Is this Deja Vu?

Hello old sports!

Another long break between blog posts, but since my retirement, I thought I was entitled to as much time off as I'd like. It's my right, isn't it? Not so it seems according to Spode.

What have I been up to? Eating, mostly. Sure, we go on walks and I have a strict grooming routine, but other than that I don't get up to a whole lot with my days. It's been glorious. And I thought I was pretty much settled like this for the rest of my life. But Spode likes to surprise me. Well done, I'm surprised!

To be fair, I've known something is up for a while. The vet has kept coming out for various things in the past month and I've seen Spode going carefully through all my things.

Tell me what's going on or I'll eat all your hair!

But I was very shocked when a horsebox pulled up yesterday and Spode informed me I was starting my journey back home to Canada. So shocked in fact that when she handed my lead rope over to Oli while she went to greet the shipper and discuss my paperwork, I saw my opportunity and ran. I know, I know. It was a bit mean of me ti take advantage of Oli like that. I just couldn't resist. And I'll admit, old sports, I did feel very cheeky when I saw the look of surprise on Spode's face to see me galloping away across the field, my lead rope flying in the wind.

I decided I would just let Spode make the long walk across the field and get me after that. And once she explained I was going home I just walked straight onto the horsebox as usual. Everyone laughed afterward, so job done and no hard feelings I guess.

It was pretty heartbreaking for both of us saying goodbye though. I'm not sure exactly when I'll see Spode again. September 29th at the earliest. I hope it's that day or very shortly after!

We both cried as we looked at each other getting further and further away once I started driving

Once loaded onto the small horsebox, I travelled to the coast and rested in a stable for the evening while I waited for the big trip to Europe to start. Very late at night, I was loaded onto this monster of a truck with 9 other horses.

Gatsby sized transport!

I was last up so I could have the most fresh air and to be the first dropped off. We were off to the ferry around midnight. I'm a tired boy now!

Lighted by the moon! I'm off! 

It was a clear and calm night so the ferry was easy peasy and I arrive at the Amstel Horse Hotel in the Netherlands early the next morning. 

Now, I remember this place! I stayed at this hotel after arriving at Amsterdam's airport when I arrived here from Canada. Deja Vu! 

Wait a second...

I know this place!

Everyone is being very nice to me here and they've been sending photos of me to Spode to put her at ease. I just hope I don't have to wait here too long for my quarantine as I want to get back home and rest now! 

This looks like a nice enough place to sleep. I also get to go outside into a paddock every day. 

And Spode asked them to put me on diet. But the joke's on her! I'll just eat all this straw! 

That's all for now, old sports.  Until Canada,

Jay. 

Answers

Hello, old sports.

Well, in my last post I explained that I was waiting for answers. I've had a very, very busy week and now have those answers.

Last week, Spode loaded me up and took me back to the hospital for my follow up appointment. I've picked up weight and am looking the very picture of health so we had high hopes that I would maybe get some good news after a plethora of bad. Just look-this was me in March.

Tucked up all the time 

And super big abdominal muscles from breathing effort. 

Now I'm looking much better. The spring grass is in, I'm not putting as much effort into breathing, and I'm just feeling a lot more like me. 

Look at me now, just last week. Much more relaxed abdominally!

With me looking much healthier, Spode was much less stressed about the trip to RVC. So off we all went together to see our favourite vet team. Spode tells me I'm their favourite too (maybe because we have provided them with so much money since September when this all started? Unsure...I do have a global fan club now so maybe they really do love me. I do have that effect.)

The trip went smoothly and Spode left me to have my x-ray, my ultrasound, and then the very scary lung biopsy. I was out of it so didn't really notice to be honest, while Spode practically chewed her own arm off with anxiety while waiting for the vet to call and say I was okay. Apparently it was risky and Spode had to sign my life away. I know, old sports! The audacity! Nobody asked me to sign anything!? What's happened to a horse's rights?

Ouch. And two staples as well!

Anyway, it all went smoothly, they let me rest for several hours, and then Spode took me to a new home. WHAT!? I had no idea I would be leaving my home when I left it. Not very happy with the secrets. Sheesh. But Spode tells me that this is my retirement home so that I don't need to come inside at night anymore. It's more like my home in Canada so I'm quite happy. More than happy, I'm loving the freedom.

Blissfully peaceful. 

I've pretty much settled in at my new home with pony pals Theo and Oli, and I'm enjoying retired living. 

It involves a lot of relaxing

Yep, a lot of sleeping too. 

