Something that is working...

It's been quite a while since I had a Ramsey update.  No news is good news.  The camera angle was off for this recent photo making it look like the outer wall is much longer than the inner, which is not accurate.  However, it does show that the walls are now straight instead of curving to the side.

The outer wall on the left where the missing coffin bone is, still shows poor connection and a widening of the white line, but it always will.  I think this is as close to "normal" as this foot will ever be.

From this angle, you can see that it is a pretty nice looking foot now.  More importantly, it is a generally sound foot.  That's what matters.  For quite some time, I trimmed it just a very small amount each week.  As the distortions have grown out, I have slowly been able to extend that time frame.  I am now trimming it a small amount every 3 weeks.  It seems to be working well for him.

Ramsey does, occasionally, have some soreness, but it is in the arthritic fetlock joint not the hoof.  I am certainly frustrated by that, but we are managing it well.  I have been giving Ramsey (and Tanner) turmeric each day.  It has been shown to be an effective anti-inflammatory with no negative side effects if given at the proper dose.  I was skeptical at first, but both Tanner and Ramsey have been on it since last Fall with excellent results.

Tanner has had joint issues all of his life and has suffered with periodic episodes of extreme lameness.  He does not tolerate pain medicines well or visits to the vet.  He has not had a single bad episode since starting the turmeric last year (even with the extremely cold winter, which would normally cause him trouble) and no negative effects whatsoever.  I'm convinced.  And I'm happy with this pretty little donkey foot as well.

An Overdue Update

Seems like it's been a long time since I had any foot updates.  Honestly, this winter has been kicking my butt in more ways than one and I know I've been slacking a bit, especially with the blog.  One of the issues that came up with all my recent doctor visits and tests was an extremely low vitamin D level despite the fact that I was taking high levels of supplemental D.  I am now taking stratospheric levels and it has helped, kind of like coming out of a dense fog.  Some of the bone and muscle pain has improved as well although there are other problems there as well. Autoimmune disorders suck.

One of the problems I am dealing with is improper absorption of nutrients as a result of damage to my GI tract caused by celiac disease.  It is ironic to me as I have been delving so deeply into equine nutrition.  Turns out Ramsey and I have had some of the same problems.  In Ramsey's case, the nutrients were missing from his diet.  In my case, I am unable to absorb them.  Different problems, similar results. 

I haven't forgotten my promise to write about nutrition either, it just got lost in the fog for a bit.  I have also been struggling with it to a degree because I have found that many (most?) people are very resistant to talking about it at all.  I have encountered a tremendous reluctance to even discuss the possibility of nutritional issues and this has left me seriously puzzled.  After pondering this for several months, I have come to think that the problem of nutrition is two-fold:  first, it is a complex, often bewildering subject that can't always be easily fixed.  Second, many horse owners take any suggestion that there could be a nutritional problem as a criticism of their horse keeping skills. 

It is far easier and more satisfying to buy a tub of vitamins and feel that we have done right by our animals than it is to go looking for trouble.   Unfortunately, I have come to believe that most of our horses do well in spite of those lovely white supplement tubs rather than because of them.  For those who are interested (and I know there are a few:), I will get around to it one of these days.

For now, a rather overdue foot update:

If you recall, last Fall, Ramsey's foot had gone all sideways on me and was collapsing inwards...
10/26/13

I can't tell you how many hours I have spent looking at this foot as well as all the bones above it and watching how Ramsey moves.  In late Fall, I made a conscious effort to set aside all of the trimming advice I had gotten to date and stopped studying other hoof trimming methods.  I am not saying that any of that information was bad, any skill has to start somewhere after all.  Rather, there comes a point when you have to step away from books and experts and let the foot in front of you tell you what it needs.  I think this is true for any hands-on skill, at least it is for me.  I study everything I can until I come to a point where I have to stop studying in order to learn. 

It is also true that, just as every finger print is unique, every hoof is unique.  Ramsey's foot is a bit more unique yet.  There is no book that covers this foot.  It was obvious that what I had been doing was not working any more. 

