In Loving Memory of Brego

We lost a great horse yesterday.

It turned out that the recurring coronary abscess that we've been fighting all this time was actually an infection of P3 (the coffin bone) that ran from the tip of the bone all the way up into the coronet band. Because of the extent of the infection, it was inoperable. There was really only one decision to make.

You're probably wondering how, after all this time, we could have missed something so extensive. My vet has literally taken nearly a hundred xrays of his foot (and the other one for comparison). We have done ultrasounds, a veinogram, and used basically every diagnostic tool we had at our disposal short of a recumbent MRI, because he couldn't have handled the sedation and his ginormous foot wouldn't have fit into a standing MRI. There are four other excellent vets in-house at our clinic, plus my vet consulted with three external vets on his case (including the one who is considered the expert equine podiatrist in the US). There have been a LOT of exceptionally good people involved with this case, and yet somehow Brego managed to stump them all.

You see, there was never any indication on his xrays that there was infection. The bone was solid on every film. He was never lame, except when he was blowing out an abscess.

After his first hoof wall resection back in July, we had high hopes even though we weren't able to find the root cause of the problem. But then the hoof wasn't growing in normally - it grew up instead of down. We did a second, very minor resection in late August to try to correct that problem, and at the same time we dissected the area around the coronet band and halfway up the pastern to try to find the root of the problem. My vet found no tracks, no foreign bodies, nothing. Brego recovered from that surgery just fine, and the new hoof he was laying down grew in straighter, but it had an odd, cracked quality to it.

Then mid September, Brego went very lame immediately after he'd had his shoes reset. Our farrier (who is an amazingly talented man with a piece of metal), made an emergency visit and found an abscess right in the middle of the area where there was no hoof wall, about halfway down his foot. It was quite a puzzle... why was there an abscess there? We took more xrays to try to find where it was coming from, but nothing showed up on the films. We speculated and scratched our heads while Brego begged cookies from the entire clinic staff, but eventually decided to wait and see since we didn't have anything to go on.

Then on Monday, the abscess blew out again, in the same spot. This time, we did a dye study to follow the track of the abscess. The dye showed a shadowed spot at the tip of P3, as well as a number of little "filament" tracks going partway up the front of P3. At this point we knew the news wasn't good, but we decided to go in anyway and at least try to give Brego the best possible chance.

You can see the probe coming in on the left, and ending nearly at the tip of P3 (obscured because of the nails). The little filaments going up the front of P3 are dye tracks, but even these don't show the extent of the infection that they found.

My vet found that the tip of P3 was infected - not badly, she managed to clean it, but then she began following the tracks upward. She still had not found it all when she stopped at the base of the coronet band, almost two inches from the tip of P3 where the infection was based. We discussed options, and what it came down to was that while we could do surgery to remove all the infection, it would have been so extensive that it would have compromised the structural integrity of his foot. In other words, his coffin bone would have had no support, and he would have rotated and foundered. So there really was only one choice to make.

What's really amazing is that the first abscess he had was nearly four years ago, when he was with his previous mum. She's got xrays from that too, and there's nothing to be seen.  So he's been foxhunting, eventing, jousting, and living with an infected bone for literally four years, and we never knew. As my vet put it, Brego never read any of the books on how things are supposed to happen.

Brego leaves an incredible legacy. I know many folks (myself included) who started blogging because of Brego's blog, The Eventing Percheron. He touched the lives of those he met in person as well - from his massive feet to his larger-than-life personality. There was never any question that he owned the universe and everything in it.

And today it's a sadder, smaller place because he's missing from it.

We love you, big guy, and we'll miss you so much.

Brego Wrestling

Today is 17 days post-surgery, and Brego's doing great. Earlier this week, we took him off bute and let him have a bigger turnout area (haha, it's like 12x12 plus his stall). Unfortunately, the additional movement caused some soreness, so he's back in his stall with bute on board. It's frustrating because the best way to get a hoof to grow quickly is movement, but keeping him comfortable and ensuring the hoof grows correctly (if really really slowly) is the most important thing.

