Sunday 2/6

Around 9 PM, my trainer and one of her students returned to the barn from the Kyra Kyrlund Symposium, they found Welt Klasse down and rolling in his stall, and first thought he was casted, but they found him completely wet, soaking through his winter blanket. They called the vet right away, and he was administered with all the necessary medication for colic.  Because of the late hour, he was left at the Star Equine veterinary hospital, fortunately right on the premises.  Both my son and I were sick at home the whole weekend, so I couldn't go check him out.  He had gas colic in the past and quickly recovered, so we hoped it was another case like that especially for the past two and half days he was just standing in the stall doing nothing but devouring his hay, which is fed 3 to 4 flakes but, very unfortunately, all together and only once a day at this facility.

Monday 2/7

Both my son and I were still sick at home.  I called the vet clinic in the morning.  Bad news.  His condition degraded and the vets had determined it was a surgery case.  The surgeon at the clinic was on vacation, so they called in Dr. Chris Hansen from UC Davis.  He arrived at noon, and operated on him.  My trainer Maryanna stayed with him at the operation and recovery.  They found 3 feet of dead intestine twisted, or looped on top of itself.  To make it worse, it was very close to the stomach, so they could not take out the distended flaccid intestine that was close to the stomach as it couldn't be pulled out of the horse's body to be resected.  Dr. Marea Wilbur later explained to me that they could not do the resection inside the horse because the intestinal content could spill out and cause severe peritonitis, and horses won't survive that problem.  Maryanna told me that the vets asked her to leave when they tried to get him to stand up as it could get ugly sometimes, but she stayed and helped, and his recovery was actually very smooth.  It was very quiet and peaceful, and Klasse was very cooperative, letting everyone to help him.

Tuesday 2/8

I finally was well enough to drop off my son to the grand parents' place as he was not ready to go back to preschool yet, and visited Klassey today.  To my surprise, he acted as if there was nothing happened.  He was bright and alert.  He had 2-foot-long incision that was stapled together.  It was neat, dry and clean.  It was hard for me to imagine to have that big an opening and no bandages or anything required to cover it.

He had a stomach tube in his nose and taped securely to the halter.  He hated it, but he was very much the happy self as usual.  I felt relieved, but Dr. Wilbur probably noticed that, and kept reminding me that he was very very sick.  He was refluxing badly, and couldn't keep his hydration.  It meant that the intestine was not working yet.  His gum and tongue color was also very dark.  They showed me the dark lines on the gum, and told me those were toxic lines due to the toxin released from the dead intestine before it was removed.  Medically, he was really sick despite of his magnificent exterior.

Every vet came by and told me what a great patient he was, and they felt his great attitude would definitely increase his chance.  The doctors checked him and refluxed him every two hours day and night.  They gave him DMSO intravenously, so he smelled really terrible.  He was always thirsty, and I bet his mouth must have felt terrible with the dryness, the reflux, and DMSO.  He wanted to drink so badly.  They covered the waterer, so he couldn't get any water.  They also later put a muzzle on him, so he couldn't pull the stomach tube out.

Wednesday 2/9

The reflux started to take major toll on Klasse.  He tore the cover of the waterer off; the water was shut off, so it was dry.  He was also banging on the muzzle to try to get rid of it.  He was hydrated better, but the reflux volume was still high.

Thursday 2/10

I first visited him in the morning.  He looked tired, but not much worse than yesterday, but the vets told me that he had a terrible episode around 6-7 AM, that he refluxed 20 liters and the gum was all purple, and his heart rate was over 100 and running a fever.  He basically got a "toxic shower".  They were getting worried that the reflux was not improving, and he was not hydrated enough.  They told me about possibly having the second operation, but the surgeon, Dr. Hansen, would give him another day.

