Abscess, swollen leg, advice please!

[Scribbler]

@hj.eq.xc

ya, this is a good point that I need to remember. I am also conscious that I don’t want to be THAT client for the vet to deal with. I have always dealt with vets via boarding barns so I am learning the etiquette if you will of being a direct client as I go with this but of course my frustration and concern (and overthinking) over it not getting better isn’t great when I feel like I can’t do anything for him (and of course any day now I will go out to his whole leg ballooned up and massive fever and laminitis and bone infections etc etc…)

Horses do present us with genuine emergencies, and if you own a horse eventually you will hit end of life decisions too. But most horse ailments are not emergencies, and I figure I will save my panic for when I really need it

Like I said above, I don’t even call a vet for hoof abscesses. And when my main mare had a run of constipation colic (4 times in 6 months) my vet at the time (who I miss a lot) was always “give her some Banamine and call me tomorrow if it doesn’t resolve.” I did panic one time and call an emergency vet out to tube which didn’t actually speed up the resolution and kind of traumatized maresy. Obviously that’s more laissez faire than most people advise. I do get water into her and once I slept at the barn all night while she slept off the Banamine and farted, so I’m not negligent.

But it’s really important not to catastrophize around horses. It just wears you out, and sometimes it can make you miss other significant subtle things. You posted a couple of days ago that horse was moving around cantering in turnout and you were wondering when you could ride. That doesn’t sound like he’s getting worse.

Have you actually made a follow-up appointment with the vet? Or are you just texting randomly wanting advice?

Your vet is booked weeks in advance for appointments all across your district or township or county. He likely books these up in clusters of barns that are close to each other. If there was a genuine life threatening emergency he would cancel everyone else to come out and save your horse. But not for a follow-up abscess appointment.

Also vets are busy working outdoors in situations that demand their full attention. When they are with a horse, they need to be fully present. They are dealing with enough “real” scheduling and emergency communication that they usually don’t have the band width for texty chitchat about anxious clients with routine horse problems.

If you want the vets eyes on your horse, call the office and make an appointment and pay the farm call fee. The vet likely doesn’t run his own bookings. He’s not going to say “ok, I see you are worried, I will come out tomorrow morning.”

Call.his office, make an appointment, and talk to him.there when you are paying for his full attention for an hour. Don’t expect him to.have bandwidth to reassure you about your anxieties in the middle of dealing with a difficult birth, a hair line fracture, stitching up a huge gash, or a sad euthanasia. Or doing dental maintenance on ten horses in a row. Etc

[Fiesta01]

So sorry you and your horse are going through this. I don’t have anything to add to the suggestions already made. However, I would be looking for a new vet ASAP just based on the poor communications skills. That would be totally unacceptable to me. Your tolerance level may differ.

Also, have you been keeping track of his temp? Has it been elevated at all? If the temp has been and is still elevated, I would still be wondering about cellulitis or lymphangitis and continuing the antibiotics.

Jingles for your boy.

[lenapesadie]

What a mess! Sorry you and your horse are going through this!

Vet etiquette or protocol likely varies greatly from clinic to clinic in different areas etc. But I’ll share how things might work out with my clinic.

For myself, I like having the vet out for pretty much everything. Abscesses included. And certainly for a swollen leg. Anything presenting as lame gets seen by the vet. My vet clinic does provide after hours emergency services. But that is not the same as the attending vet providing text support after hours. If I’m not satisfied with how a condition is progressing, I’m going to call the office and tell them that Dobbin isn’t improving and I need the vet out again (pronto if it’s an acute situation). They’ll schedule me an appointment and relay message to attending vet. Depending on the situation and how far out they are able to get me scheduled, the vet may call or text to get more info. For a chronic condition, I once had an appointment where I went to the vet clinic for a consultation with the attending vet about next steps (without the patient in attendance). What’s similar in both of those scenarios that’s not similar to your text follow ups is that my vet is invoicing me for that follow up appointment and consultation. Follow up exams, continued care protocol, additional treatment plans etc are billable services.

Without pictures of this swollen leg, it’s hard to render an opinion. That said, my dearly departed Norman was prone to getting leg swelling that may or may not have been related to several other conditions he had (including chronic abscesses). I always treated as an urgent situation and had the vet out immediately. We always treated with injectable abx. I assure you had a particular abx not provided results, I’d have had the vet right back out.

[Alex_and_Bodie_s_Mom]

@hj.eq.xc

Is it normal for vets to not respond on the weekend?

Yes. Very.

Does your vet actually offer an emergency, after-hours number, or are you texting an office phone? If the latter, it’s likely your vet isn’t even seeing the messages.

I called my vet on a Saturday night once for an acute colic. He was at a wedding. Vets do have lives outside of their practice, and if they don’t have multiple vets so that one is ‘on call’ on weekends or evenings, yours may be out of town or otherwise engaged at the moment. (Now, I do have a wonderful working relationship with my vet, so I probably have more leeway than some of his other clients do.)

