July 27, 2015

A Whirlwind of a Week

So much to write about.

Last week was insane.  My aunt died and the funeral was planned for Thursday with viewings Tuesday and Wednesday. I knew I couldn't make the entire trip work, but I could make the Wednesday evening viewing. I managed to squeeze in an entire week worth of patients in a day and a half (I had already blocked off all Monay afternoon for Gem's recheck) and hit the road early Wednesday morning.

The typical way to get to southwestern PA from SC is a pretty straight shot up north through NC --->VA --->WV ---> PA.  Having not actually ever driven back home since moving here, I just plugged it into my van and hit the road.

I have no clue why but my van decided to take me a different route. I ended up heading west once I hit NC. My route looked like this: SC ---> NC ---> TN ---> VA ---> KY ---> WV ---> PA. I' glad I made it at all.

Anyway. It was odd being back home. I moved away 9 years ago and haven't been back since the last funeral I attended 2 1/2 years ago. A lot has changed. There is a mall where I did my junior year ecology forest study. There are townhomes and apartments where I used to hike with my dog. There are different businesses where my old haunts used to be. There is a Dover instead of the BBQ joint Dusty and I ate at during his 2 hour dinner breaks when we first got married. Wait...a Dover? Ok...I can live with that one.

Just as I was beginning to believe the old saying that you can't go home again, the memories began to flood in. I took a couple of hours after the wake and before meeting for dinner with some great old friends to just drive around my favorite places. And you know what? I could picture the good times so vividly it was like nothing had ever changed. I saw myself walking Hero as a pup on my favorite trail as he chased the squirrels. I saw Christy and I shooting basketball late at night during a warm summer. I saw my kayaking friends meeting up at the now vacant Wendy's waiting for Caroline to get off work so we could get on the water. I smiled and probably looked insane to anyone who looked as I slowly drove on by. It was great.

Dinner with my friends was fantastic. I don't have many friends still in town. Most have scattered like I have, but there are still a few and it was great to laugh with them once again.

Saying goodbye to my aunt was not fantastic or fun, but is a part of life that you unfortunately can't avoid. Rest easy Aunt Jozia.

Before coming home, I made two stops. One was to get homemade pierogis. I grew up with a heavy polish culture. My mom's side is polish and came over through Ellis Island only two generations prior to her. Her grandparents only spoke Polish and my grandmother was fluent in both polish and english. I grew up eating pierogis, haluski, stuffed cabbage and the like. You can't find any of that down here, so when I had the chance I got 5 dozen homemade pierogis from a wonderful little polish store. The second stop was Dover. Gem will be living in bell boots once the shoes are on. I have a set for her, but they are non spin ones with a lump of material on the inside that sits between the heel bulbs to prevent the boot from spinning. This would be very bad for her since it would put pressure exactly where we don't want it. I needed simple boots for her.  Fortunately for my bank account, Dover didn't have a single piece of red tack or clothing in the entire store. It isn't a little store either. They remodeled the entire pre existing two story restaurant. They had to have at least a million dollars in inventory. And not anything in red. I left with black fleece lined bell boots, a mineral salt block for her stall and some more No Thrush powder since I was running low anyway and it would avoid paying shipping.

While I was away Dusty changed Gemmie's cast for me. It needed removed Friday, the wound cleaned and put back on. He went over on his lunch break, grabbed Gemmie from solitary confinement and put her in the cross ties on the cement to have the cleanest possible area. It all came off fine and he was impressed with how good it looked. There was one area in the center that didn't look so great, but he poked around and found the culprit. A penrose drain acting as a stent had been left in and the body was pushing it out. He removed it and was much happier. He snapped some pictures for me which I am leaving out because I will hopefully have some newer ones to post very soon anyway and they don't look much different than the last set. As he was wrapping her back up, she bit his butt. Several times. Sorry honey. Gem has a long long standing hatred of Dusty which is comical and while she behaved as best she could for the most part, apparently she had had enough.

She continues to be an amazing horse. No stocking up. No bute. No sedatives. She is calm and happy in her stall even when all the other horses go out for the night and she is alone. Her weight has been maintained although she has lost a good bit of her condition. In general she is being content to be lazy and have her own personal fan blowing the flies away and keeping her cool during these hot summer days. I am impressed with her attitude and so thankful that she has healed to date as well as she has.

July 21, 2015

Gem Update: Forward Progress

At the last update, Gem had been placed in a second cast with instructions for stall rest, daily wrapping above the cast, twice daily oral antibiotics and ace as needed. The vet wanted her back in 10 days exactly and so I cleared my schedule at work for the afternoon.

Gem has done exceedingly well on stall rest. Her legs have remained nice and tight,  has gobbled down her antibiotics, ate the barn nearly out of hay and has remained calm and mature. I love this mare.

Monday afternoon I hooked the trailer up and got her out of her stall. I felt really bad about leading her straight onto the trailer and she did balk upon loading. I understood her complaint loud and clear as this was the first time in 10 days that she had been out of her stall at all and 3 weeks since last in the pasture. Sorry mare, but this is just how it has to be right now.

I hit the road 30 minutes ahead of schedule and called my dad to confirm some details on the funeral and what they were planning on doing. Life is very complicated right now.

As I merged onto the highway 10 minutes later, a man in a mini van pulled up beside me in the next lane and started honking his horn and staring at me. It freaked me out. So much so that I slowed way down in the hopes that he just wanted over before the exit that was coming up.

He slowed down as well and continued to honk and then rolled down his window. This really freaked me out, so I slowed even more and he eventually pulled ahead of me. He then slammed on his breaks and honked. Um??

