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  Discussion on Elusive lameness
Author Message
Member:
Frances

Posted on Monday, Dec 6, 2004 - 7:26 am:

Dear DrO and others, may I just run by you what has been happening with my 17-year old TB mare since Sept. 25th for any comments/advice?

Sept. 25th, shod, two-weeks later than should have been. Farrier very pleased with feet.
Sept. 26th, slightly lame on LF, no heat, pulse or swelling. Toe had been cut pretty short, assumed temporary soreness, walked only for few days, fine in walk but still not right when tried arena work. Farrier out of town.
Oct. 3rd, Bute for 5 days and just walking. Fine as long as just walking.
Oct. 8th, tried trot, still not really sound.
Oct. 9th, my farrier still away, got local one to remove shoe. He said cause was toe dumping, no sign of abscess (and still no heat or pulse), replaced shoe without toe clip and said ok to work her.
Oct. 10th - 20th, no real change. Some days slightly better, some days slightly worse.
Oct. 21st, galloped and bucked around while turned out.
Oct. 23rd, worse,vet saw her, agreed toes dumped, wanted to nerve block her to make sure but no time right then. Scheduled for few days later but when he came she was not lame enough for a nerve block to give a clear result.
Nov. 5th, my farrier back to shoe again - couldn't find anything wrong and said he hadn't changed anything drastically last time.
Nov. 18th, vet X-rayed FL hoof and also knee (as both knees show signs of blistering from long ago when she was at racetrack). Results: seedy toe (not founder-related, he said) and some knee injury, but this was an "old story", not recent. Vet felt seedy toe would explain intermittence of her lameness, but still wanted to nerve block just to make sure nothing going on higher up limb (esp. as she once had some upper suspensory soreness in same leg, 2 1/2 years ago).
Nov. 21st, mare once more thwarted attempt to nerve block by becoming magically "almost sound".
Nov. 30th, mare finally really lame, even in walk. Vet hurried over, nerve blocked hoof, still lame, nerve blocked knee, sound. Injected knee with cortisone and Hyonate (Legend). Said there was very little synovial fluid in knee joint. Prescribed: 2 days box rest, 2 days walking in hand for 10-15 mins, no turnout, 2 days walking under saddle 10-15 mins with some turnout, and to take it easy for 10 days (I assume 10 days in total). Said injection should last for 6 months.

He's instructing the farrier to cut away the front of the hoof on his next visit and clean out the seedy toe (farrier insists to me that there'll be nothing there). Vet says I should then leave it exposed and clean with Betadine.

Does all this sound as if we're finally on the right track, and is 10 days in walk enough? I would hate to do any more damage to the knee by overdoing things, as there may not be any signs of pain to warn me now.

I'm really sorry it's such a long and tedious post, but would be grateful for any thoughts?

Lynn
New Member:
Brandi

Posted on Monday, Dec 6, 2004 - 5:51 pm:

Lynn, regarding the "is 10 days enough" question, my horse's surgeon, who injected my gelding's coffin joints and later, navicular bursa, told me that joint injections are typically at their peak effectiveness within 4 - 14 days. There can be some initial "swelling" due to the fluid just injected, but the body very quickly balances this out.

There are always so many factors involved with lamenesses, only your horse can tell you for sure if you're on the right track...take it slow and listen to your horse. Best of luck to you.
Moderator:
DrO

Posted on Monday, Dec 6, 2004 - 8:12 pm:

Hello Lynn,
There are 3 joints to the knee and the 2 lower ones block together, do you know which block resulted in soundness? The reason I ask is the lower jt blocks can also block the origin of the suspensory (see Carpal Lameness for more).

But lets assume the foot block was done properly and the IA carpal block is real, yes these are rational therapies and for more on managing arthritis see Arthritis Overview and its companion article on treatments (do not skip the overview). Many horses with carpal arthritis can be managed for years of usefulness, yes at a lower level of work that before, but not much lower.
DrO
Member:
Frances

Posted on Tuesday, Dec 7, 2004 - 8:52 am:

Brandi - thanks a lot for sharing your experiences with injected medications. I think in my mare's case the cortisone component was perhaps the main reason for the go-slow. Gosh, I hope her treatment's effectiveness lasts longer than 14 days or we're sunk! Hope your horse is fine now.

DrO - Many thanks for your response. Yes, I read the heads-up re nerve blocking knees and the effect on the upper suspensory, but only after the vet's visit. I suppose if there's little improvement after the 10 days are up, we should bear in mind that the ligament hasn't yet been given a clean bill of health and might be another cause (the lack of fluid he found in the knee must mean that the knee is definitely one cause I would think?).

By the way and just FYI, when I'm in the Arthritis Overview and click on "Causes", "Prognosis" etc from the side menu, I get a big "Forbidden" page in response.

Thanks again

Lynn
Member:
Frances

Posted on Monday, Dec 13, 2004 - 2:14 pm:

Could someone please explain to me the difference between seedy toe and white line disease? They sound so similar, and as the farrier is supposed to excise the affected area (described as seedy toe by the vet) in a few days, I'd like to know what exactly we're dealing with, and how big a deal it is before he comes.

Thanks!
Moderator:
DrO

Posted on Tuesday, Dec 14, 2004 - 7:18 am:

Seedy toe is a thrush infection of the white line usually secondary to poor quality or distorted horn from past or chronic laminitis. WLD is a primary fungal infection of the white line. They look quite different and this is described in the articles on these diseases along with treatment recommendations.
DrO
Member:
Frances

Posted on Tuesday, Dec 14, 2004 - 8:12 am:

Thanks as ever Dr.O. I think the reason for my confusion is that:

1) everything my vet says about it makes it sound like WDL (esp that it's a fungal infection and nothing to do with founder)

2) that some websites refer to "WDL, otherwise known as seedy toe"

3) that my farrier has been trying to pare it out of a hole, cutting triangular holes in both front toes, and that vertical cracks have nevertheless succeeded in rising from these holes - just like Kim's post above re her horse's WDL.

Does excision of the affected area usually mean time off afterwards for the horse until the horn grows back, or can it still be ridden (or at least turned out)?

Lynn
Moderator:
DrO

Posted on Wednesday, Dec 15, 2004 - 7:43 am:

While both "seedy toe" and "white line disease" are diseases of the white line, WLD implies a specific clinical entity as described in our article. It sounds like your farrier is not getting to the root and not considering the abducting forces on the sides of such holes.

The exercise regimen of the horse will depend on how much wall needs to be removed (and how clever the farrier is keeping shoes on). If the horse ends up with weight bearing on the sole he will need to be rested with the severity of the rest depending on how much sole is exposed to weight bearing.
DrO
Member:
Frances

Posted on Wednesday, Apr 20, 2005 - 9:23 am:

Well, we seemed to be out of the woods for a month or two, maybe because we had a VERY wet winter and were mostly trail riding (flooded arena). Gradually, however, lameness on the left fore returned.

Anyway, diagnosis was: left upper suspensory strain?/sprain?. 25% damage shown on ultrasound. Left knee still holding after Nov. 30th Legend/cortisone IA, but right knee now needy.

Vet injected left upper suspensory and two lower joints of right knee with Legend/cortisone. Prescribed 2 days stall rest, 3 days hand walking 10 minutes, then walking under saddle daily 10 - 15 minutes.

After a week, he said to ride in walk 20-25 mins. daily, and after 10 days from injection date to start going for short hacks (trail rides) on hard ground, and other days lunge her for 15 mins, in walk and TROT. Why is he going so FAST?

I have not trotted her, as it seems MONTHS too early to me, but is there any reason you can think of, DrO, for his accelerated rehab program? Something to do with the knees being an issue too?

I don't quite know what to do, as there aren't many vets here, and I don't want to go against his advice. He has kindly offered to come out on Sunday without a fee (he's in the area) to see how my mare's getting on, and I'm hoping he won't want her trotted on the lunge for him ...

Any thoughts appreciated!
Moderator:
DrO

Posted on Thursday, Apr 21, 2005 - 8:39 am:

If he is certain that you have upper suspensory desmitis I agree this is too aggressive. I have had good luck with prolonged stall rest and hand walking as described in our article on this lameness.
DrO
Member:
Frances

Posted on Tuesday, Apr 26, 2005 - 7:18 am:

Thanks a lot DrO. On Sunday I told the vet I didn't want to trot her up for him because I thought it was too soon, and asked if there was any reason why I couldn't do the slow rehab route with ultrasounds to check progress (as per your article). His reply was: "yes, it's better to do it that way" (??!!).

So thank you yet again for the great advice.
Member:
Frances

Posted on Thursday, May 5, 2005 - 9:20 am:

DrO and any others with thoughts to share: I was away for 4 days recently, and asked the groom to walk my mare daily. When I got back, she was much less sound and had started pointing the LF (the one with the suspensory sprain) again every so often.

When I walked her she was really short on both front legs, but especially the right (the one with the knee recently injected for arthritis - the left knee having been done 5 months ago).

It seems she played up each time the groom took her out (probably thought he was going to turn her out) before settling to walk.

