Trip to the vet but not with Louie for once

Bonnie and I went up to the vet today with her mule River and my mare Marie. Just for routine vaccinations. Both behaved very well. Gosh but just the routine care is getting expensive. $30 for a fecal float! $40 for Coggins. YIKES! And while the coggins is good here in Maine for 3 years, if you plan to go out of state, you have to get one every year. And I do plan to take Marie to some competitions out of state this year.

Today Louie was looking pretty comfortable. I even saw him standing with all his weight on his "bad" leg several times. When I backed him up, he is only swinging around one leg instead of both. And he looked good the couple times he got trotting around.

Part of his physical therapy routine includes "tail pulls". We are aiming for him to tolerate this for 10 seconds. Yesterday he would only tolerate it for about 4 to 5 seconds. Today was closer to 7. I am also doing some leg holds. He will stand very well when I hold up his "good" leg so he has to stand on just his "bad" leg. He will easily go up to 10 seconds with that.

Barn chores and a bored mule...

Today I went out to the barn around 1:30pm. I usually clean stalls in the morning but I got home from work early and it was still dark when I fed so I decided I would clean stall in the afternoon. And because it rained all day, the stalls were a mess. I had left everyone separated to make sure eveyone would be able to stay inside if they wanted to.

I opened the gate in the barn and let Marie and Louie together. This got them both squirreling around and running back and forth through the barn. I had to get after them as it was making it impossible to clean the stalls. Soon Marie settled down to cleaning up the hay Louie had left from the morning. Louie was still looking for some action. He kept sneaking up behind me, yes sneaking as I would not hear him coming at all, and would lay his head on my shoulder, "wanna' play?" he kept asking. He just would not leave me alone. He was not rude or pushy but just kept right there trying to play with me, the pitch fork, the wheel barrow..... silly mule.

Keeping Louie...For Now....

I've decided that I am going to keep Louie for a while at this point. On Saturday, I walked over to my neighbors that were intrested in Louie. Their donkeys look great I have to say. Just the right weight with nicely trimmed feet. Real sweet too though they wanted to get at my little dog that I had with me.

But, I just wasn't feeling good about letting Louie go at this point. And it worked out as the neighbor called me later in the day to say they just weren't ready to take on another equine just yet.



But, the biggest reason I'm not ready to let Louie go is I'm just not totally convinced of the vet's diagnosis of him having malformed hips. Of course they certainly can be right. BUT, both hips looked the same. What if that is just how mules hips are. Maybe mule hips simply aren't the same as a horses hips. The x-rays showed dark areas which indicated Louie's femural head was not completely round, but had what looked like flat spots. But the x-rays didn't actually show any real obvious signs of any arthritic changes. There was only where the vets thought there was going to be some. Or some places where it looked like there "might" be some.

Both vet's that did the x-rays are good and experienced vets that I like very well. But, on the off chance they are wrong and I give Louie away now, I give up one super nice mule and totally lose the $3600 I now have invested in this mule with purchase price, shipping and vet bills. So, for now I am going to continue treating him for a soft tissue injury and give him at least 6 to 9 months. If in that time he is not sound, then his problem is indeed bad and at that time I will decide what needs to be done with him. I have a good horse to ride so there is no rush to get ride of Louie. And Louie is such a sweetheart and a pleasure to have around.

Call today

When I was at the vet's on Tuesday, Dr. Brown and I had a long talk about Louie and what possible options there are for him. She told me to call one of my neighbors, Lola, who she knew was looking for a horse. I've know Lola since I was, as they say, knee high to a grasshopper. I used to ride her horses when I was a little girl. I have not known her to do much riding in years, and if all she was looking for was a pasture pet, Louie would be wonderful for her. And a better home could not be found.

I called Lola Wednesday night from work. She told me right up straight, "no, I don't want your mule". Lola plans to start riding again and wants to find a nice quiet steady horse. But, she did happen to know that the people who lived across the street from her were actively looking for a mule. So, she told me to give them a call. I don't know these people really, but had noticed they have some donkeys. So, I took their phone number and said I'd call them on Thursday. I didn't know if Louie was be anything they would be interested in, nor am I sure I'm ready to let him go. But, there would be no harm in talking with them.

When I got home Thursday morning, I spent quite a bit of time out in the barn, then came in, checked my email, and promptly fell asleep in my recliner. I was awaken by the doorbell ringing at about 11:30 AM. There was a woman at the door and she introduced herself as Penny, the woman Lola had told me about. She was very interested in taking a look at Louie. She had two young girls with her. We went out back and Louie came right to the gate looking for attention and showed just what a love sponge he is. Penny really liked Louie. She said she and her husband were looking for something that was trained so they could go for rides out on the trail. I told her I was not sure whether Louie would ever be up to that again or not. I sure hoped so and was going to work hard to get him to that point, but no guarantees. I told her the best thing would be for her to call my vet. We have the same vet and she said she would do this. I wanted to make sure she fully understands what she is getting if she takes Louie, and if I decide to let him go. And, I told her I would only let him go on trial. If either one of us was not happy with things, he would come right back to me.





