Jacques Update: The Bad, The Ugly, and The Hopeful

[Lady_MCSE]

While I did post about this fairly recently in the Vent section, I figured it’s time to start off a fresh thread with a little more detail, and more of a focus on Jacques’ health.

The summary is that Jacques has a tumor on his leg, and it is Squamous Cell Carcinoma. He was given a prognosis of probably less than a year to live, given the fact that it is located so close to the joint and tendon sheath. Surgery is a possible option, but not one I am willing to consider. Tomorrow he will start a chemotherapy treatment which is experimental, but does give me some hope that he may stick around a bit longer than if nothing were done at all.

Now, those of you who know me, know that I’m not one to skimp on details … here’s a bit more of the story.

Jacques is a teen-aged Clydesdale whom I have had for four years. He’s my first horse, and the HT community has been instrumental in helping me thru so many big decisions and those nagging worries that new owners have. You know the ones – if three apples seem to be OK, do you think four could cause colic???

When I first got the beast, he was very headshy, quick to “spook,” hated men, and water was his greatest enemy. Not if it fell from the sky, but water in a bucket, out of a hose, or out of a spray bottle all elicited the same response from him that medieval torture devices might in humans. In fact, I saw him drag a man 30 feet across a round pen and then attempt to leap the 6-foot round pen panel just to try to get away from the spray bottle in his hand. He was thus dubbed “The Clydemonster.”

But he was a fast learner. His big reactions to scary things grew smaller and smaller with time and trust. At the time it never seemed fast enough, but looking back on it, it feels like it was all too fast. By the end of our first year together, I was starting to call him “The Clydepuppy.”

In these four years I have learned so much from him that I feel almost like he has been my practice horse. There may have been days that I wished I had purchased a gentler, been there, done that, quiet trail horse, so these past four years could have been filled with trail rides instead of hours spent trying to “figure out” problems. But if I had done that, then I wouldn’t know even a quarter of what I know now.

Riding. He has bucked me off. I’ve taken him to trainers. I worked with riding instructors. I finally learned that the saddle I had been using was too small, in spite of many people more experienced than I telling me it fit fine.

Lameness. He was lame on and off for over three years. I knew before purchasing him that he had ringbone, and I would be taking the risk that he would have some good days and some bad days, but that as long as I stuck to trail and kept him off of tight turns and jumping, he might have some good years left for trail riding. After two years on I was told that he was so lame I should never ride him again without injections and supplements. (more on this in the next two paragraphs)

Missing Frog. The first question I asked my farrier when I got him was about the lack of a frog on one foot. His response was that had been eaten away by thrush and would never grow back. It took me two years before I found that this wasn’t true, and was able to grow back a healthy by application of an anti-fungal and ant-bacterial cream. This greatly reduced his bouts of lameness.

Foot Care. I started trimming his feet myself two years ago. All along I turned to HT for advice on my trims, and one year ago was fortunate enough to have an HTer finally point out to me that his right front was longer than his left! A photographic history shows that this had been the case all the way back to when I first purchased him. I consulted with a farrier who advised me to make no changes because this was probably natural. For once, I did not listen, and I evened the feet up. Now he has been sound for 8 months with no supplements or injections.

(more to come ....)

[Lady_MCSE]

In the span of three years he had seen several vets, several trainers, and several farriers, none of whom caught the very simple problem of one foot being too long. Oh, there are so many stories, so many things Jacques has taught me. I could go on and on with more of his history. But instead let us both teach those reading this entry that it is not always wise to listen to those who claim to have more experience and knowledge.

In July of 2008, I wanted to teach Jacques how to stand tied at a trailer. I was prepared with time, a chair, and a good book. I tied him up using my long lead rope, giving him about a body-length of line so that he could munch on grass. I hadn’t sat down yet when the barn owner came out to chat, and we got to talking. He encouraged me to come up to the barn office to look at something on the computer, and as I was very hesitant and trying to decline, he kept telling me, “Don’t worry about Jacques, he’ll be fine.”

So against my judgment, I listened to him and left Jacques tied and grazing. When I came back out 20 minutes later, I found Jacques standing on three legs, with the rope pulled around behind his ankle, causing his back leg to get hiked all the way up to hip level. He was white-eyed and frothing at the mouth. He had pulled everything so tight I couldn’t get the knots undone. Fearing for my own safety, I didn’t even come up to his head, fearing he would fall over at any minute. So I talked him into a bit more calm, and asked him to move toward me, which he managed to do, and freed his back leg in the process. I was amazed at his flexibility and that he got out of the situation relatively unscathed.

