Day four: My horse is a druggie ...

And so day four came around. After a week of no treatment the ears started to look pretty crusty and I was itching to get them thoroughly cleaned out. Unfortunately we still had the issue of getting him sedated enough to come close. I had the vet come out to figure out what his preferred cocktail would be. He got a load of something IV (I believe the same I had used as a gel) and the idea was that in about 1-5 min he would be dosed into oblivion ... 10 min later Mr. B is still eating his scraps of hay and he hasn't even slowed down his chewing. The vet is really surprised at Beamer's tolerance and comes to the conclusion that he is gone immune to this drug. I have to admit I felt slightly vindicated that it was not my amateur administration of the drug but his bio system that caused the lack of sedation.

So out come the big guns and he gets loaded up once more this time on some more heavy duty stuff. Within a few minutes Beamer is wobbling on all four legs and I'm afraid he'll buckle and drop down. Although that would make treating him soooo much easier !!! I still expect him to wake up when starting to touch his ears.

I did not need to fear he might snap out of this medical confinement. We open the stall door and he nearly falls through the opening as he was tucked in the corner. He is down and out, 0-1 for the vet. With Beamers nose safely tucked under said vet's arm I start 'poking' his ears, put the cream in and  he's fighting a bit. This is where it helps having a big strong man to hold on. But he's giving up the fight soon and slips deeper into dreamland. By now he's not even trying to struggle anymore and I get to work on the crusts and gunk after clipping a bit more hair off. These drugs are great as I'm now pulling on thick chunks that I thought were crusted ridges of cartilage but come lose and are scabs about a 1/4 inch thick. Lots of pink skin underneath and I can finally get the cream to where it has to go as I dab on an other layer. I think there has been some normal skin that has gotten damaged by the inexact administration of the cream on the previous attempts and it's making it look worse. I hope this will get better as I from now on I can get to the correct spots.

We let him be as it's all done now. During all this Beamer has started getting really hot and is steaming. I take his blanket off and put the cooler on. I'm glad I just gave him his body clip while waiting for the vet or he would be sweating even more. Within 30 min he is starting to roam around and look for the rest of the hay scraps. I put his blanket back on and give him his grain.

I think we have a plan that works now and I'm glad we can make this whole ordeal less stressful or dangerous for all involved.

Here are the after treatment pictures, not too sharp but there was a lot of bright sunlight coming in. I'll try new ones on Wednesday night after treatment five ...

Right ear:

 Left ear:

Day three: The good, the bad and the ugly ....

Looking back at the first three treatments, the first one was the best... The second one was BAD, I thought. It wasn't until the third, today, that I realized it was ... just bad.
After the last treatment I was not going to bother with 2/3 of a tube of Dermosedan gel and I gave him the whole thing like on the first day. Waited for an hour.

So the GOOD thing is that the Imiquimod cream seems to be working. His ear is definitely in a high state of an inflammatory response with yellow crusty plaques slouching off at parts and showing red oozing skin (think 3rd degree burn wounds without the black). But if I had not been warned by having seen pictures of treated horse ears, I might have called it quits there as it ain't pretty.
The BAD thing is that the sedation is not working as it was and I'm afraid his system is getting tolerant to it. That is where things got to the UGLY part ......

Getting him from the paddock I was happy to see that he came trotting over to me, giving me hope that the terror of my last visit was forgotten. After the ride and subsequent sedation wait period, I soothed and smooched and could get him to cuddle with me with his head at my waist. However coming close to his ears immediately sent his head up into the hay loft. I managed to trick him twice and got his left ear somewhat treated. Time for a different tactic I decided. I got out the towel and wrapped it over his eyes. This way he would not see my hand coming and I could aim for the right spot to put the cream. I figured if he'd swing his head blindfolded into the wall it would also be somewhat padded and hoped he would have his eyes closed under the towel. Turns out he knows exactly where the walls in his stall are as he managed to lift and swing me into them several times. Now I had a blindfolded not-so-sedated horse turning circles in his stall with his owner being flung from his head. All of a sudden I know why my arm muscles have been so sore this week ..... Some bruises and numb fingers later and it's done. 
Clearly something will need to change. I'm serious about considering these options:

• Double dosing on the sedation
• To lay him down
• Twitching him
• Get the vet out each time and anesthetize him
• Any other ideas ??? 

Some are risky, some are costly and some may be plain stupid. I will have to check with the vet on how to proceed. Either way Beamer is free of torture until his next treatment in a week.

Just to show the 'progress'

 Left ear:

 Right ear:

Day two: next treatment

Treatment day two after two days off.
I gave him 2/3 of the tube of sedation. After an hour he was dozing a little but when I started treating it was clear he's was not having any of it. With some trickery and quick action got his good (left) ear treated.