So I feel the pointing of the LF (the leg with the suspensory sprain) is probably due to this jumping around, and presumably indicates a need to go really slowly, but the shortness esp. on the RF is making me wonder whether the rehab regime for the ligament will actually worsen the DJD of the knees? And if so, should I modify the program somewhat - the vet sees the DJD as the bigger problem longterm?

Thanks so much for any ideas.
Moderator:
DrO

Posted on Friday, May 6, 2005 - 6:45 am:

Standing around on a chronically arthritic joint will definately stiffen it up but there are also other possibilities for worsening bilateral front limb lameness, I think this deserves a recheck by your vet to see if your feelings about this are correct and also whether the suspected suspensory problem might not be really carpal arthritis.
DrO
Member:
Frances

Posted on Saturday, May 7, 2005 - 11:15 am:

Yes. I have made an appointment with another vet who is known for his high-powered ultrasound equipment on Wednesday, as I note in your article on rehabbing ligament injuries that "proper technique and interpretation are difficult to do accurately on an occasional basis". Hopefully he does it frequently.

Then I'll see where to go from there.

Thank you so much, as always, for your advice.

Lynn
Member:
Frances

Posted on Sunday, May 8, 2005 - 3:58 pm:

Sorry, just one more question (well, to be honest there'll probably be more!): is it better NOT to use clay ("Ice Tight"), tendon gel or the like in the days before an ultrasound? Could they spoil the image in some way?
Moderator:
DrO

Posted on Monday, May 9, 2005 - 6:31 am:

I would consult the veterinarin doing the ultrasound about his preferences. He will need a clean leg and the shorter the hair the better. Wetting is not a problem and may even help the coupling gel.
DrO
Member:
Frances

Posted on Sunday, May 15, 2005 - 7:56 am:

The second vet came, and felt the suspensory lesion shown on the ultrasound was significant, and that it would require a year from when the lameness began until the mare can be back in work. He did not give me a rating (mild, moderate or severe), not a percentage of damage CSA. He said there was some improvement from the previous (other vet's) ultrasound nearly a month ago, and that healing, although only in the form of connective tissue so far, has begun, but the lesion is far from closed as yet.

DrO, if I manage to upload the ultrasound,could you possibly comment as to the severity, so that I can follow your rehab protocol? At the moment, I've gone back to hand walking her for between 10 and 15 minutes twice a day.

I would be very grateful. Think I'll have to post the two ultrasounds separately.
Moderator:
DrO

Posted on Monday, May 16, 2005 - 9:40 am:

Hello LL,
I am sorry but cannot comment on the severity of your horses lesions because of the limited amount of information in the single images you present. Ultrasound images are both machine and operator specific. Very slight changes in limb preparation, tranducer coupling to the limb, and angle of examination can greatly effect the appearance of the tissues on ultrasound. Artifacts are the norm and require great care to eliminate. My inability to know exactly where these images are taken, move the transducer around to compare the surrounding tissues while attempting to get the best image, eliminating artifacts, and then follow the lesions and measure them accurately makes it impossible for me to diagnose the extent of the injuries from such a presentation.

You must rely on those doing the actual ultrasound to gauge the severity. If those doing the ultrasound are uncomfortable grading the problem perhaps referral to a a specialist would help.
DrO
Member:
9193

Posted on Monday, May 16, 2005 - 1:29 pm:

Hi LL,

You asked in your post on another discussion how it was to do the walking rehab program.

In a word, challenging. Dr Gillis believes in a program of rest, rest, rest with graduated levels of DAILY exercise. It is her opinion that any injury whether mild, moderate or severe requires a minimum of six months rest/rehab along with other adjuncts such as Adequan, Glucosamine HCL (not sulfate) and very good shoeing/balance technique.

Our Justin was diagnosed with a moderately severe check ligament injury, a slightly bowed SDF, and the ultrasound showed that he has a chronic, inactive desmitis of both the medial and lateral suspensory branches. We are to go for ultrasound checkups every 8 weeks to determine if healing has progressed to go to the next level of exercise. By Christmas, we hope to be trotting 15 minutes with 5 minutes of canter.. We are following the protocol for moderate injury.

We walk 30 minutes a day on a long stretch of road as well as a very nice bridle path that is firm but a bit more cushy than the road. The challenge is to keep him at the walk. He feels good! Several trainers here will not walk rehabbing horses with out sedating them.

My daughter and I have found that walking him in the bitless bridle that we bought when he injured his tooth last year has been a great help with the walking. (If Katrina is still reading HA, I am so grateful to have this bridle)

With the halter, he would get frisky and I was feeling like I wanted more control of his head without resorting to drugs.. The bitless bridle gives me more "power steering" and he is less inclined to take advantage of the bridle. At the end of our walks, then I undo the nose band and he grazes for about another half hour.

Every 14 days we can increase our walks 5 minutes. I try to stay as level as I can, but part of the bridle path has a slight incline that we walk for a change of scenery. That is one of the questions that I need to address. What amount of incline is too much too soon? It would seem to me that jumping around and being frisky on level ground would be more detrimental to healing than plodding along at a walk up and down a gradual incline..

I am happy to stay in touch as you progress with your horse. My heart sank when I learned of the extent of Justin's injuries, but Dr Gillis was very optimistic that slow and steady would eventually get our buddy sound and strong. She acknowleges that it can be frustrating and tempting to try to go faster, but she feels strongly that if you give the injury time to heal completely the first time, then you reduce the chance of reinjury occuring over and over again that leads to bigger issues farther down the road.

I will be interested to know what level of injury your horse has sustained.. I will be interested to follow your progress.

Smiles,
Debra
Member:
Frances

Posted on Tuesday, May 17, 2005 - 10:32 am:

DrO: thank you for the explanation; I understand why you can't assess the lesion. There isn't really anyone else to go to here, so I'll play safe and start at the beginning of your rehab. The second vet at least seems to be on the same page, and in fact suggested only 10 mins twice a day of handwalking.

Debra: it's really interesting to hear someone else's experiences in this and you seem to be getting on pretty well.

At present, I am handwalking in our arena, which happens to be pretty hard right now, but will soon be plowed and harrowed, at which point I'll have to venture outside. I worry about this for two reasons: 1) that she's almost certain to jump around at some point (the 2nd vet said to ride her instead if I thought she'd be lively, but of course that's not part of the protocol - and she'll still get excited anyway, having had no turnout for some time), and 2) there really isn't anywhere nice and firm and flat that you can reach without going over rocky, uneven hilly ground, or plowed deep fields or being attacked by a couple of stray, hock-biting dogs (and they are on a perfect, nearby stretch of asphalt road I could otherwise use.) (Wish I could minituarize her, carry her to a safe spot, and bring her back to size again! )

I wonder how disastrous a bit of leaping up and down on the spot would be, bearing in mind that she'd be wearing exercise bandages for support? Very, probably (sigh)

Perhaps we should have a special tendon/ligament rehab section on HA, as there are quite a few of us struggling through the rehab at the moment, and we could compare notes and give each other ideas?

Thanks again Debra, and let's stay in touch.

Lynn
Moderator:
DrO

Posted on Tuesday, May 17, 2005 - 10:52 am:

There is such a place Lynn and that is the article on rehab. We also have a article (and accompanying discussions) on stall resting horses which might have helpful ideas on keeping horses up, see Training Horses » Behavioral Problems » Stall Resting Horses. You might also run a search on "rehab rehabilitation stall rest". It has a discussion below it.
DrO
Member:
Dres

Posted on Tuesday, May 17, 2005 - 10:55 am:

Just a thought on rehabbing a hot horse... can you put a bridle and saddle attached with side reins to give you more control on the ground..? Just a thought... I know a lot of folks will send their horse out for rehab , that can be very expensive, and the horse is then either ponied or put on a horse mill ( exercisor walker ).... I know with my gelding when he has had to be hand walked just rigging him up with the side reins helped me out tons with control....

On the first day God created horses, on the second day he painted them with SPOTS..
Member:
Canter

Posted on Tuesday, May 17, 2005 - 1:27 pm:

If this is at all possible, try doing the walking routine either very late in the day or very early in the morning. When my mare was on stall rest and getting a little silly with energy (a barn cat sneezing would send her into a rearing, bucking fit), I walked her as early and / or late in the day as I could manage. Usually things are quieter in and around the barn and there are fewer reasons for the horse to get nuts. Avoid feeding times, times when horses were being brought in, ridden or turned out, etc.

Good luck...for me it was a very stressful time as I constantly worried about re-injury.
Member:
Ajudson1

Posted on Tuesday, May 17, 2005 - 8:31 pm:

HI Lynn,

I've been following your post as I have a horse also with on again off again lameness. Does fine with stall rest, then small paddock rest. Now I just let him out to pasture with the rest of the gang, and he's limping again.

So just letting you know you're not alone on this quest for a sound horse!!! Too bad we can't walk them together, huh?

Hang in there....

Angie
Member:
Frances

Posted on Wednesday, May 18, 2005 - 7:48 am:

Ann: Hmm, I like the idea of side reins - that might make all the difference when we have to go out. Thanks for the tip!

Fran: I agree, the worry about re-injury is very stressful. We do generally manage to do our handwalking when other horses aren't gaily cantering past (that REALLY infuriates her!)and for the evening walk, the groom seems to be feeding her before I get there. Not too sure that this is a good idea for her digestion, but it's only a tiny meal, we only walk for 10 minutes, and it does stop her feeling anxious that someone else might get to it first (my mare's worst nightmare!).

