Tales From The Trenches: When You Know They're Going To Die

I will start this post saying that if you want to read this, do so promptly because I might decide to remove it after publishing. It is a strange post and a dark one, and one that has been wanting to be written for a long time now. Months.

Over the winter I had started my Tales From The Trenches series and then it came to a grinding halt when we started a bad run of euthanasias at work. There were more bad endings than happy endings, and I simply didn't want to talk nor think about work when I wasn't physically at the veterinary hospital, so I stopped writing about it. 

There is no doubt in anyone's mind that euthanasia is the hardest part of the veterinary profession. I don't care if you don't agree with the concept: I think it is a wonderful thing and I wish with all my heart that it was a legal option for humans with debilitating and/or terminal illnesses with poor quality of life. Who wants to slowly die of cancer? I sure don't. Why? Why do we have to suffer for months in pain in a hospital bed until our bodies give up? Why??

When a pet is euthanized, they are often given a strong sedative and then the lethal injection itself. In our hospital, we always always place an IV catheter for this purpose, whether the owner chooses to be present or not, as it makes things go so much more smoothly. And what is it like when it goes smoothly? The pet falls asleep and is gone within seconds. Peacefully. Painlessly. Quickly. They literally look like they have fallen asleep, enough so that sometimes owners have a hard time believing that they are gone. 

I can't think of a better way to go. For man or beast.

It still doesn't make it any easier for the owner that has to make this decision nor for the veterinary staff that work with this scenario day in and day out. One of the major drawbacks of emergency and critical care is that there is SO MUCH death. We see the worst of the worst. It is wonderful when an animal defeats all odds and makes it. But more often than not, the miracle does not occur and they don't survive. Or the owner can't afford the cost of the treatment that might not save the pet anyway. Or the animal is just too far gone with too many issues.

One of the skills the experienced ER tech develops is an uncanny ability for knowing when an animal appears fine but is critical, and when they appear to be very sick but in fact are not.

One time we had an older Golden Retriever walk in the door. I assessed him in the lobby while his owner told me his story. He was 10 years old and had been brought in for suddenly not acting like his usual self at home. He was wagging his tail, but I just got this bad feeling while looking at him. I couldn't pinpoint why. The dog was panting happily and he had pink mucous membranes with a normal capillary refill time of less than 2 seconds.  I checked his femoral pulse: it was very fast at 170 beats per minute, and thready. Not nice and steady. Red alert: this dog was in the beginnings of shock and doing a good job of hiding it. His owner needed to fill out paperwork at the front desk so he could get checked in, so I asked for permission to take his dog back to the ER treatment area so the doctor could take a look at him. The owner had no problem with this, so I borrowed the dog. Dr. J was in the ER waiting. "There is something really wrong with this dog. I think he could be a hemoabdomen." 

Hemoabdomen literally means "blood in the abdomen". They can be caused by trauma like being hit by a car, but most often they are the result of a bleeding tumor, usually in the spleen or liver. They commonly present with pale gums, bounding pulses and a distended abdomen, none of which this dog had. The inciting factor in having the dog brought to the ER is most often a sudden collapse at home +/- a vomiting episode. It is a death or death situation: take the dog to surgery and remove the spleen or affected liver lobe (unless the cancer has taken over the whole liver, in which case the patient must be euthanized. You can't live without your liver) and prolong their life for a few months whether you put the dog through chemotherapy or not...or don't do surgery and have to euthanize because the dog will bleed to death otherwise. Hemoabdomens can be caused by a slow bleed, where you see a dog with less severe symptoms if the owner catches it early, or they can be caused by a sudden massive bleed where the dog goes downhill rapidly, sometimes in a matter of hours. It is the tumor that decides how fast it will bleed. It is a devastating emergency because most of the time, these dogs are absolutely fine up until the moment their body can't compensate for the bleeding anymore, and it catches their owners completely by surprise.

Now, there are exceptions: every once in a blue moon, you get a hemoabdomen resulting from a benign splenic mass. You remove it and the dog lives a long happy life. In 7 years working in this field, I have sadly only witnessed this twice. :(

Dr. J assessed the dog and thought maybe there was something wrong with his heart. We took chest radiographs and in a corner of the view, you could see a glimpse of the abdomen. It didn't look normal. The dog also was starting to look less and less bright as the minutes ticked on. Some dogs will put up a facade for their owners to hide that they are not feeling well, but once in the ER with us will tell us the truth. This dog was telling us what was going on. Dr. J used our ultrasound machine (sonogram in human medicine) to take a quick peek in the patient's belly.

There was free fluid. He ran out of the ER to talk to the dog's owners to let them know what was going on, and returned to obtain a quick sample of the abdominal fluid we had just seen.

It was blood. Diagnosis confirmed.

I was praised for my wildly accurate instincts in this case but it's not the kind of thing that you want to be right about. 

This dog went to surgery and made it, but the tumor in the removed spleen was not a benign one. I don't know what the owners elected after that, nor how much time he had remaining after his surgery. I just know that he walked out of the hospital alive, and sometimes that is enough.

Dr. J is one of our senior staff doctors. He is in his early 30's and is one of the ER favorites both amongst techs and doctors. Everyone loves working with him. His medicine is honest and matter-of-fact, and he has a great sarcastic sense of humor and a mind like a whip. He's one of those people that can positively change the atmosphere in a room just by walking into it. He is one of our most efficient doctors, seeing triple the amount of cases that the other vets will see in the same time frame. Which also means he is the one that euthanizes the most animals. It is just a matter of numbers: a third to half of the patients we see in the ER will die.

He'd been having a particularly bad run when this kitten was brought into our ER. She had all sorts of things wrong with her and was barely a year old. The issues were mostly congenital. It was a wonder she had lived as long as she had.

The owners elected euthanasia. It was the right thing to do given the circumstances. The owners chose to be present for the procedure, which was done in an exam room.

Dr. J brought the kitten's body back into the ER afterwards, bundled up in a towel pressed to his chest. His face was red, and he gently lay the kitty on the table in front of me so I could process her body while he silently stepped out of the room. We didn't see him again for a while.

I took the kitten's body back to the morgue afterwards where, in solitude, I was able to cry myself.

It is so much harder with the young ones. The young patients and the young doctors.

This week we had a gorgeous cat brought in in the evening. His owners were hysterical. The cat was screaming. His hind legs and tail were limp and cold.

A saddle thrombus.

Saddle thrombi are one of the worst feline emergencies. Like hemoabdomens, they don't have happy endings. The saddle is the bifurcation of the aorta, where it branches into each hind leg. Kitties with heart disease will often throw a large clot (thrombus) that will lodge in the saddle, cutting off circulation to the hind legs. It is one of the most painful things that can happen to a cat. You can recognize a saddle thrombus by the wails of the cat as they are being brought into the veterinary hospital. If caught promptly, the cat can recover use of his hind legs with medication to help dissolve the clot. The heart disease that caused the problem will need to be addressed. Often times, the saddle thrombus is the first sign of heart disease, which sucks. Even then, only 50% of cases will survive to leave the hospital. Even then, the average surviving saddle thrombus cat will only live for 2 more months. 1/4 of the cats that survive and receive treatment will have another thromboembolic episode within the next 6 to 12 months. Chances of survival are greater if the clot occurred in a front leg or if only one hind leg was affected. If the cat's rectal body temperature on presentation is lower than 98.9, the chances of survival drop rapidly.

