Thursday, August 11, 2011

What's up doc? (Apparently, not the upper suspensory)

Riley goes through his paces with a UPenn vet student (she did a great job)
New Bolton, like many other facilities, likes to redo some of the referring vet's initial work. When we got to NB, Ri had a lameness exam, similar to what my referring vet had done, except on blacktop and grass, and with quite an audience of interns. Here is the scoop:
  • As with the last exam, the left hind started out gimpy but he worked out of it quickly.
  • In this exam he was short on both fronts, with a sporadic headbob in both directions on a circle.
  • They palpated the upper suspensory of his left front. They could not feel any enlargement.
Nerve block
Next the vet blocked the heels/hooves on BOTH front feet. They sent him to a stall while the drugs took effect.  I patted Ri through the bars and counseled him to remain lame through this part of the test. Heel pain was not something I particularly wanted to see or hear about. We took him out of his stall and walked him toward the lameness exam area (AKA the parking lot). This time, Ri floated over the blacktop -- dramatic improvement, both directions. The vet noted 90% improvement.

Accounting for the different findings (or, "never go with the first diagnosis")
Okay, so if I believe this set of blocks, we're looking at hoof/heel pain primarily, not a suspensory. That blacktop was awfully unforgiving (does any horse go sound on blacktop?). My home vet did the exam in the rubber footing of the  indoor ring, with me riding to excacerbate the lameness.  Maybe the cushier footing masked the core issue? Still,  he did go much sounder after that last block that anesthetized the suspensory ligament.  I can't explain it.  Anyone?

More tomorrow...


8 comments:

  1. Well, heel pain is always a worry, and I know where you head is going on that one. But navicular syndrome can be very well managed.

    And yes, a sound horse will go sound on blacktop and trotting one out on a hard surface like that is quite telling of foot soreness. Often soft tissue problems tend to show up on soft surfaces where the leg and joints have to flex with the softer surface.

    Could be that just a shoeing change may help. I will be interested in hearing more about this, of course. I would hope you came away with a good idea of what's going on???

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  2. Reminds me of a vet call I had that started as "checking a ligament" and ended in both front feet blocked and trotting on hard ground in a small circle.

    In my horse's case, he was INDEED sore footed on the hard ground. He had weak feet that were slowly getting better out of shoes, and wasn't worked outside the cushy arena.

    Maybe just maybe Riley is a sensitive guy?

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  3. What really struck me about that visit, watching people watch my horse, was how truly lovely he is. He was wide-eyed, alert, but curious and not afraid -- it was magnificent to look at. The intern that took care of him referred to him as "your big pretty boy."

    Oh, and the vet looked at him initially and said to me "Well, he's obviously a hunter." :-)

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  4. That's confusing. According to what Jean said about soft tissue showing up in soft footing and foot sore showing up on hard footing . . . maybe it's both? I know probably not something you want to consider, but it's possible. I hope you can find the source of his pain and get it sorted out quickly. Dealing with lameness sucks.

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  5. Well, if he's protecting the LF it makes sense it might stress somewhere up higher. I'm not ruling it out, and was a little suprised that NB really didnt want to ultrasound. They said grass was soft enough to make a different footing...

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  6. I winced when I saw Riley trotting on that pavement, but I guess it does make sense to more easily route out an issue. One thing's for sure; I really hope you two are not going to have to climb back on that particular merry-go-round again (yeesh).

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  7. I think the use of pavement might be an old secret in determining soundness. Before I purchased Harley, our local older horse expert (a gentleman around 70 years of age) trotted him first on driveway rocks then on blacktop. I remember thinking like you. Please do not go lame, I really like this horse. He was fine and the man insisted that I did not need to waste my money on a pre-purchase exam. I did anyway, and found the same result.

    The least dramatic possibility would be thrush. I remember a video where you were packing some white stuff into the central sulcus. Thrush (fungal or bacterial) can make a horse tenderfooted and prevent him from landing properly. If there is a groove or crease in the central sulcus, assume there is thrush which can work it's way quite far into the tissue. This would be much nicer to deal with than navicular, although frog pain can lead to navicular syndrome if the horse refuses to land on the caudal hoof for an extended period of time (the heels contract, the caudal hoof gets weaker, the horse resists landing on the heels, the frog gets less circulation and is susceptible to thrush, repeat). Best wishes.

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  8. Subtle lamenesses can be so frustrating. I think if you trot a horse in a tight circle on hard ground long enough, even a sound horse will go lame, and the diagnostics are so expensive, but at least you can find out what the problem is and take action to make it better.

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