When his regular veterinarian, Dr. Garrison from Waverly Equine Services, arrived to look at him we learned he had strained the joints and ligaments of the lower leg on his right front. We also found a gigantic ulcer on his left eye from thrashing around while he was stuck, thus injuring it banging it on the ground and fencing.
Diagnostics included xrays of the injured leg with clipping and cleaning the very small abrasions on the sides. Dr. Garrison also stained the injured eye which is how we identified the large ulcer. We proceeded to get him fixed up as best we could with a mud poultice on his leg with a pressure wrap. In addition to his oral pain meds, Casper also began a four-times-a-day regimen of various eye ointments to keep the pupil dilated (and eye muscles relaxed) and prevent infection from entering the eye.
Things were progressing smoothly. It took a few weeks but the eye cleared up beautifully and he was walking around on the injured leg sound at the walk with the wrap on his leg being changed regularly. On the morning of April 7th Casper marched up to me for breakfast completely sound. Just two hours later Dr. Garrison came to recheck him, and when his owner went to halter him he was very lame. Even though there was no significant visible trauma to the skin when he had been found hanging in the fence, we later learned the tissues had been stretched and damaged. It took nearly two weeks for the skin to die and slough off, which then left an opening through which infection set into the pastern joint.
Dr. Garrison immediately recognized that the joint was infected, doing more radiographs and an ultrasound of the leg to try to confirm. She then referred us to Colorado State University for joint surgery for Casper.
When we got to CSU with Casper and his septic joint the prognosis was grim. The veterinarians there said if we had caught it soon enough potentially Casper would make it, but if the infection had been sitting for days to a week in the joint he likely would never be sound. Casper's owner elected to do a smaller version of the surgery offered to us to give Casper a chance.
Casper was taken into the surgery area and laid down by being pressed up against the wall. Once he was injected with induction medications he fell asleep and the people assisting guided him as he laid down in the surgery room.
A veterinary resident ran anesthesia for Casper, you can see in this photo he has a purple towel over his eyes to keep things dark for him. He has an IV in his vein in his neck for the drugs to enter his system and keep him asleep, and the tube in his nose is for oxygen. On the clipboard the resident kept detailed notes on his vital signs and how deeply he was asleep.
In this video you can see the veterinarians flushing out the joint with saline solution to rinse it.
https://www.youtube.com/watch?v=ZPE3FC-cfMo
Once the saline had been poured through the joint the veterinarian injected antibiotic. This was to hopefully kill any bacteria that remained after the lavage.
Lastly they put a cast on Casper's lower leg. This was to keep it completely clean so no further infection could be introduced to the already compromised joint, as well as to stabilize the joint because the collateral ligaments were damaged.
Casper came back to Bit of Honey on stall rest. We were to look for any heat or moisture to appear in the cast, as well as any lameness or fever which would indicate the infection had returned. This could have happened because of not getting every last bit of bacteria out of a difficult joint to flush, and if that was the case we would have had to euthanize Casper.
As an ongoing treatment, Dr. Garrison put additional antibiotic in the blood vessels descending down his leg into the cast in an effort to prevent the infection from coming back. Unfortunately, when he was hauled to Dr. Garrison's for the first treatment after CSU, we discovered that the blood vessels had been compromised by hanging upside down in the initial trauma. Because of that only a small amount of antibiotic could be injected into the leg at a time, otherwise the vein would blow because it was too fragile to be injected into.
Casper still needed these treatments, but it was determined that they needed to happen daily in smaller amounts rather than every two to three days in larger amounts. To ease the stress on him (and the vet!) of traveling from Bit of Honey to the vet clinic and back so often, we decided to hospitalize him at Dr. Garrison's.
This photo is of Casper with his lower leg in the cast, also wearing a tourniquet on his upper leg so the antibiotic could be injected.
This photo shows the line going into Casper's leg, and the antibiotic is going through it. The human in the photo is the husband of Casper's owner.
The red wrap is covering the area where the antibiotic went in, to keep in clean and support the injured blood vessels.
Dr. Garrison is a very forward-thinking veterinarian and uses different modalities to help horses heal. Here she is using laser therapy on Casper's leg to stimulate the blood vessels to heal. It worked well, and she was able to do further antibiotic injections into the veins.
Casper was sedated for this work, here he is resting his head on a friendly chest.
Because we had caught the infection within a couple hours of it invading the joint and then addressed it quickly, Casper did well with his cast. He didn't go lame, the infection didn't return, and on April 20th he went back to CSU to have his cast removed. They found the wounds were healing well and after removing some proud flesh they bandaged him up again to return to Bit of Honey for more stall rest.
Since then I've been doing bandage changes for Casper. He's gotten feisty because he's tired of people messing with that leg. He isn't opposed to striking with it as well as aiming a swift kick in someone's direction with his hind leg on the same side. He and I have had a few frank discussions about his behavior. I carry a crop in my back pocket when I do bandage changes, and he's been swatted a few times as I protect myself and emphasize to him what is and is not acceptable behavior. I also hearkened back to my small animal veterinary technician days, and got a little creative with his bandage change. In light of his attitude, the devilish red and black smile seemed appropriate.
His leg does look good now that the cast is off. The wounds are looking healthy and are healing well.
There is some residual swelling around the pastern on the injured leg, as you can see in this photo when compared to the right leg. He is walking around sound on it, though, and is feeling plenty fresh. The shenanigans in his stall are entertaining to watch.
https://www.youtube.com/watch?v=nKF3fHOwapk
Casper is mentally ready to go back out to play with his friends. We are waiting on one more recheck by Dr. Garrison, and we want the wounds completely closed on his leg before we turn him loose. Casper really has turned out to be a miracle baby. His odds were not very good, but youth and vigor were on his side and he's doing well. Now to channel that youth and vigor towards good instead of evil!
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