Zzzzzzzzz

A lot of hanging out and chilling with the crew

Don't judge. It's a hard life being this lazy.

Spode has been loving it as much as me. She saw me three times today after discovering that she can practically walk from her house to get to me on a public path. I predict a very Spode-filled summer once she's done teaching for the year. 

She's just as lazy as me when on term break!

Alas, amidst this happiness we did get my biopsy results back which showed that I do have fibrosis and more evidence of soon to be scars and haemorrhage from the scars I have already. The good news is that it's mild at the moment. The bad news is that it's degenerative, diffuse, and confirms the fears and suspicions the vets had about me having equine multinodular pulmonary fibrosis. We're out of options now as I had already been treated for it when we were just assuming it's what I probably had. We just have to wait and hope that this disease doesn't progress quickly. Unfortunately it's quite unpredictable, but the vet said to take hope in the fact that I've been stable for a couple of months now, perhaps due to the complete lack of exercise. We're all hoping it's slow and that I have many years left to enjoy my retirement. I look so much better than I did before, so it seems I'm in a good patch at the moment at least. I still breathe too quickly, but it doesn't take quite as much effort at the moment. Maybe the weather change is helping. 

It's upsetting news of course, old sports, and I think we both took it hard as Spode had her hopes up since I look visibly healthier (even though my ability to exercise is still poor). I think we both imagined that it might just be possible that I wouldn't actually have fibrosis or that maybe I had even recovered a bit from the inflammation. Now that we've properly digested the news and the diagnosis has been confirmed, Spode is just focused on enjoying every day and living life like a horse: in the present. I'm not worried about the future. I worry about two things: food, and where Spode is (since she has my food).

So there's your answer, old sports. I have fibrosis and my life span is in question now, but I will keep eating the greenest grass I can find and keep making Spode laugh with the time I have with her. Although I no longer have the hope of not having fibrosis anymore, I have the hope of outlasting the statistics beyond the 2-5 year expectancy. I still have time to be the miracle horse again. It's 5 years since my eye surgery, and just look at the extra life that gave me. And it's been a year and a half since my inflammatory bowel disease, and now I'm over weight! I make things happen. They don't call me the GREAT Gatsby for nothing. I've been put on this earth to surprise vets, I'm convinced! Let's do it again, old sports!

Until later,

Jay.

Waiting for answers

Hello old sports,

I thought I would give you all a little update. I know, right? Two posts in one month!? Gasp, it's just like the old days before Spode started working in the non-horse world! Spode tells me that people have been wondering how I am, so I figure I owe ya one.

I've been on my course of steroids for about a month now, but they haven't helped me one bit. My respiration rate is still too high and my breathing effort is too evident at the end of the day. Still can't go for a ride with Spode as I start snorting and am unable to hold a trot. I can manage a bit of running in the field sometimes, but not for very long. So I'm coming off of them now and will be finished them in about a week.

I still look pretty damn good, if I do say so myself. 

Originally, we were going to try a second steroid in March, but the vets consulted and don't see the point since the steroid I'm on now made absolutely no difference to me. Instead, the plan of action now is to continue resting (sorry, Spode, still no riding) and return to the hospital in April for a recheck of my lungs. The vet said she is feeling highly doubtful that I can ever return to being ridden now since I didn't respond to the steroids, but the only way to know for certain what is going on in my lungs is to have that chest x-ray again and see what changes are there. Best case scenario would be no changes as it would mean my disease is slow progressing or maybe even stable now. I daren't hope for clear x-rays. The vet didn't think that was in the realm of possibilities, especially as my symptoms haven't changed except to get ever so slightly worse... but I am miraculous in some ways so maybe I will still surprise everyone!

But if there are negative changes, as upsetting as that would be, then it should at least give us a better understanding of what my prognosis and life expectancy will be. If the vets can't see any changes, then they want to do that lung biopsy to see precisely what is going on with my cells and what amount of scarring I have already and if there are any more medications we could possibly try depending on what they find. This biopsy would also definitively tell us whether I can hope to return to work one day or not... if the x-rays don't already provide that answer clearly. If the x-rays have negative changes then the vet said all there is to do is keep me comfortable for as long as we can. The vet suggested that, no matter what they see or don't see, Spode shouldn't get her hopes up that I will be a riding horse again since this has progressed negatively over almost 7 months now despite trying 4 different medications. Still not quite sure how to process that, so let's just wait for April's news, shall we? 