Just a little while after I'd gotten back into the house, I got a call from the vet clinic. They said they'd gotten a call from someone looking for information on Louie and needed my permission before they could give out any information. So, I'll see if I hear anything now that the neighbors have talked to the vet. My feeling is they are going to want a mule they know they are going to be able to ride.

What to do next....

I've spent a lot of time thinking in the past 36 hours. I want to do what is best for this sweet boy.

If I had the money, I would go ahead and try the polyglycan injections. But, they are $100 each and it is recommended that I do a heavy loading dose of one injection once a week for 4 weeks. Then, if that seemed to make a significant difference, to follow up with nutraceuticals and see if he maintained the improvement. But, I don't have the money for the injections at this time though I will likely start him on a joint supplement. I will also get a plan from the physical therapist to help build up the muscles in his hips slowly and easily. This should also help a lot to stabilize the joints. Dr. Boulton said the the arthritic changes in Louie's hips are quite mild right now. So, if he does respond well to joint supplements, he may be able to be maintained pain free for quite a long time.




Dr. Brown and Dr. Boulton really feel that Louie's hip problem is something he was born with and has been dealing with all his life. It was just when I started riding him, I was speeding things up just hard enough and fast enough that he couldn't cope with it and his hip got really inflamed. Though I never had ridden him even close to what I would call hard, it was still more then he had ever done before. Louie's previous owner had told me that Louie did "some kind of gait" but didn't know what it was. Both vets think it is more likely that Louie was not gaiting but rather his way of traveling to protect his hips. I do know when Louie showed the first signs of trouble for me, I too thought he must be doing the "some kind of gait" I'd been told about. That is until I kept riding him and increasing the amount of time trotting and Louie's patella's started locking up on any hill. That was when I knew we had a problem and he had not been doing any kind of gait.

Today Louie was actually looking much better. When he trotted around the paddock, there was no real obvious signs of lameness. He is still swinging his legs around when he backs up. There is no rush to make any big decisions right now. I have my horse to ride. And though she is 19 years old, she is still fit and healthy and can do all the things I want to do at this time. So, I'll just take it a day at a time for now and do what I can to improve Louie's condition.

Bad news for the Little Brown mule...

Today Louie went back to Annabessacook Veterinary Clinic to have x-rays of his hips. It is a wet, dreary day. I cleaned Louie up, put a blanket on him, loaded him up and headed out. When I got to the vet, I put him in a stall while we waited for the vets. I removed his blanked and he immediately rolled, as any respectable mule would. Because he was wet from the rain, the shaving stuck to him and he was a mess. Dr. Boulton and Dr. Brown were the vet's that did the x-rays today. Normally x-rays of the hips are done by putting them right out, putting them on a table, and turning them right upside down. But, Louie is small and scrawny with so little muscling of his hindquarters, they felt they would be able to do them with him standing. And they were able to do this. I'm glad as it was so much easier on Louie. He was only given a light sedative.



So, here was Dr. Conrad's theory. The x-rays show that both of Louie's hips look just the same and both are slightly malformed. Dr. Conrad theorized that Louie is showing lameness in only his right hind simply because that is the one that is most uncomfortable at this time. So, there are some hard decisions to be made here. Dr. Conrad and Dr. Brown said if I want to spend a bunch more money, we can try polyglycan injections and see if he responds to this. It may stabilize the joints for a while and slow down the progression of inevitable degenerative joint disease. Dr. Brown suggested it would not be unreasonable to consider putting Louie down.

But, they came to this conclusion of malformed hips based on Louie's hips looking different then a horses hip. They showed me pictures of a horses hips and showed me Louie's x-rays so I could see the slight difference. I don't know what to think as I would not have expected Louie's hip to look like a horses. He's NOT A HORSE. But, I have no idea what the normal differences are between a horses hip and a mules hip. I do know I'm not going to rush into ANY decision.

Not doing well....

It seemed to be a tough day for Louie today. When I was working out around the barn this morning, I noticed that quite often when he started off at a walk, he was have problems with intermittent locking of his left patella. This is the first time I've ever seen the left leg present any trouble other then when backing up. It would take him a few strides to get going. He is extremely reluctant to back up at all. He is not bearing weight on the right leg much at all.

The farrier came today. I had Louie's shoes pulled as I certainly won't be needing them anytime soon. Louie was not happy about having any of his legs held up. Especially the fronts as that is where he is stable. Once a front leg is picked up, he is forced to put weight on both his back legs and he just doesn't want to do that right now. Louie did the best he could though and my farrier was very patient with him.

Bonnie and I went riding this afternoon. I was worried as this was the first time Louie was left behind all alone. I didn't know if being left alone would make him fuss. Thankfully, he handled it very well. He called to us a few times but that was about it. GOOD BOY. He has been so good about everything that's been thrown at him. When we got back from riding, Bonnie and I were hanging around in the paddock chatting and Louie had to be right there soaking up all the love he could get. Louie is just the sweetest mule. Bonnie said it right when she compared him to a big,goofy, lovable Lab (dog). That does very well describe his personality. It just breaks my heart to see such a lovely animal going through what Louie is going through right now.

