Gravel

The following is a chapter from Dr J's first book, Maine Horse Doctor : On the Road with Dr J

Gravel is the unusual name for what is probably our most common cause of lameness. It would be rare for any equine vet not to be dealing with a case a week. A horse that is “graveled” might be three legged lame one day and completely sound the next. Many horses recover with no outside help. Even more remarkable is that usually, once a horse is over it, there are no after effects.

In order to understand this lameness and how to deal with it, we have to start with some basic knowledge of the horse’s foot. Pick up your horse’s foot and look at the bottom. The junction between the wall and the sole is called the white line. It’s just like the junction between the wall and the floor in a room. It’s not really a structure in itself; it’s just a place where the wall and the sole meet. In a healthy foot it’s a faint line which is lighter in color than the wall or the sole. Have your farrier point it out the next time he is trimming.

The culprit is usually a piece of gravel that penetrates at that wall/sole junction. The small stone gets wedged in the white line and allows bacteria to enter. An infection may follow. If it is unable to drain out the bottom of the foot, the horse is on his way to becoming “graveled.” Some people think the stone travels up the foot and causes the lameness. It doesn’t. What does travel up is the bacteria and the inflammation that they cause.

The abscess may just drain, or be drained, by your vet or farrier from the bottom of the foot. Often it works its way up the white line inside the hoof wall, following the path of least resistance. When the infection gets up to the sensitive areas of the foot, near the coronary band, the horse will become very lame, sometimes to the point of refusing to put the foot down. The lameness may not appear for days or even weeks after the original penetration. A graveled horse looks and acts like a horse with a broken leg. It hurts. The foot is often warm and there is almost always a very strong digital pulse at the back of the pastern and low ankle. Pressure with hoof testers may cause more pain. If there is some doubt as to the diagnosis, X-rays may have to be taken, and sometimes (but not always) show exactly where the abscess is.

If your farrier or vet cannot get a graveled foot to drain from the bottom, then there are two other ways that the issue is usually resolved. As the infection reaches the top of the wall at the coronary band, it may break open. The skin splits, and smelly watery pus will drain out. Relief comes quickly. To encourage this, soak the foot in a strong solution of Epsom salts. Place the foot in a corded black rubber feed tub and then slowly add water. Once you see that the horse will accept that, add the Epsom salts until you see a little bit undissolved on the bottom of the tub. There is nothing as soluble as Epsom salts, and the more concentrated the solution is, the more drawing power it has. Poultices can also help. Even with these aids, some graveled feet do not open up at the top, and then the third possibility will happen. In these stubborn cases the abscess will slowly be absorbed, and the horse gradually becomes less lame.

Even though gravel is an infection, we usually advise not giving antibiotics. No matter how high the dosage, it is hard to get a therapeutic level. Abscesses tend to get walled off with fibrous tissue, and the medicine is unable to penetrate them. If possible it’s best to avoid using anti- inflammatory medicines such as Bute or Banamine which may make the animal more comfortable. These drugs do decrease the pain, but they also tend to slow down the possible release of the infection from the bottom of the foot or at the coronary band. Although rare, there are cases where the infection becomes very entrenched and severe, and these horses often have to be hospitalized and more specialized procedures done to alleviate the problem. Graveled horses should be current on their tetanus vaccination.

If you have a lame horse for no apparent reason, always check the digital pulse of the foot. A strong pulse as compared to the normal foot is often the best indication that your horse may have gravel. It seems to be a more consistent finding than heat in the foot. If you don’t know how to find and assess the pulse, have your vet show you the next time he or she is in the barn. It is a skill that is easy to learn and one that every horse owner should master. I always ask owners who call about an acutely lame horse if there is a stronger pulse in that foot. If there is, the chances are good that the animal has that strange foot infection we call gravel.

Acceptance

The following is a chapter from Dr J's book Goodbye Old Friend: The Euthanasia of Your Horse available on Amazon now.

Horse sense is that thing a horse has which keeps it from betting on people.

~WC Fields

This chapter is about the difference you can make to the animals left behind when one of their own has been euthanized.

Occasionally I would hear from clients about what happened after I left following a euthanasia. They would say that another horse in the barn called for his friend for hours, days, and sometimes weeks. I was told of survivors pacing fence lines for hours and looking for their companion. Perhaps you have seen videos from Africa of elephants exhibiting grieving behavior when one of their group dies. Individuals in both species form strong bonds with relatives and friends. Perhaps you have had personal experience with a dog grieving for his missing friend.

This is the story of what happened one day 20 years ago, and the lesson it taught me about how horses can more easily accept the death of one of their own.

Christina had two horses, a Quarter Horse mare named Penny that she liked to trail ride, and a retired Standardbred gelding named Steadfast, who we all called Steady. Steady was a racetrack rescue at 14, the mandatory retirement age. Christina took Steady in as a companion for Penny. Penny thought Steady was pretty special and was always anxious when they were separated. Once Steady arrived, Christina didn’t ride her mare as much as she used to, because it became a battle. Tack Penny up, lead her out of the barn, and she would constantly look back and call to Steady. On the ride she danced in circles rather than go where pointed. Penny would holler for Steady throughout the ride. On the way home it was all Christina could do to keep her from galloping back to the barn and Steady. Penny had extreme separation anxiety.

Steady had been on the farm with Penny for 15 years. Nearly 30, he was experiencing some arthritis in his hind end and was having trouble getting up and down. He had also become a very hard keeper. No matter what he was fed, he was getting thinner. We were both concerned that he wouldn’t make it through the winter.

