guardedly optimistic update on Algiers
When I last wrote, he seemed to be on a recovery path. The day he trotted a couple steps was a peak, though, and was followed by a plateau and then slow decline. He still wasn't drinking on his own, he still was roaming the pasture looking for....something. Stuck at about 4-6 manure piles/day...half rations. Sometimes just standing with his head over the fence staring into the woods. Not responding to my touch, except sometimes to move away. When I spoke with Bonzai Bonnie the other day, we both concluded he was separating. (Thank you, Bonzai, for sharing my pain and tears. Your empathy was a huge relief to me.)
After much research on liver disease and herbs, on Tuesday I headed down to the horse store to check out supplements and see if I could find something with milk thistle. No dice, but I stopped in front of the electrolytes and suddenly had a vague memory of the vet saying his potassium was low. She had glossed over it very quickly while I was scrambling for pen and paper, didn't give me a value, but zeroed in on the liver results. I scribbled down the liver tests, but then she went on about wanting to test him for cushings and I forgot to go back and add the potassium. She ended by telling me to add salt to his food to get him to drink. I was faithfully adding mineral salt, but it wasn't making much or any difference.
Seeing the electrolytes brought back the memory, so I immediately replaced the mineral salt with the electrolytes. Voila -- 2 ounces and he was drinking normally. That was 3 days ago, and I'm giving him 3 ounces/day. Yesterday, for the first time in weeks, he responded to me by pressing his head against my belly, the way he used to when he was sick or hurt as a youngster. This morning, he passed 3 piles of manure in just 3 hours...a normal daytime rate. The manure is looking more normal too. This afternoon, I scritched his neck in his favorite spot and he bobbed his head up and down, shaking a mouthful of hay about. And tonight I got to see him with his coat well flattened -- he's less ribby than a week ago, with some body mass returning, and less hollow in the flanks.
His energy is still low and he stands around looking confused sometimes until I drop a fresh flake of hay in front of him. Then he immediately starts to eat, slow but steady. So there are half-eaten piles of hay all over the place...for some reason when he gets confused he seems to forget there is hay just 10 steps away.
I have ordered an equine metabolic/liver support herb mix for him, which should arrive shortly. One of the world's leading herbalists (Dr. James Duke) wrote that he has seen people even with cirrhosis improve on milk thistle. It can slow and sometimes even reverse fibrosis. I don't have a lot of hope that a 27 year old will get much, if any, liver regeneration. But it's possible that his liver isn't too far gone. Although everything I read said that by the time symptoms appear, the liver is 60-70% destroyed, it turns out his major symptom of dehydration colic was due to the low K, not diminished liver activity. So maybe he's in better shape than I was fearing a week ago.
In the meantime, I also have tried calling 2 different vets and gotten no return calls. Most vets around here will *not* take emergency calls for anyone who isn't a regular client. And due to the shortage, most equine vets are not taking on new clients. So I'm going back to the "lead" role in his treatment, pushing the vet to give me a copy of his lab results. I'm annoyed that she told me to give him salt instead of electrolytes. I had low electrolytes in the desert once, for just 12 hours or so. It is *not* fun and I hate to think of him suffering like that for weeks. It's also scary because, at least in humans, RBCs have 20 times the K as plasma. By the time plasma shows a decrease, there is a very serious deficiency.
But he is bright-eyed now, and no longer grinding his teeth or biting at his knees (stress signs). He seems to have accepted his new role as herd follower instead of leader, dutifully followed Dahli out into the cold rain today (I had dressed him in his rain sheet just in case) and stood there waiting for hay to appear (which it did as soon as I spotted them).
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