This kitty's rectal temperature was 97.2.

He was vocalizing and I told the doctor we needed pain meds for him STAT. She gave us a dose to give IV via injection. The problem with that is that we only had 2 front legs to work with: you don't want to inject anything IV in hind legs with compromised circulation. And we would need to place an IV catheter whether the owners decided to treat or not, and it would have to go in a front leg. The doctor gave permission for us to just place the catheter and give the injection through it.

Most saddle thrombus cats are in so much pain that they will try to bite anything and everything that attempts to touch them: not even owners are exempt. They don't want to be touched, and it is understandable.

This cat was wiggly and he tried to push our hands away with his paws, but he never once tried to bite. Not once. We were able to quickly place the IV catheter and give him his pain medication. We placed him in a kitty bed so that he would feel safe and let him chill in one of our ER cages. I stayed close by to make sure he didn't have a bad reaction to the pain medication. Some cats don't quite know what to do with themselves and will flail.

The pain relief was instant for him. Once he found himself in the cage, he straightened his shoulders and looked about. He had stopped vocalizing. I opened the cage door to reassure him. He was lucid and now that he had relaxed, there was an almost regal quality about him.

Brilliant liquid green eyes met mine. The cat half closed his eyes at me, giving me a "kitty kiss." "Thank you for making me feel better," he said. My eyes teared up as I reached over and rubbed my hand against his cheek. He leaned into my touch, his eyes holding mine. "I'm so sorry," I whispered to him. "I will be okay," he said.

Since he was comfortable, I gently closed the cage door and turned away. We had other emergencies that needed treatment and it was a good way to distract myself from the sudden wave of grief I was feeling.

I was relieved when one of my coworkers took care of him after he was gone. They all get to you, but every once in a while there is one that gets to you more. This was one of them.

We fight the battle between life and death every shift that we are in the ER, dancing in the line between the two worlds, trying to hold back death for one more day, one more month, one more year, one more decade. We know that sooner or later, death will ultimately win. It is the only certain thing about life. But we fight the battle anyway.

I went to Catholic school but always had my own opinions on things that I kept mostly to myself outside of our home. My family was a funny mix of Catholic, Buddhist and New Age. We took what we liked of each religion and chose what we wanted to believe in. There are no absolutes in life other than death itself. Why should a belief be absolute? We would later discover that our beliefs pretty much matched the Wiccan beliefs, so nowadays when anyone asks me what religion I am and I want to shock them, I'll just tell them I'm Wiccan. I like the idea of praying to a Mother Goddess either way.

I would not be able to do this job if I didn't believe what I believe. If I believed that life ends at death, I would not be able to cope. I believe that all living things, from the spider in your closet to the tree outside your door to your canine companion to you yourself have souls. That we come back sooner or later, and so do our animals. I believe that most of the people that we know in this life we have met before: they were our sisters, brothers, fathers, significant others, or just very good friends. We fought in wars with them, raised families with them, moved across a continent with them. I don't believe in love at first sight; I believe in love at first memory. That relative with whom you just can't get along, you've had a dispute with over centuries and you will keep having difficulties with that person for centuries more if you don't resolve your disagreements now. (Ha! Believing in that doesn't mean I want to deal with it!) I believe in karma and can tell you that it exists. I believe that the animals that we love and need the most come back to us. Sometimes repeatedly in the same journey if we live long enough.

And I may lose followers for sharing all this, but I need to share it to explain to you that even believing this does not make working with death every day any easier. It only makes it easier to recognize. It is a door I opened to allow me to better do my job, but I am not able to close it at will now. I often refrain from touching friends' animals, especially dogs, especially older dogs, because I don't want to know. I don't want to know how that dog will die.

We had just euthanized yet another last night. An advanced heart failure case. If the owners had not elected euthanasia, the little one would have drowned in the excess fluid produced by his failing heart: a slow and horrific death. It is a hospital policy that we make paw prints of the pets that have died; they are mailed to the clients afterwards as a last remembrance. I was working intently on the final details of this paw print: choosing the stamp font and wondering, as I always do, if it would be appreciated by the owner. Grief is an unpredictable thing, unique to each person that goes through it. Most people love the paw prints and cherish them forever, but some people don't, and I can understand that. And as I smoothed out the clay around the paw print, I thought about writing this post. And then Dr. J, who had been leaning silently against the counter next to me and apparently watching my efforts, suddenly said, "We do good things here."

I glanced up in surprise. He had a sad half smile that I returned. I couldn't say anything. I finished stamping the pet's name on the paw print as Dr. J looked straight ahead, lost in his own thoughts. I asked him about the case that he was working on. He was waiting for the owners to make a decision. It would be another case that would end in death during our watch. 

Yes, we do good things. We just wish death wasn't one of them.

Experiment

On Saturday I tacked up Lily with a different setup: I threw the cover for Gracie's saddle on the Wintec Dressage Contourbloc and saddled her up with this and one of my regular all purpose cotton pads. I added my regular pommel pack and my cantle pack with 2 spare Gloves, one for each front hoof: a size 0 for Lily's smaller LF and a 0.5 for her RF.  (Gracie's saddle is a Len Brown Ortho Flex Patriot I found used on eBay in Charles's side for my birthday. Yup: I got a saddle on my birthday for Charles. The gift for myself was that I'd be able to use MY Alta when we rode together again! The saddle cover is this one. I really love it because it fits two very different saddles quite well. And no we didn't suddenly win the lottery. ;) We saved up for each of these things.) I swapped out my dressage stirrups for my EZ-Ride stirrups but left the sheepskin covers on the stirrup leathers. Lily wore her Vipers on her front hooves and Gloves on her hinds.

Lily after the ride. But this is what we rode in, sans the hind boots, which I will tell about later in this post.

Why did I do this?
1. The Wintec is lighter. Lily can move out more and recover faster with less weight on her back. That's a no-brainer. You too would move faster hiking with a 15 lb backpack than with a 50 lb backpack.
2. The Wintec fits perfectly with a thin pad, not so much with the Woolback I use with the Alta.
3. I wanted to see how Lily's performance with Wintec + all the saddle bags would compare to her performance with the Alta + all the saddle bags.
4. I'm kind of an anomaly I guess in that I like a wide twist on a saddle. The Alta has a wide twist and so does the Wintec. Now, the panels and flaps are slim, so the saddle feels so much more narrow when I'm riding in it and the giant knee blocks will sometimes give me bruises on my knees. I figured adding the full saddle cover over it would help with both of these things. I wanted to test this out over a longer distance.
5. The footing was extra-dry (no boot-sucking mud) so I wanted to test, yet again, Vipers vs Gloves. (I've been alternating bare and booted for training rides in the park and booting only fronts or hinds when booting at all. Less boots to worry about falling off!)