If all you’re doing is texting the vet with questions - well, it’s anyone’s guess as to how many clients they see in a given day, and he may simply not have the time to deal with it, to be honest. Vets burn out faster than almost any other profession out there. Just call the office and make another appointment. I’m trying to say this as kindly as I can - you need to pay for the advice you’re asking the vet for. That means a second appointment.

[hj.eq.xc]

I do get that abscesses are run of the mill more or less, swelling that has lasted now 3 weeks is not and its has gone past the “don’t catastrophize” to the something is definitely wrong and it needs to be seen and actually assessed by professional eyes and hands, retained swelling this long is not good and shouldn’t be ignored. When he was cantering and moving better in turnout, I did feel like it was on the mend and should be moving positively forward and getting back in ridden work soon. However, today, he was quite reluctant to do more than walk. I play with him in his paddock, playing with targets and going the loop of their field, walking and jogging in sections. Normally, he will follow right along walking and trotting respectively, today he was not willing to trot. Could it be nothing, sure, do I think its worth considering that he has now been 48 hours without bute (the longest its been in the past three weeks) and seems to be slipping comfort wise, yes. I also do not randomly text wanting advice or to chit chat. I texted him to update him that the swelling had gotten significantly worse, 5 days after that I texted to say the swelling is still present and not improving with treatment whereupon he told me to add bute to the SMZs, I asked what I should make note of or look for improvements in while he is on the medication (ironic side note: he said watch for improvement in swelling and the first 24hrs on SMZs saw the worst swelling), I asked how long he needs to be on the meds and hoof wrapping/soaking protocol, and I asked what causes the increasing/decreasing swelling effect and asked if we could sort out a time for an appointment.

The text is a practice wide one where the vets and techs and office people can all see it, however, I do not see that my questions do anything except clarify directions I should have been told otherwise and update the vet on how he is doing and let him know about the lack of improvement or in some cases degradation. This may be improper but I kind of expect the vet to be more proactive. Like him being the professional should take the lead? I don’t know, I could be totally wrong about this and I as the client should just dictate everything? I also get that vets are busy, obviously, but like I said, my questions are super simple and only get instructions and update his condition. Like I think max 10 updates/questions in the three weeks this has been going on. I mean they have vet techs they work with in the field, while they drive to their next appointment, is it too much to tell me how much and how often I need to be doing treatment or if I need to change protocol? Vet techs can text dictated instruction too. Also, personal opinion, if the vet can’t deal with their day in day out treatment/work and communicate with patients on drug and injury treatment protocol that requires a 10 second text, they are in the wrong profession. As hard as it is to go from a devastating euthanasia to a simple dental or PPE for example, it’s in the job description.

[hj.eq.xc]

Communication is very important to me, I value dialogue, I want to be informed and I want to know what is going on and what I can be doing to help reach the best result. Like honestly, I will do anything, I don’t need to be coddled in that way, I just need to be able to rely on someone to talk to and be guided by. I have already reached out to another practice. We all know the anxious horse owner isn’t a great label to be smacked with but ironically, if the vet doest want an “anxious horse owner” I need to be communicated with in order to not get my mind racing in a million different ways becoming the “anxious horse owner.” if he thinks its benign, he should say, just as he should say otherwise. AND if he can’t make a diagnosis or say good or bad over text then he should come out and he should say. Like all I want is communication. I will take his temp tomorrow and see where he is. Thanks for your reply!

[hj.eq.xc]

Thank you for your reply! I appreciate knowing that for your practice general advice and treatment consultation appointments are a service and are chargeable. I mentioned in another reply what my texts have consisted of, it really isn’t long drawn out conversations, I don’t need a long format answer, it is an I need an answer to know how long I need to be continuing this treatment, if I need to change it and for how long I need to give how much drugs, kind of thing. It has progressed to, the swelling is bad, do you think you need to come out/ in your professional opinion based on pictures and the update, should I make an appointment? so it really is that kind of thing and its super basic and simple, so I feel like I shouldn’t need to be chasing down answers. I don’t know the complications of over feeding bute and SMZs, besides ulcers and GI discomfort, id not know if it gets more serious, but I take drug doses and durations very seriously, the cautious amateur, and not being instructed about length of time despite asking (except for SMZs it was written on the bottle) and the overall protocol of hoof soaking/poulticing duration is concerning/annoying/aggravating. I don’t want a dissertation just tell me what I should be doing and tell me if the progression is abnormal and I need to make an appointment, ya know

[hj.eq.xc]

