Picture of the week!

Still off, but not 'lame'

Boomer has adjusted very well to the stall rest.  He seems to enjoy our daily hand walks and is always trying to paw at the snow to find some grass.  

Today we finally got above freezing and were actually around 40 degrees!  I decided to put Boomer in the small medical turnout (maybe 40'x60') while I cleaned his stall.  He seemed to enjoy walking around and grazing.  I got into the paddock with him and asked him to trot around me like we were lunging and he was definitely still quite off.  I wouldn't call him 'lame' because it really isn't a hind limb lameness.  It really looks higher up like he is 'hitching' his hips.  He was off in both directions.  He tried cantering a little on his own and was very short and choppy in the back.  As soon as he was back to the walk, he was fine and didn't act like there was any residual pain.   

I was a little disappointed to see how off he still is.  I had really hoped that he was doing much better with all of the stall rest.  I'm really hoping we have good weather for the rest of the week and the chiropractor will be able to see him trotting on a circle.  My hope is that she can adjust him, give him another 1-2 weeks of stall rest with walking/turnout and then adjust him again if needed and get him back out in the pasture.  

Second opinion!

I've got good news!  

Boomer has been doing better every day.  He has been on total stall rest for 11 days with only one or two days where he got out to walk up and down the barn isle a few times.  He has shown no signs of lameness, swelling, heat, or soreness.  He has behaved himself well and doesn't seem to be going too crazy being in the stall.  

Our regular vet came out today and did a very good lameness exam.  He confirmed what I suspected, which was that Boomer reacts the same to palpation on both legs.  He has always been touchy and quick to pick up his feet.  However, when he was dead lame, he only reacted on the one side because he couldn't weight the other leg to react on the 'good' side.  The vet watched him walk and did a flexion test and trot out and Boomer short stepped for about 3 strides (no head bobbing) and then worked out of it and trotted sound the rest of the way down the isle.  So, the vet thinks it is not soft tissue, not a fracture, no pulled muscle.  

Which led us to spinal compression, pinched nerve, sciatica, etc.  When the vet palpated along him hips/spine/top of rump Boomer would nearly buckle his back legs.  It was obviously uncomfortable.  However, it didn't seem like sharp pain that made him want to jump or kick out.  He just slowly buckled his legs to lower away from the pressure.  The vet also had him stand square and no matter how he stood or  moved, his left hip just seemed higher.  It was a visible difference, even to me.  The right side didn't seem sunken, it was more of a rotation looking thing.  Also, when the vet pulled on his tail straight back, Boomer's rump muscles quivered quite a bit and when he let go, Boomer really had to stumble to regain his balance.  

So, where do we go from here?  

First, keep up the stall rest, but add hand walking.  

Start at 5 minutes per day and work up to 15 minutes per day.  

Second, get Boomer adjusted by a chiropractor in 2 weeks.

Appointment is scheduled for February 2nd.  

The vet and chiropractor work closely together and 

share information for better treatment.

Third, after adjustment, allow Boomer short, supervised turnout each day 

in addition to hand walking.  

Hopefully this will quickly lead to him being turned back out 24/7.  

We also have options of giving Boomer muscle relaxers or an electromagnetic pulse therapy to help loosen up his muscles and aid the chiropractic adjustment.  For now, those options are not needed.  

So, this all seems like a good direction to be moving in.  I am very happy with the prognosis and I actually do agree with the assessment.  I am hopeful that this can be a comparatively easy fix.  1-2 chiropractor visits is a cake-walk compared to suspensory rehab!!!

Progress and details

We just got the bill for the vet visits which contained details on exactly what drugs he got.  In the IV bag he got DMSO (which I have learned converts instantly into MSM), Equioxx, and Banamine.  So, basically a huge dose of anti-inflamitories and pain reducers.  This explains why he stopped shaking and sweating right away.  The second day he got Adequan.  

He is still making steady progress.  Today he is fully weight bearing and using his leg to walk and turn in the stall.  He is still visibly lame.  There is still no heat or swelling, but he is still tender when I pinch the tendon area.  I am remaining cautiously optimistic that perhaps a torn suspensory is an 'over diagnosis'.  Another boarder at the barn is a small animal vet and she said that she would be surprised if it was a torn suspensory based on how fast he is recovering and that there has never been swelling.  Based on my reading, if it was a torn suspensory the progress he is making would seem way too fast.  However, this is also the common trap of suspensory injuries, the horse seems sound, gets put back to work, and re-injures himself way worse.  

So, I have my regular vet coming out for a second opinion and ultrasound on Tuesday.  

I'm just shocked at how fast he is improving.  Monday morning he was dead lame and in shock and Thursday afternoon he is fully weight bearing and pissed about being in a stall.  I'm not sure how to feel, but I can't help but have hope that it is something much less serious than a torn suspensory.  

