"And, when you want something, the entire Universe conspires in helping you to achieve it." -The Alchemist, by Paulo Coehlo



Tuesday, October 2, 2012

X-Rays

So it's been an interesting few days.

On Thursday I was in a rush at the barn, so I did not soak Lily's foot for the first time in I don't know how many weeks, thinking at this point she'd be fine.

On Friday I went to the barn to ride. While grooming and tacking up, I noticed Lily was resting her left hind ALL the time. This worried me. I got on, and she immediately popped her weight off that foot to rest it. Extremely unusual. I warmed her up as usual at a walk. She felt fine, but I noticed some resistance turning to the left. More concern. I asked her to trot, and she pinned her ears going into the transition but obliged. It felt like I was posting on the wrong diagonal. I looked down-I was on the correct diagonal. We changed directions, changed diagonals. That sensation of being off was still there. I immediately brought her to a halt and swung off, grabbed her rope halter and lunge line, slipped on the halter, and had her walk on the lunge. She seemed fine. I asked her to trot. She pinned her ears again when asked for the up transition, but she did it. She was head-bobbing lame at the trot, in both directions. It was the freaking foot acting up.

I was pretty upset. I left a message with my vet's office (since, of course, they were already closed for the weekend), brought her into the barn, untacked her, and soaked her foot. There were no changes in the frog, but she was a lot more sore than she had been previously, and she flinched every time I touched the skin above her heels. I wondered if she was getting ready to blow another abscess? I gave her bute, dried up the foot after her 30 minute soak, plastered her frog and heel with ichthammol, and bandaged her up with duct tape. It was dry outside, so she got turned out with little Willy for the night.

On Saturday, Marianne the trimmer came back to do Bali, and we asked if she could take a look at Lily's foot while she was there. She confirmed that it seemed like there was something inside the foot still, and she gently tried cutting off the part of the frog that's getting ready to slough off. Lily was fine with this, until Marianne put pressure over the original puncture wound. She gave a monumental flinch, which made Marianne jump. She picked up Lily's foot again, and you could see a small spot of yellow skin around the puncture wound. She said it definetely looked like there was something in there, and recommended I have the hoof radiographed, and the leg nerve-blocked so the vet could do some debriding of the wound to see what was going on in there.

I soaked the foot immediately after, and while getting ready to bandage it, I noticed something different about the puncture wound. I could see something in the hole, which Marianne had opened up. I inspected it, and it was a piece of wood! I gently pulled it out, and felt it come out in one piece. It fit in the hole perfectly, and was about 1/4" wide x 1/2" long. So this is what had been causing the problem all along. Of course, this could have been a piece of wood that wormed itself into a pre-existing hole, but I highly doubted it, as the skin fit perfectly around it-I really think she'd had a piece of wood stuck in her foot that had finally worked its way to the surface.

On Sunday, I repeated the soaks and the bandaging. I had her trot a bit on the lunge just to check her comfort level, and she seemed to be a lot less ouchy. Still a little sore, but not head bobbing anymore.

On Monday morning, I called my vet and made an appointment for x-rays for Tuesday at noon. It poured in the afternoon Monday, so I didn't even get to lunge Lily. I repeated the soaking and the bandaging.

Today, Tuesday, Dr. G came out. Marianne had wanted to be present for the appointment, and I encouraged it because I wanted the support. Dr. G can be conservative, which is what I like about him-some vets go balls-to-the-wall over little things and will charge an arm and a leg for something that didn't require such an aggressive treatment. Dr. G will protect your wallet, and he will explain why. He will spend your money only if he sees it absolutely necessary, but he usually has great success with more conservative approaches, as long as the horse's caregivers are compliant and follow his instructions to a T.

I was just frustrated because we have been treating this for over a month and it's not getting better, and I was concerned about her abscessing again, never mind the possibility of more wood being stuck inside her foot, since wood loves to splinter when it's inside living tissue... So yes, Dr. Gillard wanted to continue the current track of treatment, but I insisted on the radiographs. He said it is not a treatment, which of course I'm fully aware of. I told him I just want to see what's going on inside her foot. It's only guesswork until we really know. So he went ahead with my wishes.

It was very cool to watch because I've never seen radiographs taken on a horse in person. Dr. G has the digital radiography equipment from Sound Technologies, a company whose equipment I've used in small animal practice, and they produce lovely, detailed, high-quality images. Marianne arrived as we were setting up, introduced herself, and Dr. G went silent. Uh-oh. It didn't help when she started talking to him about hoof angles and Lily's heels being too low (which Dr. Gillard had also brought up before) and how barefoot trimming could help, which I agree with her on. While I love my vet, he is of the mind that hoof problems should be corrected with shoes, and he had already recommended bar shoes with pads. He recommended them again. I completely understand his point of view, and agree with him to a certain point. Sometimes you need shoes. But sometimes you can use boots. And there are a bazillion other options inbetween, such as casting the hoof. So my trimmer and my vet ended up getting into a small argument over bad farriers vs bad trimmers, and why shoes are good vs awful, and how we've bred the good hoof out of the modern horse vs most horses can go barefoot (but only if they are trimmed properly!). They both had very valid points, and to a certain degree, they were actually agreeing on many of their points. I could see it, but neither one of them was seeing it. They could have completely met in the middle, but they did not. Dr. G became very brusque and short, and at that point I wanted to crawl into a hole and die. I respect this man very much, have used him for 3 years on my horses, and have the whole barn using him now. He is one of the best vets in our area, and I value the fact that he respects me as a knowledgeable horse owner, but I was afraid I was about to lose all that now.

