The Recovery – Part 1 – Ethyl Alcohol Fusion of Pastern Joint

Winter 2013-2014 in Syracuse, New York behaved as it was supposed to.  Very cold and very snowy.  Perfect conditions for Bailey to want to stand in her stall and eat hay all day and let her pastern joint fuse together.  I still was giving her 1 gram of bute 5 days on, 2 days off.  All was going fine for about 4 months.  I was getting pretty optimistic that I would have a horse to ride in the summer.  That all changed on April fools day 2014.  Could this lameness be starting all over again?

April 2, 2014.  6 months since the ethyl alcohol injection.  Bailey can’t walk at all.  She won’t put the foot down at all.  What is going on?  Is this the final stage of fusion?

4-7-2014 90% fusion

4-7-201490% fused

April 7, 2014.  Dr. Romero is called to examine Bailey and take an x-ray as to what is going on with the severe lameness.  The x-rays reveal 90% fusion.  I guess I am happy, although Bailey seems terrible.

Patience is a familiar word in this procedure I am learning.

EXAM – Diagnosis: Osteoarthritis right front pastern joint.
History: Degenerative arthritis of the right front pastern joint, previously injected with
alcohol 5 months ago. Owner reports increased degree of lameness over the past week but
has been improving slowly. Owner also reports increased coughing spells which also
started about a week ago. Coughing doesn’t seem productive and may be associated with
the new use of wood pellets for bedding.
Exam: BAR. T 99.7, P 44, R 16. BCS: 6/9. Increased effort and lung sounds. Small
whistle on the right side on exhalation. 4/5 grade lameness on the right front, sensitivity
to palpation of the pastern. No sensitivity to hoof testers. Small sore on right hind
calcaneous. 1cmx 3cm non haired plaque of skin, raised, and pigmented on the right neck.
Radiographs reveal 90% ablation of the PIP.
1) Use anti inflammatories and pain killers for one month.
2) Recheck in 1 month. (Alfredo Romero, DVM, DACVS)

April 8, 2014.  Bailey out and about walking in pasture.  Still favoring right leg, but definitely getting around better than last week.

April 16, 2014.  Bailey with a bit of spirit in her walk.

April 20, 2014.  Almost 7 months from the Ethyl Alcohol injection.  Bailey walking around pretty good.

April 27, 2014.  Slow progress.  Hoping slow and steady wins the race.

May 7, 2014.  Dr. Romero checks Bailey again.  He suggests again putting her on Gabapentin for a two week trial to see if that helps her since her lameness is so intermittent.  One day good, one day bad.  Nothing seems to matter.

June 5-22, 2014.  I decide to try as a last resort Gabapentin.  Gabapentin is a nerve pain medication and anticonvulsant.  Gabapentin is a structural analogue of GABA, an inhibitory neurotransmitter.  I complete 2-1/2 weeks of Gabapentin on Bailey.  Her lameness reacted the way it has all along.  One day good, then bad, then terrible, then better.  Dr. Romero said if she was going to respond to it, she would have by now so we stop the medication.  Plus the drug is really expensive and it really effected her mentally.  She was a zombie horse, even after we adjusted her dosage.  I did not like that drug on her at all.

I am exhausted from watching Bailey deal with high ringbone for 4 years, and especially the last 8 months not being successful in this treatment.  I am discouraged that after all Bailey has gone through, she is no better, and maybe worse than before the injection.  I make a decision to look for another horse that I can ride and if Bailey continues so poorly, I will do the humane thing and put her down before winter. 



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