Slow Start: Diagnosis

Well, we have a diagnosis. 

And (more importantly) we have good news.

I call this series: in search of hidden treats

Turns out, the nagging slight lameness we had been noticing was a slightly pissed off lateral collateral ligament in the coffin joint. 

Sneaky little suckers are often hard to pinpoint and require an MRI to confirm.  (which we did, without anesthesia, go team).

The MRI shows that there is a mild strain (moderate focal tissue disruption), but that it's already healing.  The big lovely swingy trot that we noticed after some time off from the holidays is the result of that healing, and now that we know for sure what's going on - we can be more mindful of how to move forward without risking a re-injury. 

As of last week, Winds feels fab, and his slight inconsistencies from left rein to right rein no longer block out in the foot.  So we are (reasonably) confident that the collateral  is no longer causing pain, and that the inflammation has all but gone away.

The bummer is that while I was initially aiming for a season opener up at Thunderbird next week, we are on an (even) slower plan to hold off on jumping for a while longer and continue to just increase the workload on the flat in two week increments.  At this point I'm probably pushing back our first show to the end of June, assuming we don't hit any speed bumps between now and then.

Winds feels awesome, and I know that this easy spring has been good for his body. With a confirmed diagnosis I am even more convinced that we did the right thing, and I can't wait to see how this horse jumps and moves when he's feeling his best. 

In the meantime, it's all that boring, but oh so useful flatwork while we continue to build up strength!

Anyone have experience with Collateral strains?

I like our current plan of action, and am grateful that even with his crazy hard season last year, all we have is a slight strain (no tears, no holes, no scary anything) - so the prognosis is about a good as it can possibly be... but any magic tricks or special considerations are always welcome!

And lest you think I'm not getting enough saddle time, there are a few irons in the fire that hopefully I'll get to talk about sooner rather than later!

In the Interim...

Winds has been living the life the last couple of weeks.  Lots of turnout, some down time, and a bit of a dialed back routine while we take advantage of a few weeks at home.

Totally deserved after two weeks of this

The vet did come out when we got home from the June shows, and I made sure to be there so I could provide intricate details about what was feeling a tad off.

well, he's cross-leading a bit on landings.. but only from a tighter distance or weaker pace...

I see.

And he's feeling a bit sulky in the corners, though that might be ulcers because it wasn't really a thing the first week and I do think his tummy might hurt and that's the sort of thing that would really flare up week two of showing and no he's not on any gastrogard or anything right now so yeah.

Ok.

And what else, well, the cross lead never happens with me, but I only show him 2'9"  It happens in the pro classes at 3'3", but more in warm up where the ring has a shorter approach and only twice in competition

not hard - not trying

once was in the morning and I had fed him two carrots, so the next day I fed him THREE carrots and it didn't happen so maybe it has to do with carrots and not anything else but I don't really know because it's really subtle and he still won the derby so obviously he's still "going" well it just feels subtly different and I don't know if we'll be able to pinpoint it.

You get it - the all too familiar vet-ramble where we verbally diarrhea all the crazy-ass conspiracy theories we've brainstormed at 2am to explain the mystery lameness/illness/moodiness/whatever in our horses.

I asked if the vet wanted to see him under saddle since whatever the issue was, it was weird and subtle and hard to replicate.

But instead we started on the lunge, where my 18 minute preamble became immediately irrelevant as the horse was clearly stepping short on the left front.

(not weird, not subtle, not actually hard to replicate)

It was mostly gone when tracking to the right, and not any worse on the hard ground outside.... and Windsor flexed negative everywhere.... so aside from the slightly short step, there wasn't really anything obvious to pursue diagnostically.

So without going on a crazy lameness witch-hunt we decided to give him a few days of anti-inflams and the rest of the week off before pulling him out on Monday to see how he looked.

He looked sound.

Which meant we moved forward with a light week of flatwork and some cavaletti whereby he felt awesome and worked well.

Oh - I forgot to mention that the extended week off included a gastroscopy and diagnosis for some ulcers which were consistent for a horse in his level of work who's been traveling and showing and flying around the world and whatnot (as you do).

That all means he's on some tummy meds to address that particular issue and we'll see where we end up in a month.

Aside from that - all is well.  Winds is happy and sound and relishing his big grassy field. 

As for me, I am finally in town for an uninterrupted stint and trying to get back in some semblance of riding shape before our next outing up to Canada again on the 20th.

Training & Timing - when to make a change

For about a month (maybe a bit longer?) we've had Windsor working in a German Martingale that has been set to the loosest ring.

The original reasoning was that while he is *very* light in the bridle, he went from soft soft soft to grabbing the bit and having zero mouth in about .2 seconds. 

This was especially true in the lines - where we also weren't exactly eating up the ground (recall in Germany he was almost always on an add stride.. and they were baffled when we said that wouldn't fly in the US..)

Anyway, in an attempt to get him a bit softer, have some communication we fiddled around.

More bit just backed him off and made him super empty in the bridle - so that wasn't a great solution... but the German Martingale (not sure why I keep capitalizing that) had just enough added leverage to get some softness when we wanted it, but then be mostly neutral  when we didn't.

Anyway, so all the while, progress has been made both on getting up the lines, and holding leads, which was great.  One consistent point that we weren't really making progress on was getting Winds to really reach for the bridle.  There is also something weird about how he carries himself, so that when you are on him you think "wow gosh, he's so open and stretched through his topline! this is great"

But from the ground he's still at, or just behind the vertical.  I have literally never ridden a horse where the perceived carriage, and what you feel in your hand is so different from the ground. 

it's sneaky.

heart melt.