I just pray that we can find out something definite when I take Louie for his x-rays on Tuesday morning so we will better know what to do for him.

Next step in the process...

Today was the last day I had to give Louie Bute. Unfortunately, I have to say that the improvement while he's been on bute was minimal. And today I think he was looking slightly worse, as in about the same as before we started the bute.

I managed to sell the Mikmar bit I bought for Louie on ebay. That was a big help since I was able to call the vet and schedule the appointment for Louie to have hip x-rays. I will take him in next Tuesday morning. I was sorry to hear Dr. Lund is not working that day. I really like her. I will be getting Dr. Boulton and Dr. Brown. Dr. Brown is a very experienced vet so I have no worries about her doing a good job for sure. And the only thing I hold against Dr. Boulton is his dire predictions of gloom and doom on Louie. I will hate it if the x-rays prove him right, but I don't really have any worries about him doing a good job either. Dr. Lund said they usually knock them right out and lay them down to do hip x-rays, but where Louie is smallish and so scrawny and bony,(Not underweight, just slim with small frame and little muscle right now, don't worry everyone, he is being well fed) she thinks they may be able to do the x-rays with him standing. I hope so, it will be a lot easier on Louie if they can.

So, this afternoon I gave Louie a break and tortured my dog instead. Time for a hair cut!!!! (Though either way this little guy is not going to win any beauty contests.....)

Working things out

Louie has decided he does not like his molasses bute sandwiches after all. So, for two feeding, I resorted to putting the bute into his grain with molasses added. Now, he has decided to get fussy about his grain. So, I have had to go back to the standard bute mixed with carrot baby food in a syringe. He wasn't too thrilled about this either but I think he was glad that at least I did not ruin his breakfast. And, I only have to give him bute once a day now. The bute is definitely making Louie more confortable. He is bearing weight on his leg now and looks quite good at a trot though I'd rather he was NOT doing any trotting right now!

In my frustration over all this, I did send a letter to the four vet's involved with Louie's care so far. They are all good and experienced vets. I've also spent a lot of time researching on the Internet into the possible problems that Louie might have for the symptoms he is presenting. I just feel a better job could have been done to figure out what is going on with Louie before having me spend $$$$ on diagnostic work. I think there were enough signs pointing to Louie's hip being the problem that I think some time and money could have been saved on diagnostic work had that been investigated first. And had it not been for the physical therapists observations, I would have spent even more money on disgnostic work before the vets figured out for sure where the problem is. So, we now know where the problem is but still don't know what the problem is.

Two of the four vets did call me today. I missed the call from Dr. Myhre as he called during the day when I was sleeping. He left a long message full of encouragement. He seems to be a very nice man and I appreciate that he cared enough to call. Dr. Lund called me in the morning before I went to bed. I had a nice conversation with her. She does not feel things are hopeless. She agreed that the most likely diagnosis for Louie was either Osteochrondrosis (OCD)or still possibly a soft tissue injury. Louie is showing a lot of the classic symptoms of OCD. This is a congenital disease and if this is what Louie has......well, it stinks! Though Louie is on the upper end of the age you would see this problem as it happens while they are growing.

Dr. Lund feels at this point a nuclear scan would not be beneficial. Not that it was an option financially anyway. She said a nuclear scan would show us where the "hot" spots were. But would not likely help much on what exactaly the problem is. With the nerve block, we have already identified the "where" as Louie's hip joint which is inflamed. We discussed further diagnostic work. Radiographing his hip should show if he has OCD, but, it will not be cheap to radiograph his hip. The advantage being if I could confirm or discard the diagnosis of OCD, it would really help in knowing just how to treat Louie and what his expectations will be for the future. If he has a soft tissue injury, with proper rehabilitation, I might expect him to return to full use. If he has OCD, I should not even try to use him for something as strenuous as endurance riding. Though rehabilitation for either is much the same except joint injections might be beneficial for OCD. So, for now I will continue to treat Louie as if he has a soft tissue injury and I will continue talking with the vets about doing radiograpsh on Louie's hip.

Keeping Louie Quiet....yeah right...

I am supposed to keep Louie quiet for a week. This is easier said then done of course. I really don't want to lock him in a stall. I have two areas I can confine him to with access to the run-in. One is just a bit bigger then a round pen and the other is 20x40. I didn't want to change his routine too much as that might just make him fret. So, I decided to just let him and my mare, Marie, run together in the bigger paddock as they are used to being together.

Some friends went riding yesterday. Bonnie was going with River mule. I decided not to take Marie as I was afraid that would upset Louie and get him running. I have not left him alone before so don't know how upset he will get. But, I've never known one yet that was happy about being left behind alone. I did go riding but borrowed a friends horse to ride.

