Chronically ill horse- dramatic vent

[Cindyg]

I have a friend who is a horse professional, which is to say, she is in the business to make a living. She told me each of her horses has a per-incident medical cap in her mind. So, if her medical cap on Mare A is $5000, when she has spent $5000 on Mare A, if this incident is not resolved, she puts Mare A down.

It’s sad, but it’s reality.

Please don’t beat yourself up. You have reached your own cap – in heartache, in time spent, in tears, and in money. Let go. You’ve done well. You don’t have to do anything more.

[cyriz_s_mom]

I read your other thread after seeing this one. I’m curious what the insurance company has to say. Are they still paying for some of his medical care? Are they willing to pay out on mortality at this point?

I think it is amazing what you and Calvin have done in 2014 and hopefully, his story will help other horses/vets in the future.

Know that we don’t always get the happy ending we want, no matter how hard we try and do everything “right.” If he doesn’t bounce back from this latest ailment, I hope that you will feel like you’ve given him every reasonable chance and be willing to let him go and not put him through more treatments and procedures without a real upside. It is hard sometimes to remember that they aren’t human, that they don’t know they might get better, they only know that they hurt right now.

I hope 2015 is easier for both of you…whatever that means.

[OverandOnward]

Maybe this will help …

Your horse does not have the concepts of time or life that you do. He doesn’t know how long his life is or how long it could be. If you let him go, he won’t know that he’s missing any more days that he could have had. He won’t know that he is going. What a blessing for him!

And if we knew more, we might know that a horse doesn’t want those unhealthy, unhappy days. He doesn’t have the intellect to distract himself from his physical misery. He can only suffer, each hour, each day. Horses don’t seem to want that (to me).

Horses are a species that aren’t built to survive things that would be minor disturbances for humans, canines, felines, etc. other species. Can’t regurgitate so bad food has to keep going on through - can die of constipation - can’t curl up in bed to rest and heal a injured limb or foot, have to stand on it - can actually die of lying down for too long … Horses aren’t built to survive in the wild the kinds of things your horse is suffering. Sometimes we humans can overcome that, but not always.

Even Barbaro reached a point where it was time to allow him to go onward.

In spite of all the investment and time, it is ok to let him go. It’s about him and what he is suffering.

{{{{many hugs I am so sorry for what you are going through}}}}

[QUOTE=jenm;7932393]
“the horse isn’t even healthy or happy.” That phrase alone should help you make the right decision. Take yourself out of the equation and set him free.

It’s always better a day too early than a minute too late.

You will have tons of support on this forum, and it’s okay to cry, but right now you need to be strong for your horse.[/QUOTE]

Agreed 100%.

[QUOTE=SportingSun;7933242]…

Maybe if you keep going he will get better, but probably not. Chances are high that he will live a mediocre life full of vet visits, stall rest, and overall miserableness. Maybe he will have good days, but those good days have no worth to a horse who lives in the moment and only understands that right now he is hurting and cannot find comfort.

I hope he gets through this and you go on to have many more wonderful years with him, but please understand that the sacrifices you have put yourself through are in no way going to “save” this horse. Giving up your life may never allow this horse to live out his, so please consider this before completely derailing your own path for the sake of him.[/QUOTE]

Absolutely. Well said.

I pray that if the time comes I must make such decisions for my horse, I can do it clear sightedly. It’s not always easy to sort it out for one’s own horse.

[IvyHall]

Thank you

thank you so much for all the responses and support. You all have helped to put this in perspective for me.

I plan to take each day as it comes and to be sure to consider my own “quality of life” when it comes to any future care/treatments he may require.

In my opinion (and I respect that others may disagree) he is not currently suffering. He is already responding to the treatment for the pastern dermatitis and I hope and pray (to the horsey spirits) that we will be seeing less of all the wonderful vets, who I have gotten to know all to well this past year, in 2015.

Lastly here are some shots of Cal and the kid from this holiday season bc they make me smile, and I hope the will do the same for you:
http://s1285.photobucket.com/user/ivyhall1/slideshow/Cal%20December%202014

Health and happiness to all in 2015!!!

[tua37516]

[QUOTE=IvyHall;7933214]

Its certainly not time to give up on him yet. I just need a few weeks, maybe even a few months (if that isn’t too much to ask) where nothing horrible (or expensive) occurs. [/QUOTE]

I know SO well how this feels! In May I had knee surgery that was a much more invasive and lengthy recovery than I expected, so horsie had to go on training board. June my jeep’s engine dies and have to buy new car. Then, on move in day to my new home July 1st, my mother who is in her mid 50’s had a TIA (mild stroke) and was hospitalized. Trainer’s lease on barn ended in October and was moving to much more expensive farm I could not afford, so had to barn shop within 30 days. Horse stepped on shoe yanked it off and stood on clip, needed emergency vet appointment for sedation/shoe removal. Meantime previous corporate job is going thru downsizing/“re-engineering”. Due to all of these events income decreases and expenses go up.