So last week, I had been thinking that perhaps the "weight" of the martingale was enough that Winds didn't really want to reach forward, so we took it off. 

And, whaddya know.  He happily stretched his frame a bit more, poked his nose to (or just in front of) the vertical and raised his whole balance a smidge. 

Over fences it was a different horse.

(he was also a bit... excited for the fences that day, but still... different horse)

We didn't drill him much, but every.single.fence. was good.  And he held every lead. And never landed cross once.

So. the German Martingale had gone from being a useful tool - to being inhibitive.

Which sparked a philosophical discussion in the barn as to how you identify that change as soon as possible. 

Obviously it was never my intent to keep him in the GM forever, but when do you assume the gimmick, (or whatever) has done it's job and is no longer needed?

On a horse like Windsor (who wasn't in need of brakes, or any restriction from a safety standpoint) perhaps we could have taken it off once a week.  But we didn't.  mostly because it didn't feel like it was restricting progress..

But it was.

Or rather - it was restricting information.  Because what a few rides without the martingale told us was that Winds was (much) happier and (much) more comfortable when he could pick his own balance and poke his nose a tad. 

When he was being bridled more, he wasn't able to adjust properly and was popping off leads and whatever else...

Vet thought that was a good indication that something was up in his neck (facepalm) so Friday we took a looksee and, sure enough - found some arthritis in a couple spots - most notably C3/4.

After the ensuing rage blackout of "WTF we x-rayed that and it was clean sweet jesus does it ever end" (answer: no. no it doesn't).

I came around to (finally) understanding that the x-rays don't really show any degeneration on the transverse process, so we had to ultrasound (ugh) in order to see the inflammation that indicates it.

FACE PALM.

Anyway, so buddy boy got another couple injections (on the left side only) - and the more I thought about it, discomfort in his neck makes a lot of sense.

It explains his stiff direction

It explains why he wants to grab the bit and stiffen his neck in the lines

It explains why his RH is a bit tricky to gather up

It explains the rough landings/lead popping

It EXPLAINS ALL THE THINGS. 

So, from that perspective I guess I'm grateful that we had something straight forward to address that (hopefully) will benefit all of the things we have been chipping away at. 

I should have also taken a picture when he was under sedation because when he is totally relaxed his neck is SCREWED UP.  the muscling is so uneven from left to right it's absurd I couldn't see it before (or while I'm riding and staring at his little neck..). 

But - again, super consistent with the info from the gal who does bodywork said.  tightness indicating discomfort on his left side... tight nuchal ligament, tight pecs and left shoulder...

So I'm left with the residual guilt for a) schooling the tar out of him on some of these things (in which he just smiles and says "ok mom.  I'll try harder") that he really couldn't do anything about.

And also the residual guilt for not pulling the martingale sooner and starting this process more swiftly.

So.  I'll pose the question again - how stagnant is your setup? When's the last time you changed bits/boots/saddles/anything.  Is there anything in your regular tack you assume you still need but might not?

I'll hack him lightly tomorrow to see where we are, then I'm out of town and Trainer takes over for the week, but hopefully I'll squeak in a ride or two next week before he ships to Cali that weekend!

Prair Update

There hasn't been much on the Big Mare recently... mostly because the Big Mare isn't doing much.... She is still up north, happily getting fat and enjoying her stall/run/confinement with a relatively good attitude. 

I was supposed to get up there around New Years to flex her and see if she was still three legged lame on that left hind, but due to a myriad of reasons - I didn't actually get to attempt that until yesterday.

Pair's best GoT "winter is coming" face

(note: I need new photos like whoa)

If "too busy to flex my horse" is any indication of how nuts things have been - so is the fact that I showed up to attempt said flexion without ear plugs, or (more importantly) some sort of elephant tranquilizer. 

But, we threw a chain over her nose, grabbed some treats and walked out of the barn to see what we were working with.

The answer to that (idiotic) question is - a big, dumb kite.  A huge, shorty, four legged kite that hasn't walked more than twenty feet in a straight line for more than.... 10 months.

So the information gathering was limited to say the least. 

We did get some useful information like - she wasn't flinching from palpation (yay) and she was actually willing to let me flex the leg (which she wasn't a few months ago).  So.... That's helpful info.

However, trotting off after said flexion was not actually helpful because she sorta flew around like a maniac long enough that by the time her toes touched ground again, I'm not sure we would have seen any impact from the flexion...

Recognizing that she wasn't likely to magically calm down - we did one final flexion asking her to just walk off after and that looked... normal I guess?

She was still squiggly and excited about walking so I wouldn't put a lot of stock in it - but she did at least willingly use her leg in all walking/flying/leaping activities, which is for sure better than where we started.

But - I'm not a vet and the mare wasn't making it easy, so ultimately I called my lameness guru and she will be in the area next week so we'll get a real, certified opinion on where things are then.

Fingers crossed we see some real improvement.  Prairie is creeping up on 10 months of stall rest (good GOD) and I'm guessing that we are unlikely to see any real tissue change front his point forward. 

We are probably inching toward the point where she gets reintroduced to work to see what we can build up to - or.... she enters the world of professional mommyhood. 

Hang tight mama... D-day is coming.

