May 29, 2009

Royal ... Worry Time, Again

Click photo to enlarge 

Royal With Lots to Think About



If there were a "worry photo" of me right now, it would show someone in the advance stages of "frantic". 

Forgive me if I play out the details of this saga, again, but it has been almost 7 months of walking a tight rope and I'm afraid I'm facing another walk ... on the same rope!

As you know, Royal is still in recovery from serious founder caused by incorrectly administered steroids that he never should have had. My vet was afraid we were going to lose Royal and was making barn calls three times a day.

I told him if we lose Royal ... that would be the end of me, too. He said, he knew that.

The last time I wrote about Royal was last February. Things were looking good. He was calmly cruising the aisles of the barn and barn turnout. His attitude was wonderful, but he was still in confinement.

Now, almost four months later, the situation is the same. The improvement is that his sauntering about is faster and more secure.

The farrier is here every five weeks to adjust his angles and put on new therapy shoes. We are still taking things one inch at a time.

Here is the worry:
Royal is past due for the West Nile vaccine. Much of my research has shown that a compromised horse will likely be thrown into laminitis following this vaccine.

Last April, my vet said not to worry, to go ahead and give him the vaccine.
But this is the same vet that said Royal was Insulin Resistance and that was why he was overweight and had laminitis. (humm ... it was his young associate that gave the steroids). No connection between steroids and laminitis was discussed by anyone, except by me.

I read through various lectures given at veterinary conferences on the subject, as well reading through numerous dissertations written by research veterinarians. The conclusion was, yes, steroids can cause laminitis ... and do.

I printed out my findings and had a discussion with my vet on his next visit.
He said ... "you read too much".
I was shocked.
This is the same vet that has worked with me for over 15 years, that has weathered through many serious situations and always rushed to our barn the minute I called. We've always had both a professional and personal friendship. We were both serious about whatever issues there were. We always ... worked together.

The only difference in the current Royal situation seemed to be ... it was his young vet that gave the steroids. I think he felt a responsibility ... but cannot "go there".

Time proved that Royal's weight was bloating caused by the overdose of steroids, which also caused laminitis. The steroids also threw him into an artificially induced state of insulin resistance.
As the bloating reduced, his blood work returned to normal, as did his body weight. However, we are still living with founder.

Now we have the issue of giving the West Nile vaccine ... while Royal is still in recovery.
The other issue is I'm not trusting my vet. He says ... go ahead, give the vaccine, don't worry.

Well, worry, I do. So, I started doing what I always do ... micro-detailed research.

1. I talked with the Director for Laminitis Research. = Yes, there was high risk of laminitis.
2. Talked to a major breeder and discovered several horses had been given live virus West Nile vaccines and within hours .... had laminitis.
3. Talked with three Equine Pharmacuitical research vets = possible risk.

Finally, on the fourth call to a research vet at a major pharmacuitical company, I got somewhere besides possible and maybe. He wanted all the details about Royal, the how and when and current status.

The bottom line was ... yes, "live" West Nile vaccines have caused laminitis in some situations.
He strongly advised that I wait two more months and give only "killed virus" West Nile vaccine to Royal for the rest of his life. The other choice was ... not giving him any vaccine at all and face the risk of West Nile.

So, that is where we are.
The West Nile "killed virus" vaccine is in the refrigerator waiting.
The time for a decision is here ... and I'm a nervous wreck.

Has anyone been in this situation? I'd be grateful to know your experiences.

25 comments:

  1. Look, I am not an expert on...well...anything. Reading your post and living with my own chronically injured horse my heart just goes out to you. I agree with you in thinking that you vet cannot admit fault and there for is not thinking 100% clearly. That being said I wouldn't give the west nile vaccine if I was in your shoes. Why? Because as of 2007 there was only 1 case of west nile in horses in the entire state of California. I am not from your state, but if I had to guess a number of horses it would be in the 100,000s, maybe even a million. So the odds of your horse getting west nile are not very high. Even in the beginning of west nile the most cases in a year I could find was 540. I say just make sure to keep changing the water in your cute pond and dump all the water buckets everyday and risk it. The odds of him getting worse with the laminites seem much higher in comparison. What does your gut tell you to do? Here is the link where I found out about west nile in CA.
    http://www.westnile.ca.gov/2007_maps.php
    to skip the vaccine this year is just my opinion, and like the saying goes, "opinions are like a$$holes. Everyone's got one"

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  2. Oh, Marvel.

    My thoughts and prayers for you and Marvel.

    Hugs,

    --V.

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  3. Wowee there sweetie!
    I think you are AWESOME on the research department and more vets should recognise this wealth of info we do for our animals and learn because of us and our uniquie situations...
    Just as people are sometimes the standout in medical situations..so are our horses..they process similar in some situations but we should never forget that there are subtle differances that are CRUCIAL to them..just as Royal examples. Wish they'd put themselves in our shoes. Sometimes they can get too detached for us.
    Secoind opionons are good..can you call around and also there are some very haelpful folks like
    Mrs. Mom http://ohhorsefeathers.blogspot.com/ She knows feet and digestion stuff well...