He has sores on his nose from the tube and pressure sores from the halter. His halter was really snug around the crown and throatlatch because it was really not his halter, but one the breeding farm returned him with.  Since we don't use halter very much, we never changed it.  However, under this circumstance, I bought him a large leather shipping halter with sheep skin cover in hope to relieve the pressure.  He seemed to like that a lot better.  When I returned at night, I noticed the halter was hanging outside the stall, and became quite alarmed.  However, I found him comfortably sleeping in the stall without the stomach tube.  Before I could get too happy, Dr. Wilbur explained that he was getting really good pulling the tube out himself, and the reflux volume did go down some, so they decide to let him have a break.  He was so exhausted because he had not yet lied down since the operation, and apparently his local fan club kept him too busy.  He finally got to sleep some without the tube bothering him.

Friday 2/11

The reflux volume was going up and down, and his hydration level was worsened.  Probably with some sleep, he actually looked a bit more alert than yesterday.  I was hopeful that he wouldn't need another operation.

Saturday 2/12

Really bad news... the reflux volume increased over night. Clinically, he should have gotten better 3 to 5 days post-op, and since he didn't, it was time for another operation.  The vets warned me that they would open him up to see how the anasmosis (sp?) was healing, and some repair might be needed if it was leaking or got blocked by food material; however, if the damaged intestine right after the stomach died, then there was nothing they could do, and we would put him to sleep on the table.  Of course we all hope we would not have to do the latter.

I was there before the surgeon arrived, and Klasse actually looked just a bit tired, but nothing really alarming.  I played with him for a while and decided to groom Rubino in our barn, that was just 300 feet away.  By the time I came back around 12, Klasse was not in his stall any more.  I didn't know where the operation room was, but I ran around and found it, it was only 50 feet from the hospital stall.  He was already under, four feet on the sling and being lowered to the table upside down.  The operation table was very well padded, they prepared his tummy by scrubbing him while the doctors were scrubbing and putting on their gowns and layers of gloves in the preparation room.  I got to stay in the preparation room to observe.

Klasse was unconscious, so at least it didn't look too painful for him, hence less painful for me.  There was surprisingly minimum blood.  My rider/lawyer friend bled more when she bumped her head on her car door.  I was able to discuss with the doctor about his case while he was checking his intestine from the opening, which I thought was big, but now seemed to be not big enough to get the intestine out and back in now.  The intestine looked pretty red due to the inflammation, which didn't surprise the doctors.  However, it was kind of dry inside and stuck together, which was a concern because adhesion could develop, and it could be the reason that the gut motility was not coming back.  While they were checking the guts, a vet tech kept pouring in saline solution to keep the bowel hydrated and easier to move around.  They went to the original resect site, and Dr. Hansen pulled it out to show me the great job he did.  He said the healing actually looked good.  He showed me the anasmosis (sp?) and told me what he did was all anatomically correct, but since Klasse was still having problem with reflux, and we opened him up again, he wanted to improve it.  I gave him an OK.  I don't want to give up on any chance that we can get him better.  By the time Klasse was closed up and moved to the recovery room, it was almost 5:30.

During the surgery, Dr. Wilbur had a hard time keeping Klasse's blood pressure high enough.  They had to pump in large amount of fluid and throw the entire kitchen sink at him.

Dr. Hansen showed me the section that had the original connection he made, but removed for the new connection.  It did heal quite well, but there was a tiny spot that was a bit thin, and the opening allowed only two-finger width.  He said he made a new one, that can easily allow four fingers to go through, so there should be no excuse for the fluid not going down the intestine now.  He also said, the damaged portion actually had recovered quite a bit.  Well, I joked with Maryanna that I would not order any Chinese dishes with intestine tonight.  My children were home and my father was coming for dinner, and from what I know how well Klasse was in the recovery room the last time, so I decided to go home and let the vets and Maryanna to help me with Klasse from this point.  When I left he was sleeping on the soft mattress in the recovery room, and started to wake up a bit, and he was also... peeing in large volume.

Sunday 2/13

I got to Klasse's stall in the morning, and got a major shock.  He looked terrible, and his right front leg was dangling, and all bandaged up and I could see a non-functioning make-shift splint made with a stick in there.  He was on three legs.  Did he break his leg during the recovery?  I heard of things like that.  Did he founder?  I was panicking.  I couldn't find any vets in sight, but heard sawing sound from the machine room in between the hospital stalls and the operation room.  I walked in and saw three vets working on the table saw with a large white PVC tube, which was cut in half (actually a bit less than one half) across.  They were making a splint for Klasse, but why?  One of the vet was surprised to see me, and came to explain what happened.

