Saturday, January 22, 2011

Looks good, feels good

It looks like putting in the extra time to wrap Kaswyn's leg is paying off already. Two days of being wrapped and the inflammation was gone when I unwrapped him. It's wonderful. I can tell that he feels better just by the way he's acting. It's now been four days and the wound looks so much better. It's been very cold here and the horses haven't been going out, so having someone unwrap and re-wrap him has not been an issue. I've been out every day to walk him and tend the leg myself.

There are three reasons why I'm hesitant to ask someone to wrap him for me.

#1 - I want it done right, and since there are a lot of steps (see below) I'm afraid that it might not all get done to my liking.

#2 - If someone else wrapped him and there was an issue then we'd both feel bad about it.

#3 - It's kind of a pain in the butt to do. This is what I do every time I wrap him -

Step #1 - Clean the wound.

After walking Kaswyn in the arena, the wound gets arena dirt all over it. So it looks like this -



The wound needs to be cleaned gently with Nolvasan surgical scrub using sterile saline and gauze pads. I don't scrub it hard, but just gently clean it. Then it needs to be rinsed with more saline, and dried with gauze. After it's been cleaned, it looks like this -



Step #2 - Apply Dermagel to the wound and let dry a bit if possible.

The Dermagel looks like apple jelly.



It's a bit thick and will dry with a skin on it if you leave it long enough. I don't know if it makes a difference, but I usually put the Dermagel on and then groom Kaswyn and get his wraps all ready to go so that I give the Dermagel a chance to dry at least a little.

Step #3 - Put silver ointment on a gauze pad and stick it to the wound.

The silver ointment is white, but it's got silver in it to help the wound from getting infected. It's thick and a little goopy. I just scoop a little onto a gauze pad...



...and stick it right to the wound. The ointment is so thick that the gauze will stick there until I can get the wrap ready.



Step #4 - Add the pastern cuff.

In order to keep the wrap in place, and to keep a bit of pressure on the wound, Dr. G told me I must wrap the leg with a pastern cuff. It's just thick cotton wrapping that is cut to the size of his pastern, then wrapped around and secured with a strip of duct tape. High tech, I know!



Step #5 - Wrap the cannon bone with another cuff.

This cuff makes the pastern and the cannon bone the same size as the fetlock, but allows the fetlock freedom of movement. Dr. G also told me how to do it this way. Again, this is secured with duct tape.



Step #6 - Wrap whole leg with standing wrap and bandage.

I'm using no-bow wraps, but I was using my trainer's thick quilted wraps when he first came back from Dr. G's. The no-bows are working just fine, but the quilts are nicer.



I wrap the other leg too, just because I was taught to always wrap both legs if you're going to wrap one.

And here is the bucket I keep all of my wound treatment stuff in.



So that is six steps to re-wrapping his leg. It's not like someone would be able to just slap a wrap on him and be done with it. That's why I'm going to have to get my butt out to the barn every day until this thing is healed. Which might not be that much longer, because the wound looked fantastic today. The pics of the wound above are three days old. It already looks so much better than it did. I'll have to take some pictures tomorrow. It really looks good.

So good, in fact, that I did just a little trotting and cantering today on Kaswyn. The whole ride was ten minutes, with a lot of walking, but I wanted to see how he felt. Not only did he feel good, but he also was super willing. I was riding him bareback and in a halter and was not prepared for the big jumping canter depart he did when I asked him to canter. He certainly was eager to go after all this time of not working.

I am hopeful. Maybe two more weeks and the wound will be skinned over - maybe sooner.

One last thing - what's your opinion on wrapping an injured leg? Do you wrap just the injured leg or do you wrap the corresponding leg in the pair (like both front or both hind legs)? Just curious about what other people do, or were taught to do and why. I was taught that the uninjured leg should be supported. So what do you think, what do you do, and why?

Friday, January 21, 2011

New Plan

I wanted to update sooner, but this is what happens when you have a horse and kids - one doctor's appointment and two dentist appointments later I'm finally getting around to writing.

Kaswyn's wound looks a bit better. It's not great though, and he is still developing inflammation on the back of his pastern. When that inflammation is there I can't even touch that area without him flinching and picking up the foot.

When I got there on Tuesday I iced the area and it improved but didn't go away. Then on Thursday I got to the barn just as he was coming in from turnout in the snow. I iced the leg while I rode 2 horses, and when I took the ice off the inflammation was gone. I could not only touch the area but I was able to push on it and feel the bone without him objecting.

I got on and walked him for ten minutes and he felt great. I asked for a teensy bit of trot each direction and he was very eager and felt sound. This gives me hope that if I can get the leg healed and the inflammation goes away that he might just be ok.

Thinking back to just after the surgery, when I kept the leg wrapped all the time, he didn't have that inflammation. I stopped keeping the leg wrapped when he was allowed to go outside, because it becomes a pain to ask someone to unwrap the leg, turn him out, and then re-wrap the leg if I can't get out there that evening.

However I've now decided that he needs to have the leg wrapped at least overnight. And if he gets turned out then they will unwrap it for me. That means that I'll have to make it out there every day until that wound heals up. Sure, I could ask the barn manager to wrap it, but it's such a hassle, and I've screwed it up before so I kind of want to do it myself now that I know what I'm doing.