The exit came and he got off, but then stopped on the exit ramp and continued to look at me through his open drivers side window. I apologized a bit to Gem and sped way up to get past him and hoped he wouldn't sped back onto the highway in pursuit. I didn't feel like being murdered that day.

I continued on holding my breath and looking into the rearview mirror hoping never to see his dark blue van again. Thankfully, I didn't and I arrived at the clinic in one piece.

Or so I thought.

When I got out, it was over 90 and I figured Gem was getting pretty hot in her metal box. I went to open the rear top doors to give her air and noticed a big problem: the electric cord that I had assumed was nestled nicely in the plug on the truck was in fact dragging on the ground. Apparently the man did not have visions of rape and murder, but had in fact been trying to warn me of my broken trailer. Oops. 

The plug is cracked and the wing on the right side is completely worn off.


At first I was naively hopeful I could still get it to work, but the entire thing was smushed into an oval versus the circle it needed to be
 
 I texted Dusty that I had arrived safely, but had broken the trailer. Sorry, honey. Hopefully they can just replace the plug and it won't cost a fortune.
 
I opened up the trailer and headed inside to check in. I gave them Gem's name and told them we had a 3 pm with Dr. B for her cast removal. The receptionist told me that that was impossible since Dr. B was off that day and I must be mistaken.
 
My head exploded.
 
Seriously, this place has the absolute worst customer service ever. The medicine may be good, but I will never use them ever again after this injury.
 
I informed the lady that my mare was going to have her cast off at 3pm, that I had stood in that same spot 10 days prior and made the appointment per the insistence of Dr. B and that they would be seeing me. She gulped and told me to unload as she figured it out.
 
Gem came off the trailer fine and immediately tried to pull me over to the small patch of grass lining the drive. I apologized again to her for the solitary confinement and led her over to the barn. A nice tech met me halfway and took Gem to one of the outpatient stalls. She told me to wait in the lobby and I replied that I would not be leaving my horse.
 
I was 30 minutes early and so I settled in with my phone to vent to friends as I awaited some vet to come care for my Gem. In the meantime, Gem drank half a bucket of water and dropped for a nice roll in the clean shavings. Good mare!!!
 
Eventually the owner wandered over, gave her a dose of Ace and had me lead her to the treatment area. On the way he asked if her cast was bi valved. I admit I was annoyed. Why didn't he either look up her chart or communicate with the surgeon? I asked him if he knew her case at all, he stammered out something and then disappeared to text with Dr. B. Sigh.
 
Eventually he came back and got to business. With the gigli blades already in place under the fiberglass, it took about 30 seconds to remove it and Gem was none the wiser.
 
Outer layers removed with the gigli saw wires exposed

The inside portion bi valved

I was very anxious to see what the hoof looked like. Would it be healed? infected? Dehisced open? Necrotic?

It seemed like forever as he unwrapped the hoof and finally revealed her injury.



Unwrapped with sutures still in place

After sutures are removed.

I let out a huge sigh of relief once it was exposed. It looked really, really, really good. The wound is still young and very fragile, but the skin is doing it's job at healing. A lot of the swelling was gone and there was zero signs of infection.

Gem is healing this about as good as is possible right now and it is both amazing to see and slightly terrifying at how much damage was actually done.

After he cleaned it all up and removed the sutures (he left the wire in the hoof wall) we talked about the plan. Well, actually I talked about the plan while he hemmed and hawed and took pictures for Dr. B.

Eventually a plan was hashed out and I even got an explanation as to why.




Going back into the bi valved cast

Cast still fit well
  Ok...so the plan moving forward:

- No more antibiotics  - yay!!!
- She was placed back into the bi valved cast with wrapping above it.
- The wrapping will need changed daily
- The cast is to be removed on Friday with the wound cleaned and the cast put back on
- On Monday the cast is to be removed permanently - yay!!!
- On Monday she is to be placed in a bar shoe on both fronts
- Bell boots at all times on the fronts
- Even with the shoes she will need to have the heel wrapped with gauze and elastikon daily. This is to keep swelling out and to provide support for the fragile heel bulb flesh.
- Continue strict stall rest for 2 more weeks
- Return in 2 weeks

I was pretty happy and relieved with the news, the way it looked and the plan. I put Gem back on the trailer and went to check out.

They told me I owed $3800.

Now to me that seemed like a lot for a dressing change and suture removal appointment.

She rolled her eyes at me and explained that I had never paid her previous bill. Um...yes I did. I have the invoice in the truck to prove it. Once I showed her that I had in fact paid it, she rung up the $30 fee for the day.

$30 seemed awfully low, but I wasn't going to argue.

The drive back didn't involve any crazed men trying to get me to pull over to have their way with me, so I considered that a win and we arrived back at the barn safely.

I spoke with the BO and he is going to care for her in the mornings now which is a big win for me. It means I can once again take Wyatt to school before work. I will still go out in the evenings to change her dressing and make sure everything is still going well.

She is off the antibiotics, no bute and has been off the Ace for nearly a week. I am planning on adding her Grand Vite daily to help and am starting to research hoof supplements to help that injured hoof wall.

All in all it was a great report. Back to waiting for 2 more weeks!!



July 19, 2015

Goodbye and Rest Easy Aunt Jozia

I have said goodbye to more beings in my life the last 13 months than the entire 32 years that preceded them. My heart is sad and very tired.

My mom is #8 of 10 and I am fortunate that all of them have been in my life in some form or another. Some lived far away as I grew up and then I became a young adult and moved away myself. I lost contact with a lot of my family but three remained fairly constant.

