Beau – A Canker Case History

Nicola Battersby is a happily married mother of two and the proud accidental owner of a 16.2hh KWPN Gelding by Corland called Beau that she bought in March 2010.  Initially Nicola was looking for a horse to do some dressage on, but fell in love with the unbroken 4 year old grey gelding when she visited a yard in Manchester to see another horse.  Caution went by the wayside, the monies were paid and Beau duly arrived at the family home in North Wales.

In September her farrier suspected Beau had thrush and so advised Nicola to use a combination of Hydrogen peroxide and Teramycin.  Beau also had sheared heels which meant that he could be pre disposed to Thrush but Ian again said it was a case of stable management and not a problem.  On 25th Feb 2011 Nicola noticed a small white growth on the side of the frog. A ten month nightmare was about to begin which would involve three general anaesthetics, a priest, rosary beads, prayers, Holy Water, the internet and America.

Upon the advice of her farrier Beau was taken to the Veterinary Practise of Richard Owen and Associates on March 2nd and he underwent deep debridement under sedation, nerve block and biopsies.  Canker was diagnosed in both back feet on 7th March.    Canker generally proves to be fatal and Nicola now believes that it is far more common than perhaps previously believed.

1st March after surgery

That Tuesday 8th March Beau endured the first of three general anaesthetics while the assigned vet cut away as much of the tissue as she could to reveal healthy tissue.  Plates and bar shoes were put on a week later.  Alkaline cream was applied every day to try and dry the feet out.  At this point Nicola was told of the full severity of the case and not to be too hopeful.

At this juncture they were soaking the foot daily in Formaldehyde. A gruesome procedure for the most hardened.   Beau never complained, kicked out, fidgeted.  It was as if he knew he was being helped and placed his trust in the people around him.  A concrete paddock was created to keep the canker out in the air while Beau stood and endured the treatments.  To their horror the canker grew back within days.

Nicola then received unwelcome news from her Insurance Company on April 8th.  They were refusing to pay out, citing the sheared heels as the reason, despite the successful five stage vetting.  Costs were escalating beyond control and yet Nicola still persisted with the aid of her Vet who agreed to minimise the costs.  Beau’s tolerance, bravery and patience had captured the imagination of the yard and everyone who met him.  Beau was re-admitted to the Vets on 18th April, and was brought home the next day to keep expenses down.  The farrier then phoned to say that it was the worst case he had ever seen or even heard of, and advised Nicola to think long and hard about whether it was fair to continue.

Amazingly he was still sound despite the foot being completely sodden and putrid.

At her wits end, Nicola then received an astonishing phone call on the 7th May from the local Monastery.  A lady there called Anne had heard of Beau’s plight and was most insistent that she’d had a calling from God to come and see him.  Anne arrived bringing with her a powerful Holy relic, rosary beads,  Holy Water, a Blessed medal for his mane and the advice to recite the prayer ‘The Divine Mercy’ at 3pm every day.  “If God wants him, He will take him” were her words.  Nicola has been Christened and Confirmed but is not a practising Catholic and was a little bit reticent. And Beau is definitely not religious in any way apart from being one of God’s creatures..

The Canker grew back again within days and Nicola had an argument over the phone with the Vet who was insistent that she was being unfair on Beau, he would never be cured, and to call it a day.  Nicola refused and demanded that they operate again.  This time on 13th May, and with the support of her sister, she insisted on holding Beau’s foot herself while the procedure took place insisting “I am doing this for the horse, not me”.   Poor Beau leant dribbling against the wall, and kept turning his head to look back at her as the pool of blood spread around them, but still never reacted or tried to harm anyone.

That weekend the canker grew back.  Yet again.

Then on 17th May some prayers appeared to be answered.  The insurers had done a U-Turn having received letters from both the original vet and Derek Knottenbolt of Leahurst in defence of the case.  On 18th May Beau was taken to Leahurst to be assessed.