Klasse was tied up during the surgery because of his low blood pressure was not enough to pump the blood to the legs that was hanging up higher than his heart because he was upside down.  He might have suffered some nerve damage to the right shoulder area, so he couldn't control the leg.  He couldn't lock up the knee to put weight on it.  His left foot was the one to worry about, it has started to get warm and had a pulse, and he was extremely tired on three legs.

They told me 90% the cases they saw recovered fully, and assured me as soon as they put a splint on him, he would do nicely.  Three vets worked on him.  Dr. Cox, the strong one,  held Klasse's leg straight by pushing his knee back and helped support his weight.  It could be really dangerous as Klasse could fall on top of them.  They asked me to leave the stall to cut down their insurance liability.  One vet held the padded PVC behind Klasse's leg after wrapping the leg with thick padding, and one quickly put wraps around it, then elasticon tapes, then duct tape all the way around and around to hold his leg in place.   Success!  His leg was held straight by the PVC pipe.  However, he couldn't put it under himself.  He was tripping over his toe, and had to struggle to lift it up to move around, and continued putting the leg in front of himself.  Dr. Wilbur said that he could be sore from the rock hard tied up shoulder, so he wouldn't want to use it.  She applied thick layer of DMSO and Furazone mix on his entire right shoulder.  There was nothing more we could do but removing some shaving in the stall, so he wouldn't trip.  He just had to learn how to stand on that splint. The vets were pretty happy with what they made and joked about the plumber's skills that they didn't learn at the vet school.

Later, Maryanna told me how they struggled to get him up as he didn't want to.  Once they got him up with ropes and pulleys, he kept tapping the right foot, and the vet said he probably couldn't feel it, but was trying to.  They finally tried to get him to walk the 30 feet back to his hospital stall.  The vets handed him to Maryanna, and asked her to do it because he knew her better, so he might follow her.  Maryanna said she was scared because Klasse could fall down any time, but Klasse followed... moving the hind legs forward, then making a hop on the left fore and dragging the right front.  Maryanna was worried about the rubber mats in for the hallway, then the threshold to the stall, but they made it.  However, she told me Klasse just about to kill everyone when they tried to tube him again, but they got nothing, and decided to leave him alone without the tube.  He must have done OK as he stabilized without further refluxing.

I visited him again at night, and he was still not putting weight on the right leg.  He was all drugged up with all kinds of pain killers and antibiotics, so he looked really depressed and frustrated.  I finally started to feel how sick he really was.  I was very much saddened to see him suffer.  I went home and cried.  My husband tried to comfort me, and said I could always call Dr. Bade to get another horse.  I don't believe he has another Welt Klasse. My Welt Klasse...

Monday 2/14

Good news!  Klasse supported himself very nicely on the right leg with the splint.  His left foot was totally cool.  However, he was not feeling well, and was given a lot of drugs.  His head was down, and his eyes, nose and mouth were all swollen because he hanged his head really low.  He started to have edema under his belly, scrotum and inside his hind legs.  The vets assured me that it was expected, and they were happy that he put weight on the right leg, and he seemed to be able to move it quite nicely.  He also passed manure and they got some gut sounds.  So, some progress there.

He looked terrible with all the sores on his nose and nostrils.  I applied some Chinese herbal powder, and the vets said it was fine to do it.  This Chinese medicine was developed from herbs because villagers in a southern province observed that snakes were eating the herb after they were beat up by people.  It can be applied externally or ingested  It had done miracles on some huge non-healing open sores on some horses in Taiwan.

When I visited him at night, he seemed to be a lot better.  While I was there, Dr. Cox came in and pulled out his IV.  He was all dressed up and probably ready for a date on the Valentine's day, so I didn't ask him why, but I figured they knew what they were doing.

