I've always wanted to experience everything that a horse has to offer. Everything from birth, their job as they go about life and, yes, even their death. It's always been like that with all the animals that I've owned. And for those animals that I've missed out on part of the cycle of life, it's like something is missing. A piece of the puzzle isn't there and the whole picture, at least on this side of heaven, is incomplete. It appears that I get to be engaged in all the choices of Zoe's life, from birth to death. Something has happened to Zoe and even tho she no longer is officially mine, the barn owner is relying on me to keep her updated on her condition and to research the options available for the horse and convey my findings to her. Truthfully, I'm thankful to be involved in the process. Even tho it is sometimes confusing and painful, it helps me in the process of letting go. Releasing the horses to another owner was a decision that needed to be made and I do not regret it. I surrendered all "rights" that surrounded the care of those horses. And to be involved in a decision as delicate as life or death is a privilege that I thought I had given up. All I can do is submit my findings to the new owner and give her my opinion. I know that we all want what is the best for the horse, to treat her fairly and give her a chance. The time we have spent waiting to see what will happen combined with the information gathered seem to lead to a poor prognosis. We have tried many treatments to bring some partial healing to the situation and I believe they have brought some comfort to Zoe. But the ultimate problem still exists and unless she can compensate for her deficits, the kindest thing to do would be to put her down.
On the morning of July 28th I was going to ride Zoe before work. I found her with a few scrapes and cuts on her front legs. I haltered her and watched her as I walked her out of the pasture. Her hind legs weren't working, she spent a lot of time trying to balance herself, she was neurologic. It was a slow walk out of the pasture. At first I thought of washing her legs off at the wash rack but then thought better of it as her balance was so bad. Instead I put her in the arena to see what she wanted to do. She stumbled around trying to eat the mulberry leaves that had fallen to the ground. She tried to trot but couldn't. I put a flake of hay in there for her and she parked herself by it and didn't move. I think the "world was spinning" to her so she just froze. I called the owner and got permission to call the vet. Vet says EPM or Temporohyoid Osteoarthropathy with secondary vestibular disease - hear after referred to as THO. It was also possible that her problem could be TMJ, or she hit her head or neck really hard on something. She was trying to shake her head, but could only tilt it a fraction of an inch and she would almost fall over. Her right ear was a little lower than her left ear. Her right nostril drooped a little lower than her left nostril. If she was going to fall it would have been to her right. Her head tilted a bit to the right. We put her in a paddock in the barn with no access to the stall and waited. In the meantime I have been the one taking care of her. Tested for EPM, came back negative. In a few days her symptoms improved. She could walk without stumbling, side pass, move backwards when asked, walk over poles, shake her head without falling. At first she had much discomfort in swallowing and eating (dysphagia). Every bite of food was met with laid back ears, neck outstretched, slowly chewing, quidding her food (leaving food balls). I put her in the arena a few days afterwards just to see what she wanted to do. She moved about better but could not trot, could not even take a trot step. As soon as she tried she flipped over on to her right side. She did it twice and then decided walking was better. She was figuring out what her deficits were. She was moved back into her paddock. Over the next few days her improvements did not seem so big, but she did not go "backwards" in her recovery.
I ran into a friend that knows Equine Bowen. She isn't certified in it, has only taken the first of 4 courses but knows enough of the basic Bowen to do movements that would help the basic functions of a horse but nothing specific to the head and jaw area. So once a week for 3 weeks she has seen Zoe. Over that time improvements have happened. She doesn't seem as uncomfortable eating, she is moving faster at a walk, she can do turns on the hindquarters, she can back over poles but does not make any effort to trot. When the horses in the pasture run by, she will not run with them. Her ears are even now, her nostrils are straight sometimes. She doesn't drop as much food now. She can scratch her belly by lifting a back leg and moving her head to chew on her belly. She can try to eat food on the other side of the fence by putting her head to the ground, going under the fence while her rump in up in standing position.
It has been about 3 1/2 weeks now and improvements have been slow again. As time has gone on I've tried to figure out what is really wrong with her. The new owner doesn't want to spend a lot of money on diagnostics and would rather wait to see what happens. The only diagnostics left are an X-ray or scoping the horse. An X-ray would help with the TMJ or head trauma issue and may help diagnose the THO. A scope would give a definite THO diagnosis but would do nothing regarding TMJ or trauma. As time has gone on I've narrowed it down to something wrong in her head. TMJ or THO would press on nerves that would cause neurologic symptoms. There were a few things that she was doing that lead me to look into THO deeper and I believe that is what is wrong with her. The head tilt, shaking the head, dysphagia, facial deficits, possible right eye problems with sight and blinking, when I put my hand under her jaw as she chews there is an "extra" movement down there. The more I read about THO, the more I could see her symptoms.