Also, Kaswyn is looking skinny. With all the bute he's getting (which isn't really THAT much at one gram twice a day) I'm afraid that he doesn't feel well in the guts, so I'm going to put him on Succeed. I'm hoping that will help him feel better while I have to keep him on this bute, and maybe I can get some weight on him. We're going to start him back on wet alfalfa cubes too, since he's really just picking at his hay.

So, wrapping the leg again, plus Succeed and alfalfa cubes. We'll see how this works. And if it doesn't I'll make a new plan!

Tuesday, January 18, 2011

Clock move faster!

I haven't seen Kaswyn in a week and I'm going out to the barn tonight after work.

And work is going SO slowly. Ugh.

I'm sure the gals out at the barn have taken good care of him but I miss that boy. I'll take pictures of his wound if I can get decent lighting. That way everyone gets to see the grossness! Actually I'm hoping it's looking much better than it did a week ago.

I also am feeling a bit bloated and soft from not riding for a week. It's probably all in my head, but what I think is "I haven't done any exercise in a week! And I like Ho-Ho's!" See the problem?

I miss the other ponies that I get to ride too. I've had requests to post pictures of the other three I'm riding, so I need to get that done. You will love them, they are all adorable!

Ok, back to work, blah. But going to see my boy later, so YAY!

Thursday, January 06, 2011

Calling the doctors

I haven't updated about Kaswyns' leg lately because there is not much to tell. It is slowly getting better but still has inflammation, even with bute (one gram twice a day) and icing. I'm not working him at all, but he is getting turned out. They put round bales of hay in the pastures and he doesn't run at all, just walks around the round bale with his face stuck in it!

The wound is slowly healing from the bottom up and from the inside out, and every day I see slight changes in the positive direction. It's slow and the wound is looking better, but the inflammation was bothering me. I've been afraid that I might be missing something important. It has been six weeks since the surgery, so I called Doc G to find out what he thought.

Doc thought that I was doing everything right, but that I should touch base with the OSU surgeon. I called her to give her an update and we had a very interesting conversation.

First, she said she doesn't know why the wound busted open like it did, and didn't heal like the other side did. She said it could have been caused by an infection, but she can't really say for sure. She said she was sorry it happened, but couldn't explain it.

Next, after discussing the pictures I sent her (the same ones I posted here), we talked about the dark strip of necrotic tissue that the wound had (it's since fallen off or been healed over - hard to say really since it happened when I was out of town). She had a similar experience with one of the other horses she operated on. Basically she is wondering if the necrotic tissue wasn't the nerve itself, since it was rubbery. Alcohol is a fixative, and it makes tissues kind of rubbery. So she is wondering if the nerve didn't get fixed in that position when she injected it and was then exposed when the wound popped open. She can't say for sure though, and with it no longer visible or gone completely we'll never really know.

Lastly, overall she thinks that it is completely normal to have swelling if the wound is still open, which it is. It's good that bute and ice bring it down, and it's good that he can still feel the back of the pastern, which gets very sensitive and painful when it's inflamed.

So I'm just going to keep doing what I've been doing, with one addition - I'm going to add some U-Guard to his diet so I can try and counteract the affects that bute might have on his tummy. I don't like keeping him on bute but I've got to keep the inflammation at bay. Once the wound closes I might have to keep him on the bute for a bit while the area sorts itself out under there, but my hope is to wean him off of the bute eventually.

I'm going to take another picture of the wound this weekend and send it to the surgeon, which means you'll all get to see it here too! Believe me it looks a lot better than it did. It looks less "meaty" and more pink, and less angry looking.

At least I'm still able to ride. There are three horses that I'm riding or working with, but I don't ride them all every day. I've got Lee (the buckskin - I still have to get those videos from the show posted!) Brandee (a neat paint half-arab mare who knows some first level stuff) and Ivy (purebred arab mare who is out of commission until the end of January for riding - she slipped on the ice outside and pulled her stifle!) so I'm busy at the barn. What I've been doing is putting ice on Kaswyn's leg while I ride the others, and then when I'm done I tend to his wound so the ice gets to stay on a good long time. He can see me riding and grooming the other horses and today he kept calling out to me. I feel really bad about it, but I just should not be riding him right now so he needs to be patient too.

Soon buddy, soon. You heal up and we'll be good to go.

Saturday, January 01, 2011

Fat leg

Today I went out to see Kaswyn and his leg was all fat and swollen. Now I'm pretty certain that it's the inflammation that is making him sensitive, uncomfortable, and lame, because he didn't want me to touch any place that was swollen, not just between or around the incisions.

So I walked him for ten minutes and gave him 2 grams of bute. I also put some Surpass cream on the most puffy areas. I decided to put him on one gram of bute twice a day for three days, then one gram a day for three days. I think it's harder for that wound to heal with a bunch of inflammation going on, even though I don't like him being on bute for a long time.

Thanks for all of your comments and positive thoughts sent my way. I'm trying to look towards the positive, and be patient for the healing to be over before I pass judgment on if he's going to heal completely or well enough to return to work.

We'll see what tomorrow brings. Hopefully a less swollen leg.

 
Header Image from Bangbouh @ Flickr