More Down Time...

Time for another update, most likely the last one for the year.

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Mercy is back in paddock/stall rest with regular hand walking when I'm able to. Again. I took her out to ride the day after my last blog post and found her seriously lame on her left front leg after I tacked her up. No heat, no swelling, no hoof tester sensitivity. I gave her 2 weeks off just in case there was an abscess brewing, but nothing changed. So, I had Dr. Bob out to do a full lameness work up. After blocking her leg, starting with her sole, then her whole foot, then her fetlock, and finally blocking her up to the knee, she was still lame when making tight circles. There was no lameness detected on the straight aways unless her joint was flexed (stressed).

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Since the symptoms of this lameness were very similar to her previous right front leg lameness, we decided to shave the leg down any way and check her tendons and ligaments via ultrasound.

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And we found nothing. Well, we saw the previous injury in her RF that has healed nicely! But nothing more...

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Since we were no closer to a diagnosis after the very thorough exam, I decided to take Mercy back to the track to see Dr. Schneider. Once at the track, it became very clear that the lameness I was seeing and the lameness Dr. Schneider was finding could be two different ailments. This is because after only one low hoof block, he declared Mercy sound, which means the pain was in the hoof.

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We took a few radiographs to check her lower leg and Dr. Schneider found some bony changes on the front of her short pastern bone at the coffin joint. He also found a small bone spur at the pastern joint. Although these are unlikely to cause her pain, that was the best he could find that day without doing an MRI. So- back to stall and paddock rest for 60 days (til early January) and recheck with Dr.Bob.

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I'm personally not convinced that the bony changes and spur are the issues here, but I don't have anything else to go on. When I compare the new images to the old images (Aug 2010), there really isn't that much change. I guess time will tell... again...

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Until then, Mercy certainly keeps herself busy by destroying my lovely Christmas decorations... lol! ;)

All Strung Out

Lame, lame, lame. Mercy is still lame. It is ever so slight, but she is lame.
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And I needed to know why.
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That's why she was trailered down to Emerald Downs to visit Dr. Schneider. She loaded like a pro and we were on the road extra early. I had been to Emerald Downs many times, but only for the races, not to get a horse looked at and I wanted to make sure I got there in plenty of time. The drive was uneventful and we pulled in a good 30-40 minutes before my appointment.
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I climbed out of the truck once we pulled into the parking area and I went into the building to check us in. Of course, I got lost. Kinda. I couldn't find any sort of 'check-in' room or desk, and of course who sees me all confused?! Dr. Schneider! He helped point me in the right direction and I soon got us checked in. They were running behind, so they asked me to keep Mercy in the trailer until the came out to get us. No problem.
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I started looking around this end of the property. I could still see the grandstands! Amazing! And the lines and lines of barns were spectacular amoungst the fall colors!
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Then I went to check in on Mercy. *sigh* Can you see what she did to her eye?
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She appearantly got a woody piece of hay jammed into her lower eye lid. It swelled up a little and was a little sensitive, but once I got the piece out and wiped the wound clean, it looked much better. Mare... We came for a lameness exam and ultrasound, not for an eye problem! >:(

It was a half hour over my appointment time, which I know happens when horses are involved, and we started hearing a loud noise approaching. Suddenly we could see what was coming. Hundreds, if not thousands, of geese flying over head!!!

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They made so many "V's" and lines that it looked like lace! I couldn't believe how long we sat there watching and listening to them pass.

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Then, we heard another noise approaching from the other direction- a train! Yay!... :/

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The tracks are literally across the street from where we were parked, so it was loud and the vibrations were crazy! Thank goodness Mercy really doesn't care. She could see the containers moving past, so it wasn't such a big deal for her.

We finally were called over shortly thereafter, so I unloaded Mercy and followed the assistant in through the side gate. After another short wait, Dr. Schneider came out to meet us and briefly go over Mercy's history. He had his assistant take Mercy through a whole range of lameness exams. They manipulated her tendons and joints, did a hoof test, flexion tests, trotted her up and down the road over and over while Dr. Schneider watched from the side and behind. He concluded that she was slightly off on the right front, just as I thought. He couldn't, however, tell where she was hurting. He had poked and prodded her tendons, ligaments, and joints and got no reaction what so ever.