When Bonnie and I left with River, neither Marie or Louie really paid any attention. Good! I didn't think that would be a problem as neither are particularly attached to River. But, when we got back and Bonnie led River back to his pasture, Louie and Marie totally spazzed out, running and bucking. AGH! And what's worse is that the Bute therapy is working on Louie. He is feeling much more comfortable. I'm glad but that makes him more willing to run around. I may yet have to confine him to a smaller area.

Meds...

Poor Louie has been through so many unpleasent things over the past 2 weeks, I was not looking forward to shoving a syringe in his mouth twice a day to give him his bute. While looking through my email this morning, I see a thread on the MulesOnly list about worming and ways people deal with worming the less the willing equine. Caryn D. from NJ said she worms her mules with "molassas wormer sanwiches". She takes a piece of bread and quarters it. She then slathers the bread with molassas, puts the wormer on and makes a sanwich. She says her mule love this.




Hummmmmmmm, so I am now wondering how a molassas bute sanwich would go over. So, I quarter up a slice of bread, slather the bread (and counter, and myself) with molassas, spread the bute on and make a sanwich. I then head out to the pasture.

I grabbed a couple of regular horse treats on the way. Once in the pasture, I ignore Louie and head right to my horse and make a big deal of giving her the horse treats. Louie was there in an instant, "whatch got, can I have some?". I offered him the first sanwich and he wolfed if down instantly. And the second one went down just as quick and he was looking for more. Louie and I were both happy campers.

Plan of Action

I've emailed back and forth with Jennifer Brook, the physical therapist letting her know what the vet's at ABC clinic had said when they examined Louie and trying to come up with a plan of action. Though I found Dr. Boulton to be very nice, and he was very thorough in his evaluation, I am not totally buying the gloom and doom diagnosis. He may very well be correct. But, there is still no hard evidence of it. All we know for sure at this point is that Louie's problem is in his pelvic region.

I asked Jennifer her thought's on treating Louie as if he had a soft tissue injury. My thought being if he does have one, then obviously that is what we need to do. But, if Louie's problem is the worst case scenario such as DJD or a malformed hip, rehabbing him for a soft tissue injury is not going to do him any harm at all. Jennifer thought this was a good idea and gave me the outline for a rehab plan and just wanted me to check with my vet on bute therapy.




This morning I got a call from Dr. Lund. She was one of the vets at ABC Clinic that examined Louie the other day. She had been fairly quiet through the exam mostly deferring to Dr. Boulton. Dr. Lund called to check on how Louie was doing. And he is not doing too bad. He is still lame but not any worse then he was before the exam. Dr. Lund mentioned again that we could inject Louie's hip to see what effect that has. And Dr. Lund told me that she didn't feel that things were as gloomy as Dr. Boulton may have made them seem. She feels that Louie could very well have a soft tissue injury. She mentioned that when Dr. Boulton did the nerve block, he got some fluid out of the joint. The fluid was thin and bloody. Dr. Lund said this could well be an indication of a soft tissue injury. She said the blood might have just been from poking around with the needle, but the thin fluid in and of itself was not normal. She feels that Jennifer and my plan to rehab Louie for a soft tissue injury is a good plan. And, as I felt, won't do a bit of harm if that is not the problem.



So, Louie is to be confined for a week to a small area to discourage any running around. I am to give him bute 2x's a day for 3 days, then 1x a day for another 4 days. If Louie seem to be more comfortable at that point, I will start doing the physical therapy as directed by Jennifer.

Another trip to a clinic

Today I took Louie up for another evaluation at Annabessacook Vet Clinic. I had an appointment with Dr. Lund and a new vet at the clinic, Dr. Boulton. Louie looked pretty worried when I came out of the barn this morning with his halter. Being caught lately has not equalled anything fun for the past week. He was good though and even loaded quite well into the trailer. I arrived a bit early for my appointment so I put Louie in one of the stalls while I waited for Dr. Lund to arrive. Louie immediately got down and rolled in the nice clean shavings in the stall. Now that's a typical mule for you. Dr. Boulton was already at the clinic when I arrived and introduced himself.

Once Dr. Lund arrived, we took Louie into the indoor arena. He was trotted in straight lines and circles and showed consistent lameness of his right rear. He was flexed forward, back and to the side. That produced positive results. Mostly when flexed forward and sideways. So, both vets agreed the next logical step was nerve blocking to isolate where the problem is. There was much discussion on this as Dr. Boulton wanted to start at the hoof and work his way up. If the problem ended up being in the hip, it would cost me $700 to $900 for the nerve blocking not to mention all the needles Louie would have to endure. I just felt so strongly that Jennifer Brooks, the physical therapist, was right on the problem being in the pelvic area that I made the decision to start at the hip. Dr. Boulton didn't seem thrilled with this decision but Dr. Lund seemed to understand my reasoning.

So, a hip block it was. And my oh my what a big needle is used to nerve block the hip. 5 inches long and Louie could not be sedated. So, Louie's hip was shaved in preparation for the block. He's really looking quite interesting with his already shaved hocks and stifles. Louie was given a local. He jumped when the first one was administered but was ok for the second one they did. And when it came time for the big needle for the nerve block, I just held my breath and could hardly watch. Poor boy!!! Louie was SOOOOOOO good about it. His head was up and he swished his tail some but that is all he did. It is just amazing how tolerant this mule is. They don't come any nicer in the disposition department then Louie.

