Rest in peace, Misty

You may have figured by now after no new posts for a while that the news on Misty's progress is not good.

After weeks and weeks of continued draining from abscesses with her severe lameness, I started questioning the ability to clear up the abscesses.  I had suspected that the infection was affecting the bone inside her foot though weeks of antibiotics had not made any difference in the drainage or her level of pain.  On September 19th, I retook radiographs of her front feet.  They showed that there was even more bone loss than there had been in previous radiographs. 

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When bone infection is involved in the hoof, the most effective way to clear it up is by very invasive surgery and curetting out all the affected bone.  Given that Misty already had so much bone missing, I didn't think that was an option for her.    Still, I didn't make the call to euthanize her for several weeks.  After the radiographs, I was really heavily considering it, but as you can imagine, that is not a decision to take lightly. 

Misty's spirits were usually good and she was cheerful and always ready to eat.  And once every few weeks, she would have a good day where she was very comfortable and walking better without putting all the weight on her hind end.  Those days would make me really hopeful, but they only lasted a day.  Most of the time, she was very painful (though still cheerful) and very slow getting around overcompensating with her hind end to put less weight on the front.  It was her attitude that kept me trying for her.  She always was so easy to work with, accepting everything I had to do to her with grace and never getting cranky.  She'd occasionally try to walk away from me when I came with meds, but her crippled front feet would stop her quick.


I had been considering euthanasia for weeks, when one sunny warm day on October 7th, I went to feed the horses in the morning.  Like I often did on days that I was home, I let Misty and Jake (with grazing muzzle in place) out into the yard to graze.  On this day, I watched Misty closely as she took 10-15 minutes to walk the very short distance from her pen out the gate to the grass.  She kept stopping and standing there shaking her head with frustration that her front feet would not let her get where she wanted to go. 

It was her frustration that made the decision suddenly easy.  Once she got out into the lawn, I gave her additional pain meds, more than I would normally because I'd be worried about organ damage.  Then I slowly led her to a valley just on the other side of the pasture that was lush with long grass.  I let her graze that whole day along with her pony, Jake, then I peacefully euthanized her. 


After her death, I opened the bottom of her hooves because I wanted to see just how extensive the damage was in there.  On the left foot with the most pain (but interestingly not the most bone loss), the amount of necrotic corium was not surprising.  The "good" right front foot also had quite a bit of necrotic corium, but not as much as the left. 

I know I made the right decision for her.  After all the trying, the foot soaking, antibiotics, pain meds, ulcer issues, and not seeing any improvement at and only more bone loss after a few months, I don't think there was much hope for her to ever get over it.  And given that it was getting colder and the ground might freeze soon, I didn't want to wait until she was even more miserable before making the call.


I really was at peace with making that decision because I know she was as comfortable as she could possibly be, and undoubtedly more comfortable than in her previous situation right up until the day she died.


And I'm really sad to have to report that I also euthanized Jake, the pony, that day as well.  I haven't written at all about Jake's time with us because Misty's care was so intense as it was.  But Jake came to us as an older pony with previous issues with metabolic syndrome and laminitis.  His front feet were permanently damaged and had dished growth from his previous laminitis episodes.  And he was thin with unusual fat pads over his hindquarters.  His ribs showed easily and his hair was long and hadn't shed out this summer.  We actually shaved him to make him more comfortable when the weather was hot.  I suspected Equine Cushings disease, and indeed he tested with high ACTH levels indicative of Cushing's disease.  Jake hadn't had any recent episodes of laminitis when we got him, but even so, he was quite sore in his left front especially on hard and slanted surfaces.  So sore that I felt bad asking him to carry Wren even on short rides, so she graduated quickly to Stormy this summer.  I suspected arthritis in Jakes lower limbs, but never radiographed him. 


In August, Jake flaired up with heaves.  I attempted to treat the heaves, but the steroids caused him to become laminitic in his front feet.  At the same time I was treating him with pergolide for Cushing's disease.  After stopping the steroids, his breathing became worse, and his front feet stayed tender.  He didn't seem to be responding to the pergolide, though I did not measure his hormones again.  As Jake's breathing became worse, his feet remained sore (despite pain medications), and winter was approaching, I was also wondering what was going to be the best choice for him.  His breathing effort made his ribs really stand out.  Jakes heaves was a result of his hay eating habits due to his worn out old teeth.  He would rummage through any hay looking only for the small particles on the bottom.  I just couldn't see how he was going to get over the lung inflammation since he couldn't be on grass without a grazing muzzle or he would develop laminitis.  And winter was coming with the prospect of feeding more hay and hard frozen ground. 

Jake and Misty had become best friends in the few months she was with us.  When they were out grazing, if they got separated (usually because Jake would wander off in search of longer tender grass that he could get through his grazing muzzle while Misty was left behind due to her crippled feet), they would both suddenly realize they were separated and whinny to each other until I went and found Jake and brought him back to Misty.  It was really sweet.  So given Jake's compromised condition, and the thought of how lonely he'd be without Misty, I decided to let him go peacefully with her.  Jake spent that whole day grazing the long lush grass in the sunlight without a grazing muzzle alongside Misty.  I think they really enjoyed themselves on their last day, and that makes me feel at peace.