Saturday, January 3, 2009

Soundness: Tell us your success stories!

I have a reader whose young gelding has just sustained an upward fixation of the patella. She has, understandably, been googling like crazy trying to learn more about this injury and the chances of a successful 100% rehab and she suggested a blog topic about serious injuries we have successfully rehabbed. I think that's a great idea, so we're going to talk about that for the rest of the weekend!

Here are some of mine:

Lameness: Dead lame, could barely walk. Would only move his feet forward a few inches at a time.
Initial Diagnosis: Navicular
Recommendation: Euthanasia
I got the horse to my place and the first thing my vet did was pull the shoes (egg bars with pads). The farrier had not sealed the pads in the back and because the barn the horse came out of wasn't very clean, the gelding had developed thrush under the pads. His frogs were gone. The feet were rotting out - totally disgusting. The horse was arthritic (normal for his age, 20 at the time) but my vet did not see navicular.
Treatment: Trimmed and kept barefoot, shot up with Adequan for the arthritis, turned outside to live 24/7 in the snow (no mud - snowy and frozen conditions)
Result: Sound three weeks later. Playing polo again another month after that. Retired sound 5 years later.

Lameness: Yearling had a explosive moment and got loose with his blanket halfway removed. It, of course, came down around his front legs as he was running and he got tangled with one knee bent through the knee hole and one leg down. No apparent injury immediately afterward. Several hours later, found him dragging the leg that had been down like a limp noodle. I mean, dragging. The leg appeared to be totally dead. I was certain I was going to have to euthanize him.
Diagnosis: My vet correctly guessed it over the phone from my description - radial nerve injury. She came out shortly afterward and that is what it was.
Treatment: Rest and bute. He hobbled around pitifully for about two weeks but improved from there. He looked slightly off for about two more months and then made a full recovery.

Lameness: Teenaged AQHA gelding, got his hind end run over in a polo game. Very, very lame and massive swelling all around the hock area. Serious "elephant leg."
I don't remember all the specifics but he sustained a badly strained stifle and torn tendons around the hock.
Treatment: After a period of rest, we started a very specific exercise program involving backing up in hand, ponying at a trot and free longeing and being asked to do rollbacks. He started off still looking lame, and par for the course with a stifle injury, became sounder as he became fitter. He returned to polo probably a year later and played until he started losing his sight with no further lameness. I credit this one 100% to proper conditioning. We built up the muscles he needed to support the injured area and prevent re-injury.

Lameness/Diagnosis: Three year old AQHA mare, both tendons bowed, both tendons blistered - full of pus and infected. Dumped at dealer's that way.
Treatment: After healing up the flesh wounds and curing the infection with antibiotics, alternated ultrasound and laser treatment. Vet had new machines and wanted to use mare to see how well they worked :-) Donated use of machines! Results were absolutely stunning. The mare's tendons wound up looking close to normal and she came back completely sound. I wish I had before-and-after pictures of this one, because you would never believe it. My friends pulled her off the dealer's lot in 1989 fully expecting to euthanize her, and as far as I know she is alive and well and may even still be playing polo today!

Those are four of the worst lameness I've seen horses come back from. Normally, the ones I've failed with are horses who have multiple conditions. For example, I have a mare who has arthritis, ringbone and suspensory damage. I don't expect to get her sound enough to ever ride again. Right now she is sound enough to trot, canter and beat up everybody else in the pasture and I think that is as good as we are going to get. Her riding days are over, but she is also 23 and worked hard most of her life. However, I think this thread will reassure those of you who are dealing with one serious problem that your odds of a successful result are good.

The main things I have learned over the years are:

(a) you have to slowly and consistently re-condition a horse who has had an injury if you want him to stay sound. That means riding 5-6 days a week and taking it very slow at first. I know nobody likes to get on and just walk for 30 minutes. Listen to your ipod, talk on the phone if your horse is sane enough...but make yourself do it. Ride someone else's horse if you must canter and jump.

(b) I don't believe in stall rest. I know there are some situations where it is unavoidable, like a break, but I know I don't believe in it for any kind of tendon injury. I always keep them moving and walking around. Maybe they just go out in the round pen by themselves, but they walk around. I believe this stops scar tissue from forming and increases the odds that you will be able to return the horse to hard work, even after a bad bow. I also think it keeps them sane and keeps them from exploding and re-injuring.

(c) Check legs every time you ride. NEVER ride a horse with ANY heat or swelling in a front tendon. Swelling in back tendons can be "stocking up" from standing in a stall but that will go away in the first 5-10 minutes of walking if that's what it is. Know your horse's legs and know what is normal. I have seen people look at a tendon with obvious heat or swelling and go, oh, that's not bad, and compete the horse anyway. That is how you break them down permanently. I don't care if your trainer says it's ok, stand up to your trainer and say NO.

(d) Overnight, severe, out of nowhere lameness is a hoof abscess about 99.9% of the time. Do not panic. Your horse will be fine and has not broken a leg. :-)

All right, give the readers with lame horses some hope - tell us about your best rehabs!