Aunt Jozia was one of them.

Growing up she was an ever happy presence. I don't recall ever seeing her angry or upset. She was bubbly, positive and supportive regardless of your life choices. She came to every family function and even drive two hours for my medical graduation. If she was asked, she did her best to make it happen.

When I began this blog she was my only reader. She knew nothing about horses or endurance and yet she read and commented on every single post no matter how boring or tedious she found the material.

She flooded my Facebook page with positivity and love. I can't recall a single negative post. Ever. She filled it instead with beautiful photos, quotes and reminders to just live the world and each other.

With both her and Christy gone my world has become a little less sunny.

Thank you Aunt Jozia for your never ending love, support and happiness. Cancer is a terrible thing that doesn't discriminate. You were well loved and will be sorely missed by many.

Please keep my family in your thoughts and prayers as they learn to say goodbye to a sister, aunt, daughter, niece, wife and friend.

Life is short and haphazard. Love those close to you. Tell them you love them. Let go of negativity. Say goodbye to toxic and negative people.

Goodbye Aunt Jozia. I am sad that you are gone but I know now your pain is finally gone and you are at peace. Everyone is free to believe what they want about life and death. I choose to believe that I will see my loved ones again someday.

July 17, 2015

Mom + Injured Horse = ?

A while back I wrote a post about the challenges faced by a working mom with a horse. You can read it here if interested.

The whole working mom + horse thing has worked out for me because Gem is on full care/pasture board at her barn. I don't have to go out to care for her or see her on a daily basis. The fact that I generally only see her 2-3 times a week, and to be honest sometimes only once a week, probably wouldn't sit well with a lot of fellow bloggers who take a much more active role in the horse's lives. In an ideal world she would be in my back yard, but she isn't. This scenario works well for me and Gem has done just fine pre injury with this set up.

 But she is now post injury and everything has changed and I am way beyond stressed out with it all.

Gem needs care twice a day. She needs her doxycycline powder mixed in applesauce and then grain added to that to make a nice gooey delicious mash that she gobbles down greedily. She was getting Ace twice a day, then only at night when the horses all left the barn and now isn't getting any and she is doing just fine. Her leg needs wrapped above the cast daily. Thankfully she has not stocked up at all so her other 3 legs have been able to be bare.

The BO offered to do it, but with so much at stake I feel the need to take 100% ownership of her care. If this all goes wrong I need to know she had the best care possible and that it was just bum luck. So that means I have to go out twice a day. Plus he thinks she needs an 8 quart bucket filled to the brim of grain twice daily and my 900lb mare doesn't need that much food. Not even at the height of her conditioning. That's a ton of food.

So....my dynamics have shifted tremendously and it is taking its toll big time. Ready to listen to me whine?

I haven't been able to take Wyatt to school all week. Instead I go to the barn at 7 am before work while Dusty takes him to school. Thank god for supportive spouses.

I haven't been able to pick Wyatt up from school all week. Instead I go to the barn at 6 pm after work while Dusty picks him up. Picking him up from school is one of my all time favorite parts of the day. He sees me and screams "Mommy!" as loud as he can and comes running over to tackle me in a big toddler hug. It makes being away from him all better. I haven't gotten this all week.

I have missed bed time 3 times this week. I never miss bed time.

It sucks. A lot.

I know it is hopefully short lived and her cast comes off on Monday afternoon, but being a full time working mom and having Gem is a delicate balancing act as it is. Trying to make sure I have my "me time" with her while not giving up too much "Wyatt time" is difficult even in the best of circumstances. Now the scales have shifted so much and I am burning out big time. I love Gem and I will do all I can to take care of her and if that means twice daily dressing changes for the next year, then I will make it work somehow, but for right now 7 days into it I can tell you I am stressed. I am burnt out. I am tired. And I miss my son.

So I guess my advice on how to make being a working mom work out is to not let your horse ever get injured to the point where their care will throw everything out of balance. If they do, well..I don't know.

July 15, 2015

Einstein...Our Newest Addition


Last one, I swear!!!
 
When Hero died in the Spring of 2014, Bones was a little lost. I think she enjoyed being the only dog, but she now had nobody to play with. Knowing what a difference puppy Bones made to mid aged Hero, we decided to add a new family member that summer after my Biltmore LD in July.
 
We disagreed on who that new member should be.
 
I wanted to get a 2-3 year old dog from a local shelter. I love my Bones mutt and figured a dog in that age range would be over the puppy annoyingness and maybe house trained. Both of these things sounded wonderful with a toddler.
 
Dusty was not so keen on this idea. He was worried that a dog of unknown history might not enjoy the toddler so much and he worried Wyatt would get hurt. So that nixed that.
 
If we were now looking at actually purchasing our first pet, I wanted a Basset Hound. I had been wanting a Basset Hound for many years. Now was my chance. Add to that the fact that Dusty had promised me a Basset when I allowed him to find Lulu (the pitt bull pup who showed up at our door the previous fall) a home other than ours, and I thought I had the Basset locked down.
 
Except Dusty played the "We have 4 house pets and I had no say in any of them" card. Crap.
 
He wanted a Boykin Spaniel. My first thought was "What the heck is a Boykin Spaniel?"
 
Apparently, it is the state dog of SC bred to be both an excellent hunting dog plus the best family dog around. He figured the dog would have enough energy to hike, run and ride with us, but would still be able to sit around the house as well. It seemed like a good choice. He also just happened to know a breeder who had pups of the perfect age. We went to look.
 
Now....
 
