Thursday, August 28, 2014

Early Mornings and SMZs

I got to take Maggie home from the hospital on Monday! I thought I was doing pretty well for myself while she was up there, but after bringing her home I just feel relieved in a way. I know she got excellent care while she was at Myhre, but it's just nice to have her close by again.

Reunited with her boyfriend, Rio
The stent actually hadn't come out yet - one of the vet techs instructed me on how to do it myself so that I could take it out on Wednesday. The real bummer is that she actually has to stay on stall rest for the next two weeks until her sutures can be taken out. It would be quite a bad thing if she were to roll and pop the stitches and get the area all dirtied up. The bright side though, is at least it's two instead of three weeks until they can come out.

For the two weeks that the sutures are in she needs SMZs twice a day, so I've been swinging by the barn both before and after work. Having to go to the barn before work means getting up at 5 am every day (actually only a half hour before my normal wake up time at 5:30). If I speed through my morning routine and pack my lunch the night before then I have enough time to dose her, pick out the stall, and take her for a quick hand walk down the driveway just to get her out of the stall. As much as I hate getting up any earlier than I have to, going to the barn is actually quite a nice start to the morning. It reminds me of when I was I'm school and had to go do chores before classes (which now that I read that sentence back, doesn't sound like a good thing, but it actually was!)

Early morning hand walk and grazing.
So yesterday being Wednesday I went ahead and took the stent off and here is what it looked like: 

My horse has a wrinkly neck.
7 stitches total. I was a little concerned about those bloody-looking spots at first, but they already look better today having been exposed to the air:

Seriously, look at those wrinkles!
Not too shabby! It'll be a long two weeks, but she's being a very good girl so far.

Friday, August 22, 2014

The Lump: Part 5 - Post-Surgery

Maggie had her surgery, a hemithyroidectomy, this morning and the vet said everything went very well! I went up to visit her after work today. She was still a little bedraggled-looking and seemed like she was still trying to figure out what the heck had just happened to her, but she was bright and alert. 

No, nothing is wrong with the camera - yes, half her cheek is shaved.
Feeling good enough to eat fancy carrots from the farm stand. Nom.
The OR.
Closeup of the stint. 
They'll check Monday morning and see if the stint can come out then. If so, then she can come home that day! The removed thyroid lobe had been sent off the a lab for histopathology and we'll get results from that sometime next week,

Thursday, August 21, 2014

The Lump: Decision Update

I spoke to the vet this afternoon, some of the blood work results came back. The good news is her ACTH levels were totally normal so we can rule out any involvement of Cushing's. The bad news is that her total T4 concentration is still elevated - in fact, it was higher this time than it was at the time of either of the two previous tests. Her T3 levels were actually back in the normal range, but the vet feels that the T4 results alone are enough to recommend having the right thyroid lobe taken out. While she's still perfectly normal otherwise, i.e. no clinical signs, he's recommending having it surgically removed anyway because it will be the most efficient way of dealing with it. We'll send it out for pathology evaluation too after the fact, to see if there were any cancer cells in it. Without having the lobe removed and without any other treatment, she would continue to have the elevated levels of T4 and eventually, though no one would know when, she'd develop the poor hair coat, loss of weight, and huge appetite that seem to be evident in hyperthyroid horses. Removing it now would make sure that those symptoms never appear and the vet says she should be perfectly normal afterwards. The other lobe can compensate and produce enough thyroid hormone for the body, and on the off chance that it doesn't we can always supplement with Thyro-L. Even though she will have to go under general anesthesia, the surgery isn't terribly invasive because the thyroid is fairly superficial and there is no bony involvement. I could bring her home as early as Monday and she could go back to work in 3 weeks.

It's still nerve-wracking though...deciding to send a horse in for surgery. Especially when it is a hopefully preventative measure like this. The horse isn't actually hurting at the moment, so it almost seems like silly to put her through something like this. I've been through this decision making process before with my mini, Zipper, back when she dislocated her hip. It was much easier to make the decision then, because Zipper was in obvious pain and the surgery would help relieve that pain. In this case Maggie isn't in pain right now, but the surgery may help avoid future pain. Will it for sure? No one knows...and that it why it feels like a tougher decision.

But on the other hand, it isn't that difficult of a decision to make - if having the lobe out now gives her the best chance for a happy, healthy future and hopefully a nice long life, then I'm going to do it.

So, she;s scheduled for surgery tomorrow morning (wasting no time right?) I'll hopefully be able to get up there and visit with her when I can get out of work tomorrow. More updates then.

Tuesday, August 19, 2014

The Lump: Part 4 - The Horse Hospital

My poor Maggie is staying over at the horse hospital. I'm sad :( I hardly know what to do with my evenings this week without having her at the barn to visit. (Then I again I have a pretty good idea of what I'll be doing: hanging with my husband, maybe cleaning the kitchen, hopefully working on the blog pages a bit. I'm still sad though...)