So things are still up in the air, really. Still waiting for clearer answers on what exactly this disease will mean for the rest of my life. Thankfully my favourite regular vet is finally back from his injury as well so maybe he will have some additional ideas when I go to the hospital again.

Spode just finished her half term holiday so we've had a nice vacation together and I've been groomed like crazy. Not that it has left me clean because I go and roll in the mud every day without fail. Hey, I'm just being nice. What else is Spode going to do if she has no mud to clean off of me?! It's been lovely and warm, and the grass is getting a little bit tastier every day. Spring is definitely in the air, and I am content eating my food and enjoying Spode's company. Life is okay, just a little anxiety-provoking at the same time. I let Spode worry about that when she's at home, but we can ignore all the vet notes and research when we're together. We still successfully live in the moment and just enjoy each other's company. That's what really matters anyway, isn't it?

I really, really like my food!

Until later, old sports. I shall update you all in April.

Jay.

A scary diagnosis, but it won't stop me

Hello old sports,

In my last post, I explained to you that I had been waiting and waiting to update my blog until I found out what was wrong with me. And after almost 6 months, I was still waiting.

Well, in some ways the wait is over. In others, I now have even bigger questions than before. So, let me explain.

Spode was on orders to increase my exercise to see if that helped or worsened my breathing issues. Spode tried this for a few weeks, but in the end it was just not working out. I was miserable and started trying to stop her from taking me in the lunge pen. I had no change in how much I was snorting, and worst of all I just couldn't get the energy to do what she asked. Nothing could get me to trot some times, and it was starting to break both our hearts making me do it, so Spode called the vets again and sent me to the horse hospital. For the third time, might I add! I wonder just how many vets I've seen in my 5 and a half years with Spode in two countries (4 if you count my layover--I did see vets in Amsterdam and France, too!)? Too many for this horse to count.

At the hospital, I was trotted around and the vets agreed with my lack of energy, relatively "minor" respiratory issue, and exercise intolerance, but weren't concerned it was anything too serious. In fact, they were more concerned with my hind legs being stiff, but that was just from the trailer ride I think. Normally I feel fine.

After these observations, off I went for another ultrasound, another endoscopy (ugh, seriously the worst!) and chest x-rays. It was all very intense but worth it in the end. My repeated ultrasound showed increased roughening of my lung walls but still nothing too drastic, though admittedly it's a bit tricky due to my size. The x-ray, on the other hand, revealed a major problem. I was diagnosed with interstitial pneumonia. To put it in basic horse terms for you, the fluid filled space around my lungs that takes oxygen out of the air inhaled and puts it into my blood is all swollen, all over my lungs. The vets couldn't tell if this was permanent scarring or not, as the lungs are not regenerative and so are easily permanently damaged.  Based on the fact that my breathing has been a problem for almost 6 months, it's not looking good in that regard. So finally, I understand what has happened. I have been breathing faster and struggling to exercise because I'm not getting as much oxygen into my blood stream. No wonder I've been feeling breathless when I run.

During the endoscopy, they took cells out of my lungs to test them for viruses, bacteria, and general inflammation. They've done this before already, but it was not as detailed due to the tube not reaching down all the way to my lungs last time (another big horse problem). So last time, we only saw inflammation and assumed it was asthma.

This deeper test revealed an even worse problem than interstitial pneumonia. It showed chronic inflammation based on my cell counts (already knew that), some evidence of blood in my lungs, and unfortunately I also tested positive for EHV-5, meaning I was infected with it sometime ago. Now, most horses are exposed to EHV-5 in their lives. There's no vaccine for this strain, and it's so common that for most horses it poses no problem whatsoever. In fact, until recently they thought it was not related to any issues at all. Nearly every horse in the world has been exposed to it. But some horses, and I am one of the unlucky ones it seems (possibly due to my already compromised immune system caused by my first major issue: leptospirosis/uveitis), respond negatively to it. Therefore I was given a new diagnosis: suspected Equine Multinodular Pulmonary Fibrosis (EMPF). They cannot say with 100% certainty that this is what I have right now, but EHV-5 is almost only found in lung fluid of affected horses, and the fact that I have interstitial pneumonia means it's even more likely. They have never had a case of EMPF that didn't test positive for EHV-5. So it's extremely likely that this is what I have. A lung biopsy would guarantee it, but Spode doesn't want me to do that as it's invasive and risky, especially for a horse my size. Even if it's not EMPF and just regular interstitial pneumonia, it's not looking good regardless.

