Dr. R called her a 4/5 lame when she looked at her. Lily had been off bute for 24 hours in preparation for the exam so the vet could see the true colors of her lameness. I told Dr. R that I thought Lily was also off in the right hind. I've been seeing things with both hind legs since February, but it was so on and off that I thought I had been imagining everything, that I was being paranoid. However, it was nagging me enough that it was the #1 driving force behind my having her switched to semi-private turnout in a smaller paddock. I didn't think I was good at seeing hind leg lameness. It turns out I'm actually quite good at it: Dr. R agreed on what I was seeing in the right hind. She also saw a slight offness in the right front, but she suspected it was a compensatory thing.
Dr. R took a look at the puncture wound, scraping it gently with a hoof knife. She only had to flick off a tiny bit of hoof before the wound started to bleed. The vet was not happy with that. She said that if Lily had some sort of sepsis in her hoof, she would be crippled right now, but the fact that she was bleeding so easily meant that there was laminae involvement.
She also looked at the right hind, and discovered that the white line on that hoof is very soft. She thinks that there might be quite a bit of white line disease in that hoof, and that is why Lily is off there. We will know more when we can get it radiographed.
We blocked the left hind hoof. This was quite the ordeal-Lily ended up having to be twitched so Dr. R could get the needles where they had to go, and she still tried to kick out. Thankfully, my vet survived unscathed, and Lily had her hoof successfully blocked. When the twitch was removed, she turned her head to look at me, and whinnied loudly right in my face! Lmao!! Charles, who had come for moral support, laughed and said, "I don't think she could say 'F you!' more clearly!" Agreed!
We walked Lily for 5 minutes to get the blood pumping in her leg and let the lidocaine do its job. Then Dr. R's tech trotted Lily. She was still lame. Slightly improved, but still quite lame.
I was actually a little relieved at this point: the tremendous pain Lily has been in was not just her hoof. There was more than one cause, which meant that any chances that there was something septic inside her hoof automatically went down.
So we blocked the fetlock, which was a little less dramatic than doing the hoof even though it involved 3 needle pokes instead of just 2. Lily still had to be twitched, though, and again, as soon as the twitch was removed, she very vocally let us know how offended she was by the whole ordeal.
She trotted sound. Even the right front offness disappeared.
The vet found some abnormal effusion on palpation of the back of Lily's left hind fetlock. Out came the portable ultrasound, and Lily got sedated with xylazine.
|One droopy mare|
|Dr. R clips Lily's fetlock.|
|This is where the swelling is on the back of her fetlock, right around her annular ligament.|
|Getting the ultrasound probe ready.|
|In this image you could see the fluid around the branches of Lily's suspensory.|
|Tina had offered to hold Lily's lead rope, and leaned over to take a look at the screen. That's her in the plaid shirt. :)|
|Lily says, "Why couldn't you guys do this before stabbing me with 5 gazillion needles?"|
Treatment? Thankfully my vet is NOT one of the ones that believes in 6 months of strict stall rest for horses with soft tissue injuries. We will be following what we now call the Jez protocol: 1 month of stall rest with 15 minutes of handwalking once a day (vs twice a day for Jez), and as much hand grazing as I want, and then 1 month of tack walking, going from 20 minutes 6 days a week to 30 minutes 6 days a week over the course of 4 weeks. Trotting can be started after that, and once she is back in full work, she can get turned out again. Since there is some swelling at the fetlock, it's going to get iced for the first 7 days, and Lily will also get Robaxin. Her back has become quite sore from compensating.
This, of course, is the soft tissue injury treatment. We still need an answer regarding the puncture wound. I was instructed to continue the Epsom salt soaks, and wrap the hoof with Animalintex and a duct tape bootie. I did this after the vet visit, and also set up one of Lily's old slow feeders. She's back at her ideal weight, but she doesn't need to be getting fat when she has a ligament injury.
On the way home from the barn, Dr. R's tech called: the x-ray machine has been fixed! They will be coming back out tomorrow to do rads.
Send positive thoughts our way, please!