The plan for App has been in place since March, when we made the extraordinary effort to get him through until spring. If he couldn't be comfortable when spring arrived, I would put him down. We made it through winter and into spring. And while he is still gimpy, he was moving pretty decently. He then started to lose weight after the spring grass turned into mature summer grass, but changing up his weight supplements AGAIN seemed to do the trick. He is within 100lbs of a good weight and is in excellent spirits.
He is maintained on Buteless pellets, 30k units of MSM, and Equioxx daily with 10g of acetaminophen as needed. He also gets a bi-monthly injection of Pentosan and a monthly injection of Polyglycan. He ends up with a dose every week or two of acetaminophen, overall things are fairly good. He gets a shot of Banamine on top of that for his farrier appointments. The guy is drugged up, for sure. He also gets a massage once a month, bc why not. It does help him loosen up. $$$$
When he got his massage 2 weeks ago, all seemed well. The therapist didn't notice anything odd, and I didn't see anything amiss that night. The next day, I got a text from the barn manager that he was really uncomfortable in his hind end and the barn was giving him his acetaminophen. On Saturday am, I got another that he was really walking weird and was still really uncomfortable. They dosed him again with acetaminophen and I made my way to the barn. When I got there, he was walking really weird in his hind end and being unsteady.
I called the vet out and App was diagnosed with a probable pelvic fracture. A bone scan would confirm, but really there is no point in considering testing since I can't even trailer him. A rectal exam confirmed it at least isn't a clear break, and it is likely a stress fracture from getting up and down so much. He gets up and down If it was a clear break, I would have put him down because then he would be at even more risk for Really Bad Things.
The solution for a pelvic fracture is 100% stall rest, including the inability to lay down. Basically have the horse live in cross ties for 3-6 months and hope it doesn't drive their mind insane. Which is the absolute opposite solution when including his shoulder injury since he can't stand for 12 hours, let alone 24. That doesn't even consider the fact of the less he walks, the worse he moves.
The plan is to try to keep him comfortable and then put him down. The vet said that even with a stress fracture, putting him down isn't something I have to do right now and that he still looks to be in good condition both mentally and physically. The barn gives me almost daily updates, and I have stressed repeatedly that if he is having a difficult time, I am going to make that call. For now, he has a bag of carrots and apples for people to dispense at their leisure. He is doing well enough. On his bad days, he has balance issues (the vet says their balance comes from their hind end, so when it is awry, he can look neurological and could be a fall risk) and can't walk in a straight line. On his good days, he just has a wonky walk. He is still getting up and laying down regularly and will still trot after something/someone when he wants to.
So far, he has only had 1-2 bad days per week, this being the 2nd week of having the fracture. The plan is to have him buried at the farm next to another old horse that he babysat for about a year who had to be put down last year. I am ready enough to do it at any time, though this is going to kill me. I've had this guy for 25 years now, we've been through everything together. I used to threaten my SO that App was here before him, and App would be here after him, but that isn't going to be true anymore and that guts me. But I REALLY don't want App to go when he is in pain so the plan is to put him down the last weekend of Sept at the latest. I have some business trips in Oct and Nov that will pull me away and I don't want that something to happen while I am gone. The end of Summer seems fitting, so I am showering him with love as much as I can now.