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Not-So-Speedy Dressage

From Endurance to Dressage

What's Wrong With Speedy G? (part 2)

2/13/2014

 
part 1

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.
Picture
Alamo's trot out area. It's a long, sloping driveway covered with a thick layer of smooth pea gravel.
Thankfully (?), Speedy trotted out lame. Nothing is worse than going in for a lameness exam with a sound horse. And even better, Speedy actually showed which leg was lame, right front. All along, it's been really hard to tell because he also acts like the left hurts. 

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.
Picture
Waiting for the nerve blocks to do their thing. Speedy got much perkier as his foot started to feel better.
After giving the nerve blocks some time to work, Speedy came up more than 90% sound. The vet was certain the injury was within the hoof itself. While there aren't that many structures within the hoof, diagnosing foot problems in a horse can be difficult as it is hard to feel and see what is happening beneath the hoof wall. Dr. Judy suggested we begin with the most obvious diagnostic tool; radiographs.
Picture
Alamo has a great radiograph bay (entrance on the left side of the building) with an attached office that holds a large computer monitor for client consultations.
Of course radiographs of the foot meant that Speedy's week old shoes needed to be pulled. Fortunately, Alamo had a farrier on site who pulled the shoe and then re-tacked it on later. 
Picture
But we just put them on!
The radiographs revealed some good news and some not so good news. To both the vet's and my relief, there were no fractures. In fact, other than some expected wear and tear, Speedy's radiographs came back quite clean. The coffin bone was right where it was supposed to be, and there were no abnormalities. The bad news was that Speedy's lameness couldn't be diagnosed based on the radiographs.

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.
Picture
The CL is in the bottom third of the picture.
In the first case, an abscess will usually just blow out on its own if given the opportunity. For the other two diagnoses, the treatment was virtually the same, time off. The only difference is that a bone bruise/contusion will be solidly healed in two months while damage to the collateral ligament requires a period of rest followed by rehab; a six month process. In addition, damage to the collateral ligament may reappear in the future, as scar tissue is usually formed.

Deep sigh … continued tomorrow.
Tracy link
2/12/2014 10:17:23 pm

Definitely glad there isn't a fracture, but sad that the diagnosis really means lots of time off for Speedy :-(

jenj
2/12/2014 10:34:42 pm

D'awww, I'm so sorry to hear this. I mean, I'm glad he's not got anything broken in his foot, but soft tissue injuries are tough. Sending healing thoughts to him and extra strength to you in this difficult time. Hugs.

Jessica @ The Georgia Horse link
2/12/2014 10:56:56 pm

I had a gelding who tore his collateral ligament. I used those 6 months to work on ground work issues and spent a lot of time bonding. After those 6 months, he was %100 sound. Glad to hear that you could narrow it down to the foot. That is helpful.

Bakersfield Dressage link
2/14/2014 10:30:01 am

Thanks for the "share." It's helpful to hear about other horses who make it through rehab sound. :0)

Judy
2/13/2014 12:16:14 am

The diagnostic process is always very interesting to me. Sorry it's Speedy's diagnosis that I'm reading about, but at least it looks like an eventual full recovery will be expected!

Bakersfield Dressage link
2/14/2014 10:31:07 am

I know. It is interesting, and I took full advantage of our visit to learn as much as I could. It would be better if it was someone else's horse, but I guess it's just our turn. :0)

Dom
2/13/2014 01:05:31 am

As the owner of a horse who trotted completely sound at his lameness exam, I am 'glad' that Speedy showed the doc what you were referring to. I'm also glad it wasn't a fracture, and I sympathize with having to draw the line on diagnostics. You would think that an abscess would show up as a dark patch on x-rays. Did Speedy react to hoof testers when you took him to your farrier? (I can't remember off the top of my head.) It would be strange for him to have bruising and NOT react. Unfortunately, I'm guessing he does have a soft tissue injury. What a PITA :(

Bakersfield Dressage link
2/14/2014 10:33:24 am

Nope. He didn't react with the farrier or with the vet tech, and they TRIED to get a reaction. The vet said the lameness may come and go depending on how inflamed the tissues are. Interestingly, Speedy has been really comfortable since Tuesday with none of those horrible lame walking steps. Today, he positively skipped out of his stall. I am just playing it by ear.

