11/16/2018 - Diagnosing Penn, Part 1

Winter decided to rear its ugly head right before we were supposed to travel down to VA for Penn’s recheck. We only got a little ice and snow, but the vet office got a good deal more. They called to say they might have to push appointments back a bit because of a delayed start, which I said was fine because I had already pushed my own appointment back an hour to 2 pm because I was concerned I wouldn’t be able to get out of the barn’s valley.

Not much snow, but it has ice under it.

However, all things lucked out! The snow plow came through as I was hooking up the trailer and salted the steepest part of the road, Penn loaded right up, and off we went! We had a nice drive down to VA, and arrived early despite leaving 45 min later than I originally planned. I ended up hanging around for a bit waiting for the vet to be done with her prior appointment (that's where most of the stall pictures happened- I don't have other media from Friday)

Enter: One feed tub of alfalox.

The vet ran her hands all over Penn first to check pain points and body condition, and found an unreasonable amount of hind end pain. We did the usual tests first- walking on a straight line, trotting on a straight line, trotting both directions on a circle on a hard surface.

He was pretty much the same as last time- 1/5 bilaterally lame on the hard surface on the inside front when trotting. We went over how hit or miss he’s been feeling at trot under saddle. She decided to put the surcingle with 60lbs of deadweight back on since I said it’s worse under saddle and he had quite a bit of hind end pain.

This is where things turned a bit: he became sound with added weight. He wasn’t happy at all, he tossed his head frequently but remained sound. She jokingly called it “the dressage horse response”, aka lift your back and use yourself. She did call it positive for back pain since he was tossing his head.

Penn had enough of gray horse's anger issues and decided to attack, but was not prepared for the gray horse to "fight back".

We went back to the barn and did straight line trots after flexions. The flexions were better than last time: the RF was unremarkable (for the first time ever) and the LF was mild. The hinds saw an increase in pain though- the lower and upper flexions were mild + on the left hind, and moderate on the right.

That left us at an interesting place: his hind end pain concerned the vet especially since I said we’ve battled hind end pain for as long as I’ve owned him, but the front end hadn’t gotten better. She gave me a choice about where best to spend my money: we can redo the nerve blocks on the front end, or we can do a CURO test on the hind end suspensory tendons. She was concerned about the health of the suspensory tendons, citing there is a disease that attacks them and causes irreparable damage, but we often don’t know about it until too late. She said it also could be that he’d benefit greatly from hock injections. Doing the CURO test would make her sleep better about just doing hock injections.

I hemmed and hawed over it, but settled on the front end issues. Those are the one preventing him from being a ‘useful’ horse- he can’t show or go to lessons as he is now. I never know if I’m going to have a sound horse or a lame horse until we’re trotting. As they were scrubbing him up to do nerve blocks in the front heels, I asked how much the CURO test was to do. She said $150. I was like, “Oh, that’s nothing. Let’s do that too if the nerve blocks won’t affect the results.” She was very pleased and we got the CURO test set up after the blocks had been injected.

Penn, I think this is why other horses beat you up so easily. You don't take a hint!

So CURO is kind of interesting- it’s sensors placed on the hind end suspensory below the hock, which are hooked up to a pack on a surcingle. The horse walks back and forth, then trots back and forth, then walks again. Normal output is 5 or above. I could barely find anything out about it online, but here’s a link to their website.

His results were as follows:
LH:
       Overall – 5
       First walk: 4.8
       Final walk: 5.3
RH:
       Overall – 6
       First walk: 6.5
       Final walk: 5.7

Both seemed within normal tolerances, but to me, the left seems worse off… which actually tallies with how he’s felt under saddle. He wants to pitch his hind end left and not use his left hind. The right hind is the more sore hind, so he might be compensating for the left hind. Both results were within normal tolerance, so she thought we would be safe to do the hock injections at some point.

"MAHM HALP"

The first nerve block didn’t produce a change, which was both good and bad. His heels don’t appear to be hurting anymore, which means the shoeing changes we’ve made are working for him. The bad news is that something else hurts.

The next set of nerve blocks blocked the entire foot, and he became much sounder. Well fuck it all. She said that basically puts us firmly in MRI land to further diagnose the problem. We could do that, or continue as we were and see if he gets better or worse. I had prepared to do an MRI on this visit, so we opted for the MRI.

I didn’t realize that VEI doesn’t have an MRI, they use the one at Virginia Tech’s Morven Park medical facility. It has to be booked ahead of time, so we booked it for the first day we could- the next Tuesday morning at 7:30a. Unfortunately that left us in a bit of a lurch for what to do with Penn. I had planned on going over to GP Trainer’s barn that evening and having a simple walk trot rehab lesson with one of her assistants Saturday morning. The vet approved having a lesson- GP Trainer’s footing is practically perfect and extremely safe so she had no issue with walking and doing some limited trot on it.

The problem is the amount of traveling Penn would have to do in the following days: The original plan was to bring him down for his vet visit Friday morning, take him to spend the night at GP Trainer’s, have a lesson Saturday morning, load him up and go home. Well, if we adhered to that schedule, we’d have to pack him back up in the trailer Monday, bring him to either GP Trainer’s or VEI to spend Monday night, then load him up at the buttcrack of dawn to take to Morven on Tuesday, then bring him home again on Tuesday (we would come back for any treatment based on the MRI results since they wouldn’t be available until Tuesday evening anyway). He’d spend 6 hours in a trailer for 4 of 5 days in a row.

Friends?

Luckily, GP Trainer quickly agreed to just house Penn and my trailer until Tuesday. That left me scrambling for feed and blankets for Penn- this was the one visit where I hadn’t brought a bunch of extra feed, nor had I brought any of his turnout blankets! She said they could find something for him to wear if he needed it (he had a BOT mesh sheet and mid weight stable blanket), so that just left the feed problem to be dealt with on Saturday.

To be continued!