It is very defeating to be trying to rise about so much every day. I’m sorry you are going thru this. I think you are local to me? If you need a nice ride let me know.

[Laurierace]

Switch him to hospice care in your mind. To me that means palliative care only. Keep him happy and comfortable as long as you can and when you can not it is time to let him go. That may mean giving him drugs that could have adverse effects like high doses of steroids that could make him founder or high doses of NSAIDS that could cause ulcers. Worry about that when and if it happens. It is always hard to let them go but I think it can be even harder when you have come so far. Hopefully in time you will be comforted by how hard you both fought.

[Jeito]

[QUOTE=IvyHall;7934312]
Lastly here are some shots of Cal and the kid from this holiday season bc they make me smile, and I hope the will do the same for you:
http://s1285.photobucket.com/user/ivyhall1/slideshow/Cal%20December%202014[/QUOTE]

He’s beautiful! I just read this entire thread and some of your other posts and have a feeling you know what is right and will do what is right by your horses. If I were a horse, I would want an owner like you.

I also know very well how it feels to need a break during which horrible happens.

[oliverreed]

Just want to add my hugs and jingles.

[danceronice]

[QUOTE=IvyHall;7934312]

Lastly here are some shots of Cal and the kid from this holiday season bc they make me smile, and I hope the will do the same for you:
http://s1285.photobucket.com/user/ivyhall1/slideshow/Cal%20December%202014 [/QUOTE]

“A Horse and His Girl!”

I agree with Laurie. If things keep coming up, the concept of palliative care is not a terrible thing-it doesn’t have to be “he’s either got to be 100% healthy by hook or by crook or he has to go.” Instead of trying to make things better, make him comfortable and when that’s no longer feasible, time to let him go. When I was with the zoo we had a potto (a bush-baby type primate) who was one of the oldest known in captivity. She had developed mammary tumors, which are treatable but like with humans, it’s not fun or pleasant. The decision was made that instead of aggressive treatment, she’d get pain relief, foods she liked, and the keepers would watch her to see when that was no longer enough. I keep that in mind with my fifteen-year-old dog (Puff the COTH dog.) He’s in good spirits, he still has puppy bursts of energy, he eats up well. He also has old-dog issues. Because of his age, he’s not a good candidate for major medical treatment (and at least one of the vets I use would likely refuse to do major surgeries or chemo if I asked precisely because it wouldn’t accomplish much and would make the dog suffer) so I keep an eye on him, and when there isn’t a way to keep him out of pain and happy, it’ll be time. Just because extreme measures are available doesn’t mean you’re obligated to try every single one no matter the odds.

[JumpQH]

[QUOTE=danceronice;7944042]
“A Horse and His Girl!”

I agree with Laurie. If things keep coming up, the concept of palliative care is not a terrible thing-it doesn’t have to be “he’s either got to be 100% healthy by hook or by crook or he has to go.” Instead of trying to make things better, make him comfortable and when that’s no longer feasible, time to let him go. When I was with the zoo we had a potto (a bush-baby type primate) who was one of the oldest known in captivity. She had developed mammary tumors, which are treatable but like with humans, it’s not fun or pleasant. The decision was made that instead of aggressive treatment, she’d get pain relief, foods she liked, and the keepers would watch her to see when that was no longer enough. I keep that in mind with my fifteen-year-old dog (Puff the COTH dog.) He’s in good spirits, he still has puppy bursts of energy, he eats up well. He also has old-dog issues. Because of his age, he’s not a good candidate for major medical treatment (and at least one of the vets I use would likely refuse to do major surgeries or chemo if I asked precisely because it wouldn’t accomplish much and would make the dog suffer) so I keep an eye on him, and when there isn’t a way to keep him out of pain and happy, it’ll be time. Just because extreme measures are available doesn’t mean you’re obligated to try every single one no matter the odds.[/QUOTE]

Thanks for posting this. I’m going through a situation right now where I’m debating what to do, and this took me out of my box of thought. Thank you!

[Dressagelvr]

For whatever it means, I don’t think $50k is outrageous like other folks.

I don’t know the whole story, buy have you thought about pulling his shoes & giving him a year off to be a well cared for pasture puff? I’ve known a few horses to rally on this when cared for well (which you obviously provide). Really hate the idea that a barn didn’t care for him for 2 days, though. This would be a deal breaker for me.

