Tuesday, December 20, 2016

Dealing with a knee wound

When last I put fingers to keyboard on this blog, Sasha was on rest from her tie-up. Tanna was still on rest from his fetlock issue from Biltmore in May. And Serts was still the grumpy old man (which he's been since he was 12, btw) who was firmly in retirement.

Sasha is still on rest, but through no fault of her own. She has shown no side effects of her tie-up episode, but she's just been chilling in the pasture for the most part. I have ridden her a couple times for short distances and she is feisty and ready to go. I just haven't had the time.

I run a good amount and am currently in training for my 2nd marathon. So that takes up a good bit of my time these days.

But I have another issue. Another time-sink that is keeping me from conditioning my endurance horses. And that is Tanna.

On October 8, 2016, I went out to feed the horses. Serts and Sasha came flying and I gave them their breakfast. Tanna did not come right away. That's not entirely unusual. Some days he comes up at his own pace. So I continued doing chores and Tanna still didn't come. I went to fill the water trough. I could see Tanna in the lower pasture, standing, facing away from me. I hollered at him to come in. He looked over his shoulder and hollered back. He did not turn to face me. Red flag.

I ran into the house, told Daniel something was wrong with Tanna, and ran to get a halter and lead rope. Daniel headed toward Tanna. First thing to notice was his front right knee. Sliced open with a pretty good flap. Next was a chunk of flesh gone from his right rear stifle area. Tanna would not move. (Don't worry, I won't show gross pictures on this post.)

I called the vet hospital and the answering service took my message and said I'd get a call back. I was in a bad area for cell service, so 30 minutes after not hearing, I called again, stressing that Tanna wouldn't move. I was scared of joint involvement or broken bones. With him refusing to move, I didn't think it wise to move him without a vet looking at him or I would have loaded him and taken him to the hospital immediately.

Dr. N called and got through to me. He was pretty close and got there, evaluated the leg, gave Tanna some drugs, bandaged up the knee and we loaded him on the trailer. Daniel positioned the trailer to give as little a step up as possible and Tanna loaded without much issue.

I'll skip the long drawn out posts I would have written if I'd written posts all along.

Turns out, no broken bones, no joint involvement! Praise God. We were really lucky. Not as lucky as it not happening, but, you know.

So we started wound treatment. Tanna was in a splint for awhile. He pouted about it for days before finally dealing and learning to swing his leg without bending it. He graduated to a long bandage with no splint, then a smaller bandage and a small paddock attached to his stall.

Finally, the wound progressed so there was no bandage at all. Things seemed to be healing well and going great. The wound on his rear leg healed with only cold hosing.

And then, on December 11, I let Tanna into a little bigger paddock. I was watching him. I wasn't concerned about him. He seemed to be smart and calm.  While mildly trotting around, doing his head toss, he just slipped and fell. Right on the right front knee. He came up favoring the leg. I ran and got him, started to hose the wound and realized it had busted open as bad as the first day.

Daniel was home and helped me bandage the knee and get Tanna into a trailer and off to the vet. It was a Sunday, so I called the answering service for the vet and told them I was bringing Tanna in.

Dr. C saw him and treated him, cleaning and bandaging up the wound. Tanna stayed in the hospital.

On Monday, Dr L and Dr M and Dr C and Dr N and Dr K and a few interns and I all stood around Tanna and discussed options. Option 1) do what we did before; splint, bandage, etc. Option 2) Surgery to close the wound as much as possible, add some skin grafts and put the leg in a cast. Option 3) Standing sedation to try to do as much as possible to clean and close the wound, then splint and bandage.

There was some concern about him coming up out of surgery with a cast. Some horses don't handle that situation well, but Tanna had been in a splint for 2 weeks or so and was at least familiar with the feel of not being able to bend that knee.

We opted for surgery. Then came days of daily bandage changes to check the wound and see if it was ready for surgery. It needed to even out some and get a good blood supply near the surface for the skin grafts to take hold.

8 days after he fell for the second time, Tanna was ready for surgery. I stood with him for an hour or more the morning of his surgery. Just standing with him in the stall.

When it was time, they prepped him by cleaning his hoofs and putting protective boots on the non-injured legs. Then rinsed out his mouth with a hose. And then they gave him some meds and into the room he went to go under anesthesia.

I was allowed to watch the surgery through a window. I wasn't sure I wanted to. When I was left alone, but the blinds were still shut, I sat down and just cried. By the time they had him on the table and wheeled into the room and opened the blinds, I had myself together again. I sat and watched and finally got up and stood next to the window, watching.

For 2 hours I watched. I watched his leg get scrubbed for a long time. I watched his belly go up and down with each breath. I watched the anesthesiologist watching Tanna. Keeping tabs on him. Helping him. I watched one surgeon remove small bits of skin from Tanna's chest. I watched another surgeon debride the wound and stitch it up as much as possible. The edges of the wound came together far more than I would have thought. I watched as the skin grafts were carefully placed in the wound that couldn't be covered by leg skin. I watched the bandage go on. I watched the leg wraps go on. I watched the big thick cast padding go on. I watched the cast go on. And before I knew it, Tanna was being moved into the recovery room to sleep it off.

And while I didn't want to watch and I might not have, it was good for me. In watching, I learned. And by learning, I banished fear. Not that I wasn't still scared. Scared of him waking up and freaking out. But the fear about the surgery itself was gone. And those 2 hours flew by.

I much appreciated Dr M stopping by to talk with me near the end of the surgery. He had stopped into the OR and talked with the surgeons and said things went well.

That was also said when the surgeon updated me after he was sleeping in recovery.

For the next couple of hours, I waited some more. I worried, I wondered, I prayed. Tanna woke up, but wasn't ready to get up. He had some dizziness. He attempted to get up a couple times, but then just laid back down. When he finally did get up, I was told it was in one controlled motion. No panic on his part. After 20 more minutes, I was allowed to peek in on him in the recovery room. He was standing with a wide stance, facing away from the door, but when I stood on tip toe to see inside, he looked back at me for a long time until he finally had to put his head back to neutral. I slipped back to the lobby to wait some more.

I think what freaked me out the most about him coming out of anesthesia was the shaking. He just shook and shook like he was cold. He was still trembling some when I left. It was a totally normal reaction, but it was very disconcerting. They finally let me put a fleece cooler on him. More for me than for him.

He was finally back in his stall by 5 PM, but I wasn't allowed in with him until after 6. I did go peek in at him and talk to him a bit before returning to the lobby. After 6, I slipped in his stall and put my hands on him and talked with him. He was still recovering from the anesthesia and his hard day. He was not allowed food until late that night and he was not amused. I finally left for home and left him in the capable hands of the vet staff.

Today, Tanna was over the effects of the anesthesia. Looking good and bright eyed. He is using his leg with the cast fairly well. Good to have had him splint trained already. He will stay in the hospital for a few more days and then hopefully come home to stall rest.

A note about this post. I did not specifically name the vets involved. While I am super proud of my vets, I do want to respect their privacy. There are also no pictures on this post. I have a ton of pictures. But most of them are either gross or from the vet hospital and again, I want to respect the privacy of the vets and the other clients and their horses.