Possibly one of the most unsettling things a horse owner can experience is lifting their horse's hoof and noticing something which does not belong there.
That was the story on Christmas Eve for Ken Murray, when he picked up one of the hooves belonging to American Cream Draft Horse mare Claire and discovered the head of a nail.
“It was one of those things, she was fine one day and the very next day she was limping,” he said. “I checked her and thought, 'Oh this isn't good.' It could not be in a worse place.”
Murray and his wife, Anne, removed the nail. Murray said that when he didn't see a huge amount of blood or fluid come out, he knew the nail had pierced a structure, and that the puncture had self-sealed, keeping the infection deep inside the foot.
“We knew it was somewhere between bad and terrible,” he said.
The couple has operated Workhorse Ranch and Olde Tyme Carriage Company in Boyd, Texas since the 1990s, so draft horses are at the heart of their lives. Ken Murray had previous experience as a mounted patrol officer, while Anne grew up riding and bred spotted drafts and mules. Now, they provide horse drawn carriages for weddings, funerals, quinceañeras and other events, and also bring drafts to various educational and historical preservation events in the area.
Claire is owned by MerEquus Equine Rescue and Sanctuary, a Maine-based organization dedicated to the survival of the American Cream breed and ended up at Workhorse Ranch as a foster horse. American Creams have been a particular source of fascination for the Murrays. According to MerEquus founder Kerrie Beckett, there are less than 400 registered American Creams living in the world today. The breed is the only draft breed to originate in North America, and is characterized by a smaller height than most other drafts, along with a trademark cream or gold coat and amber eyes.
It's never good news when a horse steps on a nail, no matter where the nail enters the hoof. When the Murrays brought Claire to Dr. Alyssa Doering at Cutting Edge Equine Hospital, they had their worst fears confirmed. Doering said that usually, veterinarians don't advise owners to remove objects from feet on their own because it can make it difficult for the vet to later figure out where the object may have damaged the foot. In Claire's case though, Doering thinks the Murrays did the right thing, and she had no difficulty figuring out that the nail had gone straight into the navicular bursa – the one place you really, really don't want it to go. Doering said the mare's prognosis at that stage was bleak.
“These cases just don't do well,” said Doering. “I gave her less than a 20 percent chance of living initially just because the infection was so bad in the navicular bursa.
“We know that synovial structures don't respond well to sepsis in general, but the navicular bursa is especially bad because it's a difficult area to access to adequately flush it.”
The Murrays conferred with Beckett, and the three agreed – they had to try to bring the mare back from the brink of euthanasia. There was their sentimental attachment to her, of course, but there was also the breed to consider. Claire was carrying an American Cream Draft foal, so there were two members of a very small population at risk.
The reason objects piercing into hoof structures can be so dangerous is that they often carry bacteria with them. In Claire's case, an infection had already begun around the puncture in the navicular bursa, and Doering had to worry about whether bacteria could travel through Claire's body to other structures, which would almost certainly negate her slim chances of survival. The infection was likely to take some time to resolve even if it could be contained, and 1,700-pound Claire was non-weightbearing in the foot where the nail had been, so Doering was also concerned about supporting limb laminitis. This can occur when one limb is injured and the horse must put significant extra weight on the opposite limb, which can gradually disrupt the blood flow in the soft laminae that attach the hoof wall to the foot, resulting in tissue death and extreme pain.
Doering had other concerns specific to Claire's breed, too.
“Anesthesia in draft horses is always difficult,” she said. “They just don't recover as well as smaller breed horses and they have a published higher risk of complications such as myopathy, neuropathy, and weakness getting up. We had every factor working against us.”
Doering decided the greatest risk to Claire was the possibility of sepsis, and determined her first priority had to be the infection. Each day for nearly two weeks, she flushed the navicular bursa with Claire under anesthesia and gave local and systemic antibiotics while working with orthopedic farrier Brad Bridges to provide support to the uninjured foot. She also used Pro-Stride, an autologous conditioned plasma with PRP and IRAP on the first day, which was designed to reduce scar tissue that could cause permanent damage in the bursa.
“I was able to use radiographic [imaging] to place the needles, and that worked surprisingly well,” she said. “I was not excited to try it, but it worked.
“When I had her under anesthesia the first day, I actually drilled out the needle tract to encourage drainage. I don't love drilling into the sole, because the soft tissues can prolapse through that hole, but I knew if I didn't get the mare comfortable we were risking support limb laminitis and we were going to lose the mare.
“Every time we were flushing her, I tried to avoid going into the tendon sheath because we don't want even one bacteria going into the tendon sheath itself, which is why we did it x-ray guided to avoid contaminating other structures.”
When Doering became concerned that subsequent rounds of anesthesia may be too much, she was able to sling the impacted foot and do a local nerve block to flush it with Claire sedated but awake.
It was a long road. Claire was in the hospital for weeks, and then required round-the-clock care when she returned home.
Three months later, the nail hole through her foot has completely closed, the infection is gone, and Claire is sound at the walk. She's a little stiff at the trot and Doering is still keeping an eye on both feet to make sure they remain supported in the coming months, but her future is once again bright.
“It was hard for us to stay optimistic but we knew we had to try,” said Doering. “Any equine surgeon can tell you a case like this sucks. We don't ever want to see something like this come in. The cards were stacked against us from the beginning. Because the owners were on board financially and emotionally, I was able to do my job and do everything I thought was necessary to give her the best chance. You get emotionally involved in these cases.
“This job can be so hard, and I don't think anything we do as equine surgeons is easy but when you have a success with one like this, that's what gets you up in the middle of the night for the next one, that's what keeps you coming back to your job – that feeling of knowing even when it's a very difficult case, you can still make a difference.”
To the delight of all the humans involved in the case, Claire delivered a healthy filly in late March in an easy foaling at home.
The filly is sired by a registered American Cream, so the Murrays expect she will be accepted by the registry too, provided that she develops in accordance with the breed standard. It may seem unconventional for a rescued mare to continue a career as a broodmare, but MerEquus is dedicated to preserving and growing the American Cream breed, so getting another foal on the ground is core to the group's mission.
For Beckett, another American Cream in the world is cause for celebration as someone who's had a long-running love affair with the breed.
“They're very affectionate,” said Beckett. “They're in your pocket, they want to please, they want to learn. They're very individual. I've had Thoroughbreds, Quarter Horses, Belgians and these horses are just so unique. They are so gentle and sweet.
“I started with one, and now I have 15.”
Ken Murray was especially thrilled the foal was a filly.
“When you're talking about a rare, endangered breed, you don't grow the breed with stallions, you grow it with fillies and mares,” he said. “That's why it became so important for us to do everything we could for this mare.”
Perhaps surprisingly, Murray said that far from going sour from her intensive treatment, Claire seems to have benefitted from the extra handling.
“Before, she wasn't a kind mare,” he called. “She was fine, but she wasn't a real people horse. She wasn't real loving or anything like that. Her ground manners were ok, but she wasn't friendly. Through this whole process, she has become the sweetest horse you can imagine. Towards the last several weeks of her treatment I could go out in the pasture and not even put a halter on. It was a complete transformation in this horse's personality. By the grace of god she said, 'These people are taking care of me.'”
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