I need that hope.  I know that even if it is a torn suspensory, we are just looking at time.  He probably won't be a competitive endurance horse again, but he will be ridable.  He would even make a great first lead line horse for our baby girl a few years down the road.  But, I am still hanging on to the hope that a 2nd opinion and ultrasound show that his tendons and ligaments are fine and that the problem is elsewhere- and not serious.  

Staying Positive

Today Boomer was putting weight on the leg while resting.  Still limping/toe touching to move.  I was happy to see that his default resting posture was with both heels on the ground.

Its amazing how easily we take for granted the health of our horses.  Boomer gave me 300 endurance miles in just 5 months in 2010.  How incredible is that?  He has really turned out to be an amazing horse and partner.  

I will do everything I can for him.  We are lucky this injury is not going to involve invasive treatment.  No surgery or anything like that.  

The hardest part is the stall rest.  I know we have to do it.  The biggest thing I have learned through my reading is that tendons and ligaments heal s-l-o-w-l-y.  A horse will look sound way before the ultrasound will look clear.  So, trust the ultrasound, not the horse.  

I have nothing but time.  I am going to make a commitment to spend a minimum of 2 hours a day with Boomer while he is on stall rest.  I can clean his stall and do clicker training.  I can groom him and I can sit and read a book.  Point is, I'm going to spend time with him and not just abandon him in the stall.  

Once he is ready for hand walking, I will be more than happy to do that once or twice a day.  That was already our form of exercise lately, so no big deal!  Once the baby arrives, we will have to figure out some details for a few days until I feel up to getting back outside.  Though, it will be spring by then and I will be thrilled to go for a walk with Charley and Boomer and the baby!  I hope eventually we can add medical-teeny-tiny-turnout to the routine and I will be thrilled to sit under a tree and play with my baby girl while Boomer grazes and gets some outside time.  

We can and will make this work and I will stay positive.

Prognosis

Well, we have a prognosis.  Its not 'worst case scenario', but that doesn't make me feel much better.  

Torn suspensory ligament.  

Had a different vet out this morning.  Boomer was slightly improved.  Still not weight bearing, but he was moving around a bit.  Hoping on his toe, but not putting the heel down.  I was happy to see him moving as that improves blood flow to the right hind and decreases chances of static laminitis in that leg.  

I let the vet know over the phone that he was still toe touching lame.  He didn't sound happy about that.  He came out and did a through exam.  Boomer had almost no muscle sensitivity up high today.  The vet spent a good deal of time flexing the fetlock and feeling the tendons in the back of the leg.  He had me walk him a few steps.  He had me feel the tendons and explained that you could feel the bands of tendon and the suspensory.  Then he had me squeeze and run down the suspensory he pointed out a bit of a 'notch' and right then, Boomer flinched his leg away.  He said that we could do an ultrasound if we wanted, but that he was confident enough to put that off a few weeks.  This is why he is now acting like he COULD put weight on it, but only the toe- it hurts to stretch the ligament to put his heel down.  Vet did say that it isn't the worst he has seen and it isn't totally ruptured, which is good.  

So, for the immediate future, we are wrapping both legs and giving a gram of bute per day.  He got an IM shot of Adequan for inflammation and to encourage tendon and ligament health.  He is on total stall rest for 10-14 days.  Then we should take an U/S to see how things look and make a decision on when to start hand walking.  It could be at 2 weeks, or it could be longer.  Beyond that, we are looking at months of recovery.  I am anticipating 6 months of stall rest with hand walking and hopefully some other sort of gentle exercise.  Beyond that, I would hope that we could put him back out in the pasture with light riding/exercise for another 3-6 months.  I hope we can compete again someday.  If not, I guess we will need to find Boomer a new job.  The vet said that it will take a minimum of 2 months before he can give an opinion on if Boomer will ever be 'useful' again.  

How 'useful' Boomer is isn't really important to me.  Time isn't really an issue either.  Its hard for me to put him on stall rest after being out in pasture his whole life.  However, from what I have been reading, managing the injury is a MUCH bigger factor in the outcome than the nature of the injury itself.  I read over and over again about people who turned the horse out after 2 months or started riding again because the horse wasn't lame any more- then BAM! lame for good and retired.

Here are two good articles on the Suspensory Ligament and Injuries from UC Davis Vet School and Thoroughbred Times.  As far as management goes, I am starting Boomer on Smart Tendon, Smart Calm Ultra, and Ultra Elite Digest.  The calming and pro/pre-biotics will hopefully help keep him comfortable and stress free while being stalled.  I figure if I'm about to drop a ton of time, effort, and cash into rehabbing his leg, it would be stupid to NOT try the Smart Tendon supplement.  It has silica, collagen, and MSM, plus anti-oxidants to fight free radical damage.  I also plan on getting him a few stall toys.  

Bad news...