Right now the biggest challenge I have (other than keeping Mr. SassyMcGiantPants from running me over - stud chains make for such POLITE Bregos!) is wrapping his foot every few days. He's a good boy for it, but goodness that is one big foot and there are a lot of steps! Plus, if he wants to put his foot down at a really inopportune time, I have to really hang on and do my best not to let him. Thusfar I've won all the wrestling matches, but we both know he's only humoring me.

So, what does it take to wrap a Brego? (warning, one somewhat squicky pic at step 4, but really, it looks so much better!)

Step 1: Acquire one Brego. Try to resist when he begs for treats. Give him a handful anyway because he's so cute and you feel sorry for him.

Step 2. Collect all your supplies (vetwrap, abdominal pad, gauze, ela$ticon) and make a duct-tape boot. This requires about half a roll of Gorilla Tape, because obviously Bregos can't use normal duct tape.

Step 3. Clean the floor as best as you can, then remove all the old wrappings. I bought bandage scissors to do this and seriously, you need some if you don't have any. Here I've removed everything except the gauze.

Step 4: Gently clean the area with saline-soaked gauze. Take pics and send to your vet. According to the vet, this looks "awesome"! And it no longer totally grosses me out either.

Step 5. Pack about 40 gauze pads in the resection site, slap a 5x9 abdominal pad over that, then use an entire roll of vetwrap to hold it all on. His foot is so big, I take the first two wraps of vetwrap while it's on the ground, and then pick it up and wrap it the rest of the way. You have to do this all at once so sorry, no pics of the gauze and stuff. 

Step 6: Pick up his foot and apply the duct-tape boot to the bottom, then fold the sides up and stick them down. Neatness doesn't count much here.

Step 7: Wrap that entire sucker with ela$ticon, being sure to get it well up on his pastern so that no shavings can get in. This is usually the part where he's done with me messing with his foot and we have our little wrestling match. I won this time. 

Step 8: Give the Brego all the cookies!

Friday fun: How much were Brego's shoes?

I got the bill for Brego's hoof wall resection, and it was as expected. But then I got the bill for his shoes, and I almost had to breathe into a paper bag to control the hyperventilating. Let's just say I didn't know that shoes could even cost that much, ever.

They don't look that fancy, do they?

What kind of magical shoes are these, you ask? They're to support his feets while the resection grows out. Here's the details:

• Handmade heart-bar shoes in size Brego
• Fronts only
• With clips

For size comparison, that's my thumb. 

Just how much did they cost? Here are a few clues:

• The most expensive shoes I'd ever had before were a full set, with clips and tapped for studs. Brego's were nearly three times as much.
• My college apartment was cheaper than these shoes.
• You probably pay less for board than these shoes cost.
• I could have bought a new pair of (not custom) tall boots.
• A set of 4 new trailer tires is less than these shoes.
• I could have bought a plane ticket to Europe (in the off season).

So, with armed that knowledge, leave your guesses in the comments! Whoever gets closest gets to send me a donation toward the cost of Brego's fancy footware.

Just kidding. Mostly.

Brego hoof update: "It looks GREAT!"

Warning: more graphic pics. Heck, let's just go with the disclaimer that for the next 9 months, if it's a Brego hoof update, there will probably be graphic pics included. You're welcome.

Let me start this post by saying that my version of "It looks great!" and my vet's version of "It looks great!" are two very, VERY different things.

My version: A completely grown-out hoof with no defects, ever again.

My vet's version: The following:

Surgery +1 day

Surgery + 3 days

Surgery +5 days. You can see the new tissue is starting to grow in from the top.

1 Brego foot requires: 1 5x9 surgical pad, ~40 gauze squares, 1 roll of vetwrap, 1 triple layer duct-tape boot, and 1 roll of ela$ticon. 

Home and hoovering as usual!