Nicola pleaded with them to try anything, something, any new treatment, but the severity of the physical evidence resulted in a negative but realistic response and the dreaded words “Normally they have to be put down”.  However Beau trotted up sound, and there was a change in attitude.  He was taken safely home.

Evenings were spent researching the condition on the Internet.  Maybe the persistent cutting away and the subsequent bleeding was allowing the bacteria to penetrate deeper, creating an inlet?  Nicola bought a cream from America that was created from ingredients found in the Amazonian Rain Forest and started to apply that.  Praying for some divine intervention.  The cream did not help.  At this point Richard Owen MRCVS took over sensing the desperation that was involved in such a highly emotional case.

On the 19th May the entire Battersby Family were called to be blessed at the Monastery  by Father Keith.   Beau’s boots were dipped in Holy Water, and by this time Nicola’s husband thought she was quite mad.  Still Nicola persisted. A month later his condition worsened and it was decided that he should enjoy a few final happy weeks in the field with the sun on his back.  Nicola promised him and herself that as soon as he became lame the fight would stop.  Until that time she visited him twice a day and every day at 3pm to continue with prayer of ‘The Divine Mercy’ have a cry, and share some time.  Beau knew the routine by now and would dip his head.

At the end of June the family were booked to go on holiday and decided to honour the arrangement, and have a break from all the angst and tears. The canker was still growing.  However on 16th June Father Keith called and insisted on coming out to see Beau himself, complete in Holy Habit with wellies.  He spent over an hour with Beau, blessing him, his field and running powerful oil into his leg.  Beau never flinched or reacted.

Before leaving on holiday on 25th June Nicola again went to see Beau and during their regular 3pm commune Beau snatched the rosary beads, crunched them, and stood with the crucifix hanging from his mouth.  On another day it could have been funny, or even symbolic, but on that day it was not.   Fortunately Anne from the Monastery subsequently  visited on 3rd July and it.

2nd July hoof collapsing

The holiday provided a brief respite with Nicola heeding Anne’s words “Leave him and have Faith”. Sadly during their time away the inside hoof wall had snapped and come away due to the pressure and Beau was lame and in pain.  Nicola had to honour her promise, she called Richard.  It was Monday 4th July.

Richard Owen wanted to come out immediately but due to the terms of the insurance he had to clarify the situation with them first and ensure that Beau was being destroyed for humane reasons and not for loss of use.  Richard argued that the level of pain required for humane destruction was inevitable and only a few days away, but the insurance company insisted on their terms and conditions, so Beau earned himself a brief reprieve.

For a horse that had fought so bravely and remained kind and gentle, the sense of loss was acute for all those around him.  Everyone came to say Goodbye to him in the field, and yet Nicola was still praying for something to intervene, despite even Richard finally admitting defeat.

That night Nicola discovered Stephen O’Grady on the internet, an equine podiatrist based in Virginia, USA with a 100% success rate of curing Canker and emailed him.  He emailed back immediately with instructions to follow in minute detail, insisting on communicating with Richard Owen.  The procedure involved cutting the foot to the bone, freezing it (cryotherapy) defrosting the foot, re-freezing it, defrosting it again, then applying crushed tablets of Metronidazole, covering with acetone soaked gauze to dry out the foot, then using foot putty to create a sole and maintain pressure on the frog.  This technique had never been used in the UK before.