Finding The Parts

A couple of weeks ago we had the vet out to do a check in on Windsor.

This was always the plan - he hasn't been off, or ouchy, or anything exciting/horrifying along those lines (well, aside from the stiffest neck in the WORLD after some shots..) but, it was basically a scheduled healthy-baby-check-up.

In my head, I know that there's no such thing with horses. 

Even if you think your baby is healthy, if you pay a vet (especially an extremely sensitive soundness vet) to look at your horse they will find something.

and in reality, I was expecting her to find something. 

Even when we were trying him, Windsor showed a desire to step off his left lead when he landed, and there was always a teeny tiny stiffness in his back that we weren't sure where it stemmed from.  He never flexed positive... nothing showed on x-rays, nothing showed in the ultrasounds... so we were reasonably certain it wasn't anything CRAZY, but still - one always holds one's breath when the vet starts poking and prodding.

What was peculiar, and honestly totally unexpected is when the vet mentioned that while he wasn't showing soreness... he almost looked a tad Neurologic in his hind end.

Cue fainting.

After I resumed consciousness from the brief, but intense panic attack - she clarified that this can be caused by any number of things, especially discomfort higher up in the limbs - and the "parked out" or loose movement can be a simple compensation not a scary, permanent state caused by an impingement or EPM or any of those scary things that I know way too much about.

The suggestion was to inject all the things.  I thought this was a little weird since I've never injected anything that didn't flex positive or wince away from palpation.. But there was enough residual panic from the whispering of neu-ro-log-ic that I agreed to do whatever it took to make it go away.

So we injected his S/I and both stifles and took a few days off and I tried not to cry myself to sleep at night.

When we resumed work (this if about two weeks ago, FYI).  Windsor felt AWESOME.  Like, how can injections possibly help this much when you weren't showing any soreness- awesome.

But I'll take it.  He's more forward (though he still trends towards slow), he's much lighter on his front end, and his lateral work - holy shit - his lateral work is miraculously easy now.

Not perfect.  But easy.  A slight half halt and some leg and he just steps up and under and doesn't even tempt me to go to my hand.  And it's amazing how much better your leg yields, shoulder ins, everything get when you don't get tricked into going to your hand...

It's lovely.  And it's not subtle.

When the vet returned to see how the injections affected him - she was also impressed at how much improvement she saw.  I can't say for certain but I've never seen her raise her eyebrows and go "wow, I guess we nailed it."

The improvement has only continued - which is really fun. 

Our flat lessons have been extremely productive, and now that Windsor is naturally sitting back a bit more all the sudden I can feel where all of his limbs are.  It's amazing how when the back lifts and softens how much more information you get from your seat.  It becomes possible to manage straightness and impulsion and each tiny little hoof without much effort.

So now, when we're working on pushing his tushy in and out on a circle, I can feel where his footfalls are.  Kind of how I can feel how my ponytail is swinging behind me when I run (assuming I ever ran). 

It doesn't feel like an extension of my own limbs (I'm not Anky), but now it at least feels like something that's actually attached to me instead of some big block that I'm bouncing along on top of. 

And that lets me relax my hips and hug my legs and actually sit on my horse.

In other words - I feel like I can ride again.

It's still a bit difficult for me to rationalize how much improvement we got when he literally didn't show any signs of discomfort (aside from a disengaged hind end..).  It goes against my experience with previous horses, and previous maintenance needs - but as new and strange as it is, the one thing that holds true is that nothing is ever the same with a new horse. 

Vet Updates (again in plural)

You know it's suboptimal when you've had more visits with the vet(s) in the last month, than lessons...

While not unheard of in the horsey world - it's certainly not my favorite balance...

Anyway, when last we spoke (about Prair), she had a disappointing 3 month checkup and had her turnout totally pulled. 

Last week we had a 4 (jesus..) month checkup, and finally got a glimmer of good news. 

Prair was a 1.5 or 2/5 on the lunge (tight circle) and a 3/5 on the flexion.  It's a tad depressing that a 3/5 felt like a good result, but it's the first time we've seen significant improvement (from a 5/5) in this process, so I'm letting my expectations think that maybe, just maybe this is one of those super slow healing strains and we still have a shot of a solid recovery to flat work.

So, we've got a couple more months of hanging out again before we re-check, because at this point... clearly we need to go extremely slow and we don't have an agenda in terms of showing or seasons, or anything.

With regard to the poop doctor, the combo of antibiotic and high quality pro-biotic seems to have been a great 1-2 punch and for the last few weeks, all signs of diarrhea have been absent.  I've even been able to comb through her tail since it is no long in a constant state of manure-dreadlock.  So, while I'm sure Prair feels better, my grooming routine is also much more gratifying. 

I strongly prefer combing out a nice tail over pressure washing manure streaks off her poor tushy.  So that's a win all the way around (literally).

On the life front, there is a new nanny, so I am inching back toward the semblance of a schedule I was carving out that allows for some regularly scheduled days, both for the office and barn.  Very eager for that normalcy to be back. 

Beyond the regular life front, a casual perusal of potential new horsey options is still underway.  I'm trying to be more patient than I usually am, since a) I'm not wanting to move Prairier along any time soon (even as a brood mare) and b) with a kiddo the cash and time is severely restricted so there's no need to rush into a new pony commitment.