SprinklerBandit
2/13/2014 01:28:42 am

I like that your vet laid out the options up front like that, instead of pushing for 2-3k MRI. If the outcome is the same, there really isn't a reason to spend that kind of money (unless you have lots and want to satisfy your curiosity).

So sorry. I was crossing my fingers that it would be something easier.

Sarah link
2/13/2014 03:05:00 am

Seeing our horses in pain and not being able to do something immediate and dramatic to address it really sucks, so I commiserate with you. On the other hand, horse injuries that just need time (rather than surgery, expensive medications, stem cell or laser therapies, etc) is definitely a reason to be thankful that it isn't worse!

Amanda link
2/13/2014 04:23:18 am

Ugh, nothing worse than knowing somethings wrong and not being able to diagnose it fully. Here's hoping it's just a long brewing abscess.

Lauren link
2/13/2014 04:45:21 am

Yay not a fracture, boo clear diagnosis. When things heal with time, I'm inclined to just give them time. Awaiting your part 3.

Teresa link
2/13/2014 09:42:48 am

I'm sorry that you didn't get an action. Irish gets lots of abscesses. Some of them take weeks to blow. And I've had him present just like Speedy. So hang in there.

Bakersfield Dressage link
2/14/2014 10:35:41 am

Thanks, Teresa. He looks really good right now, but I am still hoping an abscess is brewing. It was my first thought three weeks ago. This horse has just been so sound that it's hard to imagine him coming up so lame so fast without it being an abscess or an acute injury. I am just going day by day. I am willing to just wait and see what comes of it.

Saiph link
2/13/2014 05:06:05 pm

I'm so sorry you still don't have a clear diagnosis of Speedy's lameness. Regarding the MRI, I did want to add my 2 cents: a friend of mine has a mare that used to event. She came in from the field lame one day, starting a battle of on-again off-again lameness that took months and multiple vets to diagnose. They started treating it as an abscess, then laminitis, when x-rays were clean. My friend eventually ended up just taking her mare to one of the nearby equine specialty hospitals and having the leg radiographed. They discovered not one but two soft tissue injuries inside the hoof, and both were pretty severe. The mare was on strict stall rest, not even hand walking, for 6 months, with a very slow progression back into full work before she started turnout again. Her recovery took a little over a year. The MRI ended up being a very useful tool because they were able to get a baseline image of the injuries. At 6 months they had been expecting her to be all healed up and they repeated the MRI. They were able to see that she still needed more time to heal and the vet was able to tailor the mare's rehab program accordingly. Without knowing the exact extent of the injury, the vets would never have known exactly how much time off to give this mare.

I hope Speedy's injury is nowhere near as serious, but I did want to share an experience that hit close to home where the MRI played an important role in the diagnosis and rehab of this particular mare. I love that your vet didn't push for it though. Awaiting your part 3.

Bakersfield Dressage link
2/14/2014 10:38:09 am

Thanks for sharing,Saiph. It is difficult to not pursue every known diagnostic tool, but I am pretty practical and know the limits of my budget. I am willing to wait it out and see what time can do. Since he has been historically sound (as an endurance horse, too), I am going to just see where this leads. The MRI is always an option down the road.


Comments are closed.

    About the Writer and Rider

    ​I am a lifelong rider. 
    I began endurance riding in 1996 where I ultimately completed five, one-day 100 mile races, the 200-mile Death Valley Encounter, and numerous other 50, 65, and 75 mile races. I began showing dressage in 2010.
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    About Speedy G

    ​Speedy went from endurance horse to dressage horse. After helping me earn a USDF Bronze medal in the summer of 2020, he is now semi-retired. Speedy is a 2004, 15'1 hand, purebred Arabian gelding. His Arabian Horse Registry name is G Ima Starr FA.
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