    I have always given "killed virus".
    And My vet totally does not recommend some thinkgs if there are not any recent outbreaks or recorded one around...like Strangles..Rabies,,Potomac fever..they have never recommended those for me.
    I give my mare "Springtime Inc." air dried garlic for her immune and bugs.
    Well visit MM and ask her..she is very resourseful!
    Be well..and don't rush into it.
    KacyK

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  4. I have no advice to offer, just a virtual hug. I am sick with worry about my mare and she just has an infection in her leg. Good luck and I hope you get some good advice.

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  5. I think you are astute to not trust the vet 100%. He is in CYA mode. He does not want to take responsibility for his associate. Unfortunately that seems to be the state of many professions. "Its not my fault" Now he wants to classify you as one of those hysterical internet MD wannabe's (or DVM). He needs to recognize that their malpractice caused your horse profound injuries. He needs to own this and get Royal through this. 15 years is a long time to have a vet and it would be hard to quit him, but that is probably what you need to do.
    Are you going to sue them? You have a decent case, but it takes money and time to prevail. Veterinary Malpractice attorneys can be found, esp in Calif. I dont know what your bills are looking like, but my horse is moving into the $3K range for vet due to faulty gate at the barn. I am guessing you are way beyond that. Find a lawyer and have a conversation about options bc maybe thats what this guy needs is legal action to see the light. maybe that is too harsh, but his poorly qualified associate almost killed your horse and totally destroyed his quality of life. its not too much that this vet take your concerns seriously - like he takes your money - and do some homework instead of making you feel inadequate.

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  6. remember that Royal is yours and this is all just opinion from me.

    I no longer give yearly distemper to my dogs. They get it the year before they are due for their rabies so they get it every 3 years. The puppies get the entire vaccination series but the older dogs...no.

    I believe in vaccines. Totally. But am not quite so sure about how often we give them and if I have a compromised animal I choose to rely on herd immunity to protect mine for awhile. Because his laminitis and founder have not resolved completely yet, I'd wait. At least a year and then re-assess.

    I also believe firmly in vets and their training. They know far more than I do, but I question everything. And I bet if you could read the brochure that comes with the vacc....there would be a disclaimer of some sort about compromised animals.

    Remember, I'm not a vet and I have not been through the issues you have, so take this with a grain or a cup or a pound of salt...it may be worth nothing.

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  7. I'm afraid I'm no expert when it comes to horses, but I wish you all the very best of luck in making the tough decision. I hope it goes smoothly for you.

    All the best wishes and thoughts in the world, from Meg and cats xxx

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  8. Not to worry you more, but my farrier said that last year he treated a horse that foundered after the WN vaccine. I had never heard of that before & was reluctant to give mine their WN, but they've gotten every year, so I went ahead without incident. Good Luck! Sending {{{hugs}}}

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  9. On The Bit:
    Thank you, thank you for your advice and for the info on the number of WN cases in California. Sure put my mind at ease. It seems there is a lot of pressure and panic out here re. WN. I'm taking a deep breath about Royal and going with my "gut" as you suggested!

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  10. All Horse Stuff,
    Thanks for your advice ... wrote to Mrs Mom. She sure is helpful! Also, was glad to know what your vet recommends about vaccines.

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  11. Although I can't give advice regarding Royal, I did have a thought as I read your post. I recently read in the book "Carrots Love Tomatoes: Secrets of Companion Planting for Successful Gardening" that there are plants that are natural mosquito deterrents--one being lavender! It grows well in large pots and is quite drought and heat-tolerant. If you have to delay or forgo the vaccination, why not take preventative measures like surrounding Royal's living area with mosquito repelling plants? It could give you the peace of mind and Royal the recovery time needed.

    Cindy

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  12. It has been a while since my last visit, as you know lots going on in my life over the past 6 months or more and I read with joy your earlier posts about the boys getting on so well etc.

    I know you will make the right decision for Royal, like the time you just on the spur of the moment left both stable doors open (I have done this on more than one occassion with different situations, just gone on gut and impulse of the moment and it has never let me down). Good luck.

    I hate to say it but because of costs involved I have never vaccinated for WNV and we have lots of mosquitos here in Indiana, and maybe it is just dumb luck but I have had up to 22 horses in my barn at one time and never had one sick with any of the stuff they vaccinate for. I know some of you may think this is foolhardy but it has not been a choice for me. Now that I am whittling my herd down I might reconsider, especially if the horses start moving off of the farm to shows etc. Up until now we have never had horses in and out all the time so have taken the chance and it has ppaid off.

    Good luck let us know how things are going and it was great to read our news again.