But that doesn't mean I can entertain suitors, and potential good matches.  There might be a gray that I'm flirting with, along with a couple other matches.  though I'm learning that shopping in a (good), structured program feels more like entering into an arranged marriage than my usual approach of going to the bar and trying to find a decent option that looks good, dances decently and doesn't have any obvious issues....

Vet Updates (because we're doing these in groups now..)

Not an extremely exciting post - but Prair has little to report on these days.  The good news is that her poop situation has stabilized.  It no longer seems like she is uncomfortable, instead we are back to our low grade leg/tail nuisance.  so that is a small victory to celebrate.

On a more empirical level, all of her lab work has come back clean.  No scary infectious diseases, no scary blood imbalances (though we thought that was an issue before we figured out the lab equipment was broken and had given (the same) weird results on every sample....). 

So that's good.  Current next step is a antibiotic that our vet has had some luck with on unexplained diarrhea.  It's sort of a shot in the dark, but whatever, might as well attempt it?  the only drawback is clearing out all the good bacteria in her gut, so her 5 day treatment won't start until we have a really good pre/pro-biotic on hand to issue at the same time. 

In terms of non-poop related updates, the mare looks good.  Her legs are staying much tighter with less wrapping and I'm hoping that means there might be less edema surrounding the suspensory.  (fingers crossed).  Prair's tummy edema is also gone, and she's a happy lazy mare in her turnout.

I crossed paths with our sports medicine vet today, and since she'll be on the farm again next week, she's going to do a minimal exam on the mare then, since it will have been 4 weeks since the last ultrasound.  she'll palpate and flex, which presumably will still show tenderness.  If that's the case that's all that will happen.  If by some major miracle all tenderness is gone, we'll ultrasound again and see what's going on. 

All in all Prair is good.  Whatever weird stress she was responding to a couple weeks ago, seems to be gone.  It's nice to see her back to herself and enjoying all her curry comb groom sessions. :)

The Other Vet Visit

A few days before our Ultrasound, Prair's general vet came out and we officially opened a case on her chronic diarrhea.  This issue for Prair has come and gone (but mostly been around) since we moved to our current barn.  It started almost exactly after our move, and while sometimes it dies down, it doesn't really ever go away unless we are off property for an extended time (like three weeks at Thermal). 

Every vet I have spoken to has been very guarded about any optimism about finding a source for Prair's symptoms.  Apparently chronic diarrhea in horses is like saying we have a "rash." 

There are about 400 different rashes with thousands of potential causes or irritants that could cause one.  Apparently so goes watery horse poop.

Here's what we know:

There are no obvious correlations with her diet.  her hay, grain and supplements have all been adjusted at some point without a large impact on her symptoms. 

Symptoms started 2 weeks after our arrival to our farm, and have varied in severity, but have always been pretty consistent.  Most of the time her manure itself is well formed there's just extra... liquid. 

Until the last couple of weeks she has never appeared uncomfortable.  No signs of colic, no worried eyeballs, nothing.  Recently she has seem upset over passing manure, which I think is due to her skin being a bit scalded...

Her fecal showed nothing weird, egg counts are right where they should be in her worming schedule, so it's unlikely a traditional parasite.

Blood was also mostly normal.  I say mostly because protein counts were a tad off, and oddly, a few other horses on the farm who had blood drawn showed the same protein irregularities - but no tummy symptoms.

Sand was also well within a acceptable range.  I know sand checks are fairly subjective, but he didn't hear much of it in her belly, and there wasn'y much in her manure.  She's not grazing on sandy soil, and I've never seen her eating sand in her paddock, so I'm not that concerned about sand...

Our vet is Mr. Thorough.  He spent 45 minutes on the phone discussing significantly more detail on the lab results and possible causes than I could ever hope to remember or understand.  Which - is saying something since I'm usually a vet-detail-hoarder.

Right now the plan is to collect another blood and fecal sample to overnight to Davis for a different lab screening that will focus more on screening for weird viruses.  (I think).

Prair's getting some of her supplements pulled just to simplify her diet a tad, and depending on the results from Davis, we may try pulling her off traditional hay for a couple weeks and give her hay-mush only in order to let her tummy settle and not have to process stems for a while.

All in all, there's no clear path to explore.  Initially Mr. Thorough was thinking the protein levels in the bloodwork was going to be our primary avenue, but with other horses showing the same levels and no symptoms, he's less confident that is what's driving Prair's symptoms. 

The increased confinement of Prair's "stall rest" (with turnout) could also be contributing to her tummy troubles, but sadly, that's not about to change anytime soon either.

Mostly it's a big bag of question marks for the moment, but hopefully the second round of lab work will at least rule out a few causes and I can keep the mare's tushy a tad cleaner.

All the watery poop has really done a number on her tail as well... While she never had a thick, luscious tail to begin with, it's even sadder after so much breakage and snarls with manure dreadlocks.

A sad, but less serious side effect I suppose.

Always an adventure!

Ultrasound Update - Cue Despair

Prair has been getting more than her fair share of attention from her arsenal of vets recently.  Aside from the check up on her Left Hind, our GP has been out to try and investigate her chronic diarrhea which has made a angry resurgence.

I'll start with the check up on her left hind, since that's most of the drama. 

We started by lunging Prair on a small circle, where, even with a heavy martini in her veins, she was still exhibiting Dragon-like-symptoms.  But once a bit settled, she looked great.

Both directions.

No limp, no shuffle, no quick step.  Sound.

So we flexed.

