Recovery and Relaxation

Nox is doing well after his health scare.  Penny is always out and about doing work on her farm, so she passes his paddock and checks on him constantly.  She sent me this adorable photo of him napping in the shade the next morning after he returned from Cornell.  Poor boy must have been exhausted. 

Nox was even snoring a little!

Penny has also noticed that he's drinking more water than usual - she fills his bucket 5-6 times a day, whereas before the trip to Cornell, he was drinking 3 buckets.  The sedatives he was given make him sweat profusely, so we think he's a bit dehydrated and upping his water intake.
 
He hasn't had any more nosebleeds this week, so hopefully we're finished with that particular drama.  The coffin bone fracture and torn ligament are much easier to deal with emotionally - the emergency events are so frightening.  I've been through horse emergencies before, but this was the first time it happened to MY horse.

In any case, Nox is healthy and I'm spending plenty of time with him this week, since I'm off work.  Best Husband Ever has been coming with me and took the silly photo below: 

Cheese!

      

Update on Nox

Nox is home.  After 24 very scary hours, we have a diagnosis: nothing.  The radiographs yesterday morning were examined by several veterinarians and radiologists, including a sinus/nasal/throat specialist and they didn't find any masses, tumors, or anything suspicious.  To be sure they weren't missing anything, Dr. Hill and her team scoped his nasal passage and throat again.

The good news is they can't find anything that would cause a nosebleed and there is nothing life threatening going on in Nox's head.  The frustrating news is they can't find anything to fix.  Dr. Hill said that the next step, if they had found something suspicious in the radiographs, would be to put Nox under general anesthesia and perform CT scans.  However, since they haven't found anything worrisome, the risks of putting Nox under anesthesia are too high to warrant that step.  I agree.  Horses as a species are very risky to anesthetize - their huge body mass makes it difficult for them to lie on one side for too long without injuring organs, tissue, and bone; and the awakening process is fraught with hazards, as the sedated, confused horse attempts to stand up.  Some horses develop colic days later and can become very sick.  Sometimes anesthesia is unavoidable and the vets must weigh the risks with saving a horse's life.  Since we have ruled out all life-threatening issues with Nox, Dr. Hill doesn't want to take these chances.

So, at this point, Dr. Hill has to guess that he might have bumped his head just right to rupture some blood vessels in his nose.  It happens.  My Dad theorized that maybe Agnes the Goat head-butted him while they were sharing grain.  It's possible, Agnes does love to play the head-butt game.  He also likes to play "nip the nose" with his neighbor Ellie over the stall doors.  Maybe he got too excited and banged his nose.  He is a klutz.  Who knows?

I'm grateful that there is nothing seriously wrong with him.  I can't express how terrified I was on Sunday, thinking he might have Guttural Pouch Mycosis and I was going to lose him.  It brings tears to my eyes now, reliving that fear.  I haven't had enough time with Nox; I'm not ready for him to go.  But, a small part of me wishes I had a concrete explanation and something to fix, but... it is what it is.  Dr. Hill told me that if he has another nosebleed in the near future, I can give her a call, but it won't need to be treated as an emergency (unless the bleeding won't stop after 20 minutes or so), since we've ruled out the fatal conditions.  It takes months for horses to develop the damaging fungus that causes Guttural Pouch Mycosis, and we've seen that his guttural pouch is clean and clear.  However, if he has another major nosebleed next year, we might have to do all this again.  In the meantime, I can hold his head at shoulder height, wait for the bleeding to stop, and wipe his nose.  There's not much that one can do for a horse nosebleed.  Hopefully, he won't have another one.

The other positive outcome of this whole experience is the horse trailer.  When Penny, Best Husband Ever, and I arrived at the hospital yesterday to pick up Nox, he nickered as soon as he saw us.  He looked so happy that we were there.  Dr. Hill gave the technician a syringe with a sedative in it, because he needed to be sedated to get on the trailer to come down.  She asked me if I wanted to try to load him without the sedative first, and I said, "Sure, why not?", but I didn't have much hope that he would load.  I hooked up his lead rope and walked him out of the hospital and into the parking lot.  Penny opened the trailer door, I walked Nox up, and he just stepped into the trailer like it was no big deal!!  We were all so shocked that nobody said a word for about 5 seconds.  I could not believe he just did that!  I patted his neck, told him what a good boy he was, and tied him up.  My guess (and I realize that I anthropomorphize a little too much) is that he did not want to stay another minute at the place where they kept sticking things up his nose and when he saw me, he realized that he could go home to his paddock, grain, and sunshine - so he just stepped into the trailer because it was the easy path to freedom.  No more pricks and prods, just get me home!