We set off towards the park across the street. As we made it onto the pea gravel path, I could feel the pull in my inner thighs from the bulk of the sheepskin + knee blocks. More than I had expected. Figuring this would not get better after 10+ miles, I dismounted and removed the sheepskin stirrup leather covers. I re-mounted and felt much better. The saddle still felt wider than the Alta because of the knee blocks + sheepskin, but not too horrible. We continued on down the driveway.

I had dropped my stirrups two holes to compensate for the sheepskin cover and the EZ-Ride stirrups (they have a thick footbed), but when we picked up a trot on the driveway, I realized they were way too long. So again I dismounted and adjusted the stirrups, shortening them a hole.

Onwards!

Lily was a little looky once we were in the park, which was to be expected given that it had been 2 weeks since we went out there. And she may have been in heat, based on behavior observed later that same day around geldings. But lately these days I can't tell when she is or isn't. SmartMare Harmony and 24/7 turnout have been da bomb for this horse.

We picked up a very energetic trot and I was surprised when MapMyRun started calling out the miles. Lily's average pace in the park, despite our faster training rides in the fields, had been consistently about 6.6 mph (9 minute miles) and today she was going at 7.5 mph (8 minute miles) without any effort. I felt that this proved my point re: saddle weight. She stayed at that speed of a trot without any extra urging from me, and excitedly attacked all of the park hills I pointed her at at a bounding gallop.

We'd consistently been having days in the 70's for the last 2 weeks but on Saturday we were having a short heat wave: temps were soaring into the mid-80's, and about half way into our ride, Lily was dripping sweat but it did not seem to affect her enthusiasm whatsoever. Another point for the Wintec.

However, the stirrup leathers were driving me batty. For dressage rides I have offset-eye stirrups that don't bother me, but the EZ-Ride stirrups are normal so the leathers twist when your feet are in the stirrups. I have Wintec Webbers on this saddle because I hate the bulk of buckles under my leg and I had set the stirrups so the leathers wouldn't twist all the way around when my feet were in the stirrups. The problem is that the prong for adjusting the length was lying right against my shins and I knew if I didn't do something about this, I was going to end up with matching giant raw spots on my shins despite my half chaps.

We had just finished a canter set when I realized that Lily was trotting funny. I looked down at her boots: the Vipers were fine, but the Glove on her RH had spun off and was hanging by the gaiter. Grumbling, I dismounted...to realize that the boot had come off because the gaiter had torn. WTF?!!

I'm really happy with these particular boots when they work out. Like at the Old Dominon 50. But the truth of the matter is that, while the shells are great, the gaiters are crap. C.R.A.P. I tell you. The Velcro is flimsy, the gaiter neoprene-ish material frays, and the stitches used to attach the gaiter to the rubber part that screws on to the shells are poorly done. They need to use stronger thread.

The torn gaiter. The white stuff is epoxy-type glue that I used to try to reinforce the stitching on the boots. As you can see, it made no difference. :( It was a good try, but seriously: EasyCare, if you really want to market these for distance riding, you need to use better materials!

Behold the flimsiness of the Velcro.
Older Gloves had a wider, sturdier Velcro which has changed in newer models.
This shit is supposed to stand up to miles and miles of use? I don't think so.

And I want to tag the shit out of this post so that THE EASYCARE PEOPLE SEE WHAT I'M SAYING! (Not that they give a crap, apparently, based on what much more experienced endurance riders have said about these boots and the company's customer service.) I recently reinforced all of the stitches and edges on the STOOPID gaiters with an epoxy-type craft glue (see photo above), hoping that this would help extend their life. Verdict? It made absolutely no difference. I was ready to chuck the damn boot in the bushes rather than buy A THIRD GAITER IN THE LAST 2 MONTHS (!!!) but I refrained. I took out my 0.5 spare. OF COURSE I chose to stick in my saddle bag the one other 0.5 that has a gaiter that needs to be replaced, so I couldn't use it. Fuming, I pulled out my size 0 meant for Lily's smaller LF hoof and a half size smaller than what Lily's RH usually takes. I hammered it on with the broken boot, figuring the thing would never come off this way. There was something very satisfying about slamming on one boot with the other.

While I was at it, I also adjusted the stirrups so that the prong ends were lying on the outside of my shins (flat part of the strap directly against my leg). Sweating and blowing smoke out of my ears, I mounted back up. And Lily is a saint: she tells me when a boot is malfunctioning, stands patiently with her reins hanging while I figure out what to do, holds her hoof up so I can remove and replace the boot, knows by this point that my crankiness in these situations has nothing to do with her, and then stands stock still so I can swing back up into the saddle. I may be mad at the boots but I give her tons and tons of praise while all of this is going on. I love her love her love her.

We walked back to the main trail and then I asked Lily to pick up a trot again. She trotted on happily and very forward-ly, until we were almost back at the first creek crossing. Lily's gait suddenly felt off so I stopped and looked back at her hind boots.

GODDAMN @##$$%%^^&*(()*&&^^@@##!!!!!!

The RH Glove, the smaller one I had just hammered on, had popped off and was hanging by the gaiter. GRRRRRRR! At least the gaiter was still fully attached to the boot... I dismounted and simply removed both hind Gloves, grumbling about what a POS these boots are. I don't get it: every other ride, they are terrific. I've had them stay on through fetlock-deep mud and despite trotting up hills coming out of water, two of the hazards most likely to make you lose boots. But on this day with perfect footing? Nope. I will stop hating them again next time they perform fantastically, but I get SO FRUSTRATED with them when they don't work on training rides! Next time I'll just Viper all the way around. More points for Lander Industries and their awesome products!

Adjusting the stirrups allowed me to figure out where I had to be in the saddle + cover to be comfortable, and once I was where I needed to be, everything just flowed so much easier for us together. I'd been fighting the saddle somewhat up until that moment. I noted that with the cover I didn't get the knot behind my left shoulder blade nor the twinge in my left sciatic nerve like I have in that saddle in the past on long rides sans cover. I felt solid in the saddle and Lily felt forward and nicely in front of my leg with no effort from me.

We did part of our usual loop in reverse, in a way that allowed us to string together the different equestrian trails without having to ride any of them twice. We were coming back out onto the meadow trail when MapMyRun called out 9 miles. At this point Lily's gait changed again. I brought her to a stop and she immediately started frantically stomping her RF: the Viper had spun around and was hanging by the captivator. I managed to swing off while she continued stomping. "Get it off get it off get it off!" she said. "Hold on Lily" I said, as I reached for the boot. She was holding her foot up in the air and when I reached for it, she started stomping again. I had to reprimand her when she almost kneed me in the cheekbone. "You need to hold still if you want me to help you," I told her. As if she understood, she simply lifted her foot and held it in the air while I removed the boot and replaced it correctly. She was fine after that.