If you ask Dusty he will tell you that I picked out Einstein. In a way this is accurate. I was the one who looked at the entire litter, grabbed up Einstein, declared him ours and gave him his name.
 
But....
 
He put the following restrictions on my choice:
 
- Must be male
- Must not be the largest
- Must not be the runt
 
There were three males. Once was tiny, one was large and one was just right. Not much of a decision to be made. I remind Dusty of this often.
 

 
Einstein at 8 weeks old
 We waited a few weeks to bring him home and he immediately took to all our family members including Wyatt. The cats hated him at first sight. Bones was ambivalent.
Wyatt meets Einstein summer 2014.
Worn out on his first day home

Einstein is special. In a take the short bus kinda way. I'm not sure where Dusty got his information, but this breed is not well endowed in intelligence. Seriously, the dog has rolled off the couch numerous times, ran head first into trees and took 9 months to house train.

I'm special
But....he is also the sweetest dog I have ever met. Einstein is not happy to merely be sitting by you. He will climb into your lap and sit on you and be perfectly content. He will lay on top of you if you let him. And Wyatt? He puts up with everything that kid throws his way. Tackling him from across the room? No big deal. Trying to ride him like a horse? Sure, why not? Pulling his stub of a tail and his big, curly ears? Ok by him. Hangin out in Wyatt's clubhouse under hot, stinky blankets? Sign him up! We couldn't have asked for a better toddler friendly dog.


Wyatt watching a movie with his two best friends

He stayed like this for about a half an hour until Wyatt decided to move
 Einstein is also a great trail dog. We have always let our pets off leash in the park as long as it is not busy with others. While Hero was extremely intelligent and Bones moderately so, it took them both about 3 years to be 100% trusted off leash to not go chasing everything and to come back when called every single time. Einstein did this from day one. He has an innate sense of sticking around and while his hunting breeding will kick in to make him circle around us, for being just about 1 year old now he is amazing off leash.

Einstein doing what he does best.
He adores swimming as well. He splishes and splashes with Wyatt and has been caught jumping into the bath tub to enjoy the water with Wyatt.


Playing fetch in the woods
Most of Einstein's behavior issues can be directly linked to the fact that he is a high energy dog who is crated Mon-Fri while we work full time. He goes to Puppy Day Care on Thursdays where he is the biggest hit with everyone. We also hike with him every weekend and once the weather cools he will start running in the evenings again.

The only big complain I have is that he is very mouthy. He chews on everything he can get his mouth on and has destroyed so many items I can't even think of them all. Part of it is pent up energy, but even after a strenuous run he still chews on absolutely everything. We are both doubting that he will ever fully grow out of that.

Wyatt adores him though and is always calling him into whatever room he is in, covering him up with blankets and in general loving him.


Going for ride in Wyatt's care seat


July 13, 2015

Echo..cho...cho...cho

Bored yet?? Sorry, but we have two fur babies to go.

The look of a Hubby who knows he is screwed into getting another cat

September of 2008 was my 3rd year of medical school and we knew it was our last chance for a vacation for a long time. We rented a pet friendly cabin in hocking Hills, OH and took Bones and Hero to camp, hike and enjoy a long weekend away.

It was the second to last day and we were just leaving to go kayaking looking for beavers (which we actually saw and still is one of my favorite memories ever) when we heard the piercing cry of a starving kitten outside the cabin.

There stood a tiny and very skinny calico kitty. Dusty ran off to the Walmart that was a half an hour away to get cat supplies and firmly told me we had to find her a home. 3 cats and 2 dogs was enough. I agreed. She needed a home. Our home.

I won.


Echo came home with us an never left.

She got along surprisingly well with the dogs and others cats. I say surprisingly because calicos are not known to be the most friendly out there. In fact, she isn't friendly. She just knew that she had to be in order to stay. Any new comer now is made fully aware that they are not welcomed by her.


Echo barely puts up with Dusty's existence and any stranger wouldn't even know we had her. But me? She adores me. I can't sit down on the couch for 30 seconds without her popping up into my lap. All winter long she commandeers the covers and likes to sleep under blankets and sheets.


Echo has two extra toes on each back foot and one extra on each front. It makes her paws look huge, but she actually is a very small cat.

She isn't best buds with anybody in the house. She tolerates them all and I will catch her playing with Scrabble and our newest addition, Einstein, every now and again, but mostly she just sits there and looks down on everyone like they shouldn't even exist.

If we didn't have Queen Smokey, Echo would rule the house. She doesn't question Smokey's authority though.

Her favorite toy has always been the ring from the milk carton
Echo isn't super playful, but she has her moments. She is a pen stealer and we can never keep any pens in the house because she is always taking them and hiding them everywhere.

She ignores Wyatt like the other cats and only barely tolerates him.

One of my all time favorite picture ever



Echo is now going on 7 and is extremely healthy to date. She is also spayed and retains all her many claws for being a good girl and not ruining anything in the house. She is the second youngest member of our herd and I hope to have her around for many years to come.

July 10, 2015

Gem Update: She Came Home :)

There is so much to write about and honestly I am just too worn out to do it in any entertaining way, so unfortunately you will have to deal with blathering in a semi coherent fashion.

We went up for 9 am to get Gem this morning. I was anxious to see her myself and get a chance to talk to the vet face to face so that she couldn't avoid my questions. She met us with a smile and led us over to Gemmie.

She brought her out of the stall and unwrapped the leg to show us the hoof and explain some things. What I saw was actually better than what I thought I would see. It was certainly better looking than her picture led me to believe.