Unfortunately, I don't have anything good today.  I went out to see Boomer this morning to double blanket him as it was snowing quite a bit.  Boomer was not bearing weight on his hind left leg.  I had a hard time getting him up to the barn.  He was 3 legged, hopping lame.  We got his blanket off, he was shaking and had lathered white sweat all over his shoulders.  There was no heat or swelling in the leg. The vet came out and couldn't feel and fractures.  He was sensitive to the touch on his left stifle area, inner flank, left cannon bone/tendon, and right rump muscle.  His rump muscles were tight and quivering.  Our best guess is that he reared up while playing, which he frequently does with his very tall friend, and slipped in the snow.  He could have done the splits and torn a muscle, fallen and hyper-extended his leg, or landed on his rump and compressed vertebrae.  It seems most like a soft tissue injury.  The vet gave him DMSO in and IV, diluted with a liter of fluids.  I had never seen that done before.  It is basically a VERY strong anti-inflammatory.  It stopped the shaking almost immediately.  We got him into a dry blanket and put into a stall.  I went back to check him in the afternoon and there was no improvement, save that he was no longer shaking and sweating.  He was leaning against the corner, relieving himself of some weight.  

Unfortunately, portable x-rays won't go up high enough to show us the pelvis.  An ultrasound could show us a torn muscle or tendon, but knowing that info wouldn't change our course of action.  We could take him to K-State, but doing an x-ray is very risky.  You have to lay the horse down, and if you find a fracture, you are basically doomed as it is not uncommon for horses to struggle while waking up from anesthesia and shatter the fracture.  So, you would almost rather not even look for a pelvic fracture.  

It is so disheartening to know that even if I had seen it happen, even if we knew EXACTLY what and where he was injured, there is nothing more we could be doing.  It is a play it by ear, wait and see kind of injury.  But he is still hurt and he is still in pain.  

There is nothing more terrible I can imagine than seeing him in so much pain this morning.  He was clearly hurting.  My heart breaks for him.

I discussed compensation injury/founder/laminitis risks with the vet.  He said it is good that it is a back leg, but that I should wrap his opposite leg for support.  I asked about onset of laminitis episodes and he said it can be as fast as 48 hours.  

So, my fears are many.  What if it is a totally ruptured muscle or tendon?  What if he is unable to move, not because of pain, but because he PHYSICALLY can't use the leg?  How long will we be waiting for the leg to become weight bearing?  What if it is a fracture and we don't know?  Will it heal on its own?  is he at risk of shattering the pelvis during the healing time?  What if he founders?  If it is a spinal compression, should we seek chiropractic care?  If so, how soon should we do that?  Back injuries can cause pain and compensation for an eternity.  How long do we wait to try that?  Even if the best case scenario is a torn muscle, what do we do from there?  How long until he will be weight bearing, how long until he is not lame?  Time is no issue, he can have all the time he needs.  I, obviously, have no rush.  

I am going to check on him in the morning, the vet wants to do another DMSO treatment tomorrow.  There is nothing I can do, except worry, until then.  I really hope he is weight bearing tomorrow, but I'm afraid that seeing improvement is going to be a slow process.  

Clementine Face!

If I had only known what Boomer's reaction would be to eating a clementine, I would have had the camera ready!  John really wanted to give Boomer a clementine last week so I offered it to him as I was turning him out after changing blankets.  Without hesitation, he smashed it right in half, the juice squirted everywhere and he dropped it into my hand in shock.  He nodded his head and licked a bunch.  When I offered it to him again he pinned his ears and lifted his head WAY up!  It was a pretty comical sight!  He seemed so confident that he would like it but ended up with quite a shock, I guess!  

I went out again today to lunge him and I put him into the bitting rig.  I had the side reins up about halfway and he did very well.  He remembered right away what he was supposed to do and tried really hard to stretch down and towards the bit.  I could tell he felt weak, his topline is definitely back where it was before we started the dressage lessons.  Cantering was very hard for him while bitted up.  I think we probably worked for maybe 15 minutes, but I think that was plenty of time.  I am very happy with how well he behaved and how well he remembered his job.  That actually gave me a confidence boost that he isn't just going to forget everything while on a 6 month break!  

Packing on the pounds

Apparently, I'm not the only one with an expanding waistline around here! 

Boomer's blanket just isn't fitting quite like it used to.  He no longer fits into his 70" (haha) and his 72" is pretty snug.  The belly straps are getting dangerously close to being fully extended.

Can't change his diet much since he is out 24/7 with free choice hay and pasture.  

Exercise is the name of the game.  Boomer hasn't been really worked in 3-4 months.  I have hopped on and walked a few times here and there, but nothing strenuous.  

I am going to aim for lunging him 2-3 times per week as long as weather allows.  We are actually having a very mild winter so far and the arena footing is nice.  

I lunged him for maybe 20 minutes today and did 10 laps of cantering in each direction.  That was definitely his limit!  He was puffing and got a little damp on the chest, but dried quickly (thankfully, since I don't have a cooler in my locker!).  I think after a few sessions I will put the surcingle back on and get him working nicely over his back again.  Hopefully this will be a weight loss program that also keeps his topline in shape for when I am ready to saddle shop in the spring!