I decided we'd add 3 more miles in to complete 12 miles. Lily loves cantering on the meadow trail, so I let her go. She picked up her all-day canter, easily putting in 2 loops around the meadow trail without stopping (one turn around this trail is a mile), and then I had her veer off down the Hidden Pond Trail. She trotted down the slope back into the woods, then picked up a canter all on her own. She didn't ask to come back down to a trot, so I simply let her canter this loop until we were almost back at the meadow trail. I brought her back down to a walk when the app called out 12 miles. We had completed them in 1 hour and 37 minutes. I was thrilled with our pace.

I dismounted and, since we were facing home, decided to practice tailing with Lily. She is always confused when I stand behind her holding her tail. I clipped one end of the reins to the halter on her halter-bridle and held the opposite end. Lily stood and looked back at me as I took my position behind her. "Go on." I said, and clucked. Lily started walking slowly forward, but she kept turning her head slightly to check on me. "Are you sure this is what you want me to do?" she asked. "Yes. Good girl! That's exactly it." So she straightened out and walked on more confidently, still keeping an ear on me.

You can see her ear pointed back at me.

I somehow managed to drop the rein and Lily immediately came to a halt with no request from me. I praised her and picked up the rein again. She walked on at my bidding. I don't know what I was doing, but I did manage to drop the rein one more time and again she stopped immediately of her own accord.

Have I mentioned how much I love this horse?

In this manner we walked over to a friend's new barn whom I was helping to get set up, where I untacked Lily and turned her out in the empty fields. She flirted with the neighbor's geldings over the fence, then had a ball walking around, exploring and grazing by herself for 2 hours. A situation where a long time ago she would have turned into a nervous wreck at finding herself all alone. When it was time for us to go, I found her in cannon-bone high grass in the front pasture. She didn't come when I called but she stood and waited for me to go to her, giving me happy ears. I tacked her back up and walked her on a loose rein back to our barn.

I write about these events and feel like I can't put into words what each of these little things means to me. The fact that she trusts me so much now, that she is so happy being my horse now, that I can ride her for 12 miles, take her over to another barn and have her stay completely chill, then get back on and have her be fine with carrying me a little while longer. All the little things that I never thought I'd be able to do with her, and that now I can without thinking about it.

I love her.

WW: Beautiful Girl

All of these photos are by Kathy. She's been taking pictures of the farm horses and wanted to include my girls in the project. She is a seriously talented photographer with a fantastic eye!! 

And no, there is no Arab in her. She is 100% purebred Kentucky Mountain Horse; I have the papers to prove it. :) Though I guess you could argue that there is Arabian in all of the breeds.

Musical Ponies

Alyssa started a sort of informal blog hop about what music makes us think about our horses and it was so awesome to see I'm not the only one! I've waxed poetic on this blog about all the music I listen to while riding and which songs are my favorites. I listen to a pretty wide variety of music, including pop, alternative rock, dance music with hip hop/elecronica mixes, breakbeats and house being at the top of that list, oldies from the 60's and 70's (love the Beatles and the Bee Gees), Spanish rock, Spanish ballads, reggaeton, ska, funk, reggae and anything ragga (ragga-jungle, dancehall, etc), country rock, heavy metal and even some industrial. Music basically sets the beat of my life, and it is essential for both working out and riding. It is a HUGE motivation factor for both: I only allow myself to listen to Pandora while riding or running because it is something additional to look forward to. That's how much of a difference music makes for me!

Here is a brief compilation of some of my favorites. Song titles have links to the videos on YouTube.

Lily's Music

Katy Perry's song Roar is and always will be Lily's song:

The lyrics are here. This song came out on the radio right along the time I realized Lily had finally let go of all of her fears and was starting to trust me 100% of the time under saddle. She'd always trusted me on the ground but we hadn't made the connection under saddle. This song pretty accurately tells the tale.

Other songs that make me think of her when I hear them on the radio:
 Bumpy Ride by Mohombi was Lily's first song ever! Because when I first got her she used to buck every time I cued the canter!

Wild Ones by Flo Rida with Sia. This was Lily's song from the moment it came out, and it was the hymn of my turning point with her last summer, where I realized and accepted that her and I are the same.

"Hey I heard you are a wild one

Oooh

If I took you home

It'd be a home run

Show me how you do

I wanna shut down the club

With you

Hey I heard you like the wild ones (wild ones wild ones)

Ooh"

Little Bad Girl by David Guetta and Taio Cruz. Great song for a badass mare.

"Look at her go on the dance floor

She's amazing on the dance floor

When she moves, girl, I want more

Keep it going girl, like I got an encore

You got me sayin'

Go little bad girl, little bad girl

Go little bad girl!"

Kickass!

 Say Hey I Love You by Michael Franti and Spearhead. This used to be very much Cloud's song but it has become Lily's as well.

"It seems like everywhere I go

The more I see, the less I know

But I know one thing

That I love you (baby girl)

I love you, I love you, I love you"

Fallin' For You by Colbie Caillat. This one also used to be Cloud's and Lily has inherited it. It is my heart horse song. And there is nothing quite like cantering to this song out in wide open spaces on a horse that you love.

"I've been spending all my time

Just thinking about you

I don't know what to do

I think I'm fallin' for you

I've been waiting all my life and now I found you

I don't know what to do

I think I'm falling for you

I'm falling for you."

Gracie's Music

Gracie doesn't have such a huge repertoire yet (3 years of owning Lily vs 5 months owning Gracie) but the ones that make me think of the G-mare without fail are: 

 Cruise by Florida Georgia Line.

 Wagon Wheel by Darius Rucker

 Melena Al Viento by Roy Brown. Roy was a Puerto Rican singer and songwriter, and he wrote some really wonderful songs about island lore and culture, and about the internal struggle for it to be free. He set to music the poems of some of the island's greatest poets too. This was Lucero's song also. It is literally a song about a girl's coarse, wild and untamed mane of hair. It's a fun song with a beat that will match most gaited horses' way of going. Very appropriate for a horse with a long mane!

   

I apologize for the anarchy "A" that is this video, but it has the original version of the song. Just so you guys could listen to it. :) A lot of Puerto Ricans haven't heard it either.

 Songs for riding in general

Most of these are part of my "Workout Mix" playlist on my Nano. I've worked out to music since owning my first Discman back in...1996? Not long after that I realized I could stick it in a fanny pack and ride with it. Music became the background to most of my training/practice rides since then too, except when riding especially skittish/spooky horses. I honestly don't pay attention to the beats per minute when choosing songs for riding/working out; I just go with the feeling the music evokes in me that can change the tune of a ride more than whether it matches my horse's gaits. If the song makes me want to dance or sing, I'm going to want it for riding.