Louie was then put back into a stall to let the block take effect. After about 20 minutes, Louie was taken back out into the arena and trotted again. Lo and behold, I suddenly had a nearly 100% sound mule. Not perfect, but close. His reactions to the flexion tests were also significantly reduced. By this time, Louie was viewing Dr. Bolton with less then warm fuzzy feelings. Though he was only showing his displeasure with worried looks when Dr. Bolton approached him. And Louie was cuddling right up to Dr. Lund, the vet tech and me if I was close enough. He would just lay his head on our chests if he could.

No further diagnostic testing was done at this time. Dr. Boulton's opinion is that Louie has degenerative joint disease. The cause, he said, could be a number of things such as an old injury, OCD, or possibly a malformed hip joint which he compared to hip dysplasia in dogs. Both Dr. Boulton and Dr. Lund said they felt the next best diagnostic option would be to take him back to Myhre Clinic for a nuclear scan. But, this would not likely make any difference in his prognosis or treatment, but only satisfy curiosity. And, at $1200 to $1400, is not an option. With today's visit, I am already up to just about $1000 in vet bills. I asked Dr. Boulton if the problem might be a soft tissue injury such as a torn muscle. He felt quite sure this was not the case. He said that a soft tissue injury did not fit with the progression of Louie's injury where he slowly (over a period of 4 weeks that I noticed) got worse. He felt that if Louie had gotten a soft tissue injury, he would have been very lame immediately, and then slowly gotten better when I stopped riding him. The only other option suggested was to inject his hip joint to see if that helped. But, for right now I'm just going to let Louie rest and recover from his past tough week. I will give him some bute to help reduce his discomfort and any inflammation resulting from all the diagnostic work that has been done with him.

I have to admit my head is just spinning at this point. I am sick with disappointment. I feel so bad for Louie as he is just the sweetest mule on the face of this earth. And while I am grateful that the Myhre clinic took Louie on for the teaching conference, I am disappointed that they did not follow up more with making an effort to diagnose a pelvic problem after Jennifer (the physical therapist) suggested this to them. I know the clinic staff and Dr. Myhre were very busy with the conference and there just was not enough time to follow up with some diagnostic procedures that might have been done. And everyone at the clinic was extremely nice I was treated with respect by everyone as the owner of Louie and made to feel very welcome at the conference and encouraged to be an observer in any part of the conference I might find interesting. I very much appreciated that. But, I do feel a better follow up could have been done. I did pay for the initial exam, radiographs and hock injections. And, as a paying customer, I think a little better follow up could have been done. Louie was already having ultrasounds done on his hocks and stifles. I seems it would not have been too much of a problem to include his pelvic area as there were a number of signs indicating there might be a problem there and it was requested by the physical therapist.

Maybe I just expect too much. With all this push for the nuclear scan, while I fully understand it is a state of the art, top of the line diagnostics tool and can appreciate it's benefits, I sometimes feel like vets are getting so dependant on their high-tech, expensive to the client, diagnostic machines, they are not depending on their own eyes, ears, hands and brains to diagnose these days. I know in my frustration, I'm being a little unfair here but the physical therapist who has had only her own visual and hands on observations to depend on has seemed far more attentive and intuitive to the things that are going on with Louie.

New friend

Louie found a new friend to play with last night appartently. Found him with a snout full of quills this morning when I went out to feed. After he ate, I went and got a pair of needle nosed pliers and then caught Louie. I have to say that he is the most tolerant mule I've ever met. He let me pull those quills out. He sure wasn't happy about it but he was awful good. At the end I did end up snubbing him to a post only because he was flinching so bad every time the pliers touched him that I couldn't get ahold of the quills. And he didn't seem to hold any grudge once I was done as he followed me around wanting attention. He got lots of mule hugs, scratches and treats for being so good about letting me pull the quills out.

Louie is happy to be back home and hanging out with his herd mates. He is still lame on the right rear but not looking too bad overall. And he is feeling good and running around. The only time I see the locking patella is when he backs up. Then I see it in both hind legs. You can see the lameness when he is trotting but I am not seeing the locking patella when he is moving forward, only when backing.

Jennifer Brooks, the physical therapist, called me today and we had a very nice conversation. I really like her and what she says makes sense. Jennifer feels that there is something going on with Louie in the pelvic region. When she examined Louie, he had heat and discomfort, as well as a sweaty spot on his TFL (Tensor Fasciae Latae) muscle. And quite a bit of muscle atrophy of the area. Jennifer is concerned that he as a torn muscle. Or even a possible fracture of the pelvic reigon. So, she is reluctant to set me up with a physical therapy program when not knowing what is actually wrong. She would also like to see Louie confined to a smaller area to keep him from running around too much until we rule out any torn muscles or possible fractures. We don't want to end up doing more harm then good. Jennifer was a bit disappointed that that Myhre Clinic did not ultrasound his pelvic region while he was there. I guess she had called and told them she suspected a problem in the pelvic region. I'm not sure if I'm disappoined or not. I am certainly frustrated that a problem was not diagnosed. But, as I did not know what to expect from Louie being used for the teaching conference, I don't know if I could have expected more or not. I will say that there were quite a few horses being looked at and from what I could see, they simply ran out of time to do any further diagnostic work. Louie was brought in for his intermittent locking patella and he did have his hocks and stifle thoroughly examined.