And that's where the wheels fell off the wagon. 

Her left fetlock flexion is still really positive.  She shows obvious discomfort at the flexion being held and the first two steps off the line looked nearly as bad as I remember eight and a half weeks ago when this adventure started. 

I almost canceled the Ultrasound since we knew it wasn't going to show brilliant progress, but I was too curious and too interested to delay the opportunity to get more information.

The (little bit) of good news is that general inflammation in the area is down.  There is still some edema around the suspensory, but less than there was 8 weeks ago.  The medial branch of the suspensory still shows a small area of disruption, but appears to be making (some) progress.  This would be great news f the DDFT was following suit, but the DDFT looks exactly the same as the images we saved from the previous ultrasound.

There is s slight line showing on the DDFT, which is likely a small split in the tendon.  We can't confirm exactly what or where without an MRI, but I'm still holding off on that procedure since confirming it's a split doesn't change any treatment plans. 

Essentially, the vet took one look and asked for two more months of stall rest followed by another ultrasound.  A pattern we would keep repeating until we see either improvement in healing or scar tissue form. 

crap

Obviously not what I wanted to hear.  I am extremely skeptical of miraculous healing when there hasn't been much indication of progress in the initial two months - especially when the structures received PRP and shockwave to invite progress with limited results...

So. 

There we are.  I spent the long drive home from the barn being fatalistic and trying to think about my (reasonable) options.  One thing I am fairly certain of is that if we can get meaningful healing, and Prair comes back sound on that limb, I don't think it's fair to ask her to jump (however small) again as her primary job.  Attempting to rehab her as a solid, exceptional Dressage mount for an Ammy seems more responsible. 

At this point (as in today, thought I'm sure I'll waffle on this), I still really want to jump, so if Dressage-Ammy-Mount was an option, I'd likely be looking for a home I trusted for the big mare.

Of course I have to consider the possibility that she won't be serviceably sound and think about what that means too. 

She's pretty, she has great bloodlines and two (stunning) babies on the ground, so we know she has value as a broodmare as well... it just seems too soon for her to become a professional mama.

Anyway, obviously for the time being some patience is probably what I need the most - but it's hard not to let my mind race a year down the road and wonder if I should try to move her now to a less expensive facility where she can enjoy her (extended) rest in a slightly more affordable fashion. 

Though my immediate reaction to that thought is concern over moving a horse that I want keen eyeballs on to a facility where the service level might be lower and the staff won't be familiar with her.... Not necessarily a great tradeoff, especially for peace of mind.

Lots of thinking to do, and thankfully a sunny, beautiful weekend coming up so I can wallow in my Mare Despair, probably with wine in hand

Ugh.

Using My Words

Thanks for all the support (and sympathetic wine drinking) I appreciate it. 

It's been a frustrating week.  My emotions ping from "eh, this is horses and I'm totally ok with that" to a totally victimized "why Prair, why…. I'll never get her sound... etc etc."

Wisely, The Boy has been traveling for work most of the week, so my cat has suffered a majority of the manic ranting. 

Basically - as awesome as Prair has been feeling since her back injections, this little (tiny) hopping action she does during her initial warm up has been nagging in my head.  It started back when we were just getting back to trot work last summer.  Prair would pop above the bridle and sort of hop (a tranter-like thing) for a step or two, especially when changing direction. 

At the time, my vet was unconcerned so I’ve consistently told myself to shut up about it and put my head in the sand. 

However, after her back injections, the hopping seemed to exaggerate itself.  She always works out of it – usually only in a lap or two, but recently it’s been more obvious when you add left leg. 

A stiff hoppy thing for a lap or two that’s unexplainable is one thing, but something that consistently shows itself with left leg?  Quite another, and much harder for me to accept.

So, I called the vet back.  And since Prair only does the hoppy thing under saddle, I tacked her up and got ready to ride. 

The good news was her left front looks spot on.  No glimmer of shortness or soreness, so big YAY there.  The bad news was that her left hind was looking like a .5 or 1/5. 

At this point I couldn’t decide if I was relieved to be dealing with a new limb or ready to cry because we were adding a new leg to the mix… but it turns out my emotional reaction doesn’t do shit for what the mare feels, so I ignored myself and waited for some flexions (that’s what the flexi-bicep emoji stood for, btw).

Everything flexed great until her Left Hind Fetlock, which she was uncomfortable even holding the flexion in. 

Then we trotted on hard ground which didn’t exaggerate any lameness on either left limb – which was moderately encouraging.

Then we took out the ultrasound machine since Vet thought the extremely bad flexion warranted a look see. (the flying money emoji)… And the world’s-longest-ultrasound commenced….And I heard my Vet say “sorry this is taking so long, but there’s a lot to look at.” 

crap.

I could not think of any possible answer that was a good explanation such a comment.

But after what felt like endless scanning and consternated looks, we sat down to talk about what she saw. 

Good News: No major tears or massive trauma that’s readily obvious.

Bad News: The medial branch of the suspensory, medial branch of the superficial flexor tendon and lateral lobe of the DDFT (I may have mixed some of those up, but there were definitely two medials and one lateral in there) all look… angry.  Some edema, minor disruption, etc.  The most concerning of the three is the DDFT which is hard to see and (my vet thinks) could be the hardest to rehab.