Junto Al Amanecer by J. Alvarez. The beat matches both Lily's trot and Gracie's gait, and I just like the music. I love it for running too.

Limbo by Daddy Yankee. Pandora played it while galloping across the soybean fields last fall and it's just stuck as one of my favorites for any kind of speed work!

Let Go by Frou Frou. This was one of my brother's favorite bands when we were growing up. I simply LOVE this song. It made me love the movie Garden State even more because this was one of the songs on the soundtrack. It has a beautiful flow to it for riding.

Moves Like Jagger by Maroon 5. Because moves like Jagger.

Tracking Treasure Down by Gabriel and Dresden. LOOOOOOOVE this song! Great for long trot sessions.

Never Let You Go by Third Eye Blind. My favorite decade in music is the 90's. All that 90's alternative rock is fantastic for upbeat rides. At least, for me it is!

Rock Your Body Rock by Ferry Corsten. Work it!

Sunday Morning by DJ Ka-Os. This song has so many positive associations for me: Charles played it for the first time on the way to the North American Veterinary Conference in Orlando (it is an awesome veterinary conference if you're in the field! Totally recommend! So much to do and see and learn!) I used to listen to it a lot when I worked Saturday overnights back in my first veterinary ER job. I literally looked forward to Sunday mornings! I love it for running and I love it for riding. There is something about the music that just carries you along. But that might just be me. :)

Black Betty by Ram Jam. More power trotting. Even before endurance, the gait at which I worked the most was the trot. It also matches the beat of Lily's canter.

There are many, many, many more. I have about 70 songs on the one Nano playlist alone and for riding I alternate between the same 6 Pandora stations.

What about you? Do you have songs for your horse(s) and/or for riding in general?

Let Go

Today I rode Lily and since there were a million people in the park, I decided to just stay in the back fields of the barn and work on speed yet again. (Somewhere out there there is a horse trailer with my name on it. Just sayin'. "If you build it, they will come!" That means when we put the hitch receiver on the truck, the trailer will materialize, right?)

We did 10 miles in an hour, alternately trotting one mile, cantering one mile. The mare was all, "NBD." Hopefully all this speed work translates to mountain climbing. Her recoveries at the moment are insane.

But that's not what I wanted to write about. I wanted to write about how I put my stirrups up two holes at the "we are doing business" length so I could get out of the saddle for the work I had planned. I wanted to write about how my legs felt molded to Lily's sides as I warmed her up, heels cranked to China. But I especially wanted to write about the moment when we were cantering around at Lily's all-day canter. I was listening to Pandora and the song "Rude" by Magic! came on.

I have always found reggae-influenced beats soothing and I really love this song. I started singing along to the lyrics out loud as Lily cantered around the field. And then I extended one arm out while Lily cantered on, unperturbed. So I hooked the reins on the pommel of the saddle with my other hand and extended both arms out and let go.

And we cantered on and on, free. No hands. Out in the fields, as one.

Sometimes you just have to let go.

Thinking of You

Fall is coming. The temperatures have dropped this week. The high today was 63.

Astarte says, "I'm a Puerto Rican Shorthair. 63 degrees is cold!" 

We had a 50% chance of rain, which has meant sun lately so I had great plans: I was going to go for a 4 mile trail run with Charles this morning. I was going to ride Lily, maybe do hill sets in the park. And hop on Gracie for the first time in 2 weeks.

The weather chose to go to the other 50% and of course it rained all day, so we just ran errands. I absolutely had NO desire to ride with this kind of weather.

In the afternoon I went to the barn. Charles stayed home and told me to give the girls a kiss for him. I thought about Beka's recent post on support systems. I couldn't ask for more with Charles.

I got Gracie from the field. Lily was worked yesterday and G-mare needs to move around for her arthritis. She didn't get formally worked yesterday because she was sore after all the poking and prodding from the vet. I really wanted to get her moving today, especially with the cooler, humid weather. The rain had finally stopped but it was overcast and chilly. I thought of Gail and her recent post where she mentioned taking a break from intense conditioning in November, and thought, "Man, I'm looking forward to that too."

I trimmed her feet per the vet's orders, and thought of Mary's comments on my previous post re: injectable HA. I was still grinning about Dr. Ramsey's opinion on IV HA.

And then I put my spare lunging bridle on her and the surcingle, and took her out to the new round pen. It is a 40 meter round pen, larger than the circle you would do with a lunge line. I failed at the picture taking during this session because I had no pockets so my phone got left in the barn. So the text will be broken up with photos from previous lunging sessions that I have not posted on the blog before. :)

I let her walk around initially then had her warm up at an easy trot for 10 minutes sans side reins: we did 5 minutes going left first, so the arthritic leg was to the outside, and then changed directions and worked at the trot to the right. Interestingly, today she was stepping short with the RF when going to the left only. You'd think it would be the other way around. There was a lot of sass: she did a turn in each direction cantering and throwing tiny bucks. Not protesting, just happy to be working.

Sassy mare being sassy on a different day. She was trotting sideways on the lunge...
And no, she is not that fat. :p Oddly enough, my cell phone camera will really distort images depending on the angle at which I take photos.

After the warm-up, I clipped the side reins to the D-ring bit on my lunging bridle and had Gracie go 5 minutes in each direction again. She was doing silly things, sometimes curling behind the bit and sometimes going above it. I thought of Dom and her recent post on Booger. Gracie eventually started going consistently in the bridle.

Like this.

The boys started bringing the horses out for evening turnout. Gracie got very "up", flagging her tail and doing her floaty trot around the round pen. She stopped at the corner gate of the roundpen and I let her stand there while the boys walked by with 3 horses each. I didn't want their horses to freak out about Gracie running around while being led.

The round pen is in the corner of one of the fields. She was stopping at the one gate that is on a corner, the one on the left side of this drawing.

The boys had to do multiple trips and I let Gracie stop at this gate each time. The problem (and I knew this would end up being A Problem) was that Gracie then tried to take advantage of this: when I asked her to work around the round pen after the boys were done, she continued stopping at this gate. I had to get very BIG with my body language. I didn't have a lunge whip with me; I'd been using the unattached lunge line to prompt her to keep going by swinging the end of it around in circles, and this was not working anymore. So I had to smack the earth next to Gracie with the lunge line to get her to continue around the round pen. Despite this, she continued stopping at this gate every. single. time. And then she started stopping at the only other corner of the round pen, and then I realized that she had me running back and forth from one end of the round pen to the other in an attempt to keep her working, while she got to have breaks at each corner. I was working harder than she was.

Ummm, no.

I put her on the lunge line and had her work a few more minutes in each direction while walking a large circle in the center so she was still using the entire space of the round pen, but keeping her from getting stuck in the corners. She obliged with a long-strided trot, no RF shortness to be seen at all.

We then called it a day.