On closer inspection, he now had rope burns on both of his back ankles. So I only saw the one, incident, but he must have previously had the same problem with the other.

He continued to stay at that barn for the next several months. I learned more hard lessons there, both having to do with general horse care and having to do with bad business decisions. The barn stayed under the same ownership but changed management a couple of times, and promises were frequently made but not kept. In short, the rope burn on his left leg healed fine. The rope burn on his right leg never quite healed.

I had a veterinarian look at the rope burns within a day or two after the incident. I had that same vet out several months later when the right leg was not healing. Both times he reassured me that this was no big deal, that I was making too much of it. Just keep slobbering some Novalsan on it, keep it clean, and it will heal.

In April, I was so disgusted with management at the barn that I moved him to a barn much closer to home. I began treating the rope burn on his right leg with everything I could. In the past six months I have kept it as clean as possible (while still allowing turnout) by scrubbing it three times a week, and trying various different creams, sprays, and treatments.

I had a vet look at the wound in May, and he said I had taken good care of it, so I should now leave it alone. I did leave it alone for six more weeks. Not even washing it. It got significantly worse. So I called another vet who looked at it in July. He suggested that it was proud flesh grown out of control, and that the best thing to do would be to sedate him and remove the proud flesh. But this was fly season, so not a good time to try a surgery like that. He also made it sound as if I was making a mountain out of a molehill, being too concerned with cosmetic appearances. (To be clear, I don’t care a whit about apperances, but a horse shouldn’t be bleeding from an open wound for months on end!)

In September, I called that same vet back a couple of times, leaving voice messages asking to schedule this surgery he had suggested. No one ever returned my calls.

In October, I was frustrated as could be, and took Jacques up to the University of Wisconsin in Madison where they have a highly regarded veterinary school. I was immediately thrilled with the staff who seemed very competent, and very concerned to get this wound “fixed” once and for all.

[Lady_MCSE]

Here’s the ugly bugger:



They theorized that there was probably something in the wound that was causing the festering, and once removed, the wound would be able to heal. So they started with an ultrasound that came up clean. Followed up with X rays which came up clean. I thought this was great news! They then took a biopsy of the site, suggesting that it had probably turned Sarcoid. http://www.liv.ac.uk/sarcoids/facts.htm

On Tuesday, October 13, I got the devastating phone call. The biospy revealed that this wound has turned into a cancerous tumor of type Squamous Cell Carcinoma. The doctor made it very clear that it was prolonged agitation of the original wound that led to this condition. Had the wound been healed properly at the time it happened, it would not have turned cancerous.

We talked about treatment options which included a general anaesthetic surgery to remove all the affected tissue. General anaesthetic is never without risks, but draft horses are notorious for poor reactions. If the surgery were successful, he would be in a cast for several weeks. Drafts are notorious for not doing well in casts, given the massive weight borne on the remaining legs. Assuming surgery were successful and the cast went without complications, he would still be permanently lame. He would most certainly have a recurrence of the cancer.

My decision is that surgery is not an option to be considered at all.

So at that point, I was told he would probably have less than a year. I could expect it to progress to lameness in that foot as the cancer grows into the tendon sheath and joint. I could expect circulation problems in that foot. I could expect the rest of him to start feeling achy and unwell as he continued to hobble around on three legs. Squamous Cell is a slow-growing cancer but we don’t know how long it’s been around already. It would most certainly metastacize (spread) to the lymph nodes, and crop up with tumors in the penis and eyes.

I basically thought from that first phone call that we were pretty much done for, completely over. I hit the internet and tried reading up on Squamous Cell Carcinoma in humans and horses. There’s precious little out there about the horses … just so you know.

I sent a very long email to the vet who attended him in the clinic. I basically ran thru all the things we talked about on the phone, wanting to make sure I understood it all correctly. Unfortunately I did.

On Friday, October 16, I was very surprised to receive a voice message from that vet, who later followed up with several more phone calls that I continued to MISS (AAAGH!!!), and finally an email to explain what was going on. He had been in contact with the University of Liverpool in England, and wanted to make sure that my horse was even a candidate before he got my hopes up ….