7/10

7/10
There is a fair amount of primary healing that has occurred which is a great thing. There is no drainage at all, no odor and the swelling is pretty darn good. She has been off bute and is still using the leg.

I learned some new things I hadn't heard about before.

Can you see the wire sutures through her hoof wall? Yeah, apparently Gemmie had sliced right through the coronary band and was about an inch away from leaving half her hoof out in the pasture by itself. I didn't have it in me to ask what would have happened then. I'm just thankful that wasn't the case.

In any case this matters for a couple of reasons. The main one is that those tiny pieces of wire are what is holding her hoof wall on that side to the leg. It needs to heal and it needs to heal well. She will most likely end up with a permanent deformity to the hoof wall due to the trauma. How bad of a deformity will depend on how well it heals and how much damage was really done. The vet is hopeful that it will just be an unsightly ridge, but it could end up with a lot more than that. Time will tell.

She also said that her heel bulb will end up deformed as well. I don't really care about looks, although function is an issue, but this is also unavoidable.

Luckily she did not injury the frog or sole of the hoof which is why she is so sound on it. The hoof should remain fully stable and functional.

One of the bigger concerns (along with the hoof wall remaining stable and healing) is a condition known as "Quittor". I had never heard of this before, but the vet explained it as infection of the side bone. Gem fractured her side bone and part of it was removed in surgery. There is a chance this could become infected and create a massive pus filled wound. That would be very bad. So far she has shown no signs of infection at all and we have done quit a bit to prevent it: local limb perfusions, IV antibiotics and she remains on orals now as well. It appears the risk remains for about 6 months post injury, so even if all the soft tissue heals we still won't be out of the woods completely.

Overall though she said that Gem is super fit, very nice and has a great chance of returning to endurance again. WAHOO!!!

But then she went on to say that the side bone can cause residual pain. She said that this can be fixed in the future if it occurs, but didn't say if that would require another surgery to remove the remaining part or what. Residual limb pain and endurance don't really go hand and hand, so we will just wait and see on this.

While it isn't vital information I did ask if she thought she would end up needing shoes on her fronts and she seems to think so. Now she isn't a barefoot person to begin with, but I have a lot of thinking ahead of me. I don't want to shoe her at all and want to allow the hoof to form the shape and condition it needs to function. However, it is no longer a normal hoof and has suffered pretty severe trauma, so if a shoe is needed to provide support, then so be it. My bigger concern with barefoot is the deformed hoof wall and heel bulb. Depending on how it all ends up healing, she may need shoes as no boots will fit that. Time will tell on this too.

After that we talked about the plan. She wasn't comfortable removing any sutures due to it not being fully healed yet and I was ok with that. She really didn't want her in a soft dressing at all because there is too much at stake and too high of a risk if it were to be traumatized again. Letting it sit quietly is the best option.

So Gem went into a second cast.

Padding it up

Fiberglass and vet wrap applied (pay attention to those swirly things on the side)

Wrapped above with padding and elasticon to prevent shavings getting into the cast
She will wear this for 10 days and then we will return to get it removed and the sutures hopefully out.

I will need to change the upper wrap daily and check for any rubs. Any sign of pain, heat, flies accumulating on the cast or bad rubs and I am to call immediately and get her seen. Those would all be very bad things to happen.

She will remain on oral doxycycline twice daily until then and we are continuing the ace at home until we know how she will behave.

I did learn something really cool while there.

See those swirly things on the cast? There is a set on either side. They looked like little clear plastic tubes and she placed them over the cast padding, but under the fiberglass. I asked if it was for stability or to create room or what???

They are gigli saws!

They build in two saws into the cast so that when it comes time to remove it, they can remove the protective plastic tubing and then saw away the cast from the inside. She said it not only provides a nice clean edge if they want to use the cast again as a splint, but also the horses handle it really well and even the most staunch horse has issues with an electric cast saw.

How cool is that?

We took Gemmie home and settled her into her stall. She has her slow feeder hay bag and a calming supplement as well. We will keep the ace up through the weekend and then trial without it on monday. I got approval to walk her the 20 feet out of the barn to a rim of grass to let her get fresh air and hand graze 10 minutes max in one small area. No forced hand walking, but she can graze a bit.

Tonight her swelling was gone in all legs and I will keep a close eye on her. Vet said I could do no bows and standing wraps 12 hours a day and I will put them on as needed.

So now a tiny rant that is insignificant in the greater scheme of all things, but kind of point to make.

We ended up with a $3800 bill. I will go into that more in the part 2 of finances post, but thats a lot of money. Veterinary medicine (along with human medicine) is just as much about the people involved as it is the animals and too many vets are just not people friendly. If the vet themselves can't handle it, then the clinic needs to hire someone who can. Little things matter. Things like spelling my name, which I wrote very clearly on the forms, correctly.  All my paperwork and the medicine label had me as Sara Dorkowski which is about as far from my name as possible.

When I do surgery, no matter how minor, I always cater to the patient and do little things to make them smile. I put christmas trees on winter time dressings, a heart, a nike swoosh. Something small to brighten their spirits. When I come into the hospital and all my gear is red it wouldn't take a whole lot to try to use red wrap on her. Petty, yes. But seriously it is something so tiny that would have put a big smile on my face and left me feeling better. It is the details that counts.

I you are in the vet world, or any high stress situation please keep in mind that the tiny little details that don't cost any money or much time at all really do make a big difference in the perception of the care received.

Ok...end rant.