Now, Spode has explained all this to me, so basically it means that I will have lung scarring caused by the pneumonia--once it's progressed further, it should eventually be seen by x-ray as it shows up as blobs of scar tissue, which first starts with lung wall roughening (which I already have). EMPF is only a very recently discovered disease and is quite rare. Unfortunately, there are only a handful of cases of horses surviving this disease, so the prognosis is poor. It's been a shock to me, and to everyone Spode has told, really. Mostly because I look great: I'm shiny, good weight, and happy to wander round and have a huge appetite as always. Aside from breathing faster and having a heave line at night and the snorting when exercising, I look totally normal. Everyone is hoping this means I have a better chance of survival. Most horses (and people with this disease) have a life expectancy of 2-5 years. How I respond to treatment will give the vets a better idea of my prognosis. I have definitely worsened since August, but not as fast as many horses who get this disease, so my hooves are crossed for a good chance of long term survival in my case. There is no cure for the disease, but a few lucky horses respond well to steroids to at least stop the progression.

So that's where I'm at. Spode and I are wrapping our heads round it and taking it all in. I've been on steroids for a week and half with no luck so far. It's the same steroid I tried back in November which didn't help, but we're hoping a longer course might do the trick. So I'm staying on this steroid for a few more weeks to see if it does anything to my respiration rate. After that I will try a month of another steroid (the same one I was on for my temporary blindness. What a life I've had).

If nothing works, then I will just go into a very early retirement. I won't be able to be ridden because it could damage my lungs more if I'm pushed further than I feel up to. I need to decide when I want to run and when I want to rest, and it's a bit hard to tell that to Spode during a ride. Retirement was certainly not what I expected to be saying at only 7 years old, but life is strange, isn't it? I think Spode will miss the riding, but as long as I'm happy and pain-free, she's happy to retire me for as long as possible. We'll see how the next 2 months go. Maybe I'll be a miracle horse. I already have, according to Spode. She doesn't mean the fact I came back from temporary blindness not once, but twice. Nor the fact that I was given a guarded prognosis last year when diagnosed with inflammatory bowel disease, which I bounced back from easily. No, it's how I've helped her in countless ways. 

A massive appetite is surely a great sign, right? 

I have a heave line after being outside and moving around all day, but I also have a big belly and no weight loss=positive!

I'll let everyone know how I do with these steroid plans. Now that we've both got to terms with the news, Spode is determined to carry on as normal. After the initial shock, she's decided to keep her chin up and stay positive. Like I said, I look great and my personality is the same as always. So we're going to enjoy every moment at the stable, and to remain positive due to the fact that I am not losing weight like many horses with severe EMPF. Maybe I will be the miracle horse once again, with these positive signs of health. They don't call me The Great Gatsby for nothing, old sports. I really am great!

Until later, old sports.


Jay.

Just what the doctor ordered, you say? Please, no!

Hello old sports! Yep, still a disgraceful excuse for a writer. My excuse this time? Well, in July I was as healthy as the proverbial horse. But that changed in August and I decided I would write an update when I had figured out what was wrong with me. And you know what? 5 months later and I'm still not sure what's wrong. But I suppose it is time for an update regardless.

First, I am still undeniably attractive. A stylish old sport if ever there was one.

Sporting my new travel halter courtesy of Christmas. One of my relatives/admirers got it for me. 

So, where to begin? Back in August, Spode first noticed trouble when I became quite tired and reluctant to work. I really didn't want to do much and then I started to get sore abdominal muscles. I quickly started losing weight as well, and even I thought my inflammatory bowel disease disaster had flared up again after all the work to get my weight back to normal.

But after some deductions and panicked calls to the vet, Spode figured out I had sand in my intestines (please, don't ask how Spode tested for this. She disgusts me sometimes. Horse people are so gross). It was a nice quick fix with psyllium husks added to my diet and I quickly started to perk up after I got rid of the sand issue.

Back to normal? Alas, it didn't last!

Shortly after this sand issue had been resolved and Spode was trying to bring my fitness levels back up after a few weeks of lethargy, my breathing issues became apparent. I started snorting loads and had a heave line on my belly from breathing and snorting hard. Cue more panicked phone calls to the vet. 

Out came the vet and there were no lung sounds to be heard. He watched me in the round pen, but did I snort much then? No, only a few times so Spode looked like a fool. I'm good at that. Our friend Albert the vet still believed there was a problem though, so after more monitoring and ideas, he decided I should come to the hospital for a series of tests. Spode booked the horse trailer and was all ready to go when our vet called to say he had broken his leg! All things cancelled, but Spode had another vet come out to do an endoscopy.