I made changes in Ramsey's feed to address nutritional deficits and imbalances and I set about trying to do what this very special and unique foot wanted.  I made some mistakes along the way and they showed up in the foot, as they always do, but I am much happier with where we are now.  This is where we were  2/16/14...

and where we are 3/7/14...(note how much shinier the foot is, that is from the balanced nutrition)

In these next photos, you can see how that abscess he had last Fall slowly grew out.  You can also see how the hoof wall has gradually thickened.  I attribute that to nutrition as well.

 12/4/13                                                                                  2/12/14

Starting to look like a decent foot, (note, I don't usually trim the frog much at all, but Ramsey's is so tough that it does not wear down at all in the snow.  It was growing well past the bottom of the foot.) 3/7/14

The above photo is interesting to me because you can so clearly see where the missing coffin bone is.  Picture the "bite" taken out of the bone and you can see it clearly in the upper left side of the foot.  The right side shows lovely wall connection and a very tight white line.  That line turns into a 1/2 inch thick, wobbly area on the left of the foot where the bone is gone.  Those dark spots are weak, poorly connected areas. 

The bone loss shows up on the outside of the hoof as well, in the line that runs down the side of the foot...

 12/4/13

We have managed to maintain good wall connection at the toe and the heels are slowly strengthening.  I would like to see the entire foot about a 1/2 inch shorter than it is here...

2/12/14

Getting there....slowly.
3/7/14

A Very Different Picture

Cornell sent me a disk with all of Ramsey's x-rays on it.  He has had more than 60 radio-graphs taken.  Most of them were clearly taken during his surgery, probably for guidance and to make sure they had disease free margins.

The first two pictures are the first ever taken on Nov.2 and were how the vets diagnosed septic pedal osteitis.  I am no expert at reading x-rays, but if I have read this right, this is a front to back view of the right foot.  The bottom most bone is the coffin bone or P3 (the third phalanx), and is where the infection was.  If you look at the right hand side of the bone, you will see that it has fairly clear, well defined edges.  The left side of the bone appears fuzzy with vague borders, that is the infection.  Below the bone, there is a dark oval, I think that is a pocket of abscess.  The dark spot on the bottom right is where there was a piece of hoof cut out of the sole.

I think this is looking down through the top of the foot.  Again, the right side of the bone is clear, the left is a dark, fuzzy shadow.

These were taken during Ramsey's surgery on Nov. 3.  I think the needles were used as markers to gauge whether the margins were clear.

They took some bone out, repeated the x-rays and then took more.  Several times.

They were never able to tell for certain if the joint was involved so they treated it as if it were and flushed it with antibiotics.  You can see the needle inside the joint capsule.

These were taken on Nov. 30 to check Ramsey's healing progress.  The margins of the remaining bone are sharp and clear.  No infection.

A lateral view, also taken on Nov. 30.  You can still see the hole in the side wall of Ramsey's hoof.  The shape of the hoof and the position of the coffin bone is good.  The bottom of the bone is mostly parallel to the ground.

Compare the above image to this one taken on Feb. 25. (this was taken after the farrier trimmed most, but not all, of the foot).   The length of Ramsey's heel is longer here then above, but squashed underneath him.  If you are a horse or donkey owner and you hear the term "underrun heels", this is it.  It makes the coffin bone tip back a bit.  You can also see that the coffin bone is higher up in the foot then it is below.  This can get much worse in donkeys or horses whose feet have been neglected for a long time and allowed to over grow into a slipper shape.  The farrier at Cornell started to correct this, but it will take some careful trimming over time to get this foot back where it needs to be

I think this last film is the most striking for me.  You can see at a glance just how much of the coffin bone was removed and is just plain gone forever now.  That won't grow back.  You can also see where the ragged edge of his hoof wall corresponds with the missing bone.  That won't grow back fully either.  It is amazing to me that Ramsey can even walk let alone be out playing in the snow with his mom.

A Foot Update

It feels like progress has slowed a bit with Ramsey's foot.  The hoof wall is still growing fast, but the sole has a long way to go yet.  I think there is still a lot of dead tissue that needs out grow out before we get healthier hoof.  The back of the hoof wall keeps curving in toward the frog more and more as well.  I don't know if that is caused by the internal damage to the foot or the constant bandaging.  Since it has not happened on the other side of the hoof, I suspect the former with the latter possibly being a contributing factor.  I will share these photos with the vet, see what he says.