3rd July 2011

(Have copied and pasted below the fine details from the podiatry website –

Treatment consists of thorough careful debridement of the affected tissue followed by a regimen of topical therapy applied daily and continued until the disease is resolved. To debride the affected tissue, the horse can be placed under general anaesthesia or regional anaesthesia can be used with the horse standing. The horse’s foot is trimmed appropriately removing all loose exfoliating sole as well as any excess toe or heel. The use of a tourniquet is essential. Firm pressure is placed across the vascular bundles over the abaxial surface of the sesamoids using either an Esmarch a bandage or simply a few tight turns of a cohesive bandage. Debridement can be performed in two ways. One author (JBM) uses electric cautery with the horse under general anaesthesia while the other author (SEO) uses a sharp hoof knife and a number 12 scalpel blade followed by cryotherapy with the horse standing. All abnormal tissue is removed down to normal corium. A clear demarcation will be seen between normal and abnormal tissue. It is important not to remove excessive corium as this will retard cornification following surgery and may decrease the quality and depth of new sole being produced. It may be helpful to remove 1-2cm of normal tissue around the wound margins to ensure all abnormal tissue is removed. 5 If the decision has been made to place the horse under general anaesthesia, use of a typical cautery handle in the cut mode allows accurate excision of hoof tissue including frog and normal horny sole. The handle used in this way will rapidly cut through sole and frog leaving only a dry eschar behind. The cautery tip may be bent as needed to undermine the base of the mass. Debridement can be carried out in the same manner using a sharp hoof knife and is followed by cryotherapy to freeze the area that has been debrided. Liquid nitrogen has always been used for this purpose but another practical method is to freeze the debrided area with a coolant spray b that is available for electrical circuits. The area of the foot that has been debrided will be soft and pliable. Freeze this affected area until the tissue becomes hard (known as hard freeze), allow the area to thaw and then repeat the freeze once more. Gauze 4 x 4 sponges soaked in a solution of 10% benzoyl peroxide in acetone c and sprinkled with a fine powder made by crushing metronidazole tablets with a mortar and pestle or a pill grinder are then packed in the defect. In large defects, to help insure contact of the medication in the depths of the wound and to minimize the production of exuberant granulation tissue, a putty elastomer material is used to form an insert to fit in the bottom of the foot (Fig 4).

The impression material should not extend below the bearing surface of the hoof wall as this will create excessive pressure and make the horse sore. The foot is then bandaged with a dry bandage. The affected area is cleaned daily with surgical scrub, rinsed with saline, dried with a paper towel and the topical medication reapplied. It is crucial to keep the animal in a dry environment. A shoe with a treatment plate can also be used but it is sometimes hard to keep the foot as dry as necessary with this method. The authors prefer the use of bandages. Small reoccurrences may be managed with the horse standing and local anesthesia using either laser photoablation or cryotherapy. The use of systemic antibiotics such as chloramphenicol or oxytetracycline have been advocated but these authors question the use as the cases treated have resolved with local treatment only.4 A commitment is necessary from the owners, as aftercare will take several weeks to months depending on the stage of the disease until the affected tissue is cornified (Fig 5).)

Beau’s procedure was scheduled for that Thursday, however an Emergency call out resulted in it being delayed until 3pm on Friday 8th July. The most sacred and powerful time and day in the Vatican.  The operation was four hours long, and The Prayer of Divine Mercy was recited throughout by his supporters.  Beau spent a further four weeks in the hospital recovering and being monitored.  The words “It will take a miracle” had been answered.  It was the most severe case of canker that had ever been seen.

Beau is now back in work and being hailed as a ‘Miracle Horse’.  Nicola has just clipped him and has never been so happy to do such a dirty job.

image

Nicola with Beau, December 2011

 

His owner Nicola has been so determined throughout the entire experience to help others, that had they not managed to save Beau she had already arranged to donate his body to Leahurst for research purposes. Beau and Nicola now wish to undertake some type of work for the ‘Make A Wish Foundation’ to help disadvantaged children and help re-pay the enormous debt that they feel they owe ‘out there’. Nicola still says her prayer with the Rosary Beads at 3pm each day. Just in case.

August 2011

18th Oct 2011

22nd Oct

image

Beau and Nicola, December 2011

image of hoof sole

December 2011

 

 

 

 

 

 

The owner Nicola has all the veterinary documentation and the photographs that diarise the entire episode. All the parties involves are more than happy to speak about the case in an effort to raise awareness and celebrate a successful outcome.

For more information please contact: Maria Wynne at Eqwynne@googlemail.com or 07717298182