I took her back into the barn, removed the bridle and surcingle, hosed her off outside quickly, then took her for a long walk up and down the driveway to finish cooling down. I'd had to be so BIG in the round pen that now Gracie was a little skittish when I reached out to touch her. I felt bad when I saw her reaction. :(

So we walked up and down the driveway and I scratched Gracie's neck as we walked along. And she got over her skittishness. I walked in front of her and out of the corner of my eye, I saw Gracie reaching out to very gently touch her nose to my back, like Ashke does with Karen. I thought of Lytha and how Baasha also used to do a similar thing, and thought about what happened recently at a clinic with Mara, and had the idea of placing my open hand behind me...and Gracie reached forward and placed her nose in my hand. I grinned, rubbed her nose, then walked along normally. Then I did it again. Again Gracie reached forward and touched her nose to my hand. We walked along together and I continued to occasionally hold my hand next to me or behind me, palm facing backwards, and each time Gracie would lengthen her stride so that she could reach forward and place her nose in my hand. Each time I rubbed her nose and her forehead. Each time I resumed walking in a normal fashion and so did Gracie, respecting my personal space bubble. Until I showed her my hand again.

It was a fun and very sweet little game, and it made me grin from ear to ear. That mare always cracks me up. I deliberately chose to not do a prepurchase exam on her when I bought her. I knew she had some physical issues when I took her on. But that personality was way too awesome to pass up, ringbone or no ringbone.

As I was getting ready to leave the barn, Liz texted me about a friend that is pregnant. Her friend is coincidentally named Hannah, which reminded me of Hannah from The Longest Format. Liz and I talked about winter babies, and I then thought of Funder and the son that she is expecting.

As I was driving towards home, I thought of Gracie again and how I hope that she can stay comfortably rideable for years to come. And I thought of JWall's comment on her wonderful experience with Pentosan and her previous horse and thought, "Maybe Gracie can stay sound even longer?" Thank you for that comment, JWall.

I got home as the sun was finally coming out, thinking how I hope I can get a long run in this week. I read Mel's most recent post on the Orangemud hydration pack as I was walking up the stairs to the apartment.

It was kind of an odd day, but at the end of it, I thought about how everything that we post on the virtual world of the internet can affect others. The ripple effect that mere typed words can cause, and how what one person does and writes about can change the life of another. It's a fascinating thing that never ceases to amaze me. I carry all of you with me when I'm out with the horses, and today was a day where it was especially evident.

Thank you, all of you, for writing your blogs, for sharing your experiences, for following and commenting, and for being you!

Gracie's Fall

The Tuesday after Labor Day, I decided to take Gracie for a spin in the back fields for our morning ride.

I had no goals for this day, no grand mileage nor speed that I wanted to achieve. I pulled Gracie from the field and assessed her mood, expecting her to be hot and sassy after 3 days off in a row. She was not. It was a blazingly hot day, one of those days in the high 90's where just being in the sunlight makes your skin prickle. Gracie was happy but very relaxed, obviously suffering from a case of the summer doldrums. I used to longe her prior to riding after a couple of days off: she sometimes needed a reminder about who is the alpha in our relationship, something that only took about 10-15 minutes to ingrain again in her blonde head. I haven't had to do that in a while now and looking at her on this day, I knew it wouldn't be necessary. So I just tacked her up and hopped on with the intention of just working for 30 minutes, since it was so freaking hot out.

I just get these gut feelings about things. I don't know. All I know is that on this day, I decided to just ride in the flat field. I tend to warm up there and move on into the other fields, but something motivated me to just do the brunt of our session there. The footing is pretty smooth, made up of hard clay under grass that has been mowed short.

I made our goal for the day to work on collection. We worked on straight lines and bending lines, on circling and serpentines. Gracie was a rock star, fluid and attentive. She was on fire like she usually is, but no sassiness or disobedience from her. She felt rock solid.

We had already been working for 15 minutes or so when we went around the far side of the field. Where the footing is smooth. And Gracie suddenly tripped hard with her left front. My heart went into my throat as she stumbled hard and went down on her knees, floundered once in her attempt to get up, crashed down to her knees again and almost lost her balance on her hind legs, then managed to get both front legs under her and stand up. All of this happened in a split second. I somehow stayed on during all of that, a part of my brain thinking in slow motion, "Maybe...I...should...bail...". I never did though. It was like my body was glued to the freaking saddle. As soon as she was up again, she moved on into a trot and I asked her to come back into the collected gait because there was no way in hell I wanted her in a lengthened frame after an epic stumble like that one.

Gracie gaited for a few strides, then came to a halt of her own accord. I was pretty shaken up over what had happened, thinking over and over, "What if she'd fallen all the way? Would I have been able to get out of the way in time?" I stroked her neck for a minute, then sat back and asked her to continue. I figured if something was really wrong with her, she'd let me know and refuse. She's that kind of mare.

But she didn't. She happily picked up her gait and we continued working on bending and circling. We rode through the same spot a couple of times and she didn't trip at all.

For whatever reason, after all that, it suddenly seemed like a great idea to go down to the hilly field and work on faster gaiting up the hill with collection on the down sides. I can't even begin to remember why exactly that seemed like something that should be done on this particular day after what had just happened. There was some sort of logic involved, but I can't tell you guys what it was.

So anyway. Off we went to the far field with the hill. Yes, it was not one of my brightest moments, but at the same time, this hill is barely a hill. It's more like a slight slope. It's a hill when you compare it to FL. It's a joke when you compare it to WV. I mean, there's a total of a 50 foot altitude gain in these fields. That's not really something that you'd call hills.

See? This is the field I'm talking about. 

Gracie was happy to go and she wanted to attack the hill at a faster gait, but I had her go up at her medium gait, and come down at her most collected gait, almost walking. There are some lumpy spots in this field, enough that Lily, the more graceful one, will give the occasional trip in them and become extremely annoyed (if you've never seen a horse get mad at themselves for tripping, you all should watch Lily. She gives a little hop of frustration and pins her ears. It's freaking adorable.) I was making a point of avoiding these spots with the G-mare though.

We were on our second or third loop and had just reached the bottom of the field. There's some clumpy grass there, but the footing is solid.

Gracie's left front suddenly got caught underneath her and she never really had time to attempt to place her right front to catch herself. She literally bit it. She went down chest first and to the left. I didn't even have time to think about bailing because it was so sudden. I went flying in the general uphill direction, cringing at the idea of getting crushed, and felt when she fell on my left foot. I turned to look at her and she was already standing up. And then she was back up on all 4 feet, looking very upset at what had just happened. She stood for a moment, head down, and I got the impression that she was assessing herself to make sure everything was okay. She then came over to me and I saw the concerned expression in her eyes as she stuck her nose in my face and sniffed me over, "Are you okay?"

"Oh Gracie." I said. I sat up, realizing that nothing hurt. The foot she'd fallen on was fine. I had a scrape at the front of the ankle and my right knee hurt in such a manner that I knew I'd have a bruise. I think I got walloped by one of the metal stirrups of her saddle.