Right after I took these photos, I massaged some of my ointment into the foot and all of that scaly stuff on the side finally came off.

To me, it looks like the coronet band has become oddly stretched and elongated.  I have not ever seen anything like this before.  I really think it is the result of 3 months of constant bandaging and I have been trying to think of different ways to wrap the foot that would allow more air circulation, but I haven't come up with anything yet.  It has to be foolproof so I haven't dared experiment much.

In spite of how odd everything looks, Ramsey seems very sound on the foot.  He moves easily and freely with no limp and no sign of pain so I am not terribly worried.  I have been trimming the foot just a little bit each week, hoping to maintain it in tiny steps rather than trim it all at once weeks from now.  I think we will see much healthier growth once he can go without a bandage.

Speaking of bandages, I had been trying to stretch out the bandage changes to every 3-4 days, but I think I am going to have to go back to doing it every other day.  The back of his heels get so dry that the bandage rubs and chafes, making it sore.  I am still using my beeswax salve on it, which has really helped, but it needs to be reapplied more often.  I don't want him to get sore and I certainly don't want it to get infected again.  His heels were looking really good, but we seem to be losing ground so, back to every other day.  Not only is this time consuming, but between bandage materials and medicine, it costs about $10 every time I change it.  Oh well.  I have been trying to make the bandage lighter, but....

When I did this bandage change, I noticed that Ramsey now has a tiny white spot.  I don't think it is genetic though, it certainly wasn't there before.  It looks to me like a tiny scar, which often grow back in white.  It makes me wonder if this could have been the original injury that caused all of this.  I always assumed that it was a stone bruise that started everything, but it is possible that a puncture wound in the leg could have been the route in for bacteria. 

Both of the donkeys love to scrounge and nibble in whatever brush they can find, Ramsey could easily have punctured his leg on a twig or thorn.  Given how tiny this spot is and how thick and dark Ramsey's fur is, I doubt I would ever have seen it.  The actual scar under that white fur is about the size of a sesame seed.  

Ah well, now Ramsey can boast of a light point after all.

The Foot Today

I got a few pictures of Ramsey's foot this afternoon during the bandage change. 

The farrier at Cornell took off a lot of excess hoof.  The constant bandaging has made the coronet band flatten and creep upwards giving the foot a stretched and overly long look.  The foot is still overly long, but it couldn't be cut back any further, it will have to wear back over time once the bandage is no longer needed.

As you can see from the position of the surgical hole, the foot has grown over an inch since he had surgery.  Hopefully, once it grows out enough that the it no longer needs bandaging, it will start growing and wearing more normally.  I have never seen a foot that has had to remain bandaged for so long and the results are interesting.  It definitely shows how too much constricture can cause problems.  I often see horses with hoof problems that I believe are caused by wearing too-small shoes.  Ramsey's foot certainly demonstrates how those problems begin. 

I think that with careful trimming, I will be able to correct the issues in Ramsey's foot over time once we can get back to normal.  The foot is too tall and the heels are very contracted.  Both are very common problems for young donkeys and they have been exacerbated by 10 weeks of bandaging. 

The bottom of the foot shows that will still have quite a ways to go.  Sorry for the odd camera angle, the foot isn't really that off-center, it's just darned hard to get pictures.  Another case of needing more than two hands.

The spot just in front of my finger is where the sensitive, internal structures of the foot are still exposed.  If you follow the curve of the foot upwards, you can see light and dark patches in the sole.  The light color on the right is healthey sole, the grey and black on the left is where the abscess traveled under the sole, undermining the whole hoof.  All of that black and grey is going to die off and be repleced over time.  You can really see just how extensive the infection was as there isn't much healthy sole left.  The foot will have to stay clean, dry and bandaged until good hoof grows over the internal strucures and he has a bit more healthy sole to support him. 

He is going to loose a lot more of the frog as well (that's the dark, triangular bit at the back of the foot), but it will regenerate with time.  I think he will have to regrow the whole foot before it is normal again, which may take as much as a year, but I think we will get there.  Someday.

Success!