Ideally she wants another MRI, which, if the mare was insured would likely be covered since we are now dealing with a new limb.  But she’s not, so that’s another $3,000 and right now I’m not sure it’s worthwhile.  The first time around I was adamant about getting the MRI and not making any assumptions about what sort of injury we were dealing with.  But this time? I don’t know.  In talking it over with my vet, she can see enough on the ultrasound to want the mare on 2 months (gulp) of stall rest no matter what, and to shockwave the area. 

Part of me feels like if the MRI isn’t going to impact our treatment plan, then why stress the mare with the trip and spend the cash when it could go toward treatment.

Now, if we recheck the mare in two months and still have some questions? Maybe the value of additional diagnostics goes up. I’m not sure.  I just am having a huge mental block about loading the mare up and hauling her east again – but maybe I need to get over that. 

As for what potentially caused this? No one can say for sure, but the minor disruption and edema make it look like a slow irritation/strain rather than a traumatic sprain/tear.  In an infuriating twist of events it’s quite possible that the slight fill that Prair picked up in her hind legs from her previous stall rest was enough inflammation to lay the groundwork for this. 

I’m so frustrated.  And I’m mad at myself for not having felt this earlier.  I suppose my nagging concerns about the hoppy-warm-up-thing were silenced by how straight and balanced Prair has been.  Her changes have been nearly automatic, she’s pushing off straight over her fences (which is a new skill) and she’s so much calmer in her work, all signs have been pointing toward “comfortable.”

But clearly that is not the case. 

So, two months stall rest (she can go out in a small paddock if she’s good), with wraps on for 12 hours a day to try and keep her inflammation out.  Ice Vibes will be doing double duty on the front and hind limbs…. And that’s our plan. 

If this is truly a hiccup from having additional fill in her legs and extended stall rest, then fine, I can deal with it no problem.  But I can’t quite silence my worries that we’ve started a downward spiral of chasing soft tissues injuries from leg to leg to leg.  Fingers crossed this is a one-off and not a slow degradation of the big, lovely mare.

But that’s a bridge I’m not crossing yet.

 

 

 

Annnd Scene.

And Just like that.  We are back on stall rest.  I'd type a really detailed post about wtf is going on, but the rage is still strong, and it seems more appropriate to use emojis.



 

 

For those who don't speak emoji, I'll elaborate whenever I run out of wine and start using words again.

Maintaining Perspective on Maintenance

In my youth (my youthier youth, I still maintain illusions that I am youthful..) I held fairly strong, and righteous opinions about "regular" maintenance for sport horses.  My thoughts could be summed up by the philosophy that owners should not be taping their horses together to perform at a level that their bodies couldn't handle otherwise. 

Of course, I said this from the back of a 25 year old pony that was still capable of jumping 3'6" and never went lame until she was in her 40's.  Easy to think that all "performance" horses should operate well with the same (limited) regimen. 

and by limited I mean a handful of sweetfeed and one scoop of vitamins a couple times a week.

Of course the field of proactive sports medicine for horses has exploded over the last several decades, and with it a notion of what is "normal." 

Hand Grazing is good medicine too

When I was competing as a junior, plenty of people were busy injecting hocks, but not much else.  I suppose toward the end of my junior career it seemed like vets had suddenly discovered the stifle so maybe they were injecting stifles too...  it was the weirdest trend ever.

I'm sure that observation is more certainly an oversimplification, but even for my friends who were competing at higher levels - the only real therapeutic treatments I saw were hock injections, stall rest and "nerving" (for navicular horses).  My adolescent brain just didn't love the notion that without pokes and drugs and whatever else, horses weren't comfortable doing their job.

Then my focus shifted from my horses to the volleyball court and I quickly found myself in my orthopedic's office getting regular cortisone injections in order to keep my swinging arm, well, swinging.  I was astounded how those handy little injections nixed the inflammation and pain and let me continue to enjoy doing what I did without causing myself harm.

I suppose that was the turning point for me.  Realizing that somehow I was okay with maintenance for me, but not my horses.  The cognitive dissonance didn't last long and, obviously I sing a different tune now.

What's interesting is that every time Prair has a treatment (injection, shockwave, whatever) I still hear that tiny voice in the back of my head going "you shouldn't have to work this hard for sound..." and I toss and turn a bit wondering if I'm pushing Prair's body to hard or too far and if really she needs a drastically different job description.

I usually tamp down these nagging worries with wine and the repetition that we're jumping 2'6" which is approximately 3" higher than her canter stride when we're working on the flat...  And then - 5 days pass and we're clear to start work again and I get rides like this week where the mare is just Rock effing Solid.  No teeth grinding, no spook, no anxiety, supple in her back, a canter like a metronome and brilliant, adjustable work over cavaletti and small fences.

It's then that I realize, that yes, the injections are worth it.  Not so much for a more competitive performance, but for a happier, healthier horse capable of using her body correctly and freely - which ultimately is the most responsible thing I can do to protect her long term soundness.

So that is my new perspective on maintenance.  It should be a tool that allows Prair to be comfortable while working correctly .  Maintaining good, even muscling is what will keep her back healthy and supported for as long as possible.  Preventing any odd compensations that invite atrophy or overuse is what I'm avoiding with her "maintenance." 

But it most certainly is not a free pass to a higher level.

It's a fine line for sure - and maybe not always an easy one to see, but as long as I'm filtering my choices through what makes Prair stable, and not what gets me ribbons - I am doing right by her.