Good luck and whatever happens, you can know you didn’t just throw his life away like so many would have.

[OverandOnward]

[QUOTE=Laurierace;7943996]
Switch him to hospice care in your mind. To me that means palliative care only. Keep him happy and comfortable as long as you can and when you can not it is time to let him go. That may mean giving him drugs that could have adverse effects like high doses of steroids that could make him founder or high doses of NSAIDS that could cause ulcers. Worry about that when and if it happens. It is always hard to let them go but I think it can be even harder when you have come so far. Hopefully in time you will be comforted by how hard you both fought.[/QUOTE]

Thank you, this is a great way to frame a situation.

One of the great things about the hospice mindset is that, as Laurierace says, you can do everything for greater comfort and quality of life now. The caregiver can put aside the standard worries about long-term effects. Hospice caretakers have learned that, in hindsight, that’s what people wish they had done.

One door closes, another opens. All the way to the end - and beyond.

There is a beyond - there is an ongoing future after this horse, regardless if he lives another month, year or 10 years. Don’t lose sight of that - don’t get trapped in the feeling that the end of one thing is the end of all - it isn’t.

[TrotTrotPumpkn]

[QUOTE=Laurierace;7943996]
Switch him to hospice care in your mind. To me that means palliative care only. Keep him happy and comfortable as long as you can and when you can not it is time to let him go. That may mean giving him drugs that could have adverse effects like high doses of steroids that could make him founder or high doses of NSAIDS that could cause ulcers. Worry about that when and if it happens. It is always hard to let them go but I think it can be even harder when you have come so far. Hopefully in time you will be comforted by how hard you both fought.[/QUOTE]

This is great advice.

[OverandOnward]

[QUOTE=IvyHall;7933214]
…
Its certainly not time to give up on him yet. I just need a few weeks, maybe even a few months (if that isn’t too much to ask) where nothing horrible (or expensive) occurs.

Thanks again for the kind words and words of wisdom.[/QUOTE]

It is too hard to make the evaluation over and over again “is it time?”. It is increasing your suffering and making you endlessly repeat this painful evaluation. That’s making everything more stressful and harder for you while you are standing by your beautiful horse.

I suggest you have a quiet sit-down with yourself and make a decision plan. Give yourself a timeframe - 7 months, or a year, or whatever you want. Put it on paper or just in your mind, but have this to take the place of constantly worrying about the decision.

Decision framework:

• If X, Y or Z major medical issues happen within my set time period, I let him go. Be both specific and general. Give yourself examples such as surgical colic, specific major lameness, etc. And guidelines on treatments and cost that are too great to go on with for this horse (if cost is a concern for you).

• If minor issues come up I’ll continue to treat. I’ll set aside $500 to $1,000 to make this less painful to the checkbook. (Set aside $100 per month in his savings account, and in 10 months you’ve got $1,000, and in the meantime you have a growing treatment stash. Or $50 or $25 per month - the longer he doesn’t need it, the more coverage you have.)

• If more than one intermediate-level issue comes up, such as a 1-month layup type thing, I’ll do just one more, but if there is a second one within my timeframe, I will let him go and be a new star in heaven.

If nothing more happens in your chosen 7-month, 10-month or one year span, roll this decision matrix forward at least one more time. If something does come up after a long period of quiet, you’ll be worrying if you are back in the same cycle. Protect yourself from ongoing worry with your decision plan (perhaps with modifications).

Things may not work out exactly per your plan, but it will give you guidelines and a framework for what does come up.

I had to do this one year with my horse. While a major medical crisis was taking place and one unanticipated complication after another was coming up, I worked out with the vet "if this happens … if that happens … ". After that recovery, a couple of other unrelated big expensive veterinary things came up - it was just a very bad year. I came up with this decision plan to survive the year. (I didn’t spend what you did, but I spent an insane amount of money that year on veterinary and treatment costs for this one average ordinary horse.)

Fortunately we came through the year and things have been ‘normal’ since. But I still have a modified version of “the plan” as he is growing older. As he ages, I am incorporating more and more of the hospice approach into my plan for "what happens if … ".

[pezk]

[QUOTE=Laurierace;7943996]
Switch him to hospice care in your mind. To me that means palliative care only. Keep him happy and comfortable as long as you can and when you can not it is time to let him go. That may mean giving him drugs that could have adverse effects like high doses of steroids that could make him founder or high doses of NSAIDS that could cause ulcers. Worry about that when and if it happens. It is always hard to let them go but I think it can be even harder when you have come so far. Hopefully in time you will be comforted by how hard you both fought.[/QUOTE]

This is the best advice I’ve read in a long time. Can apply to horses, dogs etc.
a lot of common sense and reality in those words.

