Monday, December 15, 2014

Ultrasound Update

Friday was the big day.  I had been simultaneously anticipating and dreading our next appointment with the vet and seeing what Prair's DDFT actually looked like. 

On days when she felt great - the ultrasound couldn't come fast enough to confirm what must be good healing. 

But on those days when she felt less than stellar I was dreading the possibility of seeing angry, disrupted tendons that weren't healing as hoped...

But irrespective of my mental mind games, Friday came, and so did the ultrasound.  First my vet looked at her under saddle - Prair was particular hot to trot which made it hard to get (and keep) a steady rhythm, but apparently she looked sound, sound, sound, so we progressed to the ultrasound.

Vets have such a good poker face when they are doing diagnostics... I literally had no idea if she was loving what she saw, or gravely concerned until she was done taking still images and stood up with an assertive "okay, here's the deal."

(heart sink)

"She looks great."


Ready to get back to business
Basically the ultrasound showed a much happier DDFT with really nice edges and minimal scarring.  Back in July the same view showed quite a bit of fiber disruption and rough edges on almost the entire medial DDFT.  Now there's just the tiniest spot of a rough edge and everything else looks beautiful.  There are a few flecks of scar tissue, but apparently given the initial strain - it's a minimal amount and not something my vet is worried about in terms of return to full work. All great news.

The disadvantage of doing the ultrasound instead of returning to WSU for a full MRI is that we really can't see what's going on with the navicular - which if you recall, is what we currently believe to be the root issue.   But since we think the soft tissue is a direct reflection of her comfort within the navicular.. we're extrapolating that it is also less inflamed and angry. 

Right now I'm comfortable making that assumption and think that it outweighs the cost, risk and energy involved with shipping back to the University for an MRI again..  I don't think we'll have to go down that road unless something unexpected happens in the coming months.

In terms of continued rehab, the visual confirmation of healing is what we were waiting for to ramp up the workload again.  The balance of the month will be spent on more flatwork and increasing the workload on that left front limb (pole work, extended canter, etc). 

Assuming all goes well, we are cleared to return to crossrails in the New Year, then we'll ultrasound one more time in early Feb to ensure that we haven't lost any ground with the increased work.

Prair will keep her reverse shoe on the LF for added support, and we'll add in some Tildren treatments this year to help support the navicular.

For those who haven't used it - Tildren basically impedes bone remodeling.  For us this means that we stop the bone's natural response of increasing it's density - which in turn causes it to become more brittle...

So, flatwork until Jan, Crossrails and increased work until Feb.  One more ultrasound so see if all is still well, then some Tildren to help support the navicular bone.

All in all about as good of a report as I could hope for. 

Now I just have to remember how to ride.....

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  1. Yay! That's awesome news! Tildren would make me super nervous, but it sounds like your vet is pretty awesome and can handle it. :)

  2. YAY! That's such great news! Really excited for you and Prair to tackle cross rails in January ;)

  3. Wonderful news, I am sorry if this is obvious to those more equine educated than me; but knock-on-wood i have been very lucky with he lack of equine injuries/rehabbing i have had to do to date so am not in any way up to speed on injuries nor how to help our horse - pals get back on track after them. However a friend of mine's horse got injured back in July. Initially it was thought she'd hurt herself where she stepped on her heel - when he mare was still lame after that healed up it was discovered she had also hurt one of her tendons. She has been walking on hard ground for 30minutes for the last few months and on their return to the vet clinic last week her owner was told that the tendon still had a lot of branches off it (sorry I'm not remembering the proper technical stuff as i wasn't there at vet clinic) so healing will take a lot more slow work although now she cab walk for 30minutes in an arena so long as the footing isn't too soft. She was told there was an option to operate also...I know i haven't given you much info nor have I all the info, but at the risk of sounding stupid - is it in any way similar to Prair's current tendon issue?

    1. Sorry I do realise every horse & indeed injury are different and neither one of us are vets but i hadn't realised that tendon injuries could result in a branching off/weakening of the tendon. I am prob stupid for not knowing this but as I said knock-on-wood i have been very lucky so far in the injuries i have had to deal with and as such know very little

    2. It is definitely a blessing to have avoided intimate knowledge of specific injuries :) I feel like so much of our horsey education comes from what we deal with personally - so I'll knock on wood that you stay blissfully unaware of tendon issues!

      So, it could be similar, or it might not be... there are serveral different tendons and ligaments that support a horses lower limb... but if her initial injury had to do with a sore heel, it's possible she has a similar strain as Prair. Tenedons are TRICKY to rehab because they have very little blood flow and so getting them to heal (and heal correctly at that) can be tricky. You have to walk a fine line of asking the horse to use the strained ligament enough to increase blood flow and help support range of motion/strength with the desire to rest the tendon and immobilize the strain... It can be very frustrating and I've had friends with tendon issues where they followed dr's orders for 6 months but the tendon still showed fiber disruption and a lack of good healing... Of course the severity of the original injury is very important, and Prairie was lucky that she didn't have any full tears (or lesions) in her DDFT... But, to answer your question lots of tendons are weakened even after rehab, especially if lots of scar tissue forms, or the fibers aren't able to realign themselves.. So frustrating.

    3. Yeah, everything I've heard about tendon injuries in both humans and horses are super individual and slow healers. I'm so glad that Prair's is healing well and wish you both continued patience and full recovery.
      Thanks for answering my monster comment *blush*

  4. Wonderful news! That's so awesome, I hope the rest of the recovery goes as smoothly and well!

    bonita of A Riding Habit

  5. you must be so thrilled with this news! congrats! fingers crossed things keep progressing as expected :)

  6. Yay mostly good news. :-) I was wondering if you were going to re-attempt the crazy trek across the state in now-winter weather for that MRI. Seems prudent not to.

  7. That is such great news! I'm so happy for you and Prairie!!!


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