Tuesday 2/15

I called in the morning, and Dr. Wilbur told me that they were going to take off the splint and check the leg.  Everything else was basically good.  They stopped the IV and let him drink a few liters of water and he was really happy about it.  I arrived at lunch time to visit him, but he was not in his stall.  He was taking a stroll and having a few bites of fresh grass.  In spite of the major trauma and much of muscle mass was wasted, he again looked magnificent out there.  He could walk forward on his own.  The vet said he was dragging his toe earlier, but by the time I saw him, he lifted his leg really nicely.  The vets were all happy to see the quick recovery.  However, he still couldn't quite control the leg to move it backward yet.  The concern now was shifted to his diarrhea as he could have problem retaining hydration.

I visited Klasse again after work, and talked to Dr. Cox.  He told me that he was also on ulcer medication as he showed discomfort after eating, and that was alarming to me.  I was concerned they pushed him to go on his own too quickly.  He looked tired at night and had problem urinating, he tried frequently but very little and dark urine came out.  Dr. Cox said that was a common symptom of a horse that tied up.  He was breathing pretty hard because of a mild fever, and his edema also looked really bad.  I went home and prayed more.

Wednesday 2/16

Klasse seemed to be quite alert when I visited at lunch time.  He was strong enough to dodge me when I tried to put the herbal medicine on his nose.  He was still breathing hard and I could see clear discomfort.  His edema now looked even worse.  His scrotum looked like a water balloon (not two)-:.  There were two horses going in for surgery today, so I didn't get a chance to talk to the vets as much.  Dr. Cox fed him a little of mash.  Klasse had good appetite and wanted to eat, but it seemed to be very difficult for him to swallow and the food seemed to hurt him as he would kick up hind legs and move around a lot.  I decided to let him just eat quietly by himself, and visited Rubino.  When I got back, he had stopped eating and most of the food was still in the bucket.  He moved around and seemed to want to go down and roll.  I got really concerned and called on the vet hospital worker there.  He went to talk to the doctors, who were busy operating on a horse, and came back to check Klasse's heart rate.  It was 52, high for him as his normal rate was 28, but certainly a lot lower than in the past few days.  He assured me that he would keep an eye on him, and also by that time he quieted down already.  However, this little episode was very upsetting to me.  I had a three o'clock meeting I called at the office, so I had to leave as it was 2:40 already.

A good friend of mine at work encouraged me to think positively.  Think positive and it will happen that way!

Thursday 2/17

Klasse continued to improve as the doctors told me.  They started to feed him some Equine Senior and Bran mash, very wet and sloppy stuff.  His edema got worse, but changed shapes.  It seemed that all the fluid went between his legs, so it looked like he had breasts.  He also showed colic symptom after eating, but Dr. Wilbur assured me it was because of the ulcers.  He has been on ulcer medication, so there is really nothing more they can do.  The doctors kept saying that he would have to the rest on his own.  They worried about the most was his diarrhea.

Friday 2/18

I talked to Dr. Wilbur on the phone in the morning.  She told me that she discovered something interesting...  Klassey didn't like the tap water.  She said she gave him bottled water, he drank up the entire bucket immediately.  We were laughing that at least the water brand name was not an issue yet.  So, Klassey is now on bottled water.  I went to the barn and saw 10 big jugs in front of his stall.  Dr. Wilbur said she asked the delivery person dropped them off there... might as well.  Klassey looked a lot brighter, but he still displayed bad heart burn symptoms after just eating the mash, which is really not much.  Dr. Wilbur told me that he was fed only 2 pounds of equine senior, plus some wheat bran and some rice bran.  It's not enough to even keep his weight, but at least he started eating on his own.  He has wasted most of his muscles and the edema was partly caused by it.  Klassey hardly had any food for nearly two weeks by now.  However, he was still far from the pictures of those neglected horses.  That made me wonder how bad those horses were treated.

