What Does the Vet Think?

If you've been following along this week, you know that Izzy has seen my entire team:

• ​Trainer - Chemaine Hurtado: here and here.
• Saddle Fitter - Tina Hoover.
• Farrier - Paul Mullins.
• Chiropractor - CC.
• Plus, he's been put on Platinum Performance - here.

​The only person he hadn't seen, until Wednesday, was Dr. Tolley, my vet. I fixed that.

Tracking left - the biggest issue.

I gave Dr. Tolley the run down: trainer doesn't see an obvious lameness, sore back not due to saddle fit, hooves are in fine shape, and chiropractor suspects hocks.

Dr. Tolley started off by having me first walk and then trot Izzy out and back in a straight line - your standard trot out. After that, he lunged Izzy to the left and right. I have to interject here that I was over-the-moon happy with how calm Izzy was during the whole exam. He trotted around light and easy on the line and never pulled or got sassy.

Tracking right was less of an issue.

The lunge work showed Dr. Tolley exactly what he needed to see. Horses with sore hocks will shove the inside leg as far under their belly as they can. To the left, Izzy's hind leg is crossing over in front of the right hind (see the top photo). To the right, he didn't step as deeply, but Dr. Tolley thought he was a bit short-strided which still indicates hock pain.

He stood rock solid for the flexion test and never moved a muscle!

The exam continued with a left hind flexion test. Fortunately, this got a (mostly) negative reaction. Yes, he took an initial wonky step or two, but they always do. In the end, he trotted out straight and even. Whew!

Numbing the injection site.

Before even heading to the vet hospital, Dr. Tolley and I had a lengthy phone discussion about treatment options. I so appreciated that even though he had a busy morning, his staff made sure that I got to speak with him before lunch. In fact, he spent the first 15 minutes of his lunch hour talking to me. We decided to take care of Izzy right then. I hung up, and drove out to the barn to get him.

He's a really sweet drunk!

Since we had discussed the treatment options before I got there, it was no surprise that injecting Izzy's hocks was Dr. Tolley's choice of therapy. We chose an Adequan/Depo Medrol (steroid) mix. Dr. Tolley felt that Izzy's hocks are sore mostly due to hard work and Izzy's efforts to avoid that hard work. In other words, he was partly making himself sore by avoiding using his body correctly.

Many syringes!

When I got home later that afternoon, I told my husband about the vet visit (he didn't even know I'd gone). Since I've had horses for so many decades, we both wonder that there is still a procedure left that I haven't needed to do. I've had a horse that needed fetlock injected, but never a hock.

And now the real injection.

For those of you who are in my boat, here's how it works:

1. Hopefully your vet has already done some kind of lameness exam (see above) or taken radiographs.
2. The horse is then pretty heavily tranquilized as injecting the joint requires precision, and any movement makes the procedure quite challenging and potentially dangerous for your vet.
3.  The injection site is thoroughly cleaned with a surgical scrub and sometimes shaved.
4. The vet will probably administer a local anesthetic because the needle for the injection is really thick.
5. When the vet injects the joint, it means that he slides the needle in the gap between the bones that form the joint. In Izzy's case, the needle went in at the inter-tarsal joint (where the three arrows are - see below). Dr. Tolley did two injections per hock, one in the front of the joint, and a second at the back.

Internet Photo

What's interesting about the injection that Izzy received is that inter-tarsal joints are non-articulating, or immovable. When I asked Dr. Tolley about the physiology of that joint - why have an immovable joint in the first place? - he explained that particular joint is an evolutionary left-over from when horses were creatures that scurried and had limbs with more range of motion, not just front to back like today.

BVH has an amazing team - not pictured is T who gets Dr. Tolley on the phone when I need him.

In addition to injecting the hock joint, which should relieve Izzy's discomfort for what we hope is forever, Dr. Tolley also prescribed two weeks of Methocarbamol, called Robaxin in the past. Methocarbamol is a muscle relaxant used in humans, dogs, cats, and so on. The plan is to attack Izzy's sore back in two ways: first, we dealt with the root cause of the pain, his sore hocks. But to help give him more immediate relief, Dr. Tolley thought breaking the cycle of the back pain with a muscle relaxant would encourage Izzy to use his body more effectively once it was pain free.

All of us, including my vet, trainer, and chiropractor, suspect that at least some of Izzy's resistance to softening and relaxing might have been due to discomfort. If so, the hope is that I get a much happier pony in the next week or so.

​I'll let you know how it goes!