Week Off

Thanks to everyone for the kind comments about our show success :)  I'm grateful the "no warmup" plan seemed to work and grateful I have a trainer who is willing to think outside the box like that.  It was a strange process but all in all a great show for both the mare and I in terms of learning and good, positive experiences!

Yesterday, Prairie got a little once-over from the vet just to make sure all is well and the two weeks of showing didn't set her back at all.  She lunged totally sound, but was maybe a .5 or 1/5 on her pesky left front on the hard pack.  Our vet didn't seem too concerned, even thinking that might be her new normal - which is something I might have to accept.

All in all though, she thought the left front looked great, and that two long weeks at 2'6" seems to not affect it negatively at this point.  So that's a big WHEW.

The only slight bummer is that her back was showing a lot of soreness to palpation.  I haven't noticed any increased sensitivity when I'm currying her/poking around during my regular inspections - but in full disclosure, I also didn't groom the mare once at the show, and as good as our guys are, I'm not sure they would have noticed if she started to get a tad flinchy.  I get serious horse-owner guilt when I acknowledge that Prair was probably uncomfortable and I just wasn't hands on enough to pick up on it.  It's definitely the risk of not doing your own grooming.  the flexibility and convenience is a huge upside (especially when balancing work and a baby and a show), but the downsides are real and unavoidable.

I also don't know how much Prair's fall on the lunge the first week could have knocked things around or possibly angered a few vertebrae.

If I had to guess - I'd say it wasn't the fall, but rather her long, low back that is just in one of its angry cycles.  When we reviewed notes, it's been nearly 18 months since her last round of injections, which is pretty darn good.  Initially we were expecting to need to inject every 3 months, but if good work, and strong muscling can help us stretch that interval - well I'm all for it.

So the mare has the rest of the week (and weekend) off, and we'll get back to some light hacks next week.

In the meantime, here are a few more photos from last weekend.



not exactly perfect, but much less lurch-y!

sweet baby jesus we're almost straight



Ears *almost* forward

 

Red Light, GREEN Light!

Our Rehab/Training schedule these days feels a bit like a school yard game of Red Light/Green Light.  One minute we're in a holding pattern, the next we're back at it....

Prair's check up today was great.  She was a tad stiff starting out, but we experienced that earlier in her rehab and it seems to be a direct result of standing in a stall.  all..... day.... long. 

There was no sign of the weight bearing reluctance on that left front and Prair happily (and evenly) trotted tiny figure eights.

So, the current plan is - back to normal.  Still holding at 2'6", but full work to that point should be good. 

We did discuss her shoeing a bit.  I've had some concerns about how quickly her heels are contracting in the bar shoes, and I know that while the bar provides support... pinched heels cause their own heel pain.. which is counter productive...

Vet agreed, but doesn't want to change anything crazy before a show, so at her next trim, Prair will try normal shoes again, and possibly a shorter trim cycle to try and stay ahead of those heels.. Prior to the bar shoes, our farrier did a really nice job opening her heels up so I'm hopeful that will be a fairly easy process again...

Also, in really, really exciting news - Prair has been CLEARED FOR TURNOUT. 

She won't get to enjoy it until next week since we decided maybe put her back to work for a couple days (get some of the wiggles out) then let the mare go in a (small) paddock and enjoy the sunshine. 

I'm excited for her.  It's been so long. 

Two Steps Forward....

and a bit of stall rest back. 

I was *really* hoping for an all clear from the vet, and was looking forward to giving Prair some well deserved turnout...  But alas.  Not yet. 

She was stepping a tad short on the left when trotting a tight circle on hard ground.  It could be as innocent as some inflammation back in the coffin joint from all the work and the haul - or it could be some strain on that DDFT again...

Either way Prair isn't getting the turnout she wanted, and instead we're easing up for 10 days and just enjoying some long walks under saddle.  We'll reevaluate next Friday and see if she's still sore.  If yes, then.... well I don't know.  If no, then back to work (staying at 2'6") and maybe a week or two of showing in April. 

Not what I was hoping for, but a reasonable outcome.  Vet wasn't super concerned and seems to think this should be a small respite, not a huge change of direction in our rehab process. 

Still, sad face.  Poor mare wants a paddock. 

The Ultrasound - post script

Talked to vet this am, and the comparison to our December ultrasound images is even better than I thought. 

I was assuming (hoping) that essentially the tendon would look the same, but that the inflammation would prove to be new from the last 6 weeks of relatively heavy work. 

Turns out the inflammation was actually present in the same amount/areas in December so it doesn't appear to be a response to the increased workload.

Also, icing on cake?  The DDFT itself continues to look more organized and more healed than in December

So that's a big 'ol

I feel even more confident heading to Thermal knowing that working Prair 5-6 days a week- with a lot of jumping (in terms of reps, not difficulty) is still allowing her DDFT to continue healing.  Makes the months (and months... and months) of stall rest and walking seem like a great investment.

Obviously nothing is guaranteed, but it's always encouraging to see that our current strategy is (currently) working. 

Big. Sigh. Of. Relief.

The Ultrasound.

Today was d-day in terms of Prair's rehab and our theoretical plans for Thermal.  She's been feeling great under saddle which is wonderful, but in the back of my head there was still a 10% chance that our ultrasound would reveal some horrid new lesion or massive hole in a tendon. 

I mean, there's always a chance right? 

And with horses if it can go wrong, it probably already did... and something else bad happened too.  It's just a good rule of thumb.