Tomorrow I get to do my first solo bandage change. Luckily Brego's super good about this, but still, it's a 5-step process and that is one BIG foot. He's 100% sound and about ripped my arm off coming out of the stall this morning, complete with head tossing and squealing. Clearly he feels quite good, despite missing the better part of a hoof!

Brego's hoof wall resection

WARNING: Graphic pictures. Do not continue if you don't want to see.

Brego had his hoof wall resection yesterday. According to my vet, it was NBD for Brego (of course, he had good drugs on board and lots of people taking care of him). For me, it was super nerve-wracking - I was so worried they would get in there and find something really bad. Plus, I wasn't there for it, so I had to wait for updates as my vet could send them.

The procedure went off with no problem. He got a special set of custom shoes for support, and then they started removing the hoof wall. As they started digging, they discovered that the entire hoof wall, all the way down, was dead - there was no connection to the laminae underneath. When they got to the top of the hoof, they didn't find a keratoma, but instead a pocket of damaged and infected cells. That area got cleaned and debrided until nothing but healthy cells were left.

The theory that the vets (there were four in attendance) and the farrier have is that years ago, Brego either had some tiny bit of infection or foreign body travel up from the toe all the way to the coronary band, or he had some slight damage to the coronary band. He blew out an abscess in exactly the same spot almost two years before we got him, so this whole thing probably started back then. He then went two years with no abscess, blew one out last spring, then went ANOTHER year with no abscess, then six months, and then it really became a problem this year. But, guy has been walking around with a compromised hoof for quite some time, and he's so stoic that nobody even suspected.

As for recovery, the plan is a little up in the air. He's staying at the hospital for the next week, and right now his hoof is just wrapped with daily bandage changes. We may continue with daily changes once he comes home, or we may put a hoof cast on him. He'll definitely be on stall rest or in a very small paddock for a while, but whether that is weeks or months we won't know until we see how he progresses. Once we are sure the hoof is growing back in normally, the vet wants him to get as much (careful) movement as possible since movement helps the hoof grow. Total time to grow an entirely new hoof is 9-12 months, but he should be able to return to at least light work long before that.

So, please keep your fingers crossed for an uncomplicated recovery and a beautiful, perfect new hoof!

And now the moment you've all been waiting for... the gory pics. Seriously, if you don't do blood, please don't look.

Cutting guides for the resection. You can see just how many abscesses he's blown out in the last few months.

Starting to nip out chunks.

So much hoof to get through!

Here's what it looked like after they nipped out some of it. That black section in the middle is dead hoof that doesn't connect to the laminae underneath. 

After using the nippers, they got to work with the dremel (I would have had to leave for this, gah). You can see how many holes there are down the hoof wall, and how much dead area there is under it all. Poor guy.

Did I mention there was an audience?

Hoof wall resection complete. The white part is laminae.  Note how his coronary band is pushed up and bulging? That's where the root of the problem was.

Post-debridement under the coronary band. You can see that it's no longer bulging and the coronary band looks more even all the way around.

Today I get to FaceTime with my vet during the bandage change so I can see everything up close and personal. Ah, the magic of technology!

Brego hoof update

When last we left our overlarge hero, he'd had both my vet and the hospital farrier out to try to tackle a recurring abscess in his coronet band. We took some rads that showed two pockets of infection, and then the farrier dug some giant holes in Brego's foot to let things drain.

This still squicks me out

Brego seemed to be doing well, galloping around like an eediot, showing no signs that his Holey Hoof was bothering him at all.

And then he went lame again, and another abscess blew. In the same spot. 

And AGAIN.

I had the vet and farrier out AGAIN. They discussed options, took more rads, and called some of their peers to consult. The consensus is that there must be *something* causing these abscesses, and it's most likely that Brego has a keratoma. Keratomas are benign tumors that form under the hoof wall, for reasons yet unknown. The only way to address the issue (repeat abscessing) is to remove the tumor... which, given its probable location (up near the coronet band), means a hoof wall resection.

