An Answer

Not necessarily the one that I wanted, but at least it's definitive. I have a lot I need to say, but for today, here are the basics.
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Speedy and I went to a show in June where we earned the last score we needed to earn a Bronze Medal. We went to a show in July where we showed great improvement in our scores. My husband and I went out of town for a few days, and it was really hot, so Speedy got a week off.

SLO-CDS Wine Country Dressage Show July, 2020

When I rode him the Saturday after the show, he felt great, but by Monday, he presented as lame on what felt like both hind legs. I quickly realized his hamstrings were quite sore so I had the chiropractor do some work. My chiropractor suggested I take Speedy in for hock injections as that was from where the pain was originating. My vet and I discussed it, and we decided to pass on x-rays since we were going to do Speedy's hocks either way.

Hock injections at Bakersfield Large Animal Hospital

I followed my chiropractor's and Dr. Tolley's instructions to the letter. I took Speedy for a slow walk around the neighborhood on Saturday, and on Sunday we did an easy stretchy ride where I focused on asking Speedy to be light and soft. On Thursday, a week after the body work and hock injections, Speedy was lame again. We decided to give him Previcox (for dogs, the equine version is Equioxx, but it's what we had) for a few days to see if that helped. In the meantime, I called my chiropractor to ask for his advice who thought it must be soft tissue. My vet agreed and referred me to Alamo Pintado, a premier equine medical center on the coast, for a more thorough diagnosis. I scheduled an appointment for yesterday.

Dr. Rick doing a flexion test.

I've taken horses to Alamo Pintado several times and have to say, this is a top-notch facility. But equally important is the professionalism and friendliness of the staff. I don't think it matters if you're a first time client or one that's been around for 20 years; you are treated with respect and compassion. Dr. Mark Rick was wonderful; he was thorough in his explanations as he described each procedure, he was patient, and he acted as though he had all day to spend with Speedy and me.

Both legs were flexed many times.

Dr. Rick immediately agreed that it was the left hind, so he started out by "blocking" the left ankle. For those who might not be familiar with this procedure, the vet injects an anesthesia into a low point of the leg with the purpose of numbing the area. After a five to ten minute wait, the horse is jogged off. If he comes up sound, the vet knows from where the pain is originating. If the horse trots off lame, which Speedy did, the vet knows the injured or diseased spot is higher up on the horse, so he repeats the injection at the next spot. In Speedy's case, the vet suspected a high suspensory injury, so he gave Speedy a pretty heavy dose expecting him to trot off sound. 

Alamo's vets work from SUVs.

Combined with anesthetizing the parts of the limb, Dr. Rick did lots of different flexion tests all in an effort to diagnose Speedy's lameness. After several "nerve blocks" Dr. Rick ruled out a soft tissue injury. Speedy never did trot off sound or even less lame. For each jog, he moved out with the exact degree of lameness, never worse, never better. Dr. Rick was a a little puzzled by what he was seeing, especially given the sudden onset of Speedy's lameness. He decided that x-rays were in order. 

Even though he was a perfect gentleman, Speedy got a teeny tiny dose of Dormosedan for the x-rays.

Dr. Rick took six pictures, three of each hock. He wanted x-rays of the right hock so that he had something to which to compare. When he was finished, he invited me in to view the images. He had a definitive diagnosis. Speedy's right hock was in great shape. The left on the other hand, was in trouble.

The red arrows point to the spaces between the joints. The black lines in the bone are the gaps.

As in my last post about the hocks, the spaces between the joints are as they should be in the right hock. Those spaces are filled with cartilage that cushion the joint during movement. Speedy's left hock doesn't look anything like his right.

The red arrows point to the areas that should have gaps or black lines.

The photo above doesn't capture quite the same view as from the photo of the right hock, but you can clearly see the two joints look very different from one another. Dr. Rick's verdict is that Speedy's hock is well on its way to being "fused" meaning bone is filling in the space where cartilage should be. I think Dr. Rick was more surprised by the images than I was. Speedy should have been lame long before now. A "fusing" joint is painful, and Speedy hasn't been lame on a hind foot ever.

Waiting quietly with his handler, Jesus.

Dr. Rick was quick to point out that injecting Speedy's hocks with a steroid was not a bad decision. Had Dr. Tolley done x-rays, we probably would have still injected the hocks in the hope of helping him feel better. In Speedy's case however, the steroid might have actually done more harm than good. According to Dr. Rick, the steroid might have reduced the inflammation as intended, but then it may well have destroyed the last bit of cartilage left. In many ways he felt this was a good thing.

​There are several treatments available to "hasten" the degeneration of the cartilage so that new bone can fill in the gap, but we opted to just let time and nature run its course. Dr. Rick estimated that it will take three to nine months for the bones to completely fuse, if they ever do. Not all hocks fuse completely. When I asked if Speedy will ever compete at the same level again, he said it was unlikely, but not impossible.

So. For now, Speedy will spend the rest of the summer and the fall hanging out. After that, we will see if he becomes sound or not. I have more to say, but I'll leave all that for tomorrow.