July 9, 2015

Gem Update: The Cast Is Off

I had a whole tirade planned about the craptastic communication from the vet, but it really isn't super important. All my local friends have been messaging me about how much they don't like this place, but they didn't want to tell me at the time. Gee - thanks!

In the end I still think it was the best place to go initially. It was the closest and with her spouting blood like a fountain time was of the essence. Dusty and I will need to have as serious talk about where to go from here and if we want to continue with them or move on. I don't know what the answer is.

In any case, the cast finally came off today. I didn't get to talk to the vet because I was fuming mad at her lack of responding to my calls, so I made Dusty do it. He didn't get a whole lot of information out of her.

She has been off bute for 2 days now (thanks for telling me that 2 days ago) and is still full weight bearing on that leg, so at least that's a good sign. According to Dusty she wasn't too worked up about the hoof, but also wasn't super thrilled either.

She had placed stents along the areas of high tension and will be removing those, but leaving the sutures in place. She worries that if she takes them out the entire thing will fall apart on us and then we are shit out of luck.

I tend to go off the deep end when it is my furry family, so I am trying to keep it together until tomorrow when we get to pick her up and bring her home for more stall rest. I was really hoping it would be healed superficially along the laceration line and just need some time for the deep tissues to follow suit.

As you will see below, that isn't the case.

Good news is that there isn't any swelling, drainage or odor. The exposed tissue remains pink and viable and none of the flap has died or completely dehisced open.

The bad news is that her hoof looks like, as Saiph put it, a Frankenhoof and my dreams of a quick recovery are pretty much smashed to pieces.

I need to really focus on long term goals for her right now and not worry about the short term, but I don't even know what her long term prognosis is. To me that looks like shit and that it will scar horribly and she won't even be able to be ridden or wear boots or do endurance ever again. I know that is just my gut reaction to a nasty looking picture and after a very stressful week of not being able to get in touch with the vet and I still don't know much because she won't tell us anything until tomorrow when we show up.

We will see what tomorrow brings.

Front right taken 7/9/15 after cast removal

July 8, 2015

Scrabble, the Cat-Dog

Scrabble is another addition that was not wanted by the hubs. There appears to be a trend.

We were a month out from our wedding and stopped by the barn where we kept our then TWHs (long story on those) to get an RSVP from the BO. When we pulled into the drive we were met with a sickly little black and white kitty.

He came running over to the truck and I grabbed him up. He was about 8 weeks old and had a nasty upper respiratory infection. One look at my face and poor Dusty knew he was screwed.

Scrabble came to live with him and then us when we got married a month later.


We already had Smokey at the time and she was terrorizing the only cat Dusty has ever really loved - his blind long haired grey kitty Anakin. Ani wasn't much for playing and Smokey was, so Scrabble actually really helped out a lot. He was just about Smokey's age too and the two of them became good friends.

Scrabble has always been more like a dog than a cat. He is the first, and most days the only, member of the household that meets me at the door when I come home. In fact he greets everyone happily.


He loves to snuggle, but only stays for a short period before he moves off of you and prefers to sit next to you rather than on you. He is amicable with everyone he meets, human and animal, and will follow me around the house all day long.

If I go outside, he will be in the window of whatever room overlooks me. He really is my best bud.


Scrabble always has been obese. We put him on a diet and restrict his intake and yet he still gets fat. He will always be fat. It annoys Dusty to no end.

He is an easy going guy who doesn't know how to hold a grudge. If you ignore him he just waits patiently for his turn later on. He has chosen me as his human friend and is always within eyesight. He could care less about Dusty, but will use him for company if I am gone.


He waits for me in bed when Dusty and the dogs get up with Wyatt in the morning and joins me in the shower as well.


He really is a great cat. He is neutered and declawed. Before anyone goes off on me about the horrors of declawing your cat, understand that I fully know what it means, how it is done and what the complications can be. He had no signs of pain and was back to the litter box and running around like an idiot the following day. He got declawed because even with tons of scratching posts, other cats and a dog to play with and trimming his nails on a regular basis he decided that absolutely shredding the furniture was the only thing that would do. It was declaw or get rid of the cat.

He is about to turn 12 as well this year and is mostly doing very well. He has one non functioning and atrophied kidney and had an infection earlier this spring in the other that made me fearful for his life, but he came back quickly and vibrantly. Scrabble is such a constant in my vision daily that his brief time spent in the hospital on fluids made me very aware of how vital he is to my every day life.

July 7, 2015

Bones, My Sweet Baby Girl

I could spam you all day long with pictures of my girl. Bones came to live with us in May 2007 and my heart will break in a million pieces when she leaves us. She is an irreplaceable pooch and holds a special spot in my heart.
 
My podiatry school held a black tie fundraiser for the scholarship program every year and I always volunteered to help. The first year I showed up in my turquois ball gown and was handed a leash. On the other end was a puppy named Cinderella. She was 14 pounds at 8 weeks of age and I spent the entire night walking her around and trying to get people to bid on her in the silent auction. I couldn't help but open the bidding on her and told myself that it was ok because someone else was bound to outbid me. I wouldn't allow myself to bid more than once.
 
By the end of the night there were three bids. I lost. Except both the others had significant others who nixed the puppy. Now if it was up to me I would have forced the top bidder to pay anyway since it was a fundraiser and all and then offered the puppy to the next in line. But life isn't up to me and they let them bail. It was on me. I took her.
 
There was one big issue though. My SO also didn't want a puppy.  Good thing he was at work that night and not with me.
 
