Liam's Final Chapter

Today, I had my sweet, bright, alert and enthusiastic 2 year old euthanized.

The cute snoot

OSU diagnosed Liam with wobblers. They rated him a 4/5 on the neurological scale, which also made him ineligible for the ultra expensive basket surgery that attempts to correct wobblers. Surgery will generally downgrade horses by one grade, two grades if they're lucky. Surgery is therefore only done on horses who are grade 1 or 2, SOMETIMES 3. At 4, Liam was a non-surgical candidate. Grade 1 is sometimes rideable, grade 2 is sometimes pasture sound.

After a baseline neuro test that showed he struggled to control his hind end and triggered some struggle with his front, we moved on to neck radiographs.

From https://veteriankey.com/the-neck-and-back/

The radiographs painted a very bleak picture. Liam's neck was still growing since the growth plates are still open in the vertebrae (and at 2, they should be). The C1 to C3 looked good, with normal joint spaces and what appears to be plenty of room for the spinal column to pass through. The joint space between C4/C5 was a little cloudy and ill-defined, indicating some arthritis. The joint space between C5/C6 and C6/C7 were both very cloudy and barely defined, indicating severe arthritis.

Normal growth plate, MSD, SD, and the unlabeled green ovals are joint spaces.

The C4/C5 space is a little cloudy. C5/C6 is pretty cloudy, and the C6/C7 has a very occluded edges.
Not pictured, C7/T1. Rood and Riddle also suspected severe arthritis in that joint as it was just as occluded as C6/C7.

A secondary problem in the C7 vertebrae was a narrowing of the spinal column space (minimal sagittal diameter-MSD below) in relation to the sagittal diameter (SD below). The C7 should be the widest channel of all the cervical vertebrae. The ratio of MSD:SD should be 50% for C2-C6, and closer to 60% for C7. Not only does his C7 narrow, it was the lowest percentage of the 6 at 51%.

From https://dspace.library.uu.nl/bitstream/handle/1874/289531/Scriptie.pdf

The neck presented solid enough evidence, that when combined with his in hand neuro tests, the vets were confident that his spinal cord was being compressed somewhere in the neck, most likely near the base, but it cannot be determined from only x-rays. X-rays only paint a single cross section of the horse, meaning, while it appears the C7 spinal cord channel has gotten shorter in height, it could also be wider than the other vertebrae, which would not cause compression. Sadly, x-rays cannot be shot from above. I could opt to take him to Rood and Riddle, who would do a CT scan of majority of his neck. It would go up to the shoulders, which are simply too big to fit in the machine, so we may not even see the C7 in the scan. The other option was a myelogram.

Myelograms are highly invasive procedures where the horse is put under general anesthesia and a spinal tap is done at the cranium. Special dye is injected into the spinal column and the horse's neck is extended and flexed, and x-rays are taken as it progresses down the spinal column to see where the dye stops (which indicates compression). It is a relatively traumatic procedure for the spinal column and can result in seizures and a temporary increase in neurological issues after the horse wakes up.

Here is a great link to the myelogram procedure.

The day I officially signed papers and paid for him 

Reasons to do a myelogram: confirm exact locations of compression for surgery, confirm compression for insurance purposes, confirm for a personal need to know.

None of those reasons apply to Liam. He's not a surgical candidate even if we could find it. I didn't get insurance set up on him yet so they have no say (I'm sure that would be audited and questioned, oh geez... 2 months in and a major claim on a fairly clear PPE? FRAUD). Finally, I personally do not need to know more beyond 'in the neck somewhere'. My need to know does not out weigh the suffering he would go through waking up. The vets warned me he would probably be grade 5/5 coming out of a myelogram and would probably need a sling to stand up and stay standing.

Beefcake! His shoulders really grew at the end of May- his topline was much more level in June than in this pic from April.

The vets did put out another offer: they can do the myelogram and just not wake him up... euthanize him on the table so to speak.

I didn't think the cost of doing a myelogram justified my need to know. I spoke with event trainer, who whole heartedly agreed we don't need to know.

Liam wasn't sure he needed to know about this ball.

So instead, Liam spent several more days at OSU with several gallon size bags of horse cookies (no lie, I left 4 gallon bags of treats and 2lb of carrots), and a note that said "Please feed me LOTS of treats. I also enjoy neck scratches."  I had to go home and work several days, but then I went back Wednesday to spend time with him, and today followed the shipper back to event trainer's farm. The vets gave him a bunch of anti-inflammatories to help him be more stable for the trip home, and he arrived without a scratch. The vet met us there, and he was humanely euthanized this afternoon, happy in the sun and eating grass.

