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In Loving Memory...
~ Gogo Fatale ~

6/2/01 - 10/11/11
~ Forever the Marest of Them All ~

Saturday, September 26, 2009

Vet Update: Some good news, some bad.

Early this morning, I shuttled Gogo up to Salmon Brook Veterinary for her two-week recheck. She got a bath yesterday in preparation - can't go to the vet looking all shifty - but I must say I think it was in vain because the other horse up at the hospital was the oldest, hairiest, muddiest thing ever so I could have brought Gogo with her poopstained butt and all and it wouldn't have mattered. But I felt better knowing she was clean. As always, she was a perfect lady about everything, walking through the people door into the little one-stall clinic that smelled all scary and vet-y like she had been there all her life. She is, however, in flaming heat once again, so she bellowed like a bull at the horse statue outside the hospital. She definitely has one of the deepest whinnies I've ever heard. It's not a gross man-whinny like Ashley's though, it's a nice respectable man-whinny that proclaims, 'I am not afraid to balance my femininity with a touch of masculinity.' Sort of.

Anyway, I digress. Dr. Creden the ultrasound whiz clipped her up and took a look at both legs after reviewing the two week old ultrasounds and the paperwork I received at Lamplight, and found some very, very interesting things. First off, there is nothing in the right hind. You heard me, nothing. Nada, zip, zilch. The deep looks great and so does the check. The old windpuff on that leg, however, has reached epic proportions. It's huge. I mean HUGE. I need to get pictures of this thing because you are not going to believe it! (Windpuffs are, by the way, harmless blemishes. They're just fluid-filled distensions of the tendon sheath in this case, or joint capsules in other cases, and she's had this once since she was 5, her very first blemish.) Essentially, by presenting itself as this monster thing, it indicates that the area has in fact been stressed recently, which is why there is so much edema there. But there's a difference between an area being stressed and actual tendon damage. Dr. Creden couldn't find a thing to fault. What she DID find, however, was the area that we think the original vet found and marked as damage. She so happens to have a perfectly matching mark on the DDFT in her left hind as well, the exact same size, fiber pattern, and location as the one on the right. As perfectly matching lesions on both legs are pretty much unheard of, we epect that this isn't an actual problem, but it's just her. Every horse is different. It's not normal, per se, but it's not problematic. I bet you'd be hard pressed to run an ultrasound machine down any horse in work and find a completely clean limb. That is the body's process. Other than that, which she deemed to be nothing of concern, there was nothing there. Just... nothing! So that's great news.

However, with the good comes the bad. The left hind, which we originally thought was just a strain, turns out to have much more going on than we had originally thought. She ran the ultrasound machine down her leg and found a couple of spots of small fiber disrutpion, which we wasn't worried about and expected that with rest, they'd resolve. But, when she neared the distal part of the limb, she started going, "Oh I don't like that. Oh I really don't like that." Which is exactly what I didn't want to hear. The proximal section of the limb has decreased in size dramatically since the original injury, meaning a ton of the inflammation and excess fluid is gone, so we were doing the right thing. But, now that the excess edema is gone, we got a clearer picture, and found a definite area of distension in the distal area of the tendon, and a little lower, an actual lesion. It's not huge and glaring by any means, but it is very obviously there. Which sucks! We had a chance to jog her out as well, and she was still very definitely lame on that LH. Sigh!

We decided that since she is insured, we are going to go the most aggressive route we can in treating this, and take her up to Tufts ASAP to do PRP on her. PRP, or platelet-rich plasma, is essentially this: the vet collects a sample of her own blood, spins it down to harvest the platelet-rich portion, then injects the lesion with it, guided by ultrasound. Platelets release growth factors that stimulate rapid healing in the area, and considering it is made exclusively from her own tissue, there isn't risk of rejection or others adverse reactions. From some of the research, injuries that normally would take six months to heal can resolve in as little time as a month. We're not really sure how quickly full strength is restored to the tendon, but the architectural structure it needs for that strength regenerates that rapidly, and scarring in the tendon is minimal. (Scar tissue is less elastic and less strong than original tendon tissue, which leaves the area weak and prone to reinjury). It's like stem cell, but it's not. PRP stimulates collagen growth, rallies stem cells to the area, and releases other growth factors into the region. So essentially, it's like healing tendon on speed, but in a good way. We'll secure the appointment on Monday, as Tufts isn't open for regular business on weekends.

I am a tired child, so I am off to bed shortly. I'm sweating the RH tonight to see if I can get any more fluid out of that area, and the remaining part of this week before we do the PRP, I am handwalking for 10-15 minutes 2x daily and wrapping, so the tubbing is all done. I am sure Gogo is thanking me for this; every time I pulled out that big muck tub, she gave me a look like, are we REALLY doing this AGAIN?

Good news and bad news. We shall see.


sally said...

Oh wow that is the good and the bad!!!. I guess you at least know what you are dealing with. Hope the treatment all goes to plan.....and I love your previous post from Gogo!

Cathryn said...

Glad to hear there is at least some GOOD news in it all. Hopefully, your mare will be up and running soon!

OnTheBit said...

I am so happy to hear your good news. And as for your bad news...I always forget about the PRP, but my horse had that done at the same time as his 2nd round of stem cells. My grey geldings tendon was BLACK ultra sounds. The first round of stem cells did not fix it because there was so much to heal. With the 2nd round he got the PRP at the same time and that really did the job. It shouldn't be that expensive (I know that is what insurance is for, but you might even be able to pay out of pocket and save the insurance for another day) and I think that you will be able to see dramatic results in a short time. Good luck and I am really glad that issues with both bad legs has gone to only one back leg!

manymisadventures said...

Bummer about the LH, but it's good to hear that her RH is looking okay! Good luck with the PRP, I hope it works its magic.

It sounds like Gogo is being awfully patient with her treatment, considering how fit she is! It also sounds like you are giving her the absolute finest care possible, not that I would expect anything different. I really respect the dedication you have to your girl.

Yankecwgrl said...

At least now with your new information you have a GREAT plan of attack to get her back and going again. That is GREAT! Sometimes injuries aren't that "easy" to deal with . Not to diminish the difficulty you are going through, but it could be SO much worse! I'm glad you will have your mare sound to compete again! Will keep you in our thoughts! Thanks for updating the blog......I've gotten addicted to hearing about your awesome mare!

Anonymous said...

Well, it sounds like you've got a good plan now. Don't you just hate it when you get conflicting information from different vets? My horse has seen three different vets for the same problem, and each one has something different to say about the injury. The only thing they all have in common is that they all think he will recover...but their opinions vary greatly on the severity of the injury, time off needed, and treatment. It's very frustrating!