It was 1 am when the night ended and Dusty was working emergency at the time. I wasn't super comfortable bringing home a puppy in the middle of the night to our cats and dog, so I headed to Dusty's work. I walked in looking all pretty with my puppy on a string and his jaw dropped. Not in a wow you took my breath away sort of way but in a what the heck is that sort of way. It didn't help that he was in the middle of literally searching for a needle in a fat lab's abdomen and was already in a foul mood. Ooops...sorry honey. Can she stay the night and you bring her home?
 
He wasn't happy then, but if you asked him now he wouldn't trade Bones for the world.
 
Dusty and baby Bones always spent the mornings snuggling in bed

Hero took to Bones right away and they played all the time
Bones ended up being a Doberman/Great Dane mix weighing in around 100 pounds. She was and still is absolutely adorable.
 
My only other dog experience had been Hero who was a very high energy, super smart Corgi who needed constant stimulation. Bones was the opposite. A single day outside playing would wipe her out for the next three days.
 
She was happy when we bought her the proper sized dog bed: a human love seat

Bones is a love. Her bark can scare the most staunch offender, but I like it that way. Living in Cleveland with the hubby working nights and weekends made me nervous. Even though the worst Bones would ever do is lick your skin raw, if you came to the house you would hear her tremendous deep bark and run away.

She goes from bed to couch to bed all day long and just wants to sleep

She adores snuggling and has tried to take my place from day one with Dusty
She had her own faults at first and to this day any food left out when you turn your back is gone in a  flash. She has eaten entire loaves of frozen bread left out to thaw, a whole plate of raw hamburger patties waiting to be put on the grill and countless left overs. She knows she isn't allowed at the table when you are eating and she won't beg, but if you get up and walk away its fair game.


Can I come out to play?
She loves car rides, hiking, swimming and in general just wants to be around you and loved by you.

One day in WI I went for a run. I hooked her up and decided to take her not knowing if she would enjoy it or not. She was awesome at it. We paced well together and she just loved it. The next time I went out, I changed into my running clothes and was going to go out without her. She went ballistic. Form then on, anytime I ran, I ran with Bones.


We also decided to go kayaking with our WI neighbors (Hi Shauna!). I had spent my youth doing competitive whitewater slalom and it felt great to be back in my boat again. They brought their dog along per their norm and encouraged us to bring Bones. She had a blast.



Bones is 8 years old now and still my sweetheart. She has done well for being such a big dog. Sadly, we diagnosed her with osteosarcoma in her front left leg this past spring which already had gone to her lungs. We are loving every moment we have with her right now and she still goes on our hikes every weekend and hogs the bed nightly.

July 6, 2015

Finances....The Evil Step Child of Pet Ownership: Part 1

When it comes to financial decisions and pets it can get pretty heated and ugly and is most oftentimes ignored completely. In the interest of providing as much information as possible, I want to be clear on the cost of my treatment with Gem.

This is part 1 simply because I don't know all the information yet and won't until the end of the week. I decided to break it up and write about what I do know to avoid a massive blog entry later.

For those of you who may not know, Dusty is a small animal vet. We both know and understand the world of vet med very well. We also know about billing practices and alternate forms of payment. I am in the human medical field and while I could bore you all with my point of view of where it has all gone wrong, it does help me to keep things in perspective when it comes to charges. The human equivalent of the same vet procedure (think spay = total hysterectomy) is usually at least 10 times more expensive.

The point is that neither of us were shocked by the estimates we received.

Gemmie has so far received care from two different facilities: the local on call vet who came to the barn and the specialty hospital where she is still at. 

The emergency on call vet came to our farm on a Saturday afternoon after business hours. This created two separate charges: a farm call and an emergency charge. He also sedated her, cleaned the wound locally (he wiped it down with a saline soaked gauze pad, no irrigation or flushing) and applied a compressive soft dressing to stop the bleeding. He did not give her any bute or antibiotics.

Total charge = $372

When I arrived at the specialty hospital the vet was nice, calm and forward about everything. She asked if Gem was insured. I said no. Looking at the wound, she was able to assess quickly and provide an estimate as well as inform me about the deposit required.

What I knew at the time of the estimate:

- Gem would need full surgery meaning general anesthesia, intubation and close monitoring
- The wound would be explored and irrigated
- If the tendon was involved, that would need additional irrigation and exploration as well as repair
- The wound would need sutured closed
- A fiberglass cast would be applied
- She would get local limb perfusions for 2-3 days, IV antibiotics for 2-3 days, daily bute and daily gastroguard
- Hospital stay of 2 weeks, hopefully in ICU

The estimate? $3,000-6000

The deposit? $3,000

I called Dusty to verify this was even possible. The alternative was euthanasia. I'm not being fatalistic. She was bleeding profusely from a massive wound to her front leg. She either needed it repaired properly or put to sleep. Given that, we went ahead with the repair.

When in this situation what are the options available to cover the cost?

1) Insurance - most insurances in the animal world work by having the owner/client pay the bill in full and then submitting a receipt for reimbursement. Even if I had insurance (I will explain why I don't) I would still have had to be able to get my hands on the expected funds up front.

2) Cash/Check - good on you if you have this much readily available in a form that is accessible in the middle of the night/weekends/holidays. Having a special Rainy Day fund for these sort of things is a good idea, but make sure it isn't in a savings or bond type account where you need to move the money around to be able to use it.

3) Major credit cards - having a major credit card that is universally accepted in most situations (think Visa and Master Card. American Express is not accepted in very many medical type settings and Discover is iffy as well, but go with Discover if you can't get Visa or Master Card) with a balance that will cover you in an emergency is a really good idea. Yes, a high available balance does ding your credit score (banks look at the amount you could be in debt not necessarily what you are in debt) but having $6,000 extra available won't kill your credit. This makes the funds immediately available and you can still eat that night.