    Lori

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  13. I live in Louisiana where mosquitoes could very well be our state bird. They are huge and they bite and I probably have 4 or more bites on me right now. It's horrible. So, we HAVE to give the West Nile shot. We have a mare that foundered 3 years ago and she has been given the west nile shot every year. I was not aware of the shot having laminates complications. Our mare hasn't been lame and has not gotten worse. But she didn't have a very bad founder. So, really I am probably no help. I am going to find out if we give the live WN shot or not?!! I have no idea.

    Thanks for this post and the information. And if I were you, really what are the chances of him getting west nile? do you have a lot of mosquitoes there? I am with OnTHeBit.

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  14. Thank you, thank you to all of you for taking the time to give me your thoughts on Royal's situation to give or not give the West Nile vaccine.

    Also, thanks to all of you who sent such good thoughts my way.

    It is so wonderful to have friends in cyber space who are so helpful. Sure is a feel-good during the worry times.

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  15. Good Luck on getting Royal back to healthy!

    Thanks for stopping by my blog !

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  16. I am dealing with a mare that developed laminitis after a live west nile vaccine recently. I would like copies of the reserach you have done and to be able to correspond privately. Please contact me. Thanks, CW

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  17. CW,
    Please tell me how to contact you. I'll be more than glad to share the info I have found.

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  18. I live in Pennsylvania, which has a fairly high rate of WNV among equines. However, I have chosen not to innoculate my horses for WNV. I have chosen to follow the route of keeping my animals as healthy as possible and relying as minimally as possible on vaccines and drug protocol. You might find some useful information by reading this article: http://harmanyequine.com/vaccines.stm It is written by Dr. Joyce Harman, a well-known veterinarian from Virginia.

    Whatever your decision, you must be comfortable with it. Who's to say what is right and what is wrong. You are right in one thing, however....you are going to make an informed decision.

    Best of luck!

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  19. I'm not an expert either, BUT, IMHO, it sounds like he is "CYA" (or HIS "A"). By defending his associate, which he HAS to do...you get the picture.
    BTW, one vet office gave our German Shepherd steroids for a condition which he did NOT have. Since then, HE has deteriorated to the point he is nearly hairless and scratches ALL the time. It, too, compromised his immune system and I doubt now he will survive the summer. My thoughts and prayers go out to you and Royal. I cannot imagine you losing him.

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  20. I have no advice but I do want to let yo know I will keep Royal in my prayers, thoughts and heart. I wish there was something more I could do for you, to help, to ease your worry. Sending hugs and love your way...i will be checking back to see what happens.
    Bless you all...
    Love,
    Sue

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  21. At our veterinary clinic, we have had zero - repeat, zero reactions to the west nile virus vaccine. I've worked here for 9 years now. We use only the Fort Dodge killed West Nile Innovator vaccine. It has been on the market longer than any of the others, and Fort Dodge was the only pharmaceutical company that was doing research on west nile long before any of the other companies. We are sticking with Fort Dodge becuase they have a reliable record of efficacy. If Royal were my horse, I would definitely not worry about giving him the vaccine. West Nile is not something that you want your horse to get. The vaccines are inexpensive and they work. Period. And, I don't mean to disagree with any other commentors, but California in 2007 was the leading state in the union for the number of horses having west nile. If you would like to check the records, please contact your California Dept. of Agriculture. There are mosquitos carrying the disease everywhere, but because most responsible horse owners vaccinate their horses, the disease is falling - as would be expected. I sure hope Royal remains as sound as possible, and that your fears can be put to rest with continued success.

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  22. I know by going with you heart and instinct you'll make the very best decision for Dear Royal.
    He's so lucky to have you and be so wonderfully loved and cared for.
    God Bless you all
    Tina

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  23. Sorry I've been a little lax in visiting my favorite blogs lately and have just seen this. As others have said we are not vets but would like to help. If it were me I wouldn't even bother with the vaccine, it's so against the odds that he would even be exposed to the west nile virus in CA. anyway. I'm with On the Bit, I think she's got the whole thing down to a tee. Good luck with Royal, I know how hard this is for all of you.

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  24. I agree - try to prevent the mosquitoes and leave the shot in the frig. I give that vaccine, but was not aware of the risks. Horrible situation you are in, but thanks for sharing.

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  25. My understanding is that all vaccines are meant to be given to HEALTHY horses - so if Royal is still dealing with ongoing laminitis, I would personally suspend all vaccinations.

    Based on your research about West Nile vaccine and the possibility of a laminitic response, I think you have even more reason to skip it.

    I've been taking equine nutrition classes with Eleanor Kellon since November, and I would bet a consult with her might help with Royal's situation. She is very knowledgeable about IR and laminitis and every single suggestion she's made to me since I started her classes has been spot on and very helpful in dealing with my herd.

    Sending all the best to you and Royal - I so relate to the need to research and investigate. Sometimes the vets don't know as much as they think they do, unfortunately. :/

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