I pulled into the driveway for Steady’s final appointment at 9 AM. Christina was in the barn, grooming and talking softly to the old gelding. We visited for a while, and then Christina said quietly, “Well, guess we better get to it.” She snapped a lead onto his halter and led him out of the barn. We turned the corner and were just out of sight when Penny started screaming. Christina said, “You know, she’s making this even harder than it already is. Oh, Penny, I’m going to miss him too.”

We walked along the fence line with Steady slowly walking alongside. He paused every once in a while to grab some grass. All the way to his burial site we could hear Penny calling out and the sound of her hooves pawing the stall floor. She was frantic. The euthanasia went smoothly. Steady died as he had lived, with quiet dignity.

As we stood over Steady’s body, Christina, through her tears, said, “What will I do with Penny? I’m going to miss the old boy, but she’s just going to be crazy.” Then she paused and said, “Hey, what do you think about me bringing her down here to say goodbye. Maybe that will help her accept the fact that he is gone.”

Back then that was a novel idea to me, but Penny was acting especially frantic because this time Steady had left her. Before this she had always been the one leaving him behind. So I said, “Sure, let’s give it a try.” I thought this might be interesting, so I sat on the stone wall and stayed with Steady’s body while Christina went to fetch Penny. Pretty soon they came down from the barn, with Penny calling and dancing a jig around Christina every few steps. When they got about 30 feet away, Penny spotted her friend lying on the ground. She stopped screaming and just stared at his still body. Then she walked about half the distance to him, stretched her neck out and up, and rolled up her upper lip. This is the pose that online photos and greeting cards label as “a horse laugh”. The posture is called “flehmen”. Flehmen is a German word that I have heard pronounced most often as flamin’. Wild horses, deer, and antelope also do it. I have read that some dogs do it as well. By holding the head stretched out and curling back the upper lip, scent molecules are trapped in the nose. Here they are picked up by the vomeronasal organ which is located on the floor of the nasal cavity. Nerves from the organ carry the message to the brain. Studs exhibit flehmen after smelling a mare’s urine to check for molecules of pheromones to see if the mare might be receptive. Some horses will show flehmen when they are colicky. Others after a paste wormer or a treat like a peppermint. I often see it after a horse has gotten an intranasal vaccination. Flehmen is a horse trying to make some sense of the smells he takes in.

Penny froze when she saw Steady’s body. I think the flehmen response was her trying to get more information about why her friend was lying so still. She advanced slowly, moving her legs stiffly, acting nervous.

“Unsnap her lead, Christina.”

She did, and we all moved back to the stone wall to watch.

Now free, Penny moved around the body, sniffing here and there and went into the flehmen pose at least twice more. She nibbled at the chestnut on Steady’s hind legs. No response. She bit his neck with that little pinchy bite that horses do to each other. Finally with a wide open mouth she grabbed the front fetlock that was on top, pulled it up 2 feet and then dropped it. She did that several times. She moved to the back leg and did the same thing. Then she began pawing at the body. During this five minute attempt to rouse Steady, she would occasionally snort. Christina and I watched, spellbound.

Then, just like that, Penny lost interest, put her head down and ate some grass. Christina gave her a few more minutes, snapped her lead back onto her halter, and they walked together up to the barn. Penny turned back twice on the way, and nickered, but no more dancing and no more screaming. Steady was buried where he lay, in their pasture. Over the next few weeks Penny spent some time every day standing over his grave.

In the years since this incident I always ask owners to take the time to bring every equine on the place to visit the body of the horse that has been put down. There are no two reactions exactly the same. Some horses will sniff the body once, and move on. Others, like Penny, show a variety of behaviors and may try to rouse their friend. Her behavior was the most dramatic I’ve seen, but in all cases, sooner, or later, there is acceptance.

Acceptance is definitely a longer process when a friend is just taken away and never seen again. I believe that euthanizing horses that are ready to go is a gift to them. Another gift, to the one left, is taking them to say goodbye.

We who choose to surround ourselves with lives even more temporary than our own, live within a fragile circle, easily and often breached. Yet we would still live no other way.

~Irving Townsend

The Why

The following is from Dr J's book Goodbye Old Friend:The Euthanasia of Your Horse

Too many, the words love, hope, and dreams are synonymous with horses.

-Author unknown

Why do we have to do it anyway? In dogs and cats we use the term

“putting them to sleep”. In our domestic large animals, from goats to horses, we

call it “putting them down”. As sophisticated as veterinary medicine has

become, can’t we keep them going longer? The fact is, with all the medicine and

techniques we have, there will always be conditions that we just can’t deal with.

The fading horse like Old Red, the draft horse with a fractured hip, the pony

so badly foundered it can’t get up, the colicky horse too far gone to make it to a

surgical facility. The list is long. The only option in such cases is humane

destruction. The correct term is euthanasia. This is a word from two Greek

roots which translates as “easy death”. It doesn’t mean easy decision or easy

solution. It does mean immediate relief from incurable suffering or a lingering

decline.

When I am called to put a horse down, I often hear the comment,

“This must be the hardest part of your job.” Actually, it’s not. I won’t put horses

down just for the convenience of the owner. It is always because, in my

judgment, the horse needs to be released, and I feel that this is the last kind thing

that can be done for an animal in trouble.

Don’t worry about your ability to make a decision when it’s time. I can

assure you that almost always, when the time does come, the decision makes

itself. The actual laying away of an animal is often the only solution to a problem

that has become unbearable. It is not a decision to dread ahead of time. Part of

being a caring animal owner is the willingness to accept responsibility for an end

of life decision. My loyal veterinary technician and good friend, Erin Austin, has a

question to ask when in doubt. “Am I keeping this animal alive for their sake, or

my own?”

Grief is so painfully real, regardless of its origin. The love of and attachment to

our animal friend can equal that of human relationships. Likewise, the loss of an

animal can be just as devastating.

-Rev. Joel L Morgan