Sunday, January 15, 2017

Update

Ramsey is doing better today.  I was able to start treatment for him almost as soon as his symptoms appeared and that has made a big difference.  twenty four hours on minocycline and he is just about his normal hugable, lovable, demanding self.

Ben though....I am worried about Ben. He is holding to this pattern he has been in: looking better then getting worse.  Yesterday, he looked OK. He was bright-eyed, good appetite, moving around although still stiff.

Today, he is noticeably more sore, depressed, lethargic and poor appetite. His temp was 97.5. I put a heavier blanket on him and he perked up a little bit, but there is no good reason for him to be cold.

I will be talking with the vet again in the morning and will probably call Cornell again as well.  They have not been very helpful so far.  As soon as they hear the words "lame donkey", they assume it is laminitis and tell me to put him on a low-sugar diet.  Which he is already on.  Now that there is a second donkey sick with the same symptoms and a fever, I doubt they will blow me off so quickly.

I'm just going to keep doling out drugs and see what tomorrow brings.  

Saturday, January 14, 2017

Just Shoot Me Now

Where to start....

It's been a roller coaster week.  Ben was feeling OK once the gabapenten kicked in for him.  We started him on the minocycline on Wednesday.  Thursday, he felt awful, but I think it was the antibiotic making him feel sick.

Friday morning, I spoke with the vet again and we decided that Ben would need to show some real improvement by Monday or he needs to either go to Cornell or I need to make a decision that I really don't want to make.

By Friday night, he was feeling somewhat better and I began to have some hope that the antibiotics were finally starting to help.  I do think there is some genuine improvement, but I am rather hesitant to call it that because we have been in this cycle where it looks like he gets better, then he crashes and ends up worse then ever.

He is finally off the banamine and on bute instead, which is much safer for him.  I am taking that as a good sign.  Today, he is moving around and his appetite and interest in life are back, although he still has a lot of joint and muscle pain.

***

Then.....I went out this morning and found Ramsey standing in the exact same spot Ben was in two weeks ago with most of the same symptoms.  The only difference is that Ramsey has a fever and Ben did not, at least not by the time I checked.  I could have missed a mild fever in Ben that precluded his symptoms because donkeys do not show signs of fever the way other animals do.

Ramsey's symptoms are much milder than Ben's were, it is not a holiday weekend and I have the right drugs on hand and started him on them immediately.  I am very hopeful that he will respond faster than Ben and get over this in a day or two.

***

We still do not know what is causing this.  The fact that Ramsey is now sick raises the specter of an infectious disease.  However, they have had no contact with other animals and I never go anywhere, so where did it come from?

I still think this is likely Lyme disease.  Two years ago, they all got Lyme disease at the same time.  I see no reason why it wouldn't happen again.

The symptoms I see in Ramsey are:

  • Sudden fever
  • Chills with hard shivering even under his blanket
  • Joint and muscle pain
  • Withdrawn, depressed aspect
  • Loss of appetite
Treatment: Banamine controls the pain and brings the fever down.  Minocycline to treat the infection. 

Ben's Treatment: Bute for pain and inflammation, omeprazole to treat ulcers caused by two weeks of banamine, gabapenten for chronic pain, minocycline to treat infection. 

My treatment: Someone needs to book a room for me at the nearest psych ward.



Thursday, January 12, 2017

Ben Update

A quick update on Ben....

All of the blood tests we have run so far have come back totally normal.  There are a couple that have been sent out to Cornell that we are still waiting for.

The gabapenten (neuronton) experiment has been very interesting.  Ben is getting it twice a day and just got his 5th dose.  Initially, I saw no improvement and was getting really skeptical about continuing with it.  It did seem to make Ben a bit drowsy at first and he laid down for several very long naps.  I don't think this was a bad thing.  Ben has been lying down a lot because of pain, but not really resting well.  The gabapenten seemed to help him rest more comfortably and really sleep.

When I went out last night after work to give him his 4th dose, he was clearly feeling a bit better.  He tried to run away from me and he argued with me about having more nasty drugs shoved down his gullet, which I took as a good sign.  Today, Ben is still moving very slowly and carefully, but he is moving and his appetite has returned to its normal insatiability.

Now that he is moving around a bit more, it is increasingly obvious that this is not foot pain.  He moves like he has arthritis in every joint, which is exactly what I expect he does have.

My take on the gababpenten so far is that it takes at least 24-36 hours to show any real benefit, but does help quite a lot once it kicks in.  This is not a cure for what ails Ben, it is just a pain medication that is helping him feel better.  We are still working on treating the real problem.  However, Ben was getting increasingly depressed and in growing pain.  He was starting to loose his appetite and a donkey who won't eat is at major risk of life-threatening complications so anything that helps him feel better is a good thing.