Gracie, who will eat any food in sight, was surrounded by an ocean of grass and she chose to stay next to me. She didn't even try to eat. She was hanging her head in what looked like shame. :( I rubbed her neck and told her it was not her fault and she perked up. I then looked her over and proceeded to do a quick neuro exam on her, making her turn tightly on her haunches, having her walk backwards with her head up, crossing her legs to see if she could uncross them. Everything was absolutely normal.

I didn't get back on. I led her back into the barn, switched her bridle for a rope halter and lunge line, and led her back to the same spot where she had fallen in the field. I had her trot and canter around me, trying to see if she would trip again. She did not. She trotted and cantered both uphill and downhill without a problem, and even did this gorgeous rack on the lunge: a first.

Hmmm...

I cooled her off and took her back into the barn to hose her off.

She had a day off, then on Thursday I took her out on the lunge again and worked her over ground poles. I figured if this was a coordination issue, she would have a problem with ground poles. She did not. She was even tracking up beautifully.

Warmup with side reins

That's when I called the vet and scheduled an appointment for the following Friday. My vet has been slammed and I knew she wouldn't be able to come immediately the next day and I didn't want the appointment to be on a work day during the week, so Friday it was.

It is not normal for horses to fall. Horses will do anything to avoid falling because in the wild falling = death when predators were involved. If the footing is iffy and you're going at speed or doing crazy stuff like jumping cross country or even regular fences in deep sand, then that's a whole other type of scenario. But falling on flat natural footing is a big red alert on an otherwise normal horse. Especially if said horse has fallen more than once. Some horses are clumsy and will stumble often, especially horses that are used to being ridden in manicured footing. But falling is never normal. Any horse that falls more than once in a short period of time (weeks, months), should ideally be promptly evaluated by a veterinarian to rule out things like an orthopedic problem or neurological disease.

Gracie got lunged for half hour sessions last weekend. Gaited horses can be very hard to assess in motion because a lot of the time you aren't sure if they're really lame or just doing a weird inbetween gait, unless of course they have an obvious head bob. But I noticed during these sessions that Gracie was stepping short with her right front at the beginning of the workout. She would also blink every time that foot hit the ground (if you have a doubt about a lameness, watch your horse's eyes: they will blink every time that foot hits the ground. Really). The initial short striding was the same regardless of footing. There was no head bob, just a short stride for a turn or two on the lunge that would appear and disappear a few times for the first 10-15 minutes of work while warming up, then disappear entirely once she was really going. The blinking would also stop at this point.  I had thought I'd seen this in the past, but had thought she'd been doing a weird inbetween gait. It was subtle enough that you couldn't feel it under saddle. I could confirm it now though: she was definitely stepping short on that leg as she warmed up.

Mistified, I simply gave her this past week off. Part of it was that I was exhausted due to other things going on, and part of it was an experiment: if she got better, it was probably an injury of some sort, maybe soft tissue. If she got worse with rest, then she most likely had arthritis. Pain in the right front would explain why she couldn't catch herself with that leg every time she's tripped in the past. She always trips with the left front, then has a hard time catching herself with the right front.

I went out to the barn during the week before work to groom and set up feed, but I did nothing else. My vet came out this Friday. I told her everything that had been happening:

• I'd been told G-mare has stifle issues by both her trainer and her previous owner and I'd been working on rehabbing her for that. 
• Initially her hind end would trail while at work; she is now MUCH more able to step underneath herself both on the lunge and under saddle. I mentioned I have video of "before" and "after" on my phone if the vet needed to see them.
• She tightrope walks with her hind end and swings her LH medially more than the RH. It used to be very pronounced and has improved with work.
• She works MUCH better and is MUCH more sure-footed on rough terrain vs flat terrain. She even gaits better. I always feel  safe when I'm riding her (Gracie is opinionated but she doesn't have a mean bone in her body) and a big part of that is because she is overall so surefooted 99% of the time. 
• About 2 months ago, she tripped in the deep footing of the arena going left on the left lead in the corner. She tripped with her LF and had a hard time catching herself with her RF. She did fall to her knees.
• She did the same thing again while on the lunge a few weeks ago, also while going left. The footing in the field was a little slippery and she was being an idiot at the time, but again she tripped with the LF and had a hard time catching herself with her RF. Again fell to her knees. 
• This is exactly what happened on the day she fell while I was riding.
• She seems to step short on the RF on the lunge then warms up out of it. No head bob. Can't feel it US, and it was subtle enough for me to think I was imagining it when seeing it on the lunge.

Dr. L listened attentively to the whole saga, repeating the significant parts of all of this out loud. She is the best. (Seriously: we have some really wonderful vets in this area. Dr. R was fantastic too but the practice owner had raised their already high prices significantly at the beginning of the year which is why I'd switched to Dr. L, our current barn vet.) I pulled Gracie from her field.

Dr. L checked her right foot with hoof testers first, and she was negative. We then put G-mare on the lunge in one of the fields. I was surprised to see how much worse the lameness was: she was slightly head bobbing now at the trot. I mentioned that Gracie had been rested this past week. All Gracie does in the field is stand all day in the run-in when she's wearing her grazing muzzle (seriously Mare: the point of field board is that you move around) and just walks around eating at night. She's not one of those idiots that randomly runs around like a lunatic. She loves to work when people are involved, but on her own she is all for the conservation of energy.

After this, we did flexions with trot-outs. Gracie was positive for the fetlock flexion of her RF. Dr. L had me walk her around to allow the soreness to go away, then flexed Gracie's knee. No change. Okay: we had narrowed the lameness down to somewhere below her fetlock.

We then proceeded with nerve blocks. I want to point out that, while Lily basically tried to kill my vet when we did this to diagnose her injury last year (she had to be drugged AND twitched just for the nerve blocks!) Gracie was an absolute saint. I had her stand next to me and stroked her forehead while the vet put needles in her heels. It wasn't for lack of sensation: she could feel the occasional flies on her leg and twitched her skin, but she held that foot still when Dr. L requested her to. We then had her wait while the medication kicked in. Gracie was happy to just stand with all feet square right next to me, eyes closed while I scratched her neck. Once the foot was good and numb, I had her trot around on the lunge going to the right.

No significant improvement. Dr. L mentioned that G-mare was doing such weird things with the LF to compensate for the RF that it distracted her there for a minute. This is why, even if you work in the veterinary field, it is always recommended that you bring out a vet to look at your horse if something is off: not just for the experience but also for the fresh eyes. You get used to seeing small weird things about your horse over time. I couldn't see what Dr. L was seeing with Gracie's LF, but it would certainly explain why she was tripping with that foot: it was part of her compensatory mechanism to protect the RF.

So Dr. L blocked the fetlock. And Gracie trotted out sound. When she realized that her foot didn't hurt, she arched her neck and stepped out extravagantly. I had to laugh at her. Goofball mare.

Next up: x-rays.