Handsome boy

Sometimes you can try "stunting" the growth of a young horse with mild wobblers and pristine neck rads, and try to get them to grow out of it. The advanced level of his neck arthritis made this option a non-option.

Sometimes high doses of vitamin e also alleviate the inflammation in the spinal column. Natural Vitamin E (d-alpha, not dl-alpha) crosses the blood/brain barrier quite easily making it an excellent anti-inflammatory for the spinal cord. Therapeutic doses for this are 10,000 IU a day. We were already doing that.

The vet said we could reasonably give him anti-inflammatories for the next 3 weeks and keep him on stall rest to see if he got better and by how much. This didn't have a good feel for me, he could hurt himself at any time. This option just prolonged the inevitable with possibility of disaster.

He took his napping VERY seriously. He would lay flat out for an hour at least once a day.
He scared his vet tech the day before he came home- he was down flat out in the stall and twitching all over. I told his vet upon his arrival that he does do this daily, and it's perfectly normal for him to be down for more than an hour.The tech called her thinking Liam was having a seizure. Better safe than sorry!

We don't know why he suddenly went downhill very fast. None of his genetic line have reported cases of wobblers in the foals. His dam was carefully matched to a stallion. He was carefully fed by a wonderful woman with 40+ years of growing baby horses experience. He was turned out as a baby and yearling. All of the right boxes were checked. He also checked off the big ticket at risk checklist: big, fast growing, male, baby warmblood. What made the arthritis happen? Who knows. OSU ruled out injury since the issue is in more than one joint space. He has been brewing this for a while, it didn't just happen in the last two months. I do not think anyone knew about it, I want that clear. I do not think I was misled or lied to. The prevailing thought is he was brewing the arthritis and he might have slipped in the field playing with his new friends and tweaked it in a chain reaction. He also grew again at the end of May, where his chest widened a little so he wasn't so base narrow and he got taller. All of the above? None of the above? Wobblers is poorly understood and unfortunately is put in the "shit happens" category.

I do not think his PPE failed either. We had no reason to suspect neck issues and it doesn't make sense to do a PPE that costs 40% of the cost of the horse.

So itchy! He was always up for a grooming session with lots of currying.
Link to YouTube

I am going to try to rejoice and treasure the time I got to spend with him. Working on his confidence in the world around him, standing and leading skills, and marveling at his think first personality that lead to an incredibly brave, curious, and sensible baby horse with an old soul. I'll remember the head hugs he gave me when I cried into his neck the weekend he spent at OSU waiting to come home. How he groomed my leg with his nose when I scratched just the right spot on his neck. How quickly he came to trust me when I would tell him "step" from the halt when he was scared, and he'd pick up a front leg and put it on a mat or different color pavement or whatever was frightening him at the time. He was the horse I wanted, for sure. I was thrilled to make him a long term partner to do all the things with. I even considered a return to low level eventing because he was so sensible and had a great sense of self-preservation. I am heartbroken that it ended like this.

I taught him to step confidently onto a mat to prep him to be confident stepping into a trailer.

I feel like I failed him, even though I know we did everything that was reasonable. Putting him down was so difficult when he was bright, alert, hungry, and interested in life. He was perfectly aware he couldn't do things and was happy to walk slowly and didn't get riled up about being left behind. His mind was still perfectly intact while his body failed. In reality, I know he was dangerous. He could have wiped out at any time, injuring himself, another horse, or a person. He could have spooked and fallen and broken his neck or suffered some other traumatic event requiring an emergency vet to rush out to euthanize him... and he'd have to wait for that vet in pain. All of that logic still doesn't make it any better to have to euthanize a 2 year old who is still mentally vibrant.

Oh curiosity! He finally got over his fear of water, decided this puddle was fun, decided to roll in it, and then changed his mind half way down and kneeled for a while.

I had finally picked a registered name for him and sent it in with his DNA sample: Legato. "In music performance and notation, legato indicates that musical notes are played or sung smoothly and connected." It was a hope for connection and flow in the future. Maybe I should have kept it as Lawless, since he broke all the foaling rules and all the growing rules it seems.

At this point, I am not very upset at the further loss of my dreams. Those have been dead for a while. I have not been hungry in a while. I'm more upset at the loss of a budding relationship that should have had years to bloom and grow. But I am most upset about the life Liam never got to live. At least in his brief time here, he only knew grass and love, and never unkindness.

Legato "Liam"
April 30, 2017 - June 27, 2019