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Here are the options he gave me:

1) Do nothing more but take her back home and continue stall rest for a few more months

2) Block her leg starting from the ground up

3) Ultrasound the leg to look for soft tissue damage

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I brought Mercy all that way knowing we were going to be doing an ultrasound, so that's what we did. Another assistant asked me to move Mercy closer to the building where Mercy got her legs shaved down along the back of the leg. She was quite uncooperative for that part. Another horse had just been taken out and she wanted to follow. It took a while to get her head back to what was going on here and what was expected of her. Then Dr. Schneider came over with a light sedative. She needed to be very still for the ultrasound to come out correctly.

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After she started to relax and droop her lower lip a little, his assistant had me maneuver Mercy into the building and onto a stall mat, where he applied gel to the back of her leg and called over Dr. Schneider. I was still holding Mercy while he looked at her tendons and had a quick look at things. I had one of his assistants come over and hold Mercy (like anyone needed to do that lol!) while I moved over to watch the ultrasound screen. As soon as I got a good view, Dr. Schneider exclaimed he knew what was going on!

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In the area that I had showed him during the lameness exam where the immediate swelling occur ed after the fall, behind and directly below the knee, had a massive tear. Her superficial digital flexor tendon (SDFT) had a spotting look to it, showing where the muscle fibers were no longer whole. He compared it to the deep digital flexor tendon (DDFT) which is located right next to it for me to get a visual. The DDFT was pure white, showing the solid and complete muscle fibers. It isn't a bow, but *simply* a tear.

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The image was amazing to see and became even more incredible as he slowly moved the ultrasound head further down the leg. As he slowly moved the head down the ligament, away from the knee, you could see the muscle fibers becoming more normal- indicating a high tear. he also took a quick look at her left front leg to compare too. I wish I had asked him for copies of those images. Maybe when I see him for a recheck in the future...

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Dr. Schneider gave Mercy a good prognosis: a 70% chance of healing and returning to work without further injury. Dr. DeWard, my regular equine vet, says this is pretty conservative. It's most likely more like 80-90%, but only time will tell.

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Mercy's rehabilitation began the day she was injured. She was on stall and paddock rest for weeks, iced and cold hosed daily (if not multiple times a day) for the first week, and slowly introduced back to walk/trot trail rides. But she was still lame- so she was on and off stall resting until we saw Dr. Schneider almost 2 months from the day of the injury.

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Since we have already started the rehab program, Dr. Schneider recommended we customize his rehab program to fit what we have already done. He agreed that stall rest at this point was, well, pointless. She has a small stall and a 30'x45' paddock that she lives in, unless she is healthy and turned out to pasture for a few hours a day and being ridden. He thought the paddock was a little big, he would prefer a 30'x30' area, but I fear that making it smaller will actually make Mercy more hyper. Dr. DeWard agreed, as long as she doesn't get running around.

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Additionally, we are hand walking for up to 30 minutes a day. I try to get 20 minutes a day, but the weather is not cooperating, nor is my work schedule. I just do what I can. Dr. DeWard also asked me to gently stretch her leg out, as far as it would comfortably go, once a day. This is to apply a little stress to the leg so that as it heals it doesn't bind up. It should still be flexible and maintain a range of motion. I definitely have to be careful when I do that. She is much more sore and stiff on that leg than on her left front. In about another month or so, I should be able to start jogging her a few minutes a day, and slowly increase the time up to 20 minutes a day. That's the point at which I will be looking for some boarding. There is no where for me to safely trot her at my home. I need somewhere that is indoors, flat, and soft.

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After two or so months after we start jogging, we can then begin riding at a walk and trot. I still will not be able to trail ride what so ever... That's where that boarding facility is going to be most sweet! If she is sound at six months, I can begin riding her as usual, slowly building up to her previous athletic abilities. Dr. Schneider asked that I bring her back at six months out to perform another ultrasound to recheck the progress. I can't wait!