The Long Slow Build To Euthanasia - Part 2

For each of the three horses I have euthanized I knew in the spring that I wasn't going to ask them to go through another winter. Winter is a significant challenge for horses with mobility, strength or balance issues here. We cannot control the environment for a horse as much as we can for a dog. What do you think about when deciding if another winter is a bad idea?

This is the second part of the slow build to the euthanasia decision posts.

I am pretty sure that Brat's fragile stifle has been causing him pain that has increased over the last couple of months, and explains last spring's discomfort as well. Unstable or slippery footing forces him to use his body to stabilize his feet, straining the fragile stifle. In addition to the stifle issue, Brat's left knee is getting worse. As he bends the knee when lifting his foot, he is starting to move it to the outside instead of just straight. It is more obvious at the trot, but shows increasing discomfort in the joint.

So what can I do to help?

Brat lives outside all the time. Maybe keeping him inside at night would give him enough relief from the unstable footing to keep the fragile stifle from overworking. Unfortunately his PSSM requires as much movement as possible, and his heaves would be significantly affected by being inside that much.

His paddock has very little mud, but even a little bit of slippery surface mud makes him uncomfortable. He's already on daily Previcox as a base, arthritic pain management. I did keep him in studded boots when it was icy, however everything slips in spring mud.

Last fall the Osphos for his arthritis was in full effect and he was doing well. I was careful about the footing where we rode. Brat was moved to a new paddock and loads of wood chips were put down to cover and stabilize the mud. The ground froze earlier than the year before. I don't really have a sense of how much the Osphos affected his stifle because of all the changing factors.

I do know Osphos made him overall more comfortable and have decided to repeat the treatment. It's not the best time to do it as far as determining the effect on his stifle. The drug takes a month to show effects, and during that month the ground will be drying out and putting less strain on his stifle so I won't be able to say for sure what is making him feel better. He also needs to come off Previcox for the week before and the week after Osphos - not ideal when he's already very uncomfortable.

But. The sooner it's done, the sooner he gets the relief from the Osphos. If, big if because I don't know, if he's not going to see another winter I want his last months to be as comfortable as possible. Osphos now will get us to September or October (5-6 months). By which time I should have a better idea of how it's affecting his stifle, and how his knee is doing, giving me more information to make the decision.

As it stands right now, if nothing changes I can't let him suffer through another winter. We've got some things to try, and a lot can happen in six months. The foundation for the decision is there with a clear understanding of what I'm going to be looking for over the summer. Letting Brat go will be the most difficult thing I've ever had to do, but his quality of life is the priority.

The Long Slow Build To Euthanasia - Part 1

I'm down to one horse now.  My third horse is the last of the four horses I have owned.  He's 27 this year, and the last couple of years have had some health challenges in addition to his long term issues of heaves, PSSM and PPID (aka Cushings).  These three are still well managed through a precarious balancing act of care, but it won't take much to bring the whole thing down. 

I started this blog years ago to provide some insight around making the decision to euthanize my horse, hoping that people who needed it would find some support as it wasn't something widely discussed at the time.  There is more discussion around quality of life these days.  There are also many more veterinary options for care, resulting in many more questions about how much we should do, and when should we say enough. It's not a decision made in a short period of time. Considering the factors, options, the individual horse, and our own situation occurs over a long period of time.  Barring some catastrophic emergency, the decision to euthanize builds slowly over weeks, or months, or sometimes years.

This is the first of several posts looking at that slow build.

Here I am again. It is spring, and I'm evaluating how my senior horse handled the winter. We have real winter here - snow, ice, and freezing temperatures for months. This creates problems for horses with mobility, strength, and balance issues. Brat has several mobility concerns.

On September 30, 2022 Brat injured his stifle. He spent the winter healing and was doing very well when we got over an inch of rain in one weekend late April 2023.  The rain turned the spring mud to sucking mud, and Brat tweaked his stifle again. Over the next year he went through periods of healing and setbacks, not helped by a series of abscesses that followed a bout of cellulitis. I couldn't tell if the lameness was caused by the stifle or an abscess.

In the summer of 2024, between abscesses, he was close to sound. I realized that he was less sound on days where the footing was a little slippery. After consulting with the vet, we decided that this was probably as good as the stifle was going to get, and some strengthening work would benefit.  Brat was feeling good as he happily went out for walking with a little bit of trot trail rides. It was during those rides that I noticed he was dragging his left front toe as he swung that foot forward. He was losing some range of motion in the left knee.

Xrays showed some very minor arthritis of the sort one would expect a 26 year old horse to have. The vet recommended Osphos as a whole body arthritis treatment as an alternative to just injecting the knee.  After doing some research I opted to try it.  Osphos takes a month to show effects, and it can be done every six months.  Brat got his Osphos injection in early August, and in September I felt he was more comfortable.  He did well through the fall, but in the new year I thought he was losing the benefit.

Five months out of something that can be done every six months, and takes a month to take effect seemed like a questionable benefit.  I talked to the vet about alternatives and ended up trialing an oral joint supplement for six weeks. I didn't see any benefits, and in the third week Brat walked away from me in the paddock twice. He usually comes unless the footing is bad or he's not feeling good, in which case he stands and waits for me to go to him.

Exercise is a critical part of the management for Brat's PSSM and heaves. He wasn't really interested in going for exercise walks, and I had to give a lot of encouragement to keep him moving at a reasonable pace. He was increasingly uncomfortable about picking up his hind feet, and standing in the barn - symptoms I had blamed on constant abscesses last spring. Now I begin to consider if perhaps it was, and is, the stifle.

Snow, ice and mud are not particularly stable footing. As last fall's rides showed, he is more uncomfortable when he must stabilize his feet with his body - specifically the fragile stifle.  I noticed increasing trouble in January, three months ago.  April is typically varying degrees of muddy, making a total of four months with a noticeable degree of pain. There will be mud, ice and snow again in the fall. The question looms large. Have we reached the end of the line?