[danceronice]

[QUOTE=OverandOnward;7944518]
Thank you, this is a great way to frame a situation.

One of the great things about the hospice mindset is that, as Laurierace says, you can do everything for greater comfort and quality of life now. The caregiver can put aside the standard worries about long-term effects. Hospice caretakers have learned that, in hindsight, that’s what people wish they had done.

One door closes, another opens. All the way to the end - and beyond.

There is a beyond - there is an ongoing future after this horse, regardless if he lives another month, year or 10 years. Don’t lose sight of that - don’t get trapped in the feeling that the end of one thing is the end of all - it isn’t.[/QUOTE]

There’s a hospice service around here whose radio ads are “How do you want to LIVE?” They cite examples of a patient who just wanted to play the guitar again, one who wanted to ride a motorcycle, etc. and how they the hospice made it happen. It’s not all or nothing, every treatment known to man and damn the costs or the pink juice.

[IvyHall]

I’m so glad I started this thread b/c then I will always know where to find it when I need it as I have received some AWESOME advice. Thank you so much!

He was only on bute for a few days last week (and it was the first time I’ve ever had him on bute in the 4+ years I have owned him) and he has now been off for a few days. He is also tapering off the steroids. He seems as happy and healthy as ever.

Just seeing him not want to walk out of his stall the other week really got me upset. I will not let this horse suffer. I have always said that. I think I really just need to make sure that I am not putting myself through too much hardship in an effort to care for him.

thanks again!

[findeight]

I found with an old cat, setting a limit in my mind on what I would or would not do if this or that happened again made it so very much easier when it did happen again.

Theres a thread over on Horse Care about senior horses and colic surgery. You might want to read it. Basically it drifted to having the decision made before you have to make it in an emotional state. You may find comfort in it. I did as my old horse is aging and has other conditions that may hasten the time…it made me think about exactly what I will do and what I will not do now, when there is no rush or emotion. It’s still hard to do but at least you know what needs to happen and be at peace with it.

Your very young child may be upset but it is a teaching opportunity, might want to give some thought to that.

[AKB]

You have given Cal a wonderful year that he would not have had without your tremendous efforts. You have also given your daughter the gift of watching how much effort you are willing to put into a family member, and the value of family. Kids learn by watching and helping when there is a crisis. It helps them understand the importance of hard work, commitment to family, and perseverance in a crisis.

When it is time to put Cal down, your daughter will learn about coping with death. Kids usually seem to cope with death better than adults expect.
When my daughters were teenagers, we, and another pony club family, helped in the horse hospital NICU for sick foals. The staff tried to assign us foals that would survive the shift. The other mother, a former hospice nurse, told the staff that it was ok for their kids to work with the foals that would die on that shift. They could learn about death, and how it is a part of life.

Tell your daughter that Cal may eventually die from his cancer so it is not a shock. Read her some books about dying to help prepare. Keep going and treating Cal as long as you feel it is helping him and is tolerable for you and your family. Then, give him a decent death. A decent death without intolerable suffering is what most of us want for ourselves and our animals. Hugs to you, Cal and your daughter. The pictures of your daughter and Cal are wonderful.

[OverandOnward]

[QUOTE=IvyHall;7944625]
I’m so glad I started this thread b/c then I will always know where to find it when I need it as I have received some AWESOME advice. Thank you so much!

He was only on bute for a few days last week (and it was the first time I’ve ever had him on bute in the 4+ years I have owned him) and he has now been off for a few days. He is also tapering off the steroids. He seems as happy and healthy as ever.

Just seeing him not want to walk out of his stall the other week really got me upset. I will not let this horse suffer. I have always said that. I think I really just need to make sure that I am not putting myself through too much hardship in an effort to care for him.

thanks again![/QUOTE]

I am so glad you posted this, I feel better for you now.

@findeight;7944626

… Basically it drifted to having the decision made before you have to make it in an emotional state. …

Amen to this.

Having stood in a cold, anxious vet ER at midnight, holding the head and reassuring my suffering horse who was enduring one attempt after another to diagnose and help him, all of which frightened and confused him and made him feel worse in spite of the medication he was under … yes, know ahead of time what kinds of questions to ask, and when you are ready to call a halt and spare him another minute of this.

A “if this happens” plan gives me a list of what questions to ask the vets. Instead of asking about treatments, tell me about the prognosis and how hard it will be on the horse, now and later. And how long each stage will last. In plain English. Thanks. Then we can get to the details.