Angie: so sorry to hear your horse is limping again. It really goes against the grain to deny them turnout, doesn't it?

I'm the only one here doing this, so it's great to hear from all of you. Thanks a million for all the ideas and encouragement!

Lynn
Member:
Christos

Posted on Wednesday, May 18, 2005 - 8:34 am:

May I ask where you are located, Lynn?
I do not mean to be nosey, it is just that the situation you describe sounds pretty Greek.
How big is your arena? Can't you just leave a walking strip around the perimeter?
Member:
9193

Posted on Thursday, May 19, 2005 - 12:00 am:

Hi Lynn,

Just another thought to share.. Our horses are such creatures of habit and routine.. It occured to me as I was driving to the barn(All this walking is giving me WAAAAAYY too much thinking time) that perhaps the change in routine also contributes to the flightyness of our walks. I had been just brushing him in his stall and then putting on his halter to go out for his walk.. Usually when that happens, we are either going by-by in the trailer or getting lead to turnout..To just get lead up and down the road is NOT our usual routine.

I went back to the routine of taking him to the crossties and going thru the whole routine that we went thru when riding. Putting the bitless bridle and walking him like I am riding (two hands on the reins to guide him) is sort of like being ridden and his energy level has been much more manageable.

Perhaps the great ideas of putting on the saddle, bridle and side reins in the same routine that you would do if riding will help make a mental change for your mare.. I may be all wet, but it has been raining soooo much here in the Bay Area that I am moldy and musty..

Your walking area does sound like a major challenge.. I will be curious to see what adaptation you come up with..

Hang in there!!
Debra
Member:
Frances

Posted on Thursday, May 19, 2005 - 8:41 am:

Christo: yup, it's Greece alright! You mean the rest of the world's not like this?? The arena's not big at all, but we've kind of worked it out that I walk her at quiet(ish) times. No, we're ok for the time being as long as we can stay IN.

Debra: you may have something there, and I like the idea of handwalking the horse with two hands on the reins. Ann's side reins idea is good too, but I think I'd have to get her (the mare, not Ann) used to them in the arena first.

All these good ideas!
Member:
Christos

Posted on Thursday, May 19, 2005 - 8:57 am:

No, Lynn, it's not.
Sadly enough, there's hardly a place on this planet more horse unfriendly than Greek countryside.
Member:
Christos

Posted on Thursday, May 19, 2005 - 3:31 pm:

DrO, I was talking today with a couple of vets about Lynn's post and they say that the horse must be put on wedges to relief the ligament until it heals. What is your opinion on this?
Moderator:
DrO

Posted on Friday, May 20, 2005 - 8:34 am:

They are misinformed Christos. Elevating the heel will lessen the tension on the DDF, but it moves it to the suspensory which then has a measurably increase in tension on it. Best would be a balanced foot and pastern.
DrO
Member:
Christos

Posted on Friday, May 20, 2005 - 8:48 am:

Thanks, Doctor.
You know, it'd be nice if we had a picture of you. We can set it in a nice frame and put it on the stall wall for our horses to pray.
Member:
Frances

Posted on Friday, May 20, 2005 - 10:39 am:

Ditto to the picture idea!

Thanks Christo for thinking of the wedges, and DrO for putting us straight as usual. It's very timely as we're due for a shoeing, so if the farrier suggests wedges, I'll know what to say! Otherwise I would no doubt have bowed to his greater wisdom, with exactly the wrong results.

I forgot to mention another trail hazard in our area: a loose colt acquired by some ignorant people (don't want to be judgemental, but what else can you call them) about six months ago for who knows what earthly reason. The poor thing is either tied to a tree outside their property or let loose to forage (no doubt to save them the need to buy hay). I had a close encounter of the worst kind a few months ago, as he comes cantering up behind you looking for company, and won't be shaken off. It's really dangerous for all concerned.

Ah well! Life's never dull.
Moderator:
DrO

Posted on Friday, May 20, 2005 - 3:38 pm:

This misconception is so prevalent I will place a note in the article. Interestingly while checking the most recent research on this I found another correction to a old recommendation: egg bar shoes also decreased strain in the DDF while increased strain on the suspensory.

When we travel I tend to be the one with camera so I have thousands of photos of my wife, kids, horses, dogs etc...But there are very few of me. They have taken pictures but they usually catch me asleep in the big chair with DrOol running down my chin or some equally terrible pose.I will see what I can come up with.
DrO
Member:
Frances

Posted on Sunday, May 22, 2005 - 9:03 am:

Oh ... eggbars too? DrO, my horse has had eggbars for the past three years, with extensions to the heels for the last two, or maybe three, shoeings? The farrier thought the support would help her.

Do you believe I should ask him to stop both eggbars and extensions together, or would this be too sudden a change especially at this point? Would it be better to leave off the extensions at the next shoeing (due any day now) and wait until the following shoeing to elminate the eggbars?

Lynn
Moderator:
DrO

Posted on Sunday, May 22, 2005 - 9:37 am:

This change will put extra strain on the flexor tendon while decreasing strain on the suspensory..but the changes are less than 1%. I think you can do both. If they need convincing here is a good reference:

Equine Vet J. 1996 Mar;28(2):126-32.

Influence of shoeing on ground reaction forces and tendon strains in the forelimbs of ponies.

Riemersma DJ, van den Bogert AJ, Jansen MO, Schamhardt HC.

Department of Veterinary Anatomy, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.

Strains in the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), accessory ligament of the deep digital flexor muscle (inferior check ligament [ICL]) and the interosseus medius muscle (suspensory ligament [SL]) in the right forelimb of 5 ponies were measured using mercury-in-silastic strain gauges a few hours after implantation. Tendon strains were recorded at the walk with normal flat shoes, egg-bar shoes, a 7 degrees increased hoof angle accomplished by application of a heel-wedge and a 7 degrees decreased hoof angle using a toe-wedge, consecutively. Ground reaction forces were recorded with all 4 shoe types preoperatively and with flat shoes post operatively. The strain patterns of the SDFT, DDFT and SL showed a rapid increase at the beginning of the stance phase, followed by a plateau with a small incline or decline and a rapid decrease at the end of the stance phase. The SDFT had its maximal strain in the first half of the stance phase in all ponies. The DDFT and SL reached their maximal strain in the first half of the stance phase in 2 ponies and in the second half of the stance phase in the other 3 ponies. The ICL was strained maximally in the second half of the stance phase in all ponies. Averaged over all 5 ponies, the maximal strains in the SDFT, DDFT, ICL and SL with normal flat shoes were 2.4, 1.3, 5.4 and 3.7%, respectively. If an egg-bar was applied the mean peak strain in the DDFT was 0.13% lower and strain in the SL was 0.22% higher. With a heel-wedge, strain decreased in the DDFT and ICL (0.19% and 0.4%, respectively) and increased by 0.24% in the SL. A toe-wedge increased strain in the ICL by 0.8%. All changes mentioned were statistically significant (P < 0.1). The changes in tendon strain as a result of different types of shoeing correlated with changes in calculated torque's of the ground reaction force acting on the coffin joint.

DrO
Member:
Frances

Posted on Sunday, May 22, 2005 - 10:34 am:

Thank you very much indeed for your quick response and the much-needed reference.

Here's hoping I can convince him!

Lynn
Member:
Frances

Posted on Monday, Jul 11, 2005 - 6:48 am:

The 2nd vet came again to examine my mare and ultrasound her LF suspensory on Sat. after 2 months of handwalking according to the protocol. I was hoping for good news, but, on the contrary, he was disappointed that the lesion hadn't closed entirely yet. He said the edges of the lesion were not strong either, and, looking at an X-ray from last autumn of the knee on the same leg, he commented that she has considerable problems there. The fact that her knees were blistered at the track years ago will have caused long-term damage.

I felt all this was a bit negative seeing that only two months had passed and the lesion HAD at least made progress in healing, but when he examined her clinically, he said there was pain there, and when I trotted her a few strides for him, to my horror she was head-bobbing lame.

The vet suggested I used a poultice made by Equistro called Flogestan, hot and bandaged one day, cold and unbandaged the next, and said he'd come and examine her again when we'd got through a tubful - no need to ultrasound. Meanwhile to carry on the the walking, slightly increased. Having agreed before examining her that weekly injections of Adequan for maintenance would be helpful (we've already done the every-four-day series) he said afterwards that there really wasn't much point.

Any thoughts, DrO or others? Among those that occur to me are 1) it's 8 months since the left knee was injected - might she need another one? Although that would mean interrupting the walking schedule as she'd need complete box rest afterwards. 2) She is still in egg bars & extensions, as the farrier was NOT interested in what recent research has shown re their effect on suspensory desmitis, and basically told me not to tell him how to do his job.

One more thing: my trainer/barn owner, seeing how depressed I am about this, has offered to fence off an area between two paddocks which could be either 7 metres by 4 metres (about 23 ft. x 13 ft) or 7 m. x 8 m. (about 23 ft. x 26 ft.) so that my horse could at least be outside. There's a small shelter there too, so she could live out there except for 4 hours a day when there's a stallion in the next paddock. I would continue the walking programme of course.