Yesterday I used a vacation day from work to trailer Maggie up to Myhre Equine in Dover, NH. The trailer ride up went smoothly and so did the intake exam. Dr.Vin, their internal medicine specialist could find no abnormalities with her physically. As I've said in previous posts, with hyperthyroidism we'd expect to see a poor hair coat, an underweight body condition, and a ravenous appetite. She has none of those clinical signs. 

Dr. Vin does Maggie's intake exam.
She went in for her scintigraphy next. Dr. Myhre injected her with a radioactive iodine isotope and then the techs positioned her in front of the machine. 

Maggie gets her thyroid scanned
She was nice and drunk for this so that she would hold still. At least that was the theory - I've found that when Maggie gets sedated she seems to be fairly lazy about holding herself up straight so she likes to sway and shift her weight. The poor techs had to redo several of the scans to get a good image. At one point, and unfortunately I had wandered down he hall for a moment just when this happened, Maggie got quite tired of holding herself up and tried to take a nap (read: fall down onto) the surgical cart in the room. This was the result:

Oops. Hope they don't add that on to by bill.

After getting her scan, Maggie had to go to the isolation ward. I felt quite bad for her because there were no other horses staying there at the time (which is why they call it isolation...) She has to stay in there for 24 hours until the radioactive iodine leaves her system. During that time all her dirty bedding has to be disposed of as hazardous waste because she's literally peeing radioactivity.

Poor radioactive Maggie in her isolation stall.
I actually spent quite a bit of time there yesterday between waiting for Maggie's scan to be completed, the results processed, and being able to talk to the vet again. I got to watch some interesting stuff in the meantime including a horse getting scoped for ulcers, another having joint injections, and another getting a lameness evaluation. 


A horse being scoped for ulcers.
I was able to talk to Dr. Vin again after he had gotten the chance to confer with Dr. Myhre about Maggie's scan results. He says it definitely shows that the right lobe (the lumpy one) is the overactive one. But there were still some weird results...something about a ratio being less than normal when it was expected to be greater than normal due to the hyperthyroid...honestly, I need to do some more reading on that before I speak any more to it. 

What we decided to do was draw blood again for another (yes, another) thyroid panel. They'll also take blood and test for ACTH, for which increased levels are an indicator of Cushing's disease. Even though Cushing's disease is primarily a disease of the pituitary gland, hormones from the pituitary gland could affect the thyroid. The blood is going to Cornell for testing and will hopefully be expedited so that we can get the results back on Thursday. If the thyroid panel comes back as still elevated, the vets said they would actually recommend surgery right away to take out the right lobe instead of doing a biopsy first. 

So that's a little scary...but I see the logic. The right lobe is obviously abnormal and appears to be at least most of the reason for the elevated thyroid hormone levels. Taking a biopsy first would most likely give us either inconclusive results or perhaps even more reason to proceed with the surgery. If we go ahead with the surgery we can send a piece of the thyroid lobe out for histopathology to see if there's anything really wrong with it (like it being cancerous after all) after it;s already out, thus saving us the extra procedure of having the biopsy.

It's all a bit confusing and a good bit emotionally taxing as well.  I trust the vets though - even though this is quite an unusual case. We'll talk again after the blood results come back and go from there. 

Has anyone else ever decided to put a horse through a preventative/ preemptive surgery? What was it for and how did it go?

Friday, August 15, 2014

The Lump: Part 3

The results of Maggie's cell aspirate came back. We did indeed hit the thyroid and got some cells, so that's good. I'm afraid the results haven't given us much direction though. The good news is that the cells don't looks cancerous. However, they don't look completely normal either. The report says that the findings are consistent with thyroid adenoma but still recommends a biopsy for a definitive diagnosis.

If just the lump where the only thing going on here and the cells looked benign, then that would be fine and we could be more or less done with the issue for now (of course I'd keep an eye on it.) The really mysterious thing though, is the elevated thyroid hormone levels. Thyroid adenomas typically don't have any effect on the horse - the hormone levels usually stay in the normal range or, if anything, are lower than normal. So what's up with the hyperthyroidism? That's what we'd all like to know...

So after talking to my vet on the phone, we came up with some semblance of a plan. He's been in communication with the internal medicine specialist at Myhre Equine in Rochester, NH and I've decided to trailer her up there for a nuclear scintigraphy scan on Monday. My poor pony will have to stay up there in isolation for a little while from the radioactive iodine, but what the scan will show is which lobe of he thyroid is more active and therefore which one is causing the high hormone levels. Since adenomas don't usually cause hyperthyroidism, it could actually be the other normal-looking lobe that's acting up. Strange, huh? So after the scan, they'll likely biopsy the problem lobe to get a better look at the cells. And then....I don't know what! We'll just have to go from there....

That moment when the only thing you have in your car to take notes on is a Dover catalog with an awkward model.


Saturday, August 9, 2014

Equestrian Sports Vs. "Real" Sports


I hear debate every now and again about whether or not equestrian sports are real sports - I maintain that they are, of course. I mean, I spend 6 days a week training myself and my horse and we enter competitions...sounds like a sport to me!

However, in the past decade or so I've really lost touch with the more "traditional" sports. I love watching soccer on TV with my dad and/or husband, but I haven't actually played it in any organized manner for about 12 years now. 