For once things went almost as planned.  We made it to Cornell at 7:58 this morning with dry roads and no trouble.  Can't beat that!  As soon as we arrived, word went out that Ramsey was back and all of his fans started appearing like magic.  It really is amazing what this one little donkey seems to do to people and I can really see how donkeys can make wonderful therapy animals.  Even worried and distraught horse owners in the midst of their own crises, couldn't help but break out in smiles when they saw Ramsey headed their way, especially wearing his high-top.   One student did an actual, honest-to-God happy dance when she heard Ramsey was there.  He is simply irresistible. 

The good news for Ramsey is that the vet and farrier both thought that Ramsey's foot looks great!  They even decided that they did not need new x-rays since it is healing so well and he is walking so soundly on it.  The farrier trimmed the foot and took off all the dead hoof that I was afraid to cut.  Between what I did last week and what he did today, his foot is at least an inch shorter.  He still has a huge hole in his foot, in fact, it may actually be larger now, but the wound is clean, dry and healing beautifully.

The hole in the side wall has grown out so much that, from the side it looks to be half gone.  However, that large section of sole and frog that was dead, has now been cut out so the hole in the bottom of his foot is rather frightfully large.

After the trimming I did last week, I thought this would happen so I wasn't really surprised.  The hoof that is left is healthy and growing fast, so we all think it will be OK as long as I can continue to keep it completely clean and dry.  The only drawback is that there was no way they could use an acrylic patch on the foot.  The stuff gets very hard and, while it works well on the sidewall of the hoof, it can't be used on the sole.  It would be like making him walk on a large rock all the time.  It means I have another 5-6 weeks of having to keep the foot bandaged. 

Again, I am not surprised by this and I'm not really unhappy about it either.  The patch would have made my life much, much easier, but it also prevents any further treatment or observation of the hoof.  If something were to go wrong under that patch, I would never know until he came up lame again.  It means six more weeks of rather all-consuming care, but, we have made it this far, we'll make it another six weeks.  I do get to stretch the bandage changes out from every other day to every 3-4 four days, so there is at least a tiny reprieve.  I hope to have some pictures for you in a few days. 

The other very good news is that Ramsey's gelding surgery went very well.  Donkeys are much harder and riskier to castrate then most other animals and I have been worried about this.  I am glad I had the surgery done at Cornell in a very controlled environment rather then on the farm.  I am also just extremely relieved to have it done.  I have heard of donkeys actually breeding as early as seven months and Ramsey is just about 6 1/2 months old.  If we had had to put this of for too much longer, I would probably have had to find somewhere else for Emma to stay.  None of us would have been happy about that! 

All in all, it was a very god day and I can't tell you how happy and relieved I am to have this one done and behind us.  We still have a long way to go, but I feel good about where we are.  I had felt like we were making progress, but it is so good to have it  confirmed by the people who really know.  Both the vet and the farrier told me to just keep doing whatever I have been because the results are outstanding.  Very good to hear.

The Foot

A number of people who have donkeys of their own have sent me emails expressing interest in what has happened to Ramsey's foot and how it was treated.  I took these photos yesterday to show you what it looks like and as a way for me to better track his progress.  Since I look at it every day, it can be hard to see progress.

Be warned, these are bit graphic.  If you are not interested in such details, you might want to skip this post.

Ramsey had a lateral hoof-wall resection done so that the surgeon could access the coffin bone, which was infected.  About 1/4 of the coffin bone was removed.  There is a fair amount of granulation tissue, but obviously, it needs a lot more.  I am treating this part of his hoof with a chelated silver solution.  I soak a piece of gauze in the solution, put it directly in the hole and use conforming gauze to wrap over it.

As the hoof grows from the top down, the hole will move farther and farther down toward the ground and eventually grow out.  The resection is causing him surprisingly little pain at this point.  He no longer even flinches when I replace the gauze packing.  Hopefully, when he goes back to Cornell in four weeks, the foot will be healed and grown out enough that they can put an acrylic patch over the hole and eliminate the need for a bandage until it grows out completly.

The most painful part right now is the back of his heel.  You can see, just where my thumb is and at the coronet band above the resection, that the hide is scurfing off where the bandage has rubbed and the abscess broke out. 

I used a small amount of icthammol on that area and I am going to try some of the beeswax salve that I make.  I think it will provide a protective barrier and help keep things soft.  The foot is in need of a trim, but that cannot be done at this time.  