So, my expectations have been really guarded.  Really, really guarded.

The short version is that all is well.

The slightly longer version is that all is relatively well.

And the irritating long version is that really we don't know yet.  (which maybe is the infuriating answer for all soft tissue issues.. no smart vet ever wants to declare a tendon "totally healed," and I get that).

But, what we saw is mostly good.  No new lesions, no new roughened edges, which is what we were most concerned about potentially seeing.  What we did see is the same small area of a roughened edge (if the cross-section of the DDFT is a clock, its a little squiggly looking from 3 to 6).  What was new was a bit more inflammation in the tendon sheath and possibly some edema. Nothing huge, not enough that if this was Prair's first exam that my vet would want to inject it, but enough to notice and we're pretty sure it wasn't there before (we're not totally sure because the older films weren't loaded on her laptop, so we have to wait a few more hours for a proper side by side). 

I'm almost certain the inflammation is new though.  I have Prair's previous ultrasound seared into my brain, and I do not recall any discussion of inflammation of the tendon sheath - though it's possible it was there and just wasn't the most significant item to discuss... who knows.  Not me... yet.

Clinically though she's sound,  very sound on the lunge, and more even than she was at our last exam.  She flexed a tad positive on both forelimbs (specifically in the fetlock), which raised a few questions, but when she lunged sound on the hard pack, the vet's concern evaporated.  If she was uncomfortable on the hard pack, we'd be more alarmed, and she would have wanted to inject the coffins to alleviate it, but we avoided that.

All other flexions looked great.  Hocks, stifles.. all clear.  even her back palpated well, so all in all Prair's in comfier place than she was at this time last year.

So it looks like Prair is still healing well.  She's feeling more and more even under saddle and apparently all signs point toward things being OKAY.  So we got the green light to continue at our current workload (which is pretty heavy) and jump up to 2'6". 

Admittedly we've been working a LOT and jumping a ton.  Not big, but often and that may be part of the inflammation question.  Also, it's possible that some edema is the new normal for that tendon when it's in work... Again, who knows (not me... yet).

The current plan is to go to Thermal, play low and slow (nothing over 2'6") and then see how she comes home.  We probably won't ultrasound again (unless something bad happens) but we'll do another lameness eval and see if she's any more or less uncomfortable after three weeks of horse showing. 

The one additional thing we did explore today was Prair's neck.  She's been carrying more tension on the left side, and it's been consistent enough that it seemed prudent (though not urgent) to see if there's anything going on independently there, or if tension is potentially a result of the LF issues and her attempt at guarding it...?  There have been a few horses who have had some rather serious arthritis in their necks and have benefited greatly from having them treated.. maybe it's proximity bias, but it's been on my radar and hard to rule out.

Neck ultrasound showed nothing significant at all... so that was the end of that road.

I hoped on for a lesson after all the poking and prodding and Prair was LOVELY.  Some of our best course work and easiest flying changes yet.  I think we're on a good path... I just hope we stay on it!

Tomorrow we've got one more lesson before packing our trunk and shipping south on Friday!

It looks like I was riding in a rainbow...

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."

(ohthankgod)



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.....

Add caption

T-R-O-T

Maybe the best word I've heard in months (well, you know - aside from "here's your healthy baby! but that's lots of words and TROT is only one).

Prair got a once over while the Vet was looking at another horse and she (apparently) is sound.  SOUND.  sound.  Time for the sound-horse-emoji-praise-jesus-hands!

 

Prair's life doesn't get much more exciting, but we are cleared for five whole minutes of trot work. 

 

In theory we'll do that for two weeks then hopefully go to 10 min of trot work after that.  I know rehab is slow, but this is feeling slow-er than what I was expecting.  Although it's not like we have anything on the calendar so there's no reason to rush anything. 

 

 

In the meantime, in an attempt to be riding-ready (and also to not go totally crazy) I've been streaming every 10 minute Pure Barre/Beach Barre/Booty Barre/Barre3/why-isn't-there-any-wine-at-this-"bar"-barre class that I can find. 

 

My butt and legs are rigid with lactic acid, so hopefully it's doing something productive.

 

 

I'll be at the barn tomorrow for Prair's inaugural trot session, so let's hope she doesn't rocket me to the moon! YAY TROT!

First Steps

Sat with the mare yesterday as she got her first shockwaave treatment and was able to pick my vet's brain a bit more regarding our rehab and overall plan.

(slightly sedated)

Mostly this consisted of me asking lots of repetitive questions and my vet patiently tolerating them while she finagled the shockwave head at an awkward angle so it would target the Navicular...

We also discussed the specific plan for Prair for the next 30 days.  First is some special shoeing.  The mare will get reverse shoes up front to get some extra heel support and bring her breakover waaaaaay back.

reverse shoe.  open side toward toe...

Then we discussed how best to maintain some back strength during her layup. Ideally the vet wants Prair jogging nicely for a few minutes a day, but the Eurosizer has mats as footing and there's a scary risk of slippage if we tried to jog her in there.  Lunging is too small of a circle and, well... i don't jog, so jogging in hand isn't an option either.

Finally it seemed best to forgo the jogging and just have 30 minutes of walking in the Eurosizer each day (assuming she stays calm) to break up the stall rest.  Frankly, 30 days isn't that long and I don't think we'll lose too much ground with her back in that time....

So - Funny Shoes.  Daily Walks.  No work.

Sounds like me on maternity leave!