A fellow at the University of Liverpool has developed a Chemotherapy cream which has been shown to be very successful on Sarcoids in horses. If you’ll recall, Jacques doesn’t have a sarcoid, he has Squamous Cell. But there have been some Squamous Cell cases which have been treated with the same approach, with some success.

So I was given instructions to take good pictures of the site, which I did. Jacques thanked me for all my hard work by stepping on my digital SLR camera. Honestly, it wasn’t even Clydemonster who did it. It was the gentle Clydepuppy, but I just wasn’t fast enough to get it out of the way. Thanks bud.

I sent the vets 9 good images, with another 26 lesser quality, just in case they wanted them. They were enough to convince the University of Liverpoool that this was worth a try. We begin treatment tomorrow, and he’ll stay at U of W Madison for a week. The cream is applied topically, and should be relatively painless for him. It will make the tumorous tissue turn black and rot off, if all goes well. It is entirely experimental, so I’m not supposed to get my hopes up. (But heck they were down pretty far, they don’t have much else to do but go UP!)

Assuming the treatment goes well, I’m being asked to send in pictures of the site every month from here on out. I am to expect it will grow back eventually, at which time the treatment could be re-applied. The pictures will help determine if\when that happens, as well as provide feedback to them on how well this treatment works.

This has been very hard for me, naturally. I’ve been doing lots of crying and hugging, and all the folks at Jacques’ current barn have been very supportive. It’s so especially hard because right now he’s not limping at all, and he’s fat, and sassy and the picture of health in the prime of his life.

Heck, I forgot to include the part about how the morning I got the biopsy results back, I had taken Jacques out for a walk and the Clydemonster emerged. He had been pent up in a stall for five days, so whatever he spooked at, he spooked BIG. He knocked me over and leaped up a three foot stone wall embankment to get away …. ran another 20 feet or so before a few good snorts and buried his nose in the grass. So the Clydemonster is certainly not gone completely!

And I had the pleasure of changing the sign on his stall from “No Treats” to “Treats Allowed!” He’s certainly been getting a lot of love and treats this last week and a half.

Wish us luck on our journey … I keep telling myself that I have a cat at home who was supposed to die three years ago. So nothing’s written in stone. Maybe if I’m really lucky we will both prove the experts wrong once again and will still have many happy trails ahead of us.

[jules1962]

I certainly hope this will fix the big guy. My thoughts and prayers will be with you.

[tallyho]

OH MY, OH MY, OH MY!!!!!!!!.....what trials you 2 have been through......he alsways sounded like such a sweety, and isn't he the one with a pic with hay on his head while eating out of the hay rack?

many thoughts and prayers for success with this treatment.....
and i would certainly document all this and send it to the vets who misdiagnosed him........may save someone else, and they could at least know the pain and heartache they caused

[singing tree]

What a story! Is he part of a study then? Is the treatment expensive?
Please keep us updated. I really enjoyed reading your treatise, and hope that he does prove everyone wrong!!

[merleliz]

Lady M...I am so very, very sorry this has happened to your poor boy...I am speechless. You have all the prayers and healing vibes and best wishes that I can send...and I'm going to remind you that miracles can and do occur, they surely do.

Every single remedy that we take for granted in this day and age was an "experimental" method at one time...Jacques may just be the case that proves the cure works!

[TheUpNorthCowgirl]

Awww dammit. I'm sorry to hear that Jaques has been diagnosed with this icky nasty thing. I sure hope his treatments go well. I'll be sending up all my good thoughts for him. Jaques is a good boy and a heck of a teacher, always remember that. Here's hoping for a great outcome! I know I'm rooting for him

[Lady_MCSE]

Jules - Thank you.

Tallyho - Yes, that's Jacques (with the hay). I will try to get some pics sort of organized and uploaded so folks can check them out if they want. Don't seem to have that one in Photobucket at the moment.

As for notifying the other vets, that's exactly what I plan to do. The lead vet at U of W tried to discourage that, saying I shouldn't be too harsh with them. And he sounded genuine about it, not out of obligation or professional courtesy. He said that his department tends to only see the "tough" cases, and they see something like this maybe once in every two or three years. It really is pretty rare. But I still plan to do something, if only in the spirit of education, because not once was cancer suggested to me, instead I was told I was making too much of the issue.

(I also plan to send copies of all the bills to the jerk of a barn owner who was responsible for him for the first few months of this ordeal ... not that I expect them to be paid, but it'll make me feel better that he sees them. Another lesson learned that when a barn owner keeps promising to provide a boarding contract but never does, there's probably good reason for it.)