I need Ramsey to stand still and quiet while I change his bandage.  While he does tie fairly well, he is too wiggly without a distraction.  I have found that if I offer him something good to eat, he will stand quietly and allow me to do just about anything while the food holds out.  Since I do not want him overeating and he should not get any grain, I have been giving him a small handful of timothy hay pellets soaked in water (you can get the pellets at TSC).  They are the perfect choice for animals who should not get carbohydrates and I have used them to completely replace the minuscule amount of grain my equines were getting, none of them need grain.  All of them actually like the hay pellets better than sweet feed, which surprised me.  The pellets contain nothing but timothy hay and a small handful keeps Ramsey happily occupied for nearly 30 minutes.   

That 30 minutes gives me ample time to get this done.... 

Inseperable

I had intended to keep Emma and Ramsey separated by my stall rails.  After all, he had been successfully weaned and Emma was drying off well.  I thought it would be safer for Emma and easier to deal with Ramseys medical needs that way.  However that didn't last long.  When Ramsey, who is now 37 inches tall, tried to jump over the 60 inch wall, hurt foot and all and Emma immediately started making milk again, I gave up.  I bow once agin to the wisdome and knowing of donkeys and I will find a way to deal with it.  "Dealing with it" could be to motto of my life, that and the beleif in perseverance.The comfort and contact will be good for both Emma and Ramsey.  Their seperation was traumatic for all of us and we will heal better together.

The only real downside is that now Emma is going to have to stay incarcerated with Ramsey all the time rather then trading off babysitting duty.  In essence, I now have two donkey confined to stall rest for the next two months.  I do hope that in a few days, they will relax more and once again feel safe enough to allow a little distance.

Meanwhile, they are now more inseparable then ever.  Prior to his trip to Cornell, Ramsey had been developing a lot of independence and it was not unusual to see him and Emma at opposite ends of the field.  I tried to let Emma out for a bit this afternoon, but this is as far as she got...

"Why won't you open this gate and let my kid out?  It's a beautiful Fall day, we should be OUT."

"I'm sorry Em, I wish I could, but he has to stay in and heal."

"I guess that means I'm just going to have to have my morning nap in the sun right here."

"At least I have my baby back."

"It sure is hard being an only-donkey.  This is MUCH better"

We're in for the long, hard part now.  Ramsey is getting twice daily meds, needs his bandage changed every other day, he has to be hand-walked four times a day for the next two months and the stall has to stay clean and absolutely dry all the time.  He goes back to Cornell in four weeks for a checkup barring any trouble before then.

This is reminiscent of a time almost ten years ago when my, then, 8 month old border collie had to have shoulder surgery.  The vets sent him home and told me to keep him quiet for 8 weeks.  Those are two months best not remembered.  Still, Tanner and I made it through that, Ramsey and I will make it through this.  I hope.

If there is a silver lining to this, it is you my dear readers, friends and neighbors.  You incredible people have sent me $5000 towards Ramsey's vet bills which are just shy of $7000 right now.  I simply never imagined such a thing.  I would never have known that my animals, my little stories, and what to me is an ordinary life, would touch so many people from all over the world.  Who knew? 

Thank You.

Look Who's Finally Here - again

 "Hey Tess, who do you suppose that is?"

"I don't know, it sure looks like deluxe transportation though."

"Jeez, I wonder if it's full.  There could be a whole herd on there.  Say, why don't we get a stretch limo when we go places?  There must be someone awfully important in there."

"WAIT. WHAT!? It's that little brown pipsqueak?!!"

 "Ma, OPEN THIS FENCE AND LET ME IN.  Please."

"MOMMMMM"

"MOMMMMMMY!!!!!!"

Things got a bit chaotic here and the photographer (me) kinda fell down on the job because of an insufficient number of hands.  Two just aren't enough.  I had intended that Ramsey stay in the stall I prepared for him and just have Emma next to him.  That plan didn't last long (why-o-why do I still try to plan anything?  Lord, you'd think I'd learn!).  It became very clear that Ramsey was going to hurt himself trying to get to mom so I gave up and gave in.  What photos I managed from that point are indecipherable.  I will try to do better tomorrow. Sorry.

For now, just know that Emma and Ramsey are good and Ramsey completely forgot that his foot hurt at sight of his mom. 

Tessa is also doing well and I am going to bed.