We had Gracie stand on the wooden blocks and took 2 views of her RF. And we found the culprit, which was as I'd suspected given what we had been seeing so far:

Arthritis. Specifically: ringbone. High ringbone.

Diagram of low ringbone vs high ringbone.

And I never would have seen it on the above radiographs if the vet hadn't pointed it out. We took a view of the sound LF for comparison and here the differences are a little more evident:

On the left is Gracie's sound LF. On the right is the lame RF.
These are terrible phone pictures of the images on Dr. L's screen, but you can see some of what we were seeing.
Red circles on RF: Do you see those pointy edges? Look where the green arrows are. Compare to the same edges in the blue circles on the LF. Yup, I never would have caught that either! Also look at the red arrows. There is a slight narrowing of the joint space on the RF when you compare it to the LF. This is why she's stepping short on this foot, why she warms up out of it, and why she got worse after a week off work. She stumbles on the LF because she is over-using it to compensate for the RF, and she is not able to catch herself with the RF because it hurts.

Am I upset? Not at all!! Kathy, Zoey and BO had been gathered around listening, and they all looked devastated for me. I was just so upbeat. All I could think was; "It's not neuro! *Relief*" I don't need to compete this mare to be happy with her. She is one hell of a horse. All I wanted was to be able to keep her in work. The mare loves attention and thrives on having a job. Even the previous week when we were just doing work on the lunge, she understood that this was her job for the moment and she was all, "Let's go!" Early retirement would have been, I think, even more devastating for her than for me.

Zoey had been holding Gracie while I sat on the floor next to Dr. L to discuss the rads and options. Gracie had been slowly gravitating towards me and I didn't notice what was going on until I heard Zoey say to the G-mare, "You love your mommy, don't you?" And I look up to see Gracie's face right next to mine, eyes twinkling. I rubbed her forehead while listening to Dr. L and the blonde closed her eyes.

This is what I mean.

Okay, so I know all of you have probably heard of ringbone at some point or another. This is what an advanced case looks on x-ray:

Yellow arrow is pointing at the much more advanced case of ringbone in this horse. Red arrows are pointing at sidebones, which coincidentally Gracie also has. I'd never seen them on x-ray on a horse before and I'd read about them as being a problem. Dr. L said they are more common in drafts, but given the fact that Gracie has them on both fronts and they are identical on both feet, they are simply an incidental finding and in her case a genetic trait. They're usually a problem if they do something stupid like fracture.

High ringbone on another horse. I'm not including Gracie's lateral shot because it came out very fuzzy on my cell phone pic, but it was very boring. Thankfully. We like boring x-rays.

So you can see how very early Gracie's is!

And what are the options? My vet went through all of them with me.

a) Disease-modifying therapies:

• IRAP - this is the gold standard for treating osteoarthritis. IRAP stands for interleukin-1 receptor antagonist protein, and is more recently being called autologous conditioned serum (ACS). When done early, IRAP can significantly delay the progression of degenerative joint disease. If you want to read the details about how it's done and how it works in laymen's terms, go here. I was surprised to discover that my vet provides this therapy and that, while expensive, it is not as insanely expensive as I had originally thought. I had read about IRAP in the past and thought that it was something that was only done at the big equine clinics and thus, because of the price point, was a treatment limited to upper level performance horses. I was wrong on both counts. Good. Treatment starts with a series of 3 injections in the joint, and then you maintain after that. The average horse needs an injection every 6 months for maintenance. 
• Oral joint supplements -  with glucosamine, chondroitin and hyaluronic acid, preferably in liquid form, as they are more readily absorbed by the body. My vet recommended Actiflex 4000 in particular, which I've seen other people use successfully in the past. I tend to steer away from liquid supplements because I have to pre-make my grain rations and liquids make a huge mess, but we'll do it for Gracie.

b) Symptom-reducing therapies:

• Intra-articular steroid injections: betamethasone is preferred in a horse that can potentially have metabolic issues, as there are less systemic side effects. These are often used secondary to IRAP. 
• IM injections of products like Pentosan, Chondroprotec (used off-label; it is basically a generic Adequan) or Adequan 

You can also inject stuff like Legend into the joint. Dr. L mentioned that recent studies have shown far more joint infections from injecting Legend than any of the other available intra-articular products. It's not common enough to stop using the product in the veterinary field, but it is enough that my vet doesn't like to do it.

My vet is going to look into the price of IRAP for me, as the office recently came up with a new package deal for it that includes all of the initial injections, blood collection, harvesting, sedatives for the horse, etc. There is no rush in doing it but if I'm going to do it, it should be done in the next 1-2 years.  In the meantime, I'm doing the oral joint supplement. Gracie will get long warm-ups at the walk (I foresee an argument in our future...the mare is always, "F walking! I WANNA GO!" She'll learn) and she will be getting an aggressive mustang roll on her front toes to ease breakover. My vet is awesome enough that we reviewed Gracie's lateral shot to see how the trim needs to be adjusted. (I said it before and I'm saying it again: it's nice to work with a vet that doesn't automatically recommend shoes for all the things. A lot of problems can be remedied by changing the trim) Gracie naturally trims her toes while being ridden, and I just back her up to where her feet indicate they need to be. I'm not taking more toe off, just doing a bigger roll. You get the same effect as you would with an eggbar shoe.

For the non-barefooters out there, this is what a mustang roll looks like:

Mustang roll in process. Photo from Barefoot for Soundness.

Finished roll on the same hoof. Ignore the white and pink lines; they were talking about flares in the hoof. I just want you to look at the toe. That's the infamous mustang roll. Photo also from Barefoot for Soundness.

Side shot of a mustang roll. Photo from The Horse's Hoof.

My vet said that therapeutic shoes like egg bars with wedges are often used to help ease breakover and lift the heels in cases like this, but Gracie's heels are perfect and rolling the toes should be enough. 

I need to get that new rasp already. 

The other part of the plan is basically frequent riding spread out through the week, which is something that I always try to do with my horses anyway. I like to spread out rest days when possible, especially if working more than 3 days a week. For now I am to give 1 gram of bute 30 minutes before riding so she is more willing to pick up the RF and is less likely to stumble. 

Will I be able to compete Gracie in endurance? Maybe. We'll see what happens with the management of the condition. We might be able to do LDs or maybe even 50s on flatter, more forgiving terrain than that provided by the Old Dominion rides if I can get her comfortable enough to where she doesn't need bute prior to riding. Bute is one of the many substances banned by the AERC and pretty much every other equestrian competitive organization, as you all know. I'll only do what she's comfortable doing. If all we can do is trail ride recreationally, that is perfectly fine too. And hey, we could still do stuff like competitive trail rides. I think Gracie would have a ball doing that too. 

You can go to the link here. Go watch it!! That horse is amazing! 

(And of course, this is at the highest level of competition for this sport, which is why there is so much speed work. You walk or trot at the lower levels.)

We shall see. :)