I don't really have much to say lately. Samson is hanging in there, and I am still taking things one day at a time. I have been researching EPM with a frenzy, and am looking into a new drug that is being used in clinical trials - so far with a very high success rate. I discussed the option with one of my veterinarians yesterday, and he is consulting with the vet/PhD in charge of the trial to learn more about the possibility. In the meantime, I find myself submitting the poor guy to endless scrutinizing, amateur neurological exams, and lots of tearful hugs.
He hasn't been quite himself the last few days. It isn't horrible, but his general attitude is markedly depressed from what it typically is. It started the day we trailered to the vet for the follow-up, and I have this sinking feeling haunting me that maybe the stress of the ride induced a flare-up, if he is indeed EPM positive. Clinically, he is remaining pretty solid - vitals have been normal for over a week, appetite is fantastic - on paper, he looks pretty good. His last round of bloodwork showed an elevated white blood cell count, so it has gone to the opposite extreme. I am a little worried that it showed an increase, although I am curious to see if it had anything to do with his catheter site reaction. He developed a lump the size of a grape at the base of the catheter, so it was pulled at the last vet appointment. We are now doing hot compresses and DMSO, which helped at first - but the inflammation has remained stagnant the past two days.
Tonight will be his last dose of the antibiotic, and then his immune system will be depended on to do the rest. The next round of bloodwork will be done most likely on Monday to see if there has been any resolution in his white count.
I am uneasy. I have this unsettled feeling because of his overall attitude; and I don't know what to make of it. I'm not sure if it is a flare-up of EPM or what is going on - but something is causing him to act withdrawn all of a sudden. The only time I see him act like himself is at feeding time - that is something that NEVER changes! :-)
On a side note - I entered my favorite picture of us in a photo contest the Dover holds. You don't have to do anything, other than click a "vote" button. You can vote once a day for the next week and a half, til the contest ends. I would truly appreciate anyone who might be willing to take the time to vote - Dover has a pharmacy that carries one of the EPM medications in consideration for his treatment - and every penny helps.
Thursday, October 4, 2012
Tuesday, October 2, 2012
Three Letters You Never Want to Hear in a Diagnosis....
E.P.M.
Also known as Equine Protozoal Myeloencephalitis. Sadly, it's a disease I have encountered before. As a matter of fact, the first horse I ever saw put down suffered from EPM. "Curtain", short for Curtain Call, was an older Thoroughbred at Robin's farm in Iowa, where I had my first job as a working student. He was diagnosed somewhere around seven, after having two falls cross country - one in which his rider's leg was broken. Over the years, the disease slowly progressed and attacked his neurological function. He eventually sucumbed to colic, and it saved everyone from having to make the decision of whether he would make it through another tough Iowa winter.
That was the last time I encountered an EPM horse. Until this morning, when I received a voicemail that Samson's titer results were back. The vets at NC State decided to send it off after he exhibited some obvious ataxia after his seizure-like episode. I didn't hesitate to let them send off the test, especially since he has a long history of being "wonky" - he has always had a bizarre unsoundness that could never quite be pinpointed. In all honesty, EPM and Lyme disease have always piqued my curiousity, because either diagnosis would explain a lot of his weird symptoms over the past year. So I let them send the test. Then I proceeded to more or less forget about the whole thing, since I have been buried in the constant bustle of checking vitals, administering medications, trailering to follow-up appointments...it's been an endless stream of one thing after another, which I have gratefully accepted simply because he is still HERE.
But back to the voicemail. The attending veterinarian left me a message that the panel had come back with a greater than 95% chance that he is EPM positive.
All of a sudden, the cloudy feeling of doom I have been dragging around all day seemed to make sense. Have you ever woken up just KNOWING things weren't going to go well? I woke up with that feeling this morning. Did my best to shake it, and then three hours later, the phone call comes.
I know it isn't the end of the world. I really, honestly know that. It is a fairly treatable disease. But it's not cheap. At this point, I feel like I am in so deep I don't know how to get out anymore. I also feel like my poor boy has so many strikes against him at this point, it's just a matter of a ticking clock. The instability in his feet that could shift at any point and cause a debilitating lameness; the EPM we have to decide whether or not to treat...How could I not treat? I have watched a horse succumb to neurological disease. It isn't pretty. I don't know that I could watch my heart horse fight that kind of battle.
I have already made the decision to fight for this guy - mainly because he keeps showing the will to fight on. So I suppose the only obvious choice is to take this in stride with the rest of the problems that face us. I just feel like this poor guy can't catch a break, and I wish I could just make it all go away for him. All I can do is continue to make the best decisions possible for him. And hope and pray that I will know when enough is enough.
Also known as Equine Protozoal Myeloencephalitis. Sadly, it's a disease I have encountered before. As a matter of fact, the first horse I ever saw put down suffered from EPM. "Curtain", short for Curtain Call, was an older Thoroughbred at Robin's farm in Iowa, where I had my first job as a working student. He was diagnosed somewhere around seven, after having two falls cross country - one in which his rider's leg was broken. Over the years, the disease slowly progressed and attacked his neurological function. He eventually sucumbed to colic, and it saved everyone from having to make the decision of whether he would make it through another tough Iowa winter.
That was the last time I encountered an EPM horse. Until this morning, when I received a voicemail that Samson's titer results were back. The vets at NC State decided to send it off after he exhibited some obvious ataxia after his seizure-like episode. I didn't hesitate to let them send off the test, especially since he has a long history of being "wonky" - he has always had a bizarre unsoundness that could never quite be pinpointed. In all honesty, EPM and Lyme disease have always piqued my curiousity, because either diagnosis would explain a lot of his weird symptoms over the past year. So I let them send the test. Then I proceeded to more or less forget about the whole thing, since I have been buried in the constant bustle of checking vitals, administering medications, trailering to follow-up appointments...it's been an endless stream of one thing after another, which I have gratefully accepted simply because he is still HERE.
But back to the voicemail. The attending veterinarian left me a message that the panel had come back with a greater than 95% chance that he is EPM positive.
All of a sudden, the cloudy feeling of doom I have been dragging around all day seemed to make sense. Have you ever woken up just KNOWING things weren't going to go well? I woke up with that feeling this morning. Did my best to shake it, and then three hours later, the phone call comes.
I know it isn't the end of the world. I really, honestly know that. It is a fairly treatable disease. But it's not cheap. At this point, I feel like I am in so deep I don't know how to get out anymore. I also feel like my poor boy has so many strikes against him at this point, it's just a matter of a ticking clock. The instability in his feet that could shift at any point and cause a debilitating lameness; the EPM we have to decide whether or not to treat...How could I not treat? I have watched a horse succumb to neurological disease. It isn't pretty. I don't know that I could watch my heart horse fight that kind of battle.
I have already made the decision to fight for this guy - mainly because he keeps showing the will to fight on. So I suppose the only obvious choice is to take this in stride with the rest of the problems that face us. I just feel like this poor guy can't catch a break, and I wish I could just make it all go away for him. All I can do is continue to make the best decisions possible for him. And hope and pray that I will know when enough is enough.
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