Do you think this would be ok? Possibly we could make the area even smaller if you think that would be better, but at least she'd have a view and could get out of her hot box. Would any sort of mooching around be an extra strain, so that I should start with half an hour or so?

Thanks so much for all the help.

Lynn
Member:
Frances

Posted on Tuesday, Jul 12, 2005 - 12:09 am:

Correction to the above: the poutice recommended is Percutin, which sounds from its name as if it penetrates the skin well, but I can't find it anywhere (it's not on Equestron's website).
Member:
Frances

Posted on Tuesday, Jul 12, 2005 - 9:34 am:

DrO: Hoping for a response from you?
Moderator:
DrO

Posted on Tuesday, Jul 12, 2005 - 10:27 am:

Hello LL I am just running behind this morn because the truck had to go in to the shop.

Concerning the use of hot and cold and poultices we cover that in Equine Diseases » First Aid » Pressure Wraps, Poultices, Cold and Heat Therapy for Swelling in Horse Legs. For a logical rehab program for suspensory desmitis check out Equine Diseases » Lameness » Treatment Methods » Rehabilitating Injuries to the Tendons and Ligaments. I would determine whether to reinject the knee based on whether an exam points to the knee as a ongoing problem, primarily the reaction to flexion and blocks to decide.

Though we can provide factual information LL the questions on specific therapy for your horse should be answered by someone who can examine the horse.
DrO
Member:
Frances

Posted on Wednesday, Jul 13, 2005 - 7:57 am:

Thanks DrO. Hope I didn't seem to be hounding you - just thought you might have missed it, and I'm feeling on the desperate side

I am of course following your article's rehab protocol, as far as our circumstances permit, and the mare seems great in walk, so I was dumbstruck by the vet's gloomy prognosis after only 2 months.

Lynn
Member:
9193

Posted on Sunday, Jul 17, 2005 - 4:40 am:

Hi Lynn,

I've been in Alaska for the last three weeks and just now read your post.. I think I can understand your deep disappointment regarding your vets evaluation of the ultrasound. I was more anxious at Justin's recheck than I was at the initial evaluation because I so wanted to hear good news. I am sorry that you did not get the news you were hoping for...

I will offer this bit of information shared by Dr Gillis at our last recheck regarding the healing process of tendons/ligaments.. Dr Gillis stated that it often takes almost four weeks(or more, depending on severity of injury) for the inflammatory process to resolve before real progressive healing can begin. That is why she will not recheck any sooner than eight weeks after the initial evaluation to give the inflammatory process time to resolve. With Justin's recheck, she was able to determine that the inflammatory process had stopped and that healing had begun, but we still have a long way to go...

I don't know how severe your mare's injury was, but your vet did say that there was evidence that healing WAS happening, so I would say that the direction is encouraging..We were advised to handwalk Justin for three additional weeks (a total of 11 weeks) and just two days ago got the go ahead to start riding him at the walk for 30 minutes per day for a week and then an additional five minutes per week for two weeks and then we go in for another recheck..

How often does your vet want to recheck via ultrasound? Does he still want you to continue the Adequan? We were on a once a week injection for the first four weeks and then I have been giving one injection every 14 days since...

Justin has been in a 12x24 paddock with an attached stall ever since the initial injury. As long as she doesn't get rambunctious playing with her neigbors, having a bit more space to move around doesn't seem like it would impede the healing process of the suspensory. I can't speak to the healing process of the knee problem, so I guess you will need to be the best judge of whether the additional space works for or against you specifically regarding the knee.

Hang in there!! And keep us posted on your progress. We "Lead and Feed" moms gotta support each other in this process!!

Smiles,
Debra
Moderator:
DrO

Posted on Sunday, Jul 17, 2005 - 7:55 am:

Debra's veterinarian is correct and really a 4 month reevaluation is considered to be a better indicator than 2 months. I am currently doing a major rewrite on the tendinitis article that should be done by the middle of the next week. The rewrite focuses on prognosing injuries from severity and it may have more information that you find useful.
DrO
Member:
Frances

Posted on Monday, Jul 18, 2005 - 7:03 am:

Dear Debra,

Thanks so much for your post. I'm really glad that you're able to start riding Justin - must be a good feeling! Yes, I too found my vet's attitude very strange - after all, each ultrasound showed some improvement, and we all know these things take tons of time. I can't deny the lameness in trot was present, though. Is that still acceptable at this stage?

Re the maintenance dose of Adequan, the vet was enthusiastic until he examined her, but afterwards he said kindly (which made it worse), that there wasn't really much point in spending that much money. It's all very confusing, considering that the first vet thought she could be back in work in 2 weeks!

It was very helpful to hear Dr Gillis' comments, and also to read that Justin is in a small paddock and handling it well. As you say,whether my mare gets excited about the horses in the next paddock would be the main concern.

By the way, Debra, have you read Imogen's post re the Dalmar Tendon Support boots? They sound pretty useful, though not available till later in the year.

Dear DrO,

Thanks and I look forward to the revised article.
Member:
9193

Posted on Monday, Jul 18, 2005 - 7:15 pm:

Hi Lynn,
Thank you for your kind words. Yes, it is a good feeling to see the bridle path from between his ears instead of side by side. I'm kinda walking stiffly tho. Been a looooong time since I last sat in a saddle...So I keep the Tylenol close.....

I don't know what to say regarding your vet's attitude.. At our barn, we know that each vet (while they are all very good all-round veterinarians) has a particular affinity for different situations. One vet really likes trauma and illness cases, one vet is very good at lameness issues, another one is the "go to" vet for chronic issues such as Cushings or geriatric stuff. I am very fortunate that I can see Dr Gillis, because I believe that because her forte is tendon/ligament rehab, I am going to get rcommendations that are specific to my case and not have to deal with mixed messages or plans that may seem contradictory to the situation.. It must be beyond frustration to be in your situation and not get answers to your questions and wonderments.

Regarding the lameness at the trot..Can you tell if the lamness is related to the knee? I am unclear what is involved in the process of "blistering" and how that process contributes to damage to the knee. You do seem to have a double whammy situation which it would seem to me makes it a bit more challenging to determine if the lameness is knee or suspensory related.

Regarding the Adequan: For our case, Dr Gillis feels that Adequan every two weeks and 12,000 mg of Glucosamine HCL(not sulfate)daily is a beneficial recommendation to promote healing and maintain integrity of the tendon/ligaments. I can't tell you if the Adequan and Glucosamine is helping because I have nothing to compare to, but I do know that he is moving out much more willingly, he seems very comfortable and I will probably maintain him on this regimen for the forseeable future. It is pricey tho and I certainly can understand why cost is a factor when considering to continue with the Adequan. I wish I could help you more in this area of wonderment for you.

I did read about the Dalmar Tendon Support boots and will take the webpage to show Dr Gillis at the next recheck to hear her thoughts. She is not a fan of the sports medicine boots. She feels that the boots can restrict the movement of the ankle and tendons in a way that can inflict injury rather than prevent injury. Splint boots are OK to prevent injury by hooves hitting the legs, but it is her opinion that horses legs were meant to move freely and she advocates bareleggedness.

Good Luck with the paddock situation.."Motion is Lotion" so I hope your mare can get the benefit of extra moving space without compromising her healing... I think it is very helpful to Justin mentally to be able to wander freely even tho he can't have the fun of going to the big pasture for his daily turnout..

Are you doing the poultices that you described in your post? I was curious about it because of the versatility of the hot/cold applications.

I'm looking forward to reading the revised article too!

Where are you in the walking program regarding minutes/day?

Smiles,
Debra
Moderator:
DrO

Posted on Tuesday, Jul 19, 2005 - 7:45 am:

Debra the new article is up at Equine Diseases » Lameness » Diseases of the Lower Limb » Flexor Tendinitis.
DrO
Member:
Frances

Posted on Wednesday, Jul 20, 2005 - 8:39 am:

Hello Debra,

Yes, there's something about that view between the ears! I can imagine you're having some lovely times now, all the more so since you've been deprived of them for quite a while. I'm at least very lucky in that respect: there are always horses to be ridden here, so I ride pretty much every day.

I (and my trainer) are going to have a long list of questions for the vet when he comes in about 3 weeks, and I think I'm going to go the Adequan route again whether he thinks it's a waste of money or not. My mare was standing the soundest during the time she was on Adequan. I also have her on Cortaflex HA. I shall show him the area we're considering as a mini-paddock and see what he thinks. Certainly gentle motion would be lotion, as you say, for the knees.

The hot poultices with plastic wrap and bandaging are to encourage circulation and repair. The cold poutices without wrapping are (I think) to firm up the ligament (although I tried some on the side of my own knee yesterday and only felt a pleasant "something" for about 15 mins and then nothing!)

Does Dr Gillis not believe in exercise bandages during rehab then? My mare's been nice and calm lately, but yesterday evening another horse started leaping around, and set mine off too, which cast me into the slough of despond in case any reinjury occurred. I was glad she was wearing exercise bandages, but perhaps I was wrong to be? In answer to your question, we're now walking 35 - 40 mins a.m., and just 10 mins p.m.