This summer my husband wanted us to join our church's softball team. I admit, I was a little hesitant at first, (an evening after work where I wouldn't be able to go to the barn? Madness) but I agreed. And I'm so glad I did. I had forgotten what it felt like to be on a team. Sure, at my job I have to work as a team with my coworkers, and yeah, my horse and I are a team, but being on a sports team is really quite different. 

The camaraderie that one builds with their teammates on a sports team is unlike anything else in my opinion - we root and cheer for each other, keep the morale up, and help each other improve. We're working together to achieve a common goal: winning the game. The feeling is hard to describe other than that "team feeling."

Now, don't get me wrong: I'm not discrediting equestrian sports at all - it's just different. It's being on a type of team that a majority of people won't experience or even understand. I go to the barn 6 days a week to spend time with my horse, building a bond of trust and respect, and, like other sports, practicing and training for competition. 

Riding is more of an individual sport. However, it's still unlike anything else because there's still another being involved in the training...it's just not a human being. In a sport like running, you just have to rely on yourself. In riding, you have to rely on an animal as well - and that animal may or may not be cooperative at any given time.

In softball, my team depends on me to show up and play. In riding, my horse depends on me to show up and take care of her, but I also depend on myself to show up and put in the time. With softball, I have the expectations of a group to help motivate me. With riding, I only have myself to rely on for motivation. And not only am I training my own body and mind, I am training my horse's body and mind as well. 

I suppose riding can be a team sport too - take the Olympics or the WEG for example, where each country competes for a team medal. I imagine there is camaraderie on these teams as well and teammates root each other on, but I think the dynamic probably still remains different than with there more traditional team sports. And until I make the Olympics (haha) I probably will have no experience worth riding as a team sport.

So I guess what I'm saying is that team sports and equestrian sports are just fundamentally different (just call me Captian Obvious) - but both are certainly sports and there's a lot of value in both of them. Throughout the softball season, I realized I've actually really missed playing on a sports team - is a great feeling. Riding, of course, is still my primary sport and it's where my main goals lie. 

Softball season is over now, but I'm looking forward to the next one! In the meantime, I'm going to keep riding!

Monday, August 4, 2014

Weekend Work

Sometimes there are projects you can put off no longer. That was the case the other weekend as Billy, the goat, that lives with my mini, Zipper, both housed at my parent's place, has been continuing to do an excellent job destroying the stall that they share and it because it was high time that it was fixed for good.

A little history: my parents property was never meant to be home to any sort of livestock, but that didn't stop a very determined and stubborn then 13-year-old girl (me, duh) from building a stall in the back of the detached garage to put a mini horse in. Zipper has been quietly living there for over 10 years now and Billy (aka Destructo-Goat), has been there almost 3 years now. For whatever reason, Destructo-Goat had decided that he's been unhappy with the living arrangements recently and has been wreaking havoc on the stall. The stall, which was made by a 13-year-old girl, was never extremely sturdy though for Zipper it always held up fine. But not being a solid wall, and partially made of an old shelf, Billy was able to take it upon himself to do some redecorating and rearrange the furniture.

Thus the weekend was mainly spent building a proper stall for them - complete with a solid wall! I was very fortunate to have my husband's assistance (ok, so he was really the mastermind behind all of this) who is much more well-versed at "goat-proofing" than I am.

I now bring you the photo documentary of the project:

Before: Outside of the stall
Goat was headbutting the shelf away from the pre-existing partial wall.
Before: Inside of the stall
Before: Inside of the stall
So after assessing the situation we made a quick trip to Home Depot...


And then the demolition began!

After taking the shelf out
The shelf. aka the pretend wall
Husband was the mastermind behind the plan. Step one was to build a frame.


And nail the bottom 2x4 into the concrete...

I'm pretty sure the nailing was his favorite part. We had to buy serious nail gun to get the job done. He likes things that go bang.

"Take a picture of me with the badass nail gun!"
Billy tries to assist
Then up went the boards for the walls. We chose to use 4x8 boards instead of plywood because they would be much stronger and will hold up to the wrath of Destructo-Goat a lot better.




Honestly though, I didn't JUST stand around and take pictures the whole time. I cut a lot of the boards. And I also cleaned the stall and swept...

Finished wall from the inside
Once the wall was finished, we had to build a new gate since the old one now wasn't the right size and, let's face it, it was pretty flimsy anyway.

Gate frame goes in
Customizing the existing hinges to fit the new gate - so handy!
New hinges

I was also the bringer of sustinence
Finished gate with plywood in place
Just building the gate is what actually took that longest. I think we were done with the wall by 3 pm or so, then the gate took us until about 7:30 or 8. It was just getting dark as we finished up.

Happy animals in their new digs. I had to take this pic the following morning because it was too dark by the time we finished that day
Of course this wasn't exactly how my husband or I would have chosen to spend a Saturday (for my part, I didn't get to ride that day!), but we both enjoy building things and doing projects and it was nice to spend the whole day together working on it. All in all, a good day well spent!