You can see the new hoof is coming in completely mangled.

Since there's nothing's showing up on radiographs, my vet wanted to have an MRI done so they could see the extent of the issue before they started surgery. After calls to several clinics with standing MRIs (Brego almost died on the table during flap surgery before we got him, so he is not a candidate for full anesthesia, ever again), we discovered that standing MRIs can only handle hoofs up to 7 inches in diameter - and M'sieur Brego is 8.5 inches in diameter right after a trim. And apparently all standing MRIs are made by the same company, in one size... so an MRI is out.

Sooo... the plan is that Brego will have a standing hoof wall resection done as soon in a week or two, when my farrier and vet can get their schedules to align. They will do an ultrasound and some sort of vein trace just before, so they can attempt to pinpoint the keratoma's exact location so they know how far to go. The good news is that it hasn't affected any bones, so the prognosis is excellent if they can get it all.

Brego will be in a hoof cast for about a month, so the new hoof can start to regrow. He's already on massive doses of hoof supplement to help with hoof growth.  Once the cast can come off, he'll be in a special shoe, probably with metal bands epoxied across the surgery site for additional support. Horses seem to handle hoof wall resections surprisingly well, despite some of us humans (namely me) being completely grossed out just looking at pictures of other resections. I don't know what it is about blood and horse feets, but it's just SO WRONG. But I'm sure I'll have plenty of gross pictures to share, because there's nothing more fun, right?

And don't worry... Brego is milking this for ALL he is worth. Which is currently several carrots per day while he gets his foot cleaned and treated!

Update on the state of affairs

Sometimes, life really gets in the way of doing the things we love, like blogging. I've been holding down Wyvern Oaks solo for the last 6 weeks, because my husband has been off in Mexico doing this:

Here's the link to the Washington Post article, and the one from NPR, and the BBC. If you thought my husband was cool because he jousts, his day job is even more amazing. 

As usual, all the shit happens when he's gone. The dogs have started fighting, we had a tree fall down on the fence, and the painters accidentally knocked the hose loose from the washing machine so I flooded the laundry room.

Oh FFS.

Brego started to show signs of another abscess just days before hubby left, and we waited for it to blow but it didn't.

Suspicious looking.

When it didn't blow after two weeks, I had the vet out. When it still hadn't blown 10 days later, she came back, this time with the hospital farrier, and they took xrays to see where everything was located.

See those two dark lines going down from the hoof wall? Those are TWO rather large pockets of infection.

Roughly an hour of (unsedated) digging later, and we were left with this:

Holy hoofs, Brego.

They think that he had a white line infection somewhere deep in his foot (although the bottom of his foot is currently fine, so we had no way of knowing), and that the abscess last year didn't clear out the whole thing. The hole on the bottom right of the picture goes through to his sole (you can stick a shoe nail through, gag), and if you look in the big hole across the top you'll see a bunch of smaller holes. Those are all infection tracks. I'm flushing everything daily with betadine and copper sulfate, and actually can stick a needle in each of those small holes and flush them. Y'all, holes in horse feet are SO WRONG. 

And I know it's crazy, but Brego has been sound this entire time and is currently out galloping around like a nutcase, despite the swiss-cheese-like appearance of his foot. Vet and farrier will be visiting every two weeks together until we get this all cleared up and grown out. Fun times.

As for Paddy, he's doing fine. He's mostly being neglected, because I spend all my time riding Taran. I did have a great ride at my trainer's barn where he wanted to go zooming at the trot but I made him do nothing but laterals... eventually he decided that was too hard and started behaving himself. It's funny how riding another horse lets you figure out how to ride your own horse that much better.

When not being ridden, he helps me eat weed the garden.

Taran continues to be a rockstar. Seriously, I don't know where this amazing little horse came from - he just keeps getting better and better, a little bit every day.

Let's ignore the fact that I'm being left behind and focus on the amazing trot, ok?