Thanks so much for your interest and help. I think you should take a pic of the view between Justin's ears and post it to encourage us all!

All the best,

Lynn
Member:
9193

Posted on Thursday, Jul 21, 2005 - 1:58 am:

HI Lynn,

Had another pleasant 30 minute cruise on the ol'"J". A major benefit of getting powerwalked around a quarter mile bridle path everyday for eleven weeks has been a definite desensitization to the deer that hang out in the trees and creek along the way. We came upon a family of three deer and except for some interest and pricking of ears, he just cruised by like nothing to it.. In the past, he would crab sideways and then act like something was going to sneak up behind him..

You can ride everyday?? How wonderful..!!I have been so grateful that we could sponsor another horse to enable my daughter to continue riding. She has been terrific about sharing the rehab work with Justin, but it is hard to be leading your horse when everyone else is riding.. I'm glad you have the opportunity to enjoy riding during this layup with your mare..

Do you have your mare in the paddock now or are you going to wait till your vet visit? Regarding the exercise bandages.. Dr Gillis understands the need to wrap legs to protect them from getting thunked by the hooves, but explained to me that polo wraps, splint boots and sport medicine boots do not do much to support the tendon and ligaments. The rehab's purpose is to rest and protect the architecture while healing while at the same time gradually increasing the work load to provide stimulation to the tendon to continue the healing process. Reinjury is always a possibility, so that is why no free turnout is allowed till the horse is ready for a full work load. I understand and share your anxiety when your mare shows some flightyness. Justin has taken some minor stumbles during our walks and I immediately visualize starting all over again.. His leg looks and feels clean, tight and cool, he even has broken into a trot for a few strides when we go out for our grazing, but I see it as a glass leg! I think I will always have reinjury as a constant worry companion..

It has been helpful to me also to have another person to share this experience. What amazes me is that you are in Greece and it feels like you are someone that I might be chatting with at our barn! This cyberspace sharing is pretty neat!!

Please keep me posted on your mare and her progress, as well as your feelings. I am as close as your keyboard!!

Smiles,
Debra
Member:
Frances

Posted on Saturday, Jul 23, 2005 - 10:58 am:

Hi Debra,

Your trails sound lovely - deer peeping out of the trees! Can't imagine what my mare would make of that - her eyes stood out on stalks the first time she saw a hedgehog (as in: "my God, that rock is WALKING!")

Re the paddock idea, I don't quite dare to risk it until the vet's okayed it. Trouble is, it can't be a permanent separation from the adjoining paddock as the shavings truck has to be able to get past once a week, so we would only fence it off with a couple of chains inside hosepipe - or has anyone got a better idea? She's a bit bossy with other horses, so there would be some, shall we say "interaction". Hmmm.

I know EXACTLY what you mean about the glass leg synDrOme; even when (or, I'm beginning to think, if) my horse gets better, I think I'll be a nervous wreck every time the going's less than perfect, or she spooks at some green hairy monster. Must learn to be more phlegmatic about it!

Yes, let's hear it for cyberspace! it's great to compare notes from the other side of the world (well, almost).

Thanks for all the help, keep in touch and enjoy the deer!

Lynn
Member:
Frances

Posted on Monday, Aug 15, 2005 - 5:40 am:

An update: mare had an acute RH lameness on Sat (suspensory problem is LF). Very stiff in quarters, walked with limp and pronounced hitch at breakover on RH. Temp normal (37.2 C). Vet said on phone to cold hose and try walking again. Still lame. Waited for vet to come, brought mare out - the classic: lameness MUCH less apparent and hardly a hitch. Vet said not serious, prob kicked walls as I'd suggested, to cold hose, put clay on and continue walking programme. Also ran his key over her quarters - she flinched. Ran it along her side parallel to spine, she squealed. Said she was much too fat, should only be on hay (she had been having 1 scoop sugarbeet, 1 scoop oiled chaff, 1/2 scoop barley twice daily, along with 5 - 6 flakes hay). Conceded that I could give her a small handful of chaff at mealtimes so she would believe she was being fed, and for her Cortaflex and Farriers F.

That evening, went back to see her/walk her: lameness on RH had reappeared with a vengeance. She could hardly walk and stood dangling RH at one point. Cold hosed, applied clay and put her back in stall for the night. Cut feed almost completely, as vet had advised.

Next morning, mare fine - just a little stiff. So, what WAS that? Could it have been tying up? Weather was horribly hot (39 deg. Celsius - I think that's about 108 deg F?)and muggy. Vet was prob right that she was overfed and, interestingly, I read somewhere that "the presence of a concurrent lameness" was a possible trigger for tying up, among others. I also remember that she had a similar incident a couple of years ago that was never diagnosed satisfactorily, and which we thought could possibly have been azoturia. Any ideas??

BUT SECONDLY AND WONDERFULLY, while watching mare trotting up, vet commented that suspensory-compromised LF was considerably better. Palpated and still thought so! Said from September I could start riding her at walk, and we'd do another ultrasound end Sept.!\clipart {happy}

Possible contributory factors to improvement: new farrier who removed eggbars and extensions about 10 days ago (re DrO's recommendation), hot and cold poultices alternate days, starting liquid Cortaflex HA (used the powder before)... and of course the passage of time.

So... out of the bad news came good, and I feel we're heading towards an achievable goal again!!
Member:
Frances

Posted on Monday, Aug 15, 2005 - 5:40 am:

Oh, nearly forgot - phtu phtu phtu!
Member:
Sunny66

Posted on Monday, Aug 15, 2005 - 11:02 am:

Doing cartwheels for you!

Is it not the most relief you've felt in so long?

phtu phtu phtu :-)
Member:
9193

Posted on Monday, Aug 15, 2005 - 3:08 pm:

All right Lynn!!!

I'm cheering for the LF and thinking positive healing thoughts that the RF will get over what ever is going on and get even with the LF!!

Getting the thumbs up to ride is sure going in the right direction!! Congradulations!!

We were cleared to add a five minute trot block after our last ultrasound check. Every thing is healing well, except the medial branch of the suspensory ligament did not show as much healing as Dr Gillis was hoping to see. It measured at 1.46 eight weeks ago and was only 1.44 at the recheck.

We can ride for 45 minutes a day. The first week we added trotting for two minutes and now at the second week, we are trotting for four minutes in that time frame. Eventually we can trot for five minutes and then add five minutes every two weeks till our recheck the end of September. So far so good... Is this where I start the phtu, phtu,phtu??

Been following your posts too Aileen.. How was Brave after the rodeo day??
Member:
Sunny66

Posted on Monday, Aug 15, 2005 - 3:47 pm:

Hi Debra, Great news on your boy too!! Yes! Now is the time to incorporate the phtu phtu phtu :-)

Brave was sound, but tentative in the turnout the next day. He actually spooked, then thought better of it and walked back to his stall. I took him to the arena and had him walk over the noodles, then a little trot on the long side. Sound, even at the transition.

So phtu phtu phtu...woohoo!
Member:
Frances

Posted on Tuesday, Aug 16, 2005 - 5:29 am:

Aileen, when I read your post I could SEE you doing those cartwheels! Thank you for them! You're right on the nail - it's an incredible relief, and I've had a goofy smile on my face ever since (a real pain in the neck according to my husband). So glad your boy is staying sound, and phtu phtu phtu.

Debra, thanks so much for the cheers and positive thoughts, which I'm sure can reach us even here! The right hind issue hasn't reared its ugly head since that one day, and I feel more and more convinced it was tying up.

Great to hear that you and Justin have reached the dizzying heights of trot by now. How long did you walk before you were cleared for trot - about a month it seems to me?

Definitely phtu phtu time all the time for all of us! Thanks so much to both of you and may our horses go from strength to strength!

Lynn
Member:
9193

Posted on Tuesday, Aug 16, 2005 - 2:36 pm:

Thanks for the support you two!!

Lynn, I'm sorry I mixed up the front and hind part... My brain didn't register that it was her HIND end.. Hope there hasn't been any recurrance...Trotting has been a big step, but we are noticing that his hocks are more stiff than is comfortable. Dr. Gillis is recommending that we have flexion tests done and suspects that having his hocks injected will help reduce the loading on his medial suspensory ligament by making him more comfortable behind.. So next week is scheduled for hock injections.

We did power-walking under saddle for three and a half weeks under saddle before his recheck.. Head up, walk in frame and step out lively...!! I have to say that I was concerned that Justin would gain weight thru this process, but I think the daily 40 minute power walks and a couple pound reduction in his pelleted feed rations at dinner helped keep him from becoming a butterball.. I've lost 21 lbs since last August and I am sure that all the walking I have done since April has been a big part of my weight loss..

Big smiles to both of you... Lynn, I really loved your last sentence. I was touched by the visual that I took from it.

Time to phtu phtu out to the barn!!

Debra
Member:
Frances

Posted on Friday, Aug 19, 2005 - 12:20 pm:

Hi Debra,

Sorry to hear Justin's a little stiff in his hocks. What a good thing that you have Dr. Gillis right there to examine and advise. Will she inject with cortisone and Legend?