I also talked to my vet today and told her all that I know about Louie's history with this problem and as much as I know about what was done at Myhre clinic. I set up an appointment for Wednesday morning with Dr. Lund.

I called Myhre clinic and asked that they send all the information they had on Louie to my clinic so Dr. Lund would have it for our appointment on Wednesday. They were going to do this anyway but it might not have been by Wednesday. I then called Jennifer Brooks and asked if she would email her finding and observations to Dr. Lund also. I then got a call from Dr. Myhre. He seems to feel that it is too soon to take Louie for another examination. Louie's hock was injected at Myhre Clinic and it is too soon to tell if that is going to help Louie or not. And I am not really clear on why Dr. Myhre even thinks there is any problem with Louie's hock. Or why he didn't really seem too interested in the fact that Louie has heat and swelling and muscle atrophy in his right hip area. I am going to ask Dr. Lund if she will call Dr. Myhre and talk to him. But, honostly, even if Louie does start to improve over the next few weeks, I will not at all be convinced it is due to the hock injection as a few weeks rest can improve a whole lot of things that might be wrong. Especially since nothing was done to positively identify where the problem is such as nerve blocking and nothing was found on either the radiographs or ultrasounds that would indicate a problem in Louie's hock.

Ok class, can we all spell F R U S T R A T E D .............

Day 3 at the Myhre Clinic

I arrived at Margaret's house just 10 minutes ahead of her. It was another wonderful evening visiting with a friend who I don't get to see nearly often enough. She prepared a wonderful supper, some good wine and I kept her up way too late for a work night. We were up fairly early, Margaret made some breakfast and I headed back to the clinic. There were a lot of people at the clinic when I got there around 9:00 am. I had a hard time finding a palace to park and it is not a small parking area. I had heard there were going to be 36 vets at the conference. I only counted 28but they wouldn't stay in one place and kept moving around so it was hard to get a a good count. But, with all the vet's, vet tech's, clinic staff, specialist's there to teach and sales reps, it was quite a crowd. I have to say though, that eveyone at the clinic was wonderful. They were very courtous to me, made me feel welcome to be there and participate, and made sure I knew it was fine to join them for the catered lunch. The vet tech's said Louie had been very good for his poodle cut the previous day. I was so glad he was being such a good boy.

I hung out with Louie until it was his turn for all the vets to observe a lameness exam. Everyone went outside to observe and give opinions. Louie was very well behaved though he did not really want to trot in circles. I was standing next to a couple of vets outside when one starting making some jokes about mules. I really was not paying much attention until the other vet put her hand on my shoulder and said to the first vet, "You know this woman here is the owner of that mule....". It was quite funny really. Even better was that the vet making jokes was the only vet in the group that I'd ever met me before. We met when he'd pulled me and my horse at 45 miles on a 50 mile endurance ride........ (for good reason)

Louie was then taken back into his stall and we waited until they were ready to take him into the exam room when the ultrasonograpy specialist was ready to demonstrate how to ultrasound the hock and stifle. I was told this woman was as good as they get with ultrasonography. Louie was sedated again. This was the 3rd time Louie had been sedated in 3 days. I went in and watched the demonstration. She did a very thorough examination of Louie's hock and stifle. And, I don't know if this is good or bad, but, she found nothing wrong. She said that because Louie is not carrying any excess weight and he has lean muscles, he was very easy to ultrasound. When that was done, there was a break for lunch so Louie was put back in his stall again.

Ultrasound machines had been setup in the aisles of the barn. After the lunch break Louie was sedated once again. He was getting tired of getting needles but he was still dealing with it very well. Several horses and Louie were cross tied in the aisle and the vets spend quite a bit of time practicing ultrasound techniques and reading them.





Louie was such a good boy and I was so proud of him. He stood on those cross ties for hours with people all around him, ultrasounding, and just the whole general confusion of so many people there. He was sore from having to keep weight on his "bad" leg yet he never made a fuss. Eveyone just loved him and made a big fuss over him and were amazed at his wonderful disposition. The worst thing he did in his 3 days at the clinic was on a couple occasions, when he felt he'd had as much of something as he could handle, he would walk off with a vet tech skiing along behind him on a lead line. But, he was easily corrected and then would settle right down and be fine.