We went to our last show of the spring season this last weekend, a 2-day recognized show here in town where we did 1-2 and 1-3 both days. We spent all weekend getting 2nd place behind a lady on her very nice confirmed 3rd level horse. Interestingly, the judge on the first day didn't seem to like Taran much - we put in two solid tests and we got decent enough scores (64% and 62%) but it wasn't as good as I expected. The second day, we had a new judge at C, but the same judge at E. The judge at C scored us 2% ahead on 1-2, and only .2% behind on 1-3, but the judge at E scored us 5.5% and 3.5% lower. The judges scored within 1% of each other for all the rest of the folks in my class, so it really was just me. Her comments were perfectly reasonable and spot on, but it just seems like the scoring was harder for us. Oh well, I have that judge's name and we won't ride for her again if we can avoid it. We still managed to get a qualifying score on 1-3 for the SWDC and GAIC championship rides (65.5%), so we're now basically maxed out on everything we can do at first level (Taran needs 1 more score for a Performance Award, but we'll get that this fall). Time to think about moving up to Second!

All the ribbons.

Also, have some adorable pet pictures, because I have them:

What happens when you fall asleep mid-stretch.

TOES!

Not sure when I'll get back to regular blogging, but hopefully sometime soon. Hope y'all are well!

You might think it's funny, but it'snot

No seriously, 'snot. Thanks Brego.

Lame husband

One of the problems with having a Brego is that Bregos are quite large, and therefore quite heavy. So if said Brego might accidentally step on a foot whilst being groomed, the results may be less than ideal.

Whoops.

Normally hubby is a pretty staid guy, but given the amount of pain he was in, we figured it was probably broken, so we shipped off to the ER.

This walking cast has seen a lot of use.

The ER doctor didn't see any fractures... but she sent us to a specialist because sometimes fractures don't show up immediately, and there are a lot of tiny squishy bones in the foot. Plus, hubby has a great relationship with the specialist, since he's broken his right foot twice already. He's talented like that.

Fortunately, the specialist didn't see any fractures either, just a lot of trauma and squashed tendons. Hubby is supposed to keep the foot elevated and iced, and wean himself off the boot and crutches as he can. Movement helps with these types of injuries, not so much with broken bones.

It's turning a rather interesting shade of grey, but at least the toes now look like toes. Cute dog begging for a tummy rub also included.

So hubby won't be attending the show with me. Instead, he'll be limping around at home, staying clear of Brego feets.

Lose 20 pounds overnight with this one simple trick!

Brego got body clipped yesterday. Poor guy was overdue, and with temps in the low 80s he was just standing around sweating.

Significantly more svelte... at least, for a Brego. However, I don't think his mouse-brown winter coat is nearly as attractive as his glossy black summer coat. And most of his dapples have disappeared with the clip. :(

I did a full body clip for the first time ever (usually we do a hunt clip). I had no idea that he actually had LEGS under all that hair!

Paddy stood by the gate the entire time and commiserated.

The hair was so deep in places it was up over his feet.

So, if your Brego needs to lose 20 pounds ASAP, clip him. And uh, anybody got any suggestions on what to do with 20 pounds of Brego hair?

Haffie Snax from The Haffie Homeland

One of the things I brought back from my Austrian tack shopping spree was some treats for Paddy.

Green apple flavor.

Paddy's not particularly picky about food objects, so I figured he'd love them.

Schniff!

Chomp.

Considering....

Pffffbbbt. Yuck. Ptooey.

We tried again. 

Left nostril schniff.

Right nostril schniff.

How about I eat the phone instead?

So apparently my horse, whose daddy was imported from Austria, is completely Americanized and doesn't like Austrian horse cookies. Boo.

We tried to see if The Brego would eat them instead.

Schniffing not necessary.

Hmmmm....

You got any more of those?

While I was taking pictures of hubby and Brego, SOMEBODY wanted some attention too...

Haffie selfie.