I would have replied before, but my mare decided to have colic on Wed morning, and all the vets seemed to be away on vacation. Finally found one, who came and tubed her, and she got over it, but it was a long and stressful day. (And I had said phtu phtu - don't tell me it's not working any more!) We think she got herself into a state over the feed reduction, and my trainer/barn owner (who was away for a week and missed both episodes) doesn't agree with cutting it so much, and is upping it slightly (i.e. more than just one handful of chaff, and a little sugarbeet).

Have you really lost 21 lbs! Well, I can believe it - I've had a lot of comments too about how my horse is getting fatter and fatter and I'm getting thinner and thinner. I'm certainly looking forward to starting to ride her in Sept - but also a little nervous in case it undoes the healing that's taken place. I suppose I should start with just 20 - 30 mins. Were you advised to walk Justin in a frame right from the start? Or, say, 10 mins on a long rein, 10 in a frame and a final 10 on a long rein again? Then again, a long rein might be asking for trouble!

All the best, and good luck next week!
Member:
9193

Posted on Monday, Aug 22, 2005 - 12:00 am:

HI Lynn,

I left Wednesday and got back last night... YIKES!!! Colic?? I should say that you had a long and stressful day!!!.. Has she ever coliced before?? Did you have to do a lot of walking? I am so glad to hear she came thru it OK... And you!!??

Justin coliced last October and I have notes posted with the barn owner and on his stall that in case of colic, NOT to lunge him if he has an episode of colic.. I worry that all the lunging I had to do last time would really stress the leg now, so he is only to be walked in the event of another colic (phtu, phtu, phtu, phtu)!!!!

We had to come up with some kind of different feeding amount too after his colic, so I just reduced the evening pelleted feed over a couple week period when he injured his leg until we arrived at the amount he gets now to try to keep his weight reasonable. Good Luck with coming up with a feed amount that pleases your mare, trainer and you!

Yes on the weight loss.. Started with the South Beach diet and combined with equine rehab power walking has helped me DrOp weight I thought was cemented on forever. The best part is I am able to keep it off, so good luck to you too in that department..

Because Justin is so front heavy when he walks, Dr Gillis did want us to walk him as much as possible in a frame that shifts the weight to the rear..I would say tho that your discription is close to what we do except that the first 15 minutes and the trotting is done with him in a moderately collected frame and we let him cool down on a long rein at the end. I understand your anxiety regarding the re-injury worry. I wish I could pass on any words of wisdom; just use your good sense on footing and don't rush anything.

Thanks for the good thoughts for Tuesday's hock injections.. Our regular vet will do the injections. He has used Depo-MeDrOl the last couple of times, so I guess there will be some discussion to continue the same or try something different..

All the best back to you and keep me posted as to your progress.

Smiles,
Debra
Member:
Frances

Posted on Tuesday, Aug 23, 2005 - 9:30 am:

Hello Debra,

Thanks for your post. She doesn't colic often - last time I think was years ago when the clocks changed and breakfast was an hour later - always about food you see.

We gave her 10 c.c.s of Banamine and walked her for about 45 minutes, then put her back in her box, watched her like a hawk, and waited for the vet, who tubed her with liquid paraffin and water. After that she gradually recovered, but of course you don't know for sure that they will remain ok, and tend to stick around for hours and hours to make sure.

So, yes, it was a mentally and physically exhausting day, and I'll be glad when she can be ridden and burn up a few more calories that way, as she's made it quite clear that diets are NOT her thing!

I'm sending you and Justin good thoughts for his hock injections today, and hope the results are excellent. Will he have to have complete stall rest for a couple of days?

Let us know!
Member:
9193

Posted on Wednesday, Aug 24, 2005 - 2:11 pm:

HI Lynn,

So glad to learn that both you and your mare are recovering from your rough day..Can relate the the hanging around for hours part... I was very uncomfortable leaving Justin in the late hours after his colic. It sounds to me like getting ridden will be agreeable to both of you..

Sunday I trailered my daughter, Justin and our dog to a nearby regional park to do our walk/trot stuff for a change of venue.. Gorgeous day. Low 80's, tiny breeze, nobody in the park. Level, firm trails and all the ranchers cows were somewhere else! She rode, I walked and Justin seemed to enjoy the outing as much as we did.. She gave him a bath afterwards so he was shiny clean for the vet Monday morning.

He did better on his flexion tests than we thought he would..3/5 LH & 2/5 RH. Pretty good for coming out cold from his stall without any warmup! He was alert, energetic and cooperative. The vet injected the hocks with Depo-MeDrOl just like the last time without any problems. He said it will take about four or five days before the effects kick in..

He had yesterday as stall rest, so I just wandered him around letting him graze for about an hour. For the next four days we are to walk only (under saddle) and then we can resume the trotting. All this is being done slowly, so hopefully we have covered each leg in each corner with care..

Let me know when you start riding your mare!!

Thank you for all the good thoughts.. All the best coming right back at you!

Smiles,
Debra
Member:
Frances

Posted on Thursday, Aug 25, 2005 - 7:01 am:

Hello Debra: what a relief that the news on Justin was so good and the hock injections went smoothly (they always make me a bit nervous!).

Sounds as if you all (not forgetting the dog!) had a wonderful day out too on Sunday, so all's well, phtu phtu. Thanks for your good wishes,

Lynn
Member:
Frances

Posted on Tuesday, Sep 6, 2005 - 7:25 am:

Dear DrO,

Just wanted your opinion on the next stage in our rehab as per my vet's recommendations, as it differs somewhat from yours.

We had reached 50 mins handwalking daily, and the vet now has us riding in walk for 15 mins, but still handwalking for the remaining 35 mins. In other words the total walking time is still 50 mins, but of that, 15 mins is under saddle.

Does this seem rather a large increase all at once? I would hate to overdo things at this stage.
Moderator:
DrO

Posted on Wednesday, Sep 7, 2005 - 7:29 am:

This is not remarkably different than our suggestion on a mild case at 60 - 90 days after the second recheck Lynn. Remember however, changes are based on physical and ultrasound changes.
DrO
Member:
9193

Posted on Wednesday, Sep 7, 2005 - 12:44 pm:

Hey Lynn,

How's the view from between the ears??!!!

Congradulations on getting to the riding side of rehab!! How are the two of you doing?

We just added two more minutes of trotting to our 50 minute ride, so yesterday was nine minutes of trotting. So far, so good. Justin is a tad stiff behind for the first minute, but once we get into two minute trot phases, he goes smooth, easy and sound! (phtu, phtu,phtu)

Happy for you and your progress!

Smiles,
Debra
Member:
Frances

Posted on Wednesday, Sep 7, 2005 - 2:37 pm:

Thank you very much, DrO. We don't fit into the mild category unfortunately, but at least you're not throwing your hands up and saying this is completely off the wall. And it IS based on a clinical exam we had 3 weeks before starting this phase. In a week we're to have another check-up, with an ultrasound only if deemed necessary, so I'm keeping my fingers crossed.

Hello there, Debra.

In fact, I'm still not seeing the view between my own horse's ears (though between many other horses', luckily), as my kind trainer offered to bring my mare back into work for me. I do look forward to riding her myself, but I know the longer she's professionally ridden, the better she'll be for me in the end!

I'm so happy to hear that Justin is forging ahead (phtu phtu phtu): happy for you, and also very encouraged for all of us to hear that it's working! (Time for another phtu phtu, I think. Superstitious? Who, me?)

Take care, and lots of pats and carrots to Justin.
Member:
Frances

Posted on Friday, Sep 23, 2005 - 8:55 am:

Latest news is that we've been upgraded to 30 mins ridden walk (no more handwalking) with a little trot (about 2 mins) daily! Ultrasound showed the lesion has filled in, though unfortunately not with collagen, nor with vertically-aligned fibres.

Just in time, as rainy weather has begun, which will mean flooded arena and the need to hack out (trail ride), and I'll never keep her to a total walk after all this time without her seeing the outside world. It's such a relief to know that she can let off steam with a little trotting without it being harmful.

Slight downside, though - horses being what they are there had to be something - she's a bit off in the RH (the suspensory-challenged leg is the LF), and there's a slight puffiness in the RF. The RH is presumably because of her penchant for slamming the stall wall with that foot. The RF could be fatigue from taking extra strain all this time that the LF has been sore. Anyway, vet said to call him in a week to let him know if it's improved, and if not he'll come out again.

What news from you others, Debra, Aileen, Brandi? Hope things are still going well?
Member:
9193

Posted on Friday, Sep 23, 2005 - 12:44 pm:

Hey Lynn,
Great to hear from you and get an update on your progress...two minutes is so short, but so huge for these rehabbers!! How is your mare reacting to being asked to trot? The first couple of times we asked Justin, he kinda hesitated like he couldn't believe we were giving him permission to go faster..

So difficult to keep all corners healthy and equal! I sure hope all her compensation balances out. Maybe with a bit more opportunity to work off a little energy she will resist the urge to slam that wall! (HA)

We've experienced some rehab relapse ourselves the last couple of weeks..A couple of days after the post I wrote reporting our nine minutes of trotting was going well, Justin showed signs of a slight head bob on that LF. So, per Dr Gillis, we had our vet check the check ligaments to see if they were the problem, then went back to walking under saddle for 40 minutes and last week we went back to two minutes of trot. We had been using an arena that has smooth pea gravel in it since it has a firmer footing than the big covered arena. We also have been trotting on the dirt road in the big back pasture, so I don't know if we are doing something wrong or if it will just take a bit longer to add the trot increments.

