Wednesday, September 15, 2010

Where the heck did I put that lead shank with the CHAIN?

Keebler is officially one week status-post his tendon surgery, and unless you looked at the big, huge bandage on his leg (one more week of THAT) you'd never know it.  He apparently is feeling JUST FINE and our twice-daily walks are . . . thrilling at times.  Turkeys?  LEAP.  Rustling leaves?  BOLT.  Colt trotting up to the fence?  WHEEL AND SNORT.  This is not a spooky horse, he's just looking for stuff to do.  God help me, it is an adventure.  The boy feels GOOD.

He has not taken one single, solitary permitted step other than at the walk, but that hasn't kept him from doing some airs above the ground now and then.  And the leg does not seem to trouble him one bit.  Today's bandage change revealed perfectly clean, dry incisions.  The stitches come out in a week, at which point the bandages can be done away with.

The photo makes his (poor, naked) pastern look puffy, but it's not at all.  Looks fantastic, as a matter of fact.  There are two stitches; I'll be taking those out in a week.  And by the way, I can see him going through lots of aluminum shoes.  They are fantastically light, but durable?  Huh.  Half a dozen trips up and down the driveway at the (reluctant) walk and they're already hacked up and a bit worn.  So he can be a spotted Imelda Marcos, who cares? :-)  Chris keeps telling me that there are MANY types of aluminum and no doubt a better alloy could be devised to allow more durability without adding weight.  He'll get right on that, yup.

Next checkup is October 5th at MSU, at which point some lucky soul (probably me) gets to trot him out.  Should be fun!

Saturday, September 11, 2010

Journey to the Center of the Hoof

OK, here is the beginning, at least, of the veterinary saga that has been Keebler's life since July 4th.

Week one:  LAME, suddenly, after having a few days off after the South Farm HT.  Vet happened to be there and blocked the foot and he was sound with the palmar heel block.  He also about fell over when we did hoof testers, so the working diagnosis was bruise or abscess.

Week two:  Soaking, poulticing, soaking, poulticing . . . no improvement.  Pulled the shoe, no sign of bruising or abscess.  Stress level starts to go up a little at this point! 

Week three:  Another exam--this time the heel block left him still completely lame--WTF?!  So we blocked up higher and he went sound.  OK, now what?  X-rays show a big old sidebone, quite a surprise in a small, light, elastic-jointed, easy-moving critter like him, but possibly an issue?

Week four and five:  No improvement, tentative plan is just to see how he comes along.  I'm not much LIKING this plan--too many question marks.

Week six:  Off to Michigan State for another exam.  Still stinking lame, and this time he blocks to the heel again.  Oy vey!  I find it absolutely and completely maddening how the diagnostic process takes place when the patient is non-verbal.  X-rays give a better view of the impressive sidebone, but at this point we're all thinking it's In The Foot.  A bad place for a lameness to come from--lots of moving parts in there.

So we did an MRI of the foot, and there it was--a lesion in the Deep Digital Flexor Tendon just at the "pulley zone" where the tendon runs over the navicular bone.  The navicular bursa is sort of torn open and all the fluid has leaked out.  Here is a picture . . .
So I am FAR from an expert in interpreting MRIs, not to mention my last close examination of hoof anatomy was in 4H Horse Bowl in like 1979, but just above the frog there (the biggest, medium-gray structure on the bottom) is a black structure which is the DDFT.  Over to the right side of that structure, up top, is a tiny little gray indentation--that's the tear in the tendon, which is SMALL.  To the left are two bright, white parallel lines--that is the "healthy" part of the navicular bursa.  (Again, this is an amateur interpretation!)  The part above the little divot/tear in the tendon should look the same, but it's all dark there, indicating the disrupted part of the bursa.

Pretty cool, except when it's a dearly-loved animal that is in your care. 

So the consensus after MUCH discussion with the expert lameness vets at MSU was that Keebler's best shot at future soundness was probably surgical exploration of the area with debridement of any torn tissue, adhesions, loose bodies, etc.   For those of you who like to look at the veterinary literature, a citation of a small review of cases was provided and you can read the abstract of that here.

Basically the options were to give the horse 6-9 months off and see what we had, and that would be the horse to go on with, or do this exploratory surgery in the hopes that it would give him a better chance.  The surgery is not terribly invasive, and Keebs had tolerated the anesthesia for the MRI very well, so his owner gave the go-ahead and the date was set.

Surgery was this past Wednesday, and Keebler did very well.  When I got a post-op call, the vet told me Keebler had just pinned his ears and showed him his spotted rump, busily scarfing down the hay he'd been kept from that morning.  I figured that meant he was behaving normally.  No apparent effect on mood, anyhow!  The actual tendon lesion was not too bad, and the vets were hopeful that they were able to clean things up as well as possible.  Of course he's going to form more adhesions and scar tissue, but this gets him a head start on a proper recovery, with the help of 3-degree wedge shoes to raise his heels and take a little strain off the tendons.  They are aluminum and very light and are the Natural Balance style that I actually like very much--Gwen wore them for the whole time I had her and did beautifully in them.

Here is a picture of the inside of the navicular bursa:

The messy-looking, ragged stuff on the left is adhesions where the bursa used to be.  The part on the right is the normal half.  The instrument you see is 4mm wide, giving you an idea of how small a space this is!

So Keebler came home with his space-age shoes yesterday, and is floating around very comfortably in my very large foaling stall.  It's large enough for him to canter circles in it (I have seen him do so) but so far he is being very sensible.  We have had a few discussions about his daily Gastrogard paste, but it's getting done, and thank GOD there is peppermint-flavored Bute!  Only about another week on pain meds, and stitches come out next week, at which point no more bandages.  He's allowed to walk five minutes three times a day, gradually increasing to an hour twice a day, and that will be a good opportunity for me to make up for the fitness I'VE lost by not riding much for the past two months!

More to come . . .

Thursday, September 9, 2010

And what of the little spotted horse?

A short but phenomenally FUN horse show season with Keebler came to an unexpected end after our July trip to the South Farm Horse Trial.  Dressage was coming along little by little, jumping was awesome, and dang it--I was getting closer to my "usual" goal at a HT--to finish on  my dressage score.

A typical not-bad-could-be-better dressage test was quickly forgotten, and it was on to XC over ground that was a little hard but not too bad.  I'd popped off over Bonnie's shoulder last year at their dark-in-the-woods half coffin, so was a little anxious about that.  Of course with my awesome Mother's Day present of a helmet cam, I can just show the video rather than blather on about the course . . . South Farm XC helmet cam

Watching now I can see where the two seconds that we were over time were lost.  Dang it!  But there are still a few "steering optional" moments and I was trying to be subtle and finesse things maybe too much.  Anyway, a great clean round other than 0.8 time faults and since Keebler was completely ho-hum about the Amish buggies after the first few sightings, I was hoping to have a nice SJ round.

This is how Keebler jumped on Sunday--clean out of his skin! 

And this is what we went home with. :-)

Sadly, the happy ending was decidedly deflated when Keebler came up lame 4 or 5 days after the show.  We'd checked his back and done a little work on that, but after a few days of turnout he came in 4/5 lame on the right front.  He blocked to the foot and was positive on hoof testers, so we figured stone bruise from the galloping or maybe an abscess . . .

. . . and two months later, as I start catching up with Keebler news, the poor guy is sitting at Michigan State University recovering from surgery with hope and uncertainty keeping him company.  More later . . .