Singing Tree - I'm not sure if this is considered part of a study or not. I'm told that the cream has been around for a long time and basically it's "for sale" provided certain conditions are met, and apparently it's a bit of a pain to get it into the states. Cost wise, it is far cheaper than surgery. But expense was not my primary reason for not considering surgery.

Merlilez - that's what I'm hoping for! They at least know I can take good pictures, which is what I think will be helpful in determining the outcome.

UpNorth - Thank you.

[scrapchick]

Aw, Lady M, I'm sorry about the prognosis, and hopeful the treatment will work. Jacques has no clue how lucky he is to have you. Keep us posted.

[dunamovin]

What a good thing you and "Clydepuppy" are doing. If someone doesn't take the first step we'll never have a cure. The results of your treatment efforts will save other horses from this nasty disease. Thank you

[Mav2007]

I was shocked when I read this. I thought when you got him to madison it would all get fixed and never did I think it would be something like this. I've followed stories about your horse since I've been on here. WOW.....speachless. I can't believe it. You must have been shocked too. I'm very sorry and I hope he surprises everyone and heals up 100% from this.

[Horselessnomore]

Lady M -- so sorry that you and Jacques are going through this right now. I am keeping my fingers crossed for successful treatment.
Sending ((((( HUGS ))))) your way for both yourself and the big guy!!

[qtrhorse1993]

i was also shocked to hear this....i am hoping the best for you and definitly would like updates...and i would contact the prior vets also...its a shame to let something like this get so far, and no one take the time to really look at it. they should at least be aware of the situation and hopefully keep it in mind should some one else have it happen.

[Gotta Love Duns]

Lady M, sending healing thoughts your way to be passed onto Jacques! What a trial to go through.

[dproaps]

Oh my Lady M, what a journey you have had with the Clyde monster/puppy! I wish you all the best and hope this is a big success.

[VickiE]

I'm really sorry to hear that Jacques and you are having to go through this. I hope the study comes through with great results.

[Brownie_GA]

Oh, how terribly frustrating! Poor Jaques! I am so sorry you are going through this ordeal, and I too pray that Jaques proves the "experts" wrong, and has a lot more life left in his big Clydesdale body.

This really hits home how valuable and hard to come by a knowledgeable (truly knowledgeable) equine vet is. They are worth their weight in gold, but so hard to find. There are way more incompetent ones out there than great ones. We are fairly lucky to have a good one here, but just one, and I'm so thankful that my fiance, who's a trainer, is more competent at treating early stages of coloc, infections, cuts (he even does a cleaner, prettier job of putting in stiches if needed!) and most of the varied things that horses get themselves into much more efficiently than the majority of vets in our neck of the woods.

I will continue to look for updates on Jaques, and will be thinking of him, hoping you get some encouraging news. You have been so good about trying to do everything right for him, but were let down by those who were supposed to know what they were doing, and I just hate that for you.

[Lady_MCSE]

Very brief update since yesterday took a lot longer than I thought and got to bed 2 hrs late ...

Got him up to Madison just fine. When I got there they had some really scary paperwork saying it's only experimental (I knew that), but also that he may still have "collateral damage," meaning damage to the surrounding tissues that will make him lame, just as the surgery would have done.

I signed it all eagerly, but by this morning, I'm really wondering if I've done the right thing. I've been concerned about his perception of the whole thing, and can't help but feel that being turned out to pasture and going lame slowly is a better alternative for his horsey mind than being taken to a hospital and made lame.

I dunno, I guess I suppose the lameness depends on whether it's lameness from actual pain or lameness from sort of having damaged but scarred over tendons and what have you. Perhaps I'll be able to tell that by how generally healthy he stays afterwards. If he goes off his feed and changes personality, I guess I'll know.

I'm babbling, too little sleep.

At least he's in good hands now. I hope to get him back on Friday or Saturday. Should be hearing more from the vet sometime today as well.

[HAPPYINLOXAHATCHEE]

Lady M
Sorry About Your Horse, Hope All Goes Well. The Treatment Sounds Like A Product You Can Get For People To Use. You Can Not Buy It Here Its Mail Order Only. I Have Personally Seen What It Does . The Cancer Cells Turn Black And Fall Off. Its Called Cansema You Can Look It Up On Your Computer.
Keep The Faith And Lets Pray It Goes Well