We have a checkup/ultrasound with Dr Gillis next Tuesday, so I will get a better idea of how the healing is progressing and get a better understanding of how to introduce the trot blocks.

Always something!!! I am not looking forward to the rainy season starting up either... The arena gets so crowded and the footing either gets sloppy or pounded down like cement on the outside track..

Continued healing to your mare. Stay safe and lets keep in touch!

Smiles,
Debra
Member:
Frances

Posted on Saturday, Sep 24, 2005 - 6:33 am:

Hi Debra,

Yes, two minutes is an enormous step for us! My mare's attitude when finally not only allowed but actually asked to trot was: "It's about (expletive deleted) time too".

I like your comment about keeping the corners healthy and equal! Easier said than done isn't it?

I'm sorry to hear you've had a slight setback with Justin. Was your vet's feeling that it was the check ligaments confirmed? As you're now back to trotting two mins, it sounds as if the problem has been resolved. You're in good hands anyway - do let me know what Dr Gillis says next Tuesday.

All the best, and thanks a lot for your response!
Hugs to Justin.
Moderator:
DrO

Posted on Saturday, Sep 24, 2005 - 9:30 am:

Thank you for keeping us appraised and congrats on the improvement LL. I have sent many check ligament injuries back only to have them come on fine Debra so take heart.
DrO
Member:
Sunny66

Posted on Sunday, Sep 25, 2005 - 10:24 am:

Great news Lynn!

Debra, wishing you and your boy success.

Brave is still sound (phtu phtu phtu) - just the hocks acting up - but that gets better with work...vet came out yesterday for fall shots and checked him, while he's incredibly out of shape, heavy breathing after the vet check, the vet said to keep doing what I'm doing, he's sound and looks great. I'll be able to add side reins after he's not huffing and puffing once he gets into *real* work. I've added a couple of inches of sand so it's pretty deep in my arena, but it should be usable all year round, regardless of the amount of rain we get.

I feel very lucky and while I feel for you on the rehabbing during winter, I'm thankful that my guy can now at least trot a good bit so the arab doesn't come out in him once it gets colder.

ps...the vet said he's just under a 6 on the scale...at least I don't have to cut his feed back anymore!
Member:
Frances

Posted on Monday, Sep 26, 2005 - 7:06 am:

Hi Aileen!

Very happy to hear Brave's doing well (phtu phtu). How much work are you allowed to do with him now? And does your vet feel that deep sand is ok, as long as it doesn't get too wet and heavy?

Bet Brave's delighted to be on full rations again!

All the best to you both,

Lynn
Member:
Sunny66

Posted on Monday, Sep 26, 2005 - 10:51 am:

Oh No! Not full rations :-) He should be getting about 20 pounds a day, and he's only getting about 13.

The vet didn't caution me about the sand, he did compliment me on it though. I would say at the most 4 inches deep, I like it at 2 inches.

On the workload, he said to increase gradually, stay at each increment for a week, then see how he goes.

Wishing the best to you as well!
Member:
Frances

Posted on Thursday, Dec 15, 2005 - 10:59 am:

Latest report from the vet last Monday is that the suspensory ligament(LF) is "just fine"! BUT, she's lame in the RH: arthritis of hock and coffin joint .

Sooo ... 10 days of handwalking for 20 mins (not the dreaded handwalking again!), plus 3 days of 3gms Bute, 3 days of 2gms Bute and 4 days of 1gm Bute. Poulticing of both areas daily. Then the vet'll come back to assess.

Well, at least it's excellent news about the ligament. The arthritis we'll just have to live with, and there are worse things. Disappointing though, just when I thought I'd got my horse back.

Sigh ....
Member:
9193

Posted on Friday, Dec 16, 2005 - 12:13 am:

Awwwww nuts Lynn!!!

How did you arrive at arthritis in the hock AND coffin joint? What was going on with her between September and now that made you check out the RH leg?

I am really glad that the suspensory isn't re-injured. What do you poultice with and how do you poultice for the coffin joint? Is it to help reduce inflammation and swelling? Would injecting her hock be helpful for her? What can you do regarding the coffin joint?

I strongly recommend you go get yourself some excellent chocolate and titrate the amount you ingest to equal the amount of bute per day you give your mare.. With all that dang hand walking you'll work it off and it will help you feel just a bit better. Chocolate endorphins ya know..

In fact, I just had a piece of Kona Krunch.. Chocolate covered macadamia nuts with Rice Crisp to celebrate one solid week of Justin trotting two and a half minutes sound. I shall now have one more piece on your behalf to share your disappointment and wait for more news from you.

Hugs and understanding,
Debra
Member:
Frances

Posted on Friday, Dec 16, 2005 - 9:25 am:

Thanks for the empathy, Debra! It's the stall wall kicking that's done it, and I'm really at a loss to know how to stop it. I've even had her walls fitted with deep emerald carpeting (most elegant!) to soften the blows, but the vet says it only helps a little. It's of course a vicious circle too as the more she has to stay in, the more she does it. I hardly ever actually observe her kicking as it seems to be around mealtimes when I'm not there, and not every day either.

We had in fact been keeping an eye on some unsoundness in the RH - that was the only thing delaying our starting a little canter work. I felt it was a lot better, but of course I haven't done any lungeing at all, and when the vet had me trot her on the lunge on Monday, the problem was instantly visible.

I thought an X ray or two might be called for just to be on the safe side, but he said the hock was clearly arthritic and the foot would be much worse if there was a fracture, so there was no point.

Of course the heavens dumped a ton of rain on our arena on Wednesday, and it's still much too slippery to walk her in there, so I'm leading her up and down the aisle and out in front of the clubhouse and back, for a total of 20 mins!

It really bugs me that she's getting hyper all over again with so little exercise, when she had calmed down so much over the past six weeks; we were back to going on long solo trail rides as we used to, and she was doing some nice work in the arena, although only in walk and trot. Now she's all hotted up again.

Poultice is maybe the wrong word - I'm using "Ice Tight", without bandaging over it. On the inside area of the hock, and from the fetlock down as far as the coronet.

Re injecting, I suppose if blasting it with Bute doesn't work, that would be the next thing ... but I hope we don't have to (I feel it's always risky, and also requires stall rest for two or three days, and then even LESS than 20 mins handwalking: sure recipe for MORE wall kicking and excitability.)

Chocolate, yes, that's the answer. We'll indulge ourselves over Christmas - mucho carrots for her and even more mucho chocolate for me - or the other way round?

Thanks again Debra, and all the best to you, your daughter & Justin!

Lynn
Member:
Dsibley

Posted on Friday, Dec 16, 2005 - 9:38 am:

I had started a thread about my QH kicking stall walls...he actually broke thru a tounge-&-groove panel. Good advice from several caring members as well as Dr. O suggested that he might have gastric ulcers, which made sense, as he was not a kicker otherwise. I think the bute exacerbated his problem, and he was in pain so kicked the snot out of the stall. Sorry for the handwalking, but good time for bonding. And you can eat chocolate while you walk! I find that Mint Milanos put me in a much better frame of mind.
Member:
Frances

Posted on Sunday, Dec 18, 2005 - 9:50 am:

Hi Diane,

Yes, I read your thread (was going to reread it, but can't find it now). What news of your QH and his demolition plan?

I was thinking about ulcers too, except that my mare has always been inclined to wall-kick. It's not that she does it constantly either, but that when she does lash out it's a real slam.

Someone suggested blocking off the barred windows between stalls (it was in an old post, and the poster mentioned that there was a lot of "eeeeuuuuu - he's LOOKING at me!" going on, which I think is the perfect description of my horse's behaviour). I'm considering trying this, but my trainer thinks it won't help, as she will still HEAR her neighbours. I am also somewhat loath to isolate her in this way, as she's already pretty hostile to other horses, and hasn't had turnout for a year due to her ligament injury.

Handwalking has been "a good time for bonding" all darned summer - I was just enjoying RIDING for bonding for a change! However, eating chocolate WHILE you handwalk puts it in a whole new perspective ... hmmm, I think chocolate pralines will do it for me ... combined with a good music selection on my husband's ipod as we plod along.

Thanks!