Unfortunately, the mystery of Louie's lameness had not been solved. It really does appear that his episodes of locking patella's are a symptom of some other problem. But neither the radiographs nor ultrasounds have shown a problem. So, the problem is either higher in the hip or pelvis, or lower in the pastern or hoof. None of the vet's felt the problem was lower. Dr. Myhre talked with me a while. He really wanted to do a nucluer scan on Louie. But that would be at my cost. The cost for a scan would be $1,400. That is just not an option for me at this point. As it was, even with all the diagnostic work that was done for free because I let Louie be used for the conference, I still was going home with my wallet $600 lighter. I did let them inject Louie's hock. Dr. Myhre felt this would be helpful to see if it made any difference. So, once again, Louie was sedated. He did fuss a bit this time about getting yet another needle but not too bad. And they ended up giving him a second dose for a sixth time. Then his hock was injected with .....well, I'm not sure and I kind of wish now I hadn't done the hock injection as I just feel in my gut the problem is in his hip area.

I'm not totally sure what the plan of action will be now. Louie needs a few days to just rest. Dr. Myhre said he would not be doing the discharge papers until next Friday. Meanwhile he will be in touch with Jennifer Brooks, the physical therapist to discuss what should be done. Dr. Myhre will also be sending everything to my regular vet clinic and I will have to see what they say. So, while I'm happy that nothing bad was found in his hock or stifle, I am very frustrated that we still don't know what IS wrong.

Louie sure was glad to be home tonight. The first thing he did, as any respectable mule would, was roll, and roll, and roll........

Day 2 at Myhre Clinic

I had a wonderful time visiting Kathie and her mom. When I got to their house, Niether were home as Kathie's mom at work and Kathie had made previous obligations for the day. They had left the door open for me and had told me to go in and make myself at home. They have a lovely home. And a delightful assortment of pets. I had been up all night, then the long drive to the clinic and time there, so, settled in on a recliner, started to read my email and ended up falling asleep. Kathie's mom got home first and we had a nice visit until Kathie made it home. Kathie's mom made the most delicious supper and we had a wonderful evening. We stayed up too late of course. That was ok for me but they both had to work in the morning. I slept like a log and woke up fairly early. I realized I didn't have to get up to feed anything for once so went back to sleep and didn't get up until around 9:00am. I didn't have to be back to the clinic until 2:30 pm when I would meet with Jennifer Brooks, the physical therapist. I made myself some tea and breakfast, checked my email and then just relaxed with a book. Kathie got home from work early so we could visit a bit more before I left.




I got back to the clinic right on time. Jennifer was there already as she had given a presentation at the conference. She sat and talked to me for a while before seeing Louie. She wanted to get all the information she needed she looked at him. Once we were done with the paperwork and going over his history, we got Louie and brought him into one of the exam rooms. Louie immediatley dropped a big splattery load of diarreah on one side of the room. Poor Jennifer was in good clothes because she have given the presentation so we tiptoed around the splatter as best we could. Louie is noticably sore on the left rear side all the time. He keeps his weight off that leg whenever possible. She noted that he has a lot of muscle atrophy in the left flank. There was also heat in the hip area. He also had a sweaty spot just behind his hip bone. She went through the exercises she wanted me to do with Louie IF they found his only problem was the intermittent locking patella's. But, she felt that Dr. Myhre was right that the locking patella's were a secondary problem to something else going on. And because of that, she didn't have me do too many of the exercise with him. She wanted to wait until we had a diagnosis before making a solid physical therapy plan for Louie. I agreed that made sense to me also. Jennifer also pointed out that was I was seeing as weight loss with his flanks looking a bit hollow, was actually muscle atrophy. Which is indeed much worse on the right side. We put Louie back in his stall. I talked with Jennifer a bit more then stopped by Louie's stall before leaving. The tech's were shaving eveyone down in preperation for the "wet labs" for the ultrasonograpy the following day. Louie had been given a sedative and was getting his poodle cut.



I gave Louie a goodbye scratch and headed out. I was spending tonight with another friend, Margaret, that lived fairly close to the clinic.

Initial Exam at Myhre Clinic

The morning had an interesting start with Truck problems. I had backed my trailer up to the garage so I could check my tire pressure before heading out. When I was done and got in the truck to pull it down off the hill, the key wouldn't turn. Absolutely would not budge. I tried wiggling the steering wheel back and forth but nope, nada, nothing. Panic!! I called my garage and they didn't have much for suggestions other then the steering lock mechanism would likely have to be replaced and it would take a few days to get the parts.

Not a good answer. So, unable to think of anything better to do, I sprayed the key with WD-40 inserted the key, wiggled it a bit and wha-la, it worked. Apparently WD-40DOES fix everything. If that hadn't worked, I was going to try something with bailing twine or duct tape......