Decided to give him the rest of the tube before attempting his bad (right) ear. After an other ~ 15 min I gave it a try. No not this time. He flung me trough the stall a few times. No problem moving his full ~1100 lb, so much for sedation ....

I treated and pleaded but it wasn't until I got help and sugar cubes that with more trickery and pleading (and more flying) I got a glob in his right ear. I can only hope it will spread a little in the tissue as there is no way I can cover all surfaces this way.

Pffff..... Done for this day and they say the third treatment of each week will be the worst ... I might try to blind fold him for that one so he won't see my hand coming ...

To be continued ....

Day one: First treatment

All pieces available ?

• Gloves ... Check
• Sedative gel ... Check
• Imiquimod cream ... Check
• Willing horse ... Hmmm .....

After a great ride, blue gel under the tongue and waiting ... and waiting. Beamer is getting impatient and does not understand why I stuck that goo under his tongue and why he's still on the cross ties after 30 min. I on the other hand figured the gel was not working as he is shaking his head and pawing the floor so I start treating his better (left) ear. Cream on thumb and swipe and done. Hey, that's easy. Lets do the other one.
Well, there is some junk removal necessary so we're getting into a little fight as Mister B is clearly NOT sedated. Finally got that one halfheartedly done too and there goes the head and the eye lids and almost the rest of his body, down. He's standing crooked and is leaning into the cross ties BIG time ...
I guess I should have had a little more patience as he is clearly out now. Good time to clear out the right ear a little more. Pull of some gunk and snuggle with him to give him that mommy-loves-you kinda treatment. I truly hope it's that later part he will remember.
So now starts the waiting until the lights go on again. When the audience suggests he is not so doped anymore I try to get him back in his stall. The turn goes a little unbalanced and walking is not so coordinated but we make it. There he rests his head against the wall and takes an other snooze. Oh boy, maybe next time I should use half a tube ...
We're now a good 90 min after the sedation set in and it's feeding time. He is not responding to the sounds of feeding which is a sign to me he's not fully arrived yet. An other 30 min and he starts to look for pieces of hay on the ground still not moving his legs. 15 min after that he will eat some hay out of my hand and will clumsily follow me trough the stall. Okay we're back in town and I feel it's safe to give him his hay. He's eating slowly but chewing well. At that point I'm not too worried of choke anymore and give him his grain and call it a day.

Lessons learned,
One, do listen to the recommendations of the vet when it come to sedating animals (yes, I was told to maybe start with half a tube or 2/3 ....)
Two, Be patient. When the manufacturer says it takes 40+ min to kick in, guess what, they are right ...

I sincerely hope Beamer will forgive his amateur nurse ....

Day minus one: Pre-treatment prep.

And so we begin.
Off to the barn to ride and afterwards start the task.
Cleaning out his ears is the first step. Clippers ready, horsie tired from the work, should be easy not ?
Not so, he is so afraid I'll hurt his ears he won't let me come close with the clippers fearful that I might poke him. Now why I would ever do that is a mystery .... aside from the few times over the years I tried to flick out the white raised gunk :-(  ... oohps ...
Okay so we have to build some trust. After a few attempts where he shakes his head and into the points of the clippers, we get to a fragile understanding: If you don't move, I won't poke you with the clippers. Really not that different from me hosing your head and avoiding filling your ears, that works as long as you don't move ...

Thankfully Beamer is a smart boy and we get his ears cleaned out. Now only need to take some base line pictures and he is ready for tomorrows real job.
Hm, after all the 'good boy's' and 'braaaaaf' and scratches he thinks he's done and deserves a treat. Standing still or holding the head steady becomes a problem and holding ears in one position for me to take a shot is even more of a challenge. After about 20 shots I give up and hope I have some good baseline views.
Judge for your self :-)

Left ear:

Right ear:

And the where-is-my-cookie view:

 So far he's been good and I can even touch his left ear on the inside. Hopefully we won't need the sedation to much ....

The start ...

Aural Plaques
Also called aural papilloma, aural plaque is a condition affecting the inside of a horse’s ear. A white, plaque-like material, it sometimes appears thick and crusty. In most cases, there is tender pink skin underneath the plaque. It is a rather painful condition. Causes:

• Infection
  
  • Wart-causing virus (papillomavirus)
    
• Fly bites
  

 
Beamer has had these Aural plaques for a while. During winter time it gets painful and makes him ear shy. I heard that as a foal he had a lot of warts on his muzzle as well as him not having the best nursing start with his dam.
Wanting to get rid of this 'affliction' I did some research and found this study done at University of Minnesota (http://www.cvm.umn.edu/cic/completedstudies/lamedsurg/aldarardvm/home.html) and I want to give it a shot.

Please stay posted on the treatment !!!