I appreciate everything you mentioned in your reply, and since it is an office number, it is possible he only sees texts during office or working hours. Technically, that should mean a text Friday after 5 should be seen Saturday during their office hours but ok, weekends I understand they generally reserve for emergency. I did clarify in other responses, but the advice I text for is basically instructions on the protocol I am supposed to follow that I never got. Like how many days I should be soaking and wet poulticing, how many days does he get bute, how long should I wait to see improvement in symptoms before making an appointment and then the one off of the message that his leg is significantly swollen after starting SMZs, this doesn’t feel right, should you come out/should I call the number to make an appointment ASAP. This doesn’t seem to fall into the category of advice I need to pay for in my mind, I am by no means trying to get free advice, I will happily have him come out to the farm, I have wanted him to come out multiple times but told to give bute and let him know in a couple days or, just give it a few more days and let me know if the swelling goes away. I know time is a great healer and it would save me money on a trip out for nothing but is a swollen leg for three weeks really nothing? I mean if this is normal professional vet behavior please let me know and I can adjust my expectations but my horse has dealt with one abscess and more than likely a second one having blown out his heel bulb a few days later and a leg that has been swollen for three weeks. The deflection of give it some time or just give it bute but with no other explanation and no real improvement in the swelling or symptoms after the first week (yes as I posted previously he appeared to feel better on Friday evening and Saturday morning but seems to have slide back a little today) is just not sitting right with me.

[lenapesadie]

Generally speaking, I’d expect fairly straightforward, instructions at the conclusion of an appointment. One, perhaps two, follow up questions / updates I would consider within realm of normal. If my horse doesn’t improve on a treatment plan, I’m making another appointment! And I really think you need to do the same! I think the onus is on the owner to decide if another appointment is warranted. If you don’t think this vet is communicating sufficiently for your needs, hire a different one!

[Fiesta01]

I totally agree and feel your current unease. I’ve been lucky that I’ve never had to “fire” a vet. All of mine seemed to appreciate a concerned, informed and hands-on owner. Or at least they pretended to.

My last vet gave me the biggest compliment. Animal control had a complaint from a disgruntled former boarder and were on the property looking at the condition of all the animals. (A very old horse, not mine, was having trouble keeping weight on. Owner and BO were doing everything they could per vet instructions to get weight on but sometimes you can only do what you can do with the oldies. The disgruntled ex-boarder decided to stir up trouble by reporting the horse was being starved).

I had just finished up an appointment with my vet. After he left, the AC person was admiring my old guy’s condition and saying they couldn’t believe he was in his 30s. She said my vet told her he wished all horses got the care mine did and that when he died, he wanted to come back as one of my horses.

[Pico_Banana]

I encourage you not to get too anxious over the question of whether you are an over reactive horse owner. You will figure out over time what you can manage on your own and what you need more guidance with. Right now you’re at the beginning of that (IIRC you said this is new to you not being at a training barn) and so if that means you need more interaction with the vet, so be it.

But if that’s the case, you also need to be willing to to take more responsibility for the communication. If you need an answer and aren’t getting responses to texts, call the office number and talk to the answering service. State very clearly that you need a vet to call you back and that a visit is needed in the next day or two. Send photos or videos to help the vet understand the situation.

And if you’re not happy with their level of responsiveness, it’s time to find a vet whose practice is more what you’re looking for.

I know that might be hard to read, but please remember that you have to be your horse’s advocate here. If what you have been doing isn’t working, you need to try something else.

With what you’re seeing and three weeks after the vet was out, I’d also want to have the vet back out to assess the situation. It’s perfectly valid to ask for that even if it means they come out and say “nope, totally normal for this situation, carry on.”

I really hope your horse gets seen soon so that he can hopefully start to feel better and you can, too.

[hj.eq.xc]

Thank you so much! I really appreciate your reply, very sensible and thoughtful and very helpful input!

[Alex_and_Bodie_s_Mom]

@hj.eq.xc

I mean if this is normal professional vet behavior please let me know and I can adjust my expectations

In general? Yes. It is. Especially if you’re a new client. You need to build a relationship with your vet, and that takes time.

I’m sorry, but the kind of communication you’re looking for is just not the type of hand-holding most busy vets have the time to do. Particularly if you’re not making a follow-up appointment.

@hj.eq.xc

then the one off of the message that his leg is significantly swollen after starting SMZs, this doesn’t feel right, should you come out/should I call the number to make an appointment ASAP. This doesn’t seem to fall into the category of advice I need to pay for in my mind,

Your vet can’t tell you whether you should make an appointment. That decision is up to you.

In the meantime, what are you doing to alleviate the swelling in the leg? Is there heat, or just swelling? Are you icing or cold hosing it a few times a day? Using a DMSO sweat?

[hj.eq.xc]

I wanted to put up an update and not leave it open/unresolved. I had my vet back out, took on a lot of the feedback in regard to personal interactions and proper expectations and all that and I feel that the interaction went really well and I had a very positive feeling which I think/hope was reciprocated. The swelling dissipated significantly since my last few posts and we got the all clear from my vet to stop the wrappings and start getting back into work! It’s such a relief that he is back to himself. I really want to extend a huge thank you to everyone who replied and offered feedback and advice. I really tried to take everything on board and use it to improve the relationship with my vet present and future. It is so helpful, I really appreciate it so much and am so grateful!