March 10, 2021

The Infection: Part 7

At 1:30am on Saturday, I woke up and rolled over to look at my phone where I saw Lisa had texted that she was driving home and to call her if I was still awake. Of course I called her, how could I sleep? She ran through what the vets did that evening and let me know about the additional symptoms that had developed, but nobody really knew what was going on yet. 

Still with colic surgery in the back of my mind, I said, "We probably need to at least start having the conversation about how much is too much to put her through," and Lisa agreed, but said that she was grateful to have seen her in person that day, and that her eyes still said she wasn't done fighting this.

Hollering at her friendos when she got home

At 7:55am on Saturday, the overnight resident called me with an update. They had run bloodwork and discovered she was extremely deficient in a particular electrolyte which could have been responsible for the irregular heartbeat and the mild lack of coordination. After putting her on fluids and that electrolyte, she was "much better" and her irregular heartbeat was becoming more and more infrequent.

They thought her stomach pain was likely caused by bad ulcers (hello, take a horse with a history of ulcers, get very little food into her for 3 weeks and treat her with antibiotics - it's like a recipe for bad ulcers). Starting Saturday they told me they were going to scope her for ulcers, but in the meantime they started her on GG and Sulcrafate anyway. By Tuesday, they still hasn't scoped her, and also she hadn't produced poop in four days, so I finally put my foot down and told the resident at Tuesday morning's call I wanted her scoped, even if they didn't think they needed to.

Happy 4th(ish) birthday, Hanko!

This ended up being the best call I've made so far, because not only did they find "severe ulcers in both the glandular and the non-glandular regions of the stomach", but they also intentionally scoped her un-fasted to see how much food was getting into her stomach (normally you fast horses prior to being scoped) and it was...totally empty. 

This is the first time I've been upset with Purdue throughout this whole thing. Obviously I cannot go see and observe her eat myself due to COVID, I can't get any further than the parking lot, so I have to trust the vets when they tell me she's "ingesting 75-80% of what we give her", as was the update on Monday the 8th. Clearly that was not the case, whether it's because she's masticating it and the food is only making it as far as her mouth (we know that's partially the case, they have to syringe her mouth out to clear the food particles once a day) or it's because it's falling out of her mouth. Either way, the food is not making it to her stomach and probably hasn't been for a while. AND they discharged a patient that was not capable of EATING on Friday! What was I supposed to do with that at home?!

First porchin' of the year with a fresh Screwdriver. Had to find a way to use up all the oranges we mostly only use for peels for garnishes!

While I was upset that the horse has basically been starving for three weeks, I was also relieved, because her other majorly worrying symptom (it's Tuesday as I write this and she hasn't pooped since Friday) is likely caused by just not having enough food in her system to make any poop. That's  upsetting to me in that I hate that she was starving, but it's also a relief that we're not dealing with a colic or a perforation or twisted guts or any number of other seriously concerning problems.

So they placed a feeding tube and she's getting an alfalfa slurry fed through that three times a day. She's tolerating the naso-gastric tube well, and the irregular heartbeat cropped back up again after ~36 hours off of fluids, so she's back on fluids and electrolytes as well. 

Hopefully it's uphill from here, although someone still has to answer the question of why she's unable to swallow.We know as of Monday the 22nd when they tested her swallowing reflex everything past the tongue was normal. So is something now wrong with the esophagus? Or is this just a result of the nerves in her tongue taking their sweet time coming back to life after a pretty traumatic event? Nobody knows yet.

And now you're caught up. At the time I started writing this, it seemed like she would come home and I would settle into multiple weeks of boring wound care with very little of interest to write about, but of course with Friday night's complications, that turned out not to be the case. So I'm going to have to throw in some non-Aeres posts too, but rest assured, I'll continue updating this series as I have new updates!

30 comments:

  1. Holy smokes. So weird. So stressful. So frustrating. So ‘spensive. You’re a phenomenal horse mom. I sure hope she starts to improve consistently!

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    1. Thank you, me too. After two tube feedings she passed poop this morning, so that's an improvement!

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  2. Ugh what a mess, I’m so sorry you’re having to go through this whole ordeal (esp learning that it’s still ongoing for unknown reasons...). I knew a horse who couldn’t swallow but that was a significant neuro situation (I think epm? I think his brain stem actually separated? Idk, he didn’t make it obvi) so hopefully in this case it’s just bc of the tongue trauma :(

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    1. Yeah I'm positive it's got to be something with the tongue, either re-learning how to eat with less tongue or the nerve situation. Fingers crossed we see some improvement on that. I've asked to talk to the senior vet on her case today to get more than just a status update, and one of the things I'm asking about is that.