President's Day long weekend 2/19 - 2/21

Everyone in the family went skiing (ski boarding actually) this weekend.  I was left behind to look after Klassey, and to straighten up the bookkeeping for the tax (unfortunately)-;.  There was really nothing I needed to do with the constant care from the vets.  They have been unbelievably dedicated since day one of his trouble, especially after the first operation as he needed reflux done every two hours day and night.  A few minutes after I arrived at the hospital barn, Dr. Wilbur drove up in a truck; she dragged down a huge container (one of those for the manure) full of fresh grass.  She said she went out on a mission to pull fresh grass for Klasse, and a couple of impaction patients who also had operations.  Gosh, I feel absolutely lucky to have her taking care of Klasse.  She did tell me that she thought Klasse could not make it after the second operations as he was in very terrible condition, but she felt much more positive now.

On Monday, we got a break from the rain and the sun came out.  The vets let me take Klasse out for a walk while the stable help washed his stall.  He made a really bad mess with his diarrhea problem.  The stable help spent a good 20 minutes washing everything down.  Klasse enjoyed the sun and stroll and was extremely interested in looking at the view up on the hills.  He was so alert that he was almost as bright as before he was sick.  He also just noticed that the next door patient was a filly.  I guess survival was first, and everything else just had to wait.   The vets actually moved two mares near him earlier to keep him companied, but he certainly could care less.  One of them was a bitchy mare who got her third colic surgery in 5 years.  I don't blame Klasse for not noticing her.  :-) The other was really sweet.  She was adopted by the vets.  She had chronic laminitis and the owner wanted to put her down after a long period of treatment without much improvement, but the vets felt they could get her pasture sound in a year, so they just adopted her.

Klasse started to have nosebleeding, so it appeared to be, but the doctors told us that it was from the inflammation of his pharynx (thoat), so when he ate with his head down, the blood came out his nose, and he wiped it on the stall wall.  When he ate from the bucket on the wall, he just swallowed it with the food.  The doctors planed to scope him to see how bad the inflammation was and they might treat him with antibiotics again if it got infected.  His incision was also not doing well.  It started to have pus oozing out.

I feel absolutely lucky that Klasse is still with us.  The little 3-year-old TB stallion next door who came in for impaction surgery, suddenly died because his stomach ruptured.  He looked all fine and in a much better shape than Klasse after he came out of his operation.  It was really sad, and I guess these things were just unpredictable.  Before that, two other horses were put down.  One was found with cancer covered all over her internal organs after they opened her up.  The other had an extremely enlarged heart that Dr. Wilbur said that she never heard of this condition with horses before.  We're still fighting one day at a time, but I am even more appreciative with each day that Klasse offers us.

Tuesday 2/22

The news was not as good this morning... Klasse was running a fever, and didn't look as bright as yesterday.  Dr. Wilbur said it could be the infection at the incision, and they have scrubbed it down really well and covered with bandages now.  Also, they still plan to scope him to examine the condition of his ulcer.  He may need to be put on antibiotics again.  I hope we can halt the temporary set back quickly.
 

Wednesday 2/23

The vets scoped his pharynx this morning to see how bad the ulcers or laceration were in his throat. It turned out to be not too bad. It was definitely red and inflamed, but they found no big scabs or open sores. However, Klasse is getting weaker and weaker with hardly any food intake. I spoke a bit too early two days ago about how he still looked OK. Not any more. His hips now looked like an old milk cow's. He lost so much muscles so quickly that he had a hard time moving around. His diarrhea also worsened, perhaps from eating more food. His butt must be burning like hell, and I could hear his tummy like toilet flushing even when I stood 3 feet away. The vets gave him half a gallon Pepto Bismo, but unfortunately they had to tube him for that.

The vets keep saying that it is all up to him now, but he has become so weak that I can't believe there is nothing more we can help. I asked Dr. Wilbur any alternative medicines, such as accupressure, accupuncture, herbs, homeopathy, etc. She replied if I could find an Indian to come here chanting to get him better, she would be all for it.

I had a bout of diarrhea in the afternoon, probably just from sympathy as I had not eaten anything all day by that time, and there was no reason for me to get a diarrhea. However, it did prompt me to give a Chinese herbal medicine a try. The herbs are made into small round balls of the size of a pearl, and for humans, we take 7 balls at a time. Maybe we can break 70 up and put in a syringe to feed him. It's really smelly, but if the vets approve, I'll give it a try.