Lynn
Member:
Dsibley

Posted on Monday, Dec 19, 2005 - 9:23 am:

My Qh, Mister, has not kicked since he went off the Bute. We put rubber pads over the holes in the stall walls (Yes, he broke thru!) and those would show marks if he had been kicking. THey are still pristine. I really think it was the Bute kicking up an underlying ulcer. He tends to be nervous...sweats easily, real claustrophobic, afraid of new situations...so it really fits in. Poor baby has just been thru Hades...had strangles and got hind foot caught in a fence before I bought him, now all this. He's just a big, gangly Baby Huey. (16.2 hands at three years old). Love him to death even with all his problems. Thanks for the concern. Hope your mare comes out of it. Frangos...now there is heaven!!
Member:
Frances

Posted on Monday, Dec 19, 2005 - 1:37 pm:

Glad to hear you've got the problem beaten.
Member:
Dsibley

Posted on Tuesday, Dec 20, 2005 - 7:07 am:

This is probably on the wrong thread, but I do have to brag. Not only is Mister apparently recovered from the stall-kicking thing, but I am so very proud of his progress! We had our Christmas party at the barn where he is boarded. I bought him as a very green 3 y/o last May. Still 3, of course, he had problems with claustrophobia and any new situation.
I took Mister in the indoor arena (where he has only been worked about ten times...) with twelve other horses, a bunch of kids and rowdy adults. We played horsie games, laughing shouting, etc. Big boy didn't bat an eye! Barely broke a sweat, and I think he had fun. I just knew there was a good horse down there somewhere. Just had to brag...tomorrow he'll probably dump me.
Member:
Frances

Posted on Wednesday, Feb 15, 2006 - 9:39 am:

An update: Given the ok by the vet to start back gradually into normal work. Putting it into practice was delayed by snowfall and heavy rain, but last week she had her first canter for a year!

Trouble is, she's SOO excited about it. I can slip her into the first strides, but then it dawns on her that she's actually cantering, and she explodes. Oh well, I suppose we'll get through this too , if I survive.

Other than that, she's so sweet and happy. She goes out for a couple of hours a day (wish it were more) in a small area roped off from an old gelding and a calm mare, and the stall wall kicking seems to have stopped.

So, very good news on the whole, phtu phtu!
Member:
Sunny66

Posted on Wednesday, Feb 15, 2006 - 10:32 am:

Great news Lynn!!! Stay safe! :-) phtu phtu phtu
Moderator:
DrO

Posted on Thursday, Feb 16, 2006 - 6:51 am:

LL many a person has been injured and horse reinjured at this stage and oral acepromazine can really help ease you through this start back stage. For more see Equine Medications and Nutriceuticals » Sedatives & Anesthetics » Acepromazine and discuss it with your veterinarian.
DrO
Member:
Frances

Posted on Thursday, Feb 16, 2006 - 10:10 am:

Thanks, Aileen and DrO. I'll print out the ace article and see what my vet thinks.

Lynn
Member:
9193

Posted on Thursday, Feb 16, 2006 - 1:14 pm:

Lynn!!!! I am so happy for you and the progress!!! Whoo Hoo!!

I cannot tell you how helpful the Ace has been for us with Justin..The powdered ace has been so easy to give. He slobbers down his "mickey" and thirty minutes later we are cruising. It does NOT keep them from being silly, but it does take enough of the edge off that the "silliness" does not morph into "nuttiness..." Please do talk with your vet and I hope you can come up with a plan that keeps you safe and your mare from reinjury..

We had a tiny set back last week.. Six minutes of trot made him a tad sore, so we went back to handwalking for a week. Our "test trots" while handwalking this week look better, so we will ease back into the trot work this weekend.. We were hoping to get the go ahead to canter next month, but I have a feeling that won't happen for another couple of months.

Thanks for the update!!
Smiles and lots of "phtu-ing"
Debra
Member:
Frances

Posted on Friday, Feb 17, 2006 - 9:27 am:

Thank you so much Debra! Yes, I've been thinking about you, Justin & your positive ace experience. My trainer's not so keen on the idea - she seems to think it can suddenly wear off causing a worse reaction, but maybe she's not familiar with the oral product. Drugs sound good to me at present!

I do hope Justin strides out comfortably again for you this weekend; these setbacks are pretty common I think, and we just have to play it by ear.

Let us know how it goes!

All the best

Lynn
Member:
9193

Posted on Friday, Feb 17, 2006 - 12:40 pm:

Lynn,

Allow me to share one more story...Another boarder at my barn has been rehabbing her eventing horse who sustained a hind tendon injury and had the bone marrow surgery a year ago. He is a big boy and normally pretty mellow, but after months of walking, walking, walking, he was really having a difficult time keeping it together for his trot work...

One of the barn trainers started injecting Ace to help keep Huck calmer during his rehab workouts. The Ace was very helpful, but my friend was in a bit of a bind... She is absolutely terrified of needles and could only ride her horse if the trainer was around to do the injection. By accident a few weeks ago, she learned from me about the oral Ace. She was really excited to learn that there was an alternative to the injections. The trainer was dubious because she was more familiar with the reaction from the injectable, but she was willing to give the oral Ace a try. It took a couple of days to monkey with the dosage but "two scoops" is the amount that works for my friends horse.

It does take some trial and error, but perhaps you can convince your trainer that it is a learning experience that may serve your trainer well in the future in her career with horses and injury.

Good Luck and Be Safe,
Smiles,
Debra
Member:
9193

Posted on Friday, Feb 17, 2006 - 12:55 pm:

One more thought Lynn... What is your vet's opinion and experience regarding the use of Ace in a rehabbing horse?

If your vet recommends that you use the Ace and prescribes it to you, then it would seem to me that the decision to use a sedative is one your trainer may feel more comfortable supporting since it would not be her call.

Just a thought...I will stop now....

Smiles,
Debra
Member:
Frances

Posted on Saturday, Feb 18, 2006 - 9:54 am:

Debra,

I really appreciate your taking the time to write. I haven't so far called my vet about the Ace as I didn't want to go against my trainer's opinion - you know how it is. However, I plan to talk to her (trainer) again about the oral Ace and get her approval to ask the vet what he thinks.

My mare was completely nuts this morning (lots of horses in a lesson, spring in the air), to the extent that my trainer has offered to ride her for me next week when she has more time. I will go for a hopefully quiet trail ride tomorrow, which I hope will have a calming effect!

Can't help wondering if I'm ever going to get my horse back as she was

Many many thanks again,

Lynn
Moderator:
DrO

Posted on Saturday, Feb 18, 2006 - 9:56 am:

The possibility of exploding under the ace is real but how is that different than what you are having happen now? And while using the ace it is less likely and the explosions will likely be smaller.
DrO
Member:
Sunny66

Posted on Tuesday, Feb 21, 2006 - 10:49 am:

Lynn, you will get her back...it will just take a bit more time. Will your trainer ride her 5 days in a row? That may help.

Stay positive and wear your helmet!
Member:
Frances

Posted on Tuesday, Feb 21, 2006 - 11:15 am:

Thanks for the comforting words, Aileen! Yes, well anyway 4 days in a row. It should help a lot.

I always wear my helmet - staying positive though.... hmmm....not quite as easy!!
Member:
Sunny66

Posted on Tuesday, Feb 21, 2006 - 11:47 am:

Ah but Lynn... as I've recently learned in backing my horse again...I must *choose* to have a fabulous ride before I even see him. It helps to harness the butterflies :-)
Member:
9193

Posted on Wednesday, Feb 22, 2006 - 12:48 am:

Oh Lynn,

I can so identify with your last sentence of Feb 18th...

I had hoped that we would be a lot farther along 10 months down the road. I realize that Justin has four structures that are trying to heal and that realistically it will probably take more than a year plus months to consider him "sound". I do miss the "good old days" when I could just saddle up my boy and go for a ride without drugging him or worrying that every little shenanigan is setting us back in the rehab...

Chocolate and good red wine...Primary staples of a well rounded horse lovin' rehabber!!

By my calculations, it has been 17 months since your mare's injury.. Look how far you have come!!
I figure that it will take at least that long for Justin to come around...I intend to have eaten and imbibed much of the aforementioned "comfort foods" in my journey to "soundness".

Hang in there, hang on and keep writing!!

Smiles,
Debra
Member:
Frances

Posted on Thursday, Feb 23, 2006 - 7:00 am:

Aileen: Ok, I'll have a go at picturing wonderful rides - she doesn't always have the same pics in HER head though!

Debra: Those are exactly the good old days I miss too. But you're right, and don't think I'm not grateful for the progress we've made (and to DrO for putting me on the right track all those months ago).

I don't think you ever mentioned how Justin sustained his injuries? Although most often we just never know.

Hope he's over his soreness now?

All the best,

Lynn
Member:
Sunny66

Posted on Thursday, Feb 23, 2006 - 10:42 am:

Lynn, you should *expect* her to behave, thoughts of her misbehaving must be out of your head :-) ... the confidence will exude from you into her. I thought this whole visualization thing was kind of hokey at first, but it really works for me.

Brave has been being a bit feisty lately, and it STILL works for him :-) I have to push the thoughts out of my head and even say out loud "I expect you to behave." It's amazing how sensitive these horses are.

Give it an honest try and let me know how it goes :-)
Member:
Frances

Posted on Friday, Mar 3, 2006 - 1:13 pm:

Hi Aileen: I really like your "I expect you to behave" mantra. It just has a good calm ring of quiet authority to it. And I'm sure actually thinking (or saying) these words is much more helpful than just generally reminding yourself to be confident.

Of course, my trainer riding my mare for several days has helped a lot . Things are a lot better, phtu phtu. I'm riding her in the school one day, out on a trail ride the next, and the canter work in the school has been mostly calm. I intersperse the trot work with occasional short stretches of canter so that she won't have time to quite take in the fact that she's cantering before we're circling off in trot again! I think canter is gradually becoming a little more routine to her. Occasionally she tries a halfhearted leap, but not with the same mania as before.

Thanks again for passing on the magic words!

Lynn
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