The gababpenten was recommended to me by Cornell because they were certain that Ben had laminitis and this in one of the drugs they are using to treat that.  It is also used to treat other chronic, neuropathic pain.  This is not a drug you are going to reach for to treat minor problems, but if you are dealing with acute laminitis or some other hard to treat chronic pain, it might be worth doing some research and having a conversation with your vet about it.

The medication for treating Lyme came in this afternoon and I have started Ben on those as well.  I am very much hoping that this works and we see some real improvement soon.

Monday, January 9, 2017

If it Quacks Like a Duck...

The vet was out again this afternoon and we really gave Ben a going over.  Despite the fact that everyone says this is laminitis triggered by some unknown problem, neither of us has been completely convinced of this.  Ben is in a lot of pain and is lame in all four legs, but he just does not move the way a laminitic animal generally does and he is not responding to treatment.

We got out the hoof testers and, low and behold, Ben shows no sign of pain when we test his feet. However, he does show pain in all of his major joints and his back.  Regardless of the test results (which are notoriously inaccurate), I am still about 88% sure that this is some kind of tick borne disease.  

We drew lots of blood for more tests and we are trying a slightly experimental drug on Ben.  He is now on gabapentin (also called neuronton), which has been used in people and dogs for many years. However, its use is new in equines. We don't know if it will help, but he has plateaued with the banamine and needs something else. Depending on what the blood tests have to say, we are also planning on treating him for Lyme because if it quacks like a duck and walks like a duck, I think we should shoot it like a duck - with a shotgun.



Sunday, January 8, 2017

Running the Hamster Wheel

I would like to say that Ben is all better.  Unfortunately, he is not.

We still have no idea what triggered all of this although I am still suspicious of a tick-borne disease.  One of the big problems with donkeys is that they when one thing goes wrong, regardless of cause, they are highly prone to get laminitis as a secondary problem.  That is where we are now.  I don't know what infectious agent triggered all of this, but Ben is now clearly laminitic in all four feet.

That puts us right square on the hamster wheel.  There is nothing quite so controversial to treat as laminits.  The reason it is controversial is that there are no good treatments.

The key to getting laminitis under control is to find out what triggered it and treat that.  Except I can't do that because I don't know what triggered this.  Ben was perfectly fine and healthy one day and not the next.  He is already on a low sugar/low starch diet, which would normally be the first thing to do.

I've talked to all the experts I could find and here are a few of the suggestions:

Ben has laminits and you should ice his feet.  It is 6 degrees out and there is snow on the ground.  His feet can't get any more iced than that.

Ben has winter laminitis and you should keep his feet and legs warm.  Lets all hope this one is bullshit because it is now -6 degrees out.

He needs NSAID's to keep the inflammation under control.

He has to stop all NSAID's now because they slow healing and cause ulcers.  

I could go on, but I have had enough of the hamster wheel for tonight.  I am going to go check on Ben and the rest of the herd then take a hot bath, because even hamsters need to get off the wheel sometimes.

Thursday, January 5, 2017

Uncertain

The vet came out yesterday to see Ben.  By the time she got here, he looked 98% normal and seemed to be doing really well.  We drew some blood for a few tests and agreed to continue his antibiotics and wean him off of banamine and onto previcox (pain med), because it is safer.  We both thought we had this under control.

This morning, Ben was in trouble again.  He was very sore and lying down too much.  I put him back on banamine and when he went out and laid down on the ice for an hour and refused to get up, I gave him some more.  That finally worked and he is back on his feet and moving around, albeit very slowly and carefully.

Ben's Lyme test came back negative and his other blood test came back normal.  He shows signs of 50% muscle pain and 50% foot pain.  We can't tell if one is causing the other or vice versa.

I've sent a long letter off to the UK Donkey Sanctuary to see if they have any words of wisdom for us.  We sure could use some.

Tuesday, January 3, 2017

Big Ben

Ben is continuing to feel a little better each day, though there is still some lameness and soreness. The vet is finally going to come out tomorrow and run some tests.  I have mixed feelings about it at this point as Ben is responding to my treatment and I am not sure the tests will really be helpful, but I need more medication for him and they won't give it to me without seeing him.  They were not very eager to see him last Friday when I wasn't sure he would live through the weekend, but quite keen now.

Thus is the way of the world.  It will be nice if we can at least get some real answers.  I have a nagging suspicion that those will be elusive.

Meanwhile, Ben is feeling mostly OK and continues to enjoy his most favorite pastime - food.  Ben does love his food.

Throughout all of this, Ben's appetite remained well intact.  If this particular donkey ever stops eating, then I will really know his world is ending.

And just because it is a miserable, dreary day and its been a miserable week, here is a random puppy video from a couple years ago.