The radiographs were taken, 6 shots total. Lily was an angel, as usual, cooperating while we shifted her weight around, put her foot on the stand, and then lifted her right front so she wouldn't move.

What did we find? Regarding the puncture wound: nothing. Big relief! No foreign objects, no pockets of air nor pus, no signs of an abscess about to blow. You can see in the lateral view where, towards the back of her heel on the very bottom of the foot, there is a small pocket, which is the part of her frog that will be sloughing off at some point in the near future. But we found something else: her coffin bone has some degenerative vascular changes going on, probably from 6 years of being trimmed with heels too low and toes too long, causing that negative palmar angle of her coffin bone. There are also some changes in the wings of her coffin bone, which also confirms this. Her coffin bone is currently straight inside the hoof capsule, so I think Marianne has already corrected part of the problem. However, her sole is being worn very thin by the sand in our turnouts and arena. She will need protection to make that stop.

I want to post the radiographs, but I'm having a hard time getting the program that allows you to view them onto this computer. If I'm able to figure it out, I will update.
Marianne wanted Dr. G to do the local block and remove the affected part of Lily's foot. Dr. G, however, suggested we keep doing what we're doing for the next 2 weeks, as now we know that there is nothing else stuck in that hoof. IF the problems continue, he will do the block and go in surgically, but he prefers I continue exercising Lily, giving her turnout (weather permitting) and encouraging her hoof to grow. I liked this suggestion, and took it. He said I should repeat another round of antibiotics. I asked one more time if I should be concerned over Lily's one-day lameness on Friday. Dr. G insisted that no, I shouldn't worry. He did have me walk and trot Lily down the aisle of the barn again, just to watch her move, but she stepped out willingly and steadily. Sound. I asked about the softness in her frog, around the puncture wound site, and he said that the humidity and rain we've been having, even when she hasn't been outside walking in the wet, make it take a lot longer for a hoof to toughen up while healing. I can accept that.

Marianne suggested I try Cavallo Simple boots with pads for Lily's hind feet. I'm not too thrilled about boots, but at this point, she is going to need something else on her back feet while she grows more heel. Plus, with the Cavallo boots, I can turn her out even when it's not perfectly dry. I like this idea-she can go out, her bandage stays dry, and it helps keep her feet from wearing down faster than they can grow. The Cavallos are easy to take on & off, which makes them the most convenient right now. I love Renegades, though. If I need boots for her long-term, I'm definetely getting a pair of those babies. The one thing I'm worried about with the Cavallos is the possibility of them chafing her pasterns. We'll see.

Marianne had brought along a couple of pairs of Cavallo boots in case Lily needed them, and got to work getting her fitted while I walked with Dr. Gillard outside so I could pay my bill. Dr. Gillard did tell me exactly what he thought of my trimmer (I think he's had problems with her at other barns due to their conflicting views on hoof care), but I quietly told him I wanted to try this-the previous farriers had messed Lily's feet up, and I was trying to get them fixed. He recommended a different farrier, Curtis Burns. He was the farrier of Cigar, the racehorse who retired as the greatest money earner in the US of all time. Cigar's record still stands, and this guy did his feet. He created the Burns Polyflex shoe, which is one option that Dr. G is recommending for Lily. The Polyflex shoe is actually a pretty cool concept that I will look more into, in case the Cavallo boots don't work. Dr. G is recommending them as a temporary aid, just while Lily grows more foot, and then she can go back to being barefoot. Mr. Burns is located right here in Royal Palm Beach, and is a friend of my vet's. The idea is pretty exciting. I'm sure it would be costly, probably way more than I can afford, but you can't deny that the idea of having someone of that caliber work on your horse is exciting.

So yes, I listened to everything Dr. Gillard had to say with open and willing ears, and I think I didn't completely lose his respect. Afterwards, I walked back into the barn to listen to Marianne's side.

Lily would need size 0 Cavallos for her back feet, and size 1 for her fronts. Marianne suggested I purchase the 1s, which is what she had at the moment, to use while I got the 0s for the back, and then I would have all 4 boots. I would have loved to go with this, but I had just paid a lot of money for my peace of mind regarding Lily's left hind, and told her that right now, I could only go for 1 pair, and it would have to be for the ones she needed most-the hinds, which was the size she didn't have. She was okay with this, though I felt bad-I wanted to be able to somehow pay her for her efforts. She then showed me how to trim Lily's feet once a week, just shaping her toes to keep any flares from forming, demonstrating the angle at which I should hold the rasp. This was really cool. Afterwards, I asked her how much I owed her-she had spent a good 2.5 hours with me at the barn during the whole x-ray procedure and then fitting Lily and teaching me. She wouldn't accept any money. I offered to pay for her gas at least, but she wouldn't take it. She said I could invite her out for lunch sometime. She said it with a smile.