Have you ever had an endoscopy? Let me tell you, old sports, it was not fun. I don't recommend it. 0/5 stars.

The vets came out, still no lung sounds (hmmm?) sedated me (woohoo, love me some sedation!) and shoved a tube down my nose. Um, no thank you. So, so unpleasant. And to top it all off, my nose started to bleed. I admit, I did this to myself with the struggle, but I got them all back by snorting blood specks over the vet student's pressed white shirt. And that will be the last time HE wears a white shirt to a farm call! Valuable life lessons courtesy moi. 

They uncovered a heck of a lot of mucus on my trachea yet could not find a reason for this. They took a sample and that was that.

Then the waiting game. Those results took ages!

My blood tests came back first and revealed nothing too out of whack, and then the trach wash showed very high levels of inflammatory cells. Finally, the swab results came back showing... now hang on, I'll need to get the spelling right here... streptococcus equi subspecies zooepidemicus. What a mouth full! This is a relative to the scary sounding strangles disease. Not good news. Mrs vet tested to see what antibiotics it was sensitive to and then I went on a course of them. Not tasty. 

Because of the amount of snot I had in my throat, I also went on a course of sputulosin, which was supposed to reduce it. But alas, it did not help. And neither did the antibiotics. We did another test and found that I was still infected, and went on antibiotics again. Still no help. 

Next step, ventipulmin to open up my airways. No help. Next, steroids. These helped to reduce my rapid breathing rate a bit, but were no help with my snorting problem and my breathing rate was not consistently lower.  In other words, despite the tests and drugs, I am still a medical mystery.

What can I say? I've ALWAYS been a very special horse when it comes to my health. And everything for that matter.  

Now, Spode had been bothered by the fact that back when I went to the hospital for my inflammatory bowel disease, they discovered a small problem with my right lung. I had no difficulty breathing back then, so we didn't follow it up due to being much more concerned with my weight loss. Spode wondered if perhaps the non-working parts of the lung they saw (I had patches of lung that weren't filling with air) had gotten bigger. So Spode and the vet decided the next best step would be to do an ultrasound of my lungs. The good news was that my right lung seems to be fully aerated again. The bad news? WHAT THE HELL IS WRONG WITH ME!? I did have a few small issues with my right lung called comet tails, but the vet wasn't too worried about these. Yes, they can be a sign of lung issue and it does mean the lung is not functioning perfectly, but these can sometimes be found even on horses with no problems breathing. Apparently it could be an aging process or "scarring" from the original lung issue I had. Either way, it should not be causing the symptoms of rapid breathing, lethargy, and excessive snorting if not accompanied with fluid in the lungs or other issues. And I still have no unusual lung sounds so the chances of me having fluid is slim.

Sorry, everyone. I'm not an easy case. 

More videos and note taking. Throughout all of this, Spode has changed my feed, changed how I eat my hay, changed my bedding three times, tried riding in the morning, the evening, without eating hay, without eating grass, hacking only... nothing has made a difference so far. I'm still snorting loads, and the more I work, the more I snort. I rarely snort up snot, but always have a runny nose when I exercise. 

After consulting with other vets, they have decided that our best strategy is now to try to get fit. Their best guess is that the infection I had triggered a breathing issue that is now being exacerbated by my lack of fitness. The worse I get, the less Spode has been riding me, and so the worse I get. That's the theory. So what has the doctor ordered? A fitness regime.

I am not impressed, old sports. Not. Impressed. 

Spode is on orders to trot me on the lunge for 6 minutes at the trot every day this week, increasing to 10 mins next week, 15 the week after, and so on. If after this six week program, which will hopefully lead to riding again in 4 weeks time, I am still difficult to exercise and still snorting and breathing rapidly, then I will go to the hospital for a deeper scope to the base of my lungs (ugh, not another nose tube!) and an x ray of my lungs. A CT scan of my head is on their minds as well in case it's head shaking syndrome, but that seems less likely. I might go to the hospital sooner if Spode's anxiety about my health gets the better of her and I show zero signs of improvement, but we'll see how things go.

Can I stop now? Oh good!

I have only done 2 sessions of this exercise regime so far, and let me tell you, it is not fun. I need a lot of pushing and coaxing to get myself up to speed. I hope it will get easier. And I hope this resolves things! I'll try and update again more regularly with my progress. Hooves crossed for good results and a positive update! Because I really, really don't want another camera and tube up my nose please. 

Until later, old sports.

Jay.