THO is a degenerative bone disease. They don't really know what initially causes it, there is no preventative measures that can be taken to completely stop it, nor is there any "red flag symptoms" that would cause one to think something like this will happen. It's usually diagnosed by scoping a horse and as the scope moves into the guttural pouch it happens to go by the stylohyoid bone and at that time the vet would notice that the bone is abnormally large and the disease has already started and it's just a matter of time before it progresses to the stylohyoid bone breaking. Inside the horses head, inside the skull and jaw bones there are a series of bones that are joined together from the base of the ear to the larynx. The bone by the ear starts to degenerate and causes the stylohyoid bone to enlarge. Eventually the bones fuses together but the horse still has to move it's jaw-it has to eat, drink and vocalize. As the horse does this, it fractures the stylohyoid bone. At that point the neurologic signs show up.
There are two ways this can be dealt with. Surgery or medical treatment. If caught early, before the fracture, there are two types of surgeries that can be done to try and stop this from happening. One is to cut a piece of the stylohyoid bone out or to remove another smaller bone. The cost is close to $3000 for this to happen where I work. More money than the new owner or I would spend. The surgery could cause a complete recovery or not. Each case is different. There are no definite answers. Medically, anti inflamatories are given and you wait and see what happens. The bone is fractured, as it heals it may heal in a "good" place with no arthritic boney growths and life will go on for the horse. It probably won't return to its previous job but may become a pasture pet. Or it may cause more ear and eye problems for the horse, as if it has an ear infection, the eye can develop a corneal ulcer or uvitis. An infection may set up that will cause fevers and needs for more medications. A horse with this problem depends on their sight to compensate for their neurologic deficits. If sight is taken away from this horse, like a blind fold, the horse will not be able to walk. The bone that "healed" could fracture again as this is a degenerative bone disease and cause more neurologic symptoms. THO could mean anything from euthanasia to going back to a normal life. The surgeon at work said the pendulum usually swings somewhere in the middle of that scenario for a while but that in time THO is usually what kills the horse, even one that has "recovered" because it is a degenerative bone disease.
There are some good websites on THO.
http://www.roodandriddle.com/news/my-horse-has-what-temporohyoid-osteoarthropathy.html http://www.thehorse.com/articles/29660/equine-temporohyoid-osteoarthropathy-studied https://s3.amazonaws.com/assets.prod.vetlearn.com/mmah/b3/f591f1606d4976860b4bd3b16d7dbb/filePVE_04_06_278.pdf
I've relayed my findings to the new owner, along with LOTS of material for her to read. Some of it is in laymen's terms and some of it you would need a dictionary to read it. She has allowed me to have some input in the course of treatment for Zoe. I do know someone that is certified in Equine Bowen treatment and is willing to try to make her more comfortable in the jaw/head area. The new owner is willing to pay for 3 treatments for that. Zoe did respond to the basic Bowen so maybe this will help her to improve. The new owner, like myself, thinks that Zoe has not shown us yet how far her healing will go but she is also feeding and housing a horse that isn't making any money for her. Life has to go on at some point. She also wants Zoe back out in the pasture because she needs the stalls in the barn for new horses coming in. Zoe may be able to negotiate a herd, I'm not sure she will run with them and hopefully she can move away from a bossy horse. Over the next week one of my jobs is to get her used to the herd again. I think I'll daily try it in the arena, one day by herself, next day with one horse, next day with two horses. We will see how it goes. Zoe will be at the barn, with lots of people around that can keep an eye on her and it's all familiar territory. If that all goes well and she has her 3 weeks of extra Bowen and if she improves she will eventually go to retire at the new owners other property. That is a lot of "ifs". There comes a point that you have to try to see if life can work for her again and apparently soon is the time. If she can't be comfortable eating and if she can't live in a herd, she needs to be put down. Because if she can't do those basic things, life as a horse will not be good for her. It would be kinder to put her down rather than allow her condition deteriorate.
The story isn't over yet. More to be written later. But at this time, this is where things stand. I'm not sure where this will end.
