stall door open with only a lead rope across – since she is so lame, we had not worries of her escaping – yet, I WAS WORRIED SHE’D ESCAPE BECAUSE SHE WAS WALKING SO MUCH BETTER!
Baby steps but YAY! As the DR said, she is not out of the woods even though she is walking better. She has to grow sole.
I took this video of her today…
NEW TREATMENTS ON THE HORIZON…
Desperate to help her, I asked DR. E if there was anything out there we could do to help her – anything… and I named several conceptual treatments.
I was pleased with Tess’s progress today. I decided not to remove the glue-on shoes after all. Jesse and I came up with a way to place the straps this afternoon :)). We used a dremel type tool to grind away sections of the glue and insert the straps within the stenciled pattern to make sure the straps were placed flush with the hoof and without affecting the stability of the shoe. We’ll see how she likes the extra support from the straps.
I have debated on the stem cells for several days, but to be honest, it all sounds great but the cases that I know off, the results were 0% success on severe cases… and it’s questionable on mild to moderate cases because many times those tend to resolve without such treatment. Also, the “plumbing” (intact blood vessels/flow) needs to be there to deliver the cells. Same thing with the laminin and antibiotics via distal limb perfusion. If push comes to shove, we’ll do a venogram to check the “plumbing.” However, one of my rules is that if they are improving, I leave them alone. So we’ll see. I’ll keep it in the bag of tricks though!
I’m lucky I get to kiss her again tomorrow…I hope! :)
Eduardo De La Cruz, DVM
AND THEN I SENT ANOTHER ARTICLE …
And the DR answered with this:
Yep, I know these vets…Dr. Bras and Dr. Morrison. Great podiatrists! As they state, there is still no formal dosage, interval, or the best tissue to harvest cells from, but l may be able to talk to Dr. Bras and see what they are actually doing now… I’ll keep it in my bag of tricks for sure. Thanks for sharing. DON”T HESITATE! I will not be offended! We are a team…its not my way or the highway! :) I’ll update you tomorrow.
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