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  3. Wow what a rollercoaster! I would be LIVID with Purdue! Horses not pooping is no good. Good for you for being such an advocate for Aeres. Praying she gets back to normal eating as soon as possible. She's a fighter!

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    1. Yeah we are having a very pointed conversation later today. And thank you, she really is!

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  4. This sounds so difficult. You are a great proactive horse mom. Hopefully things get slowly better.

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  5. Wow, what an absolute roller coaster of awful. I'm so sorry. You've worked so hard for her. I will keep my fingers so, so crossed for you both.

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    1. Thank you, I really appreciate it. Blogging about it has been very therapeutic, and all the comments and good thoughts have genuinely been appreciated.

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  6. Wow. You are her hero. Thank goodness you demanded the scope, what a mess. I hope she continues to only improve from here.

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  7. Poor girl. So glad she had you to advocate for her, and that things are on the up and up now.

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    1. We all hope they are, I can't get my hopes up after how many twists and turns this story has had though.

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  8. I feel so bad for all of you, poor Aeres, poor you and Lisa, poor the new owner :( My thoughts are with you guys.

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  9. Whew, I am seriously late to the party. Crazy how much she sounded like Comrade when he had the tongue issue. He spent weeks at the hospital. Definitely makes me appreciate the amount of vets in our area. Ugh, you and Aeres deserve a break. Glad you said she is better. Lost too many cob girls recently.

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    1. We did think of Comrade quite a bit in the beginning, and honestly everyone involved was devastated when it turned out that it wasn't something as straightforward as "stuff stuck in the tongue", which still has a long recovery (as you found out) but it isn't as challenging to treat as "lengthy list of mystery symptoms that don't make sense".

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  10. I can't wrap my head around this. I've had a horse that had trouble eating, and it was very apparent what had gone in his belly and what hadn't.
    I really hope they get to the bottom of this asap. It's nuts.

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    1. Really really REALLY can't either. I will admit it was difficult to figure out how much chopped hay she was getting at home because she eats it, chews for a while, drops some, you really can't tell. But I expect a vet hospital to keep way closer tabs on that than I can!

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  11. My heart goes out to you, Lisa and Aeres. What a trooper that mare has been. I hope your pointed talk with Purdue today proved fruitful. You have every right to be disappointed in Purdue and Ares is very, very lucky that you are comfortable actively advocating for her.

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    1. Still no call yet, but I have a list of questions and I'm not getting off the phone til they answer every single one.

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  12. I kind of assumed that your last post on this would be "Everything is good and it's all over!!" but holy crow, it sounds like there is a long road ahead for everybody involved. Jingling like mad that the continued healing process for Aeres is relatively easy and there are no more hiccups <3

    Good on you for putting that external pressure on - I know I faced a similar instance when I requested to be referred to another clinic to run additional diagnostics on Annie. I was met with "Well, she just has heaves. It's a management thing." Turns out poor Annie had a giant chest infection - so thank goodness I pushed to be referred! And thank goodness you did the same for Aeres!

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    1. Ugh, yeah I remember your medical saga, that's so frustrating and doubly so when you're that far away from vet clinics. Yeah, I am just taking it one day at a time, but we do still have a long road to go. Basically at this point she just has to start eating and drinking normally and then we'll know we're on the upswing, but as long as she's on the feeding tube we're not making progress.

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  13. Wow, that is not where I thought that was heading at all... poor girl, I hope she's able to heal and come home soon.

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    1. It is pretty up in the air at this point. When the feeding tube comes out, either she learns to eat or she doesn't.

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  14. You'd think after MOUTH surgery they'd have a procedure in place to make sure the horse is eating afterwards?? Like senior feed mash in a bucket, or a stall temporarily stripped down to the mats to make sure the hay is disappearing? Jeez Louise...

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  15. Oh my gosh what an ordeal. So sorry to hear this is more ongoing that I think we all thought it would be. Sending lots of healing thoughts to Aeres and hugs for you

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  16. Aeres is so fortunate to have you looking after her. This is a good reminder that all hospital patients, animals and people, need advocates close by.

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  17. I’m running out of ways to say ‘holy fuck,what now?!’

    I don’t know enough about equine cranial nerves, but if she was human I would wonder about nerve damage impacting her ability to chew and move food to the back to trigger the swallow.

    I hope this is resolved soon. What a trooper she is

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