So, Nox loads into trailers now.  That was an expensive trailer loading lesson.  Silver linings.      

Vacation to Staycation

As I write this, I am supposed to be sitting on a plane somewhere over Ohio on my way to visit my sister for a week of relaxation and auntie/niece bonding time in Santa Cruz, California.  Our plans have changed.  Horses often have impeccable timing.

Yesterday, just before noon, Penny called me and said that Nox was having a terrible nosebleed.  She told me that his stall was covered in blood and it was pooling at his feet in the paddock.  I abandoned my suitcase packing, asked her to call the vet, and jumped in the car to head over.  By the time I arrived at the barn, the bleeding has slowed and Penny had spoken to our local vet, who recommended that we call the Cornell University Equine Hospital.  I talked to a vet at Cornell named Dr. Hill and she recommended that we get Nox on a trailer and get him to the hospital as soon as possible.  Penny already had the trailer hooked up to the truck.

Nosebleeds in horses are a symptom of a couple of different conditions.  One is very serious and fatal, called Guttural Pouch Mycosis.  This is where the horse develops a fungal infection in the guttural pouch, which contains arteries and nerves, and the fungus erodes the arterial wall and causes bleeding.  Sometimes the horse has a few minor nosebleeds before the artery is completely eroded and the horse eventually has a catastrophic nosebleed and essentially bleeds out and dies.  The only way to know if a horse has this condition is to put a scope up their nose and into their guttural pouch to see if there is an infection. 

A screen shot of my frantic Google search for Guttural Pouch Mycosis. 

Nox, as I recently related in the post about moving him to Penny's barn, refuses to get into trailers these days.  I asked my local vet to come sedate Nox so we could hopefully get him into the trailer.  As she was injecting the sedative, she told me that a few months ago, another one of her clients ignored a nosebleed and her horse ended up having a catastrophic nosebleed a few days later and died on the trailer on the way to Cornell.  This may be a rare condition, but it does happen.  I tried to stay out of panic mode as Nox slid into a drugged state and I hoped we could get him on the trailer quickly.  After a few minutes of tugging, pushing, and pulling, Nox drunkenly stumbled onto the trailer.  Best Husband Ever was able to get the day off at the last minute and he accompanied us on the 2 1/2 hour drive to Cornell, driving my car while I rode in the truck with Penny.

Dr. Hill and a whole team of veterinary students met us at the door to the state-of-the-art hospital.  The facility is amazing and the staff are so incredibly nice.  The floors are all covered with rubber flooring, but the flooring changes colors from room to room.  Nox did not want to step on the different colored flooring and I ended up having to back him into various rooms and hallways, even after he was sedated again.  He is so stubborn.  We weighed him first and he weighs 1,325 lbs!  I had always guessed 1,200 lbs... he's a big horse.  Dr. Hill and her team scoped Nox's guttural pouch and to everyone's extreme relief, everything looked clear and normal.  Nox did not have a guttural pouch infection.

However, we are not out of the woods yet.  He was bleeding heavily and there are other conditions, though not as life threatening, that cause nosebleeds.  Nox is scheduled for radiographs this morning to see if there are any masses or tumors in his sinus cavity that may be hemorrhaging.  These masses and tumors are treatable through minimally invasive procedures.  I'm waiting now for a phone call to see what Dr. Hill has found and what our next steps will be for treatment.

I canceled our vacation to California.  I'm not sure how long Nox will be at the hospital and what kind of decisions I'll need to make over the next couple of days, and so I had to stay close.  We were able to get credit for our next booked flights, so all is not lost, but I'm terribly disappointed to miss seeing my sister, her husband, and my beautiful niece.  Best Husband Ever and I are scheduled for another trip to California in November for a family wedding, and now we are looking forward to that trip even more.

I will keep everyone updated on Nox's progress and in the meantime, please think positive thoughts for him and throw out some good vibes for his speedy recovery.