4) Care Credit - this is a special medical card that can be applied for personally and used for human and animal medical expenses. Typically they offer a 0% interest rate for a short period of time and then jack it up to 25% or something crazy like that. A lot of vet and dental offices accept it and will have brochures and can help you through the process. Vets are starting to get away from it though and I can explain the reasoning if anyone is interested. Relying on this may not be the best bet unless you know for sure that all your area referral and emergency clinics will take it.

Well, I didn't have #1 or #2 and the hospital didn't accept #4, so that left me putting the deposit on a credit card. Fortunately, we do have high limits and while they were not intentionally for this reason I am glad we had them and we will keep them.

As an aside: why wasn't Gem covered by insurance?

Well....because I made a stupid decision under misguided information.

Every horse owner should know what they want in the face of colic. If this were to happen to Gem, she will receive the best medical treatment out there, but I will not put her through surgery. Knowing this, I decided not to insure because for some reason my brain was set on believing that the only reason to insure would be to cover the cost of colic surgery. No surgery = no need for coverage. Except, as we all know, that was stupid. Once she is home and things are settled, I will investigate insurance options for her. Her right front will most likely be excluded from coverage, so lets hope she never injures it again.

One last point before I sign off of this post. Is the estimate of $3,00-6,000 reasonable? Many people scoff at the cost of veterinary medicine. Lets look at it like this:

You or someone you know gets a nasty, deep, dirty wound on the lower leg and cut an artery in the process. I will ignore the cost of an ambulance as it doesn't reflect Gem's case, but typically your  bill begins with a $2000 ride in the ambulance. Instead you have someone drive you to the ER. They assess and clean the wound. The on call specialist is contacted and comes to assess. You are then taken to the OR for emergent care and undergo general anesthesia, irrigation, debridement and closure of the wound (not likely to happen BTW - if it is dirty it usually is left open with a second trip to the OR planned later for closure, but we will skip this to mirror Gem better oh and my OR charges $85 per minute the patient is in the room - not including any supplies, anesthesia charges etc...just the time the room is being used). You are taken to the ICU overnight for monitoring. In the morning you get transferred to a private room for 2 weeks. The specialist comes to visit daily (her care is now free thank you very much insurance rules) as does a primary doctor, infectious disease specialist, probably physical therapy and occupational therapy and a social worker. All charge you every single time they walk into the room.

Anyone want to guess how much that bill would cost?

I don't have time to figure it out exactly, but if it is under $30,000 you would be extremely lucky. I'm not down playing Gem's bill and it does hurt us financially to have to come up with the funds to cover it, but when people start to complain about how much vet medicine costs I get irritated. The above scenario happens all the time in human medicine and nobody bats an eye because the consumer and the payer are separated.

Anyway....I won't get started on that tirade.

I will update the financial information as we progress and I know more. She will be coming home Friday baring anything unforeseen once the cast comes off and that is when we will get the itemized bill and know the final amount due. We will also know if we are looking at continued care in the form of wound care and special shoes etc...



July 4, 2015

Smokey Cat


One night Dusty and I were chilling in my bedroom at my parents' house. We were dating at the time and spending pretty much every minute together. I'm a little fuzzy on all the details, but my dad was in his bathroom across the house and heard a persistent meowing coming from outside his window. He ran outside and saw a tiny speck of a grey fur ball by the air conditioner unit.

My dad loves cats. In fact he loves pretty much all animals, but cats are his favorite. He is also deathly allergic in a throat swelling shut kinda way. He brought the fluff ball inside and my mom named her Smokey.

While Smokey was a kitten she lived with my parents. It was late fall when she arrived and she stayed through the holidays climbing the tree and being an adorable nuisance. Unfortunately, she grew from kitten to cat and whatever hormonal changes occured with aging she quickly started to make my dad sneeze and itch and not be able to breathe.


She went to live with Dusty and the following fall we got married. Smokey has been with us for 11 years now.

Smokes is a good cat. She is insanely soft and fluffy with the type of fur that makes you walk around rubbing your nose all day thinking you still have it clinging everywhere. She is aloof. Most of her day is spent sleeping somewhere quiet and she always chooses the best spots in the house for her naps. In summer she picks the nicest breeze and in the winter the sunniest spot she can find.

When she wants company, you better watch out. She will curl up on your chest and spread her front legs to give you a wonderful kitty hug around your neck. And then she will stay for hours on end. The pre-Wyatt era was great for spending long rainy afternoons with a purring Smokey cat on your chest and movies on the TV. Nowadays, she doesn't get so much snuggle time unless it is after he goes to bed.



When she doesn't want company, you better watch out. Leave her alone. My great grandmother came over to my house after I got married and saw Smokey there. Smokey was sitting on the floor glaring at her. She asked "Who is that mean cat?"

Poor Smokey. She isn't mean. She is the absolute monarch of our household. She looks over everything with her kitty disdain and will let you know when something isn't to her liking.


 
Smokey loved Hero. They were the absolute best of friends and I know she misses him dearly. I would come home from work and find the two of them snuggled up and sleeping. They played, snuggled and cleaned each other on a daily basis. I really miss seeing the two of them together.
 

 
She is going on 12 this year and is going strong. She was spayed as a kitten, but not declawed. She uses her claws on the cat tree and scratching post only and has never ruined anything by scratching on it. She has broken numerous things when she decided she had to lay exactly where some object is and pushes it off in disgust. That's just the way she rolls.