Anyway, though I had a two hour drive, I still managed to arrive at the clinic on time. Louie was quickly settled into a stall. There seemed to be a color theme going on at the clinic, all the horses there were "red heads". Only one Icelandic stallion was different being a black. Louie had his initial exam. I'm a little discouraged I admit. Louie is not really locking much at all now except when backing up. But, he is lame on the right rear. The vet, Dr. Myhre, does not think that the intermittent locking patella is Louie's primary problem but rather secondary to something else. He has a bit of swelling in his right hock. So, x-rays were taken of his hock and stifle. Louie has mild arthritis in his hock. !!!! That took me by surprise as Louie we never ridden until he was 4 years old and then over last summer just lightly trail ridden mostly at a walk. BUT, Dr. Myhre said the arthritis is too mild to be causing the lameness we are seeing. ACK! He said an intermittent locking patella does not ususally cause constant lameness as Louie has so that is why he thinks there is something else going on. Other then the mild arthritis, everything else in the xrays looked ok. Dr. Myhre is excited about this case (glad someone is) as it is not a "black and white" case (his words) so more interesting...... :-/ Tomorrow Louie won't be doing much. They will be shaving whatever parts need to be shaved for the untrasounds. Then the "wet lab" will be on Friday. Dr. Myhre said they will do a thorough workup and that 36 of the finest vets in the area will be looking at him. (sigh)

On a brighter note, Louie was absolutely wonderful today. Dr. Myhre said they see very few mules there (as there are so few in New England period!!) Louie was perfect for the exam and the xrays. And that was scary as it was not a portable xray but a huge scary looking contraption with many mule eating arms....They gave Louie a mild sedative for the xrays and he didn't fuss over the needle or about being xrayed. He has just been his usual sweet self. Asking everyone that comes near him "wanna bond with me? hey, how 'bout you, wanna bond????" LOLOL. As I suspected he is being a wonderful mule ambassador. After Louie was settled back into his stall, I drove to my friend, Kathie's house where I am spending the night as she is only 34 miles from the clinic.


On Wed, Mar 3, 2010 at 10:03 AM, Amy Finger

All Packed and Ready to Go

(The picture was taken after I arrived at the clinic, but just wanted to show his spiffy "do")

Louie is all packed and ready to go to the Myhre Clinic tomorrow morning. I gave him a hair cut and groomed him and he looks much more presentable. His ears are already almost too short for a respectable mule, so I can't have any long hair making them appear any shorter then they already are. I gave my boarder's mule, River, a hair cut also since I had the clippers out. He was a good boy. So, both mule look nice. I was a dirty, itchy mess.

It was a busy day with clipping manes, barn cleaning, a trip to the feed store and moving some hay. I measured out Louie's meals into baggies and packed them in the trailer. Made sure I had all the paperwork I needed. And also made sure to put my GPS into the truck so I wouldn't end up in Alaska instead of NH. Hopefully, I can sneak in a quick nap in the morning before heading out.

No more waiting

Well, I've heard back from most everyone now and things are in motion. Jennifer Brooks, the equine physical therapist, has been in contact with me. She told me she was doing a presentation at the Myhre Veterinary Clinic in Rochester, NH on Thursday and as that is 1 1/2 hr. drive closer then to go to her own facility, we tentatively decided to meet at the clinic. She asked that I contact the Myhre clinic and see about having the vet there examine Louie.

Then I got an email from the woman that had Louie last summer. She never got my email but read this blog and contacted me. (Thank you Karen!!!)As I had figured, Louie was mostly ridden easily and on fairly flat terrain. So, Karen had seen no signs of Louie's condition as I hadn't until I started adding more trotting and hill work to our riding.

I called the Myhre Clinic this morning. I had not more gotten out "I am calling about setting up an appointment for my mule...." when the woman who answered the phone said "Oh, yes, we've been waiting for you to call". Threw me off for a moment. Jennifer Brooks, the physical therapist, had already told them about Louie. The clinic is holding a Veterninarian and Technician training conference this coming Thursday and Friday. The clinic wanted to know if I would be willing to let them use Louie for their "wet lab" for the conference. "Wet lab"???? Sounded ominous, like they were going to dissect my mule or something! Not so, just the term for the hands on part of the clinic on ultrasonography. Ok, I was in. My only cost will be the initial exam. I think this is a great opportunity and I think Louie will be a great mule ambASSador as he is such a nice mule that likes everyone and does not mind being poked and prodded anywhere.

I have to bring Louie to the clinic on Wednesday. They need to do the initial exam that day before the conference. I've arranged to meet with Jennifer Brooks on Thursday at 2:30pm. Then, I will pick Louie up Friday evening after the conference is over. It is a 2 hr. drive to the clinic so I am going to contact a friend that lives only 25 or so mile from the clinic to see if maybe I can stay with her a night or so to save on driving.

I had to contact ABC clinic where I took Louie when he first presented signs of his condition. Myhre Clinic wanted me to get discharge papers from the vet who examined Louie so they would have documantation on what the vet found when I brought Louie there. And I arranged with Myhre clinic to send all copies of any paperwork and diagnostic work to ABC clinic as that is where I want any continued treatment done if it is needed. I also finally heard back from one of the vets I had emailed at ABC clinic. She was away and that was why she had not contacted me sooner. I was glad to hear from her as I wanted to make sure ABC Clinic knows what was going on and why I was taking Louie to the Myhre clinic.

The weather is also looking good for the next week so there should be no problems with traveling. Now, I'm just hoping all goes well.