I really like this woman. It's sad that my vet won't listen to her point of view, but I still like her. I love my vet, and I really like my trimmer-I will keep both. They have different opinions, but they have many things in common, the best one being that people like them, who really care and want to help out, are worth their weight in gold, and are few and far between, especially in the equestrian industry.

And speaking of the barefoot vs shoes debate, that reminds me of this:


A friend posted this on Facebook. I thought it was pretty awesome, so I'm sharing it with you guys. *lol* Like I've said before, I love holistic medicine, but it does have its dangers if used incorrectly. And the same can be said for traditional medicine. It would be nice if we could just integrate them instead of limiting ourselves to just one or the other.

In the afternoon, I took Lily out for a walk in the park. The arena was flooded, so that was a no-go. We walked on the pavement, which I knew would destroy Lily's duct tape bootie, and then made our way to the smaller hill in the middle of the park, where I lunged Lily for about 15 minutes at walk and trot, just to get her to work her muscles on an incline. She was spunky and a little wired, which made me extra-happy that I had chosen to just hand-walk her instead riding, as she had not been worked in 4 days. She was distracted by the horses in the pasture, and a couple of times she arched her neck, snorted and flagged her tail, but she was a good girl, never pulling on the line, never even bucking or kicking.




At the end of the 15 minutes, I brought her in to me, and noticed that her duct tape bootie was in shreds, all around her coronet band. And there was a lot of red on it. A lot of red. I had not used anything red on it-no iodine, no red Vetrap. The red was all over her pastern, too. Horrified, I picked up her leg and removed the remainders of the bootie. There were no cuts on her pastern, but when I looked under her foot, a trickle of blood was escaping through the puncture wound. The blood was all coming from the wound. However, she had not taken a single lame step-she had worked beautifully, actually.

So we cut across the field by the lake, over towards a gazebo I knew had restrooms and a water fountain-I wanted to clean up her leg and take a closer look. On the way there, I was freaking out, debating whether I should call Dr. G on his cell to ask what I should do.

Lily nibbled on grass while I wiped her pastern clean with water from the fountain. She definetely did not have any abrasions on her hair nor heels. I lifted the foot up and rinsed it too, but it had already stopped bleeding. Hmmm... I had her trot a small circle around me on the pavement towards the left just to watch her move. She trotted out fine. I then moved her to a flat patch of grass across the street, where I had her walk, trot and canter a single circle in each direction. She was fine. I decided to not call my vet, and reminded myself that it was just blood-just blood is good. She probably opened it up from the concussion of working faster than a walk in the grass on the hill. Also, any time a part of your body is trying to heal, there will be increased vasculature to that area in order to pump blood there to allow the white cells to clean up the damage. This will even happen in eyes with long-standing ulcers - capillaries will develop, crossing over the cornea in an attempt to heal the ulcer once and for all. So of course this would happen in Lily's frog, too. It happens with thrush as well. I breathed.

We continued with my original plan, which was to work an hour in the park. I was glad I had worn my sneakers, as I had been wanting to jog with Lily. And we did-I ran on the pavement, and had her trot next to me on the strip of grass next to the road. She arched her neck and picked up the trot the second I started to jog, and stayed right next to me, shoulder to shoulder, until I decided to break to a walk again. She instantly decelerated in unison. We repeated this several times, and I was happy my cardiac endurance seemed to be up to par, if not my legs.

We alternately jogged and walked all the way to the paddocks where the Scary Cows of Death are kept, and I let Lily stand for a minute and stare at them in horror.


Staring at the Horse-Eating Cows of Death with Zebra-Striped Fly Masks

But since I was next to her, her fear only lasted a second, and she immediately relaxed and followed me as we turned around and made our way back. I grinned like an idiot watching her trot happily next to me and laughed to myself at the realization: since moving to Florida, I had yearned for a large dog to go jogging with. Well, I can jog with my small horse instead...

We walked out of the park and onto the sidewalk by the white trail, which we followed up to one of the bigger barns by the main street before turning around to head home. Lily and I were both sweating and panting at this point-we had completed our hour and then some. Yay! I'm as fit as my mare! Or maybe she's as out of shape as I am?

We walked home. When we were almost at the barn, we saw Sarah riding up the street on Romeo, and we stopped to chat. Suddenly, the skies opened up and it poured buckets. Lily and I ran home-I was sprinting and she was doing her extended trot next to me. She is such a good girl-she never once tried to get ahead of me nor pull.

In the barn, I rinsed Lily's hoof on the wash rack, put her in her stall for a second (she had cooled off, thanks to the walk prior to the downpour, and from the downpour itself), and drove home to change my clothes (the apartment is only a mile away-less than 5 minutes. I was drenched! My hair was dripping!), and quickly rushed back to the barn to bathe Lily, and soak and bandage her foot.

Even after all the bleeding earlier, she was not resting the foot tonight. Good. I want her to just heal already!