When Dr. Judy found us at the trailer, Speedy was his usual curious self, although he was cranky; chronic pain will do that to a guy. Dr. Judy listened thoughtfully as I shared the story of Speedy's on again, off again lameness. I document every barn visit on a calendar; I had brought it with me so the vet could get a good picture of what was going on. After listening to our tale of woe, he asked for a trot out.
After watching him trot out, I asked the vet if he had any suspicions, given that the lameness kept coming and going. He admitted that it was possible Speedy had a fracture in the hoof. Without diagnostic work, I knew that was only a theory so I kept my OH MY GOD to myself. To narrow down from where the pain was coming vet, the suggested we begin with nerve blocks. I readily agreed; I've been down this road before.
If you've never had the need to use nerve blocks on a horse, here is a brief, but excellent description of the process. Basically, the vet "numbs" the lowest area possible searching for the point where the horse becomes "numb" to pain. Sometimes it is necessary to go higher and higher up the limb to reach this point. In Speedy's case, the vet first blocked the heel area. This brought him to about 65% soundness which told the vet we were probably dealing with a foot injury as opposed to a fetlock issue, but to be sure, he blocked the rest of the foot as well.
Since the hoof wall is solid, we hit a brick wall of sorts. Ultrasound can't be done on a hoof. This created a problem because I wanted to know what is wrong with Speedy and more importantly, what I can do to help him get better. Since an ultrasound was not useful, Dr. Judy laid out my options: a standing MRI ($1,800) or a full MRI with anesthesia ($2,800).
Dr. Judy was very nonjudgmental as he presented my options. He made it clear that he wasn't recommending the MRI, only letting me know what the next diagnostic tool would be. After careful consideration, I asked him what he thought might be wrong. In other words, what did he think the MRI would reveal?
Dr. Judy's response was that there were three likely diagnoses. The first was that Speedy had an abscess, although three weeks would be a long time for it to brew. The second possible scenario was that Speedy has a deep bone bruise. Finally, Speedy might have suffered a soft tissue injury, most likely to the lateral collateral ligament of the coffin joint.
Deep sigh … continued tomorrow.