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In Loving Memory...
~ Gogo Fatale ~

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

Wednesday, December 2, 2009

Recheck at Tufts

Gogo's 2-month recheck at Tufts was at 9:00 this morning. Technically, this is three months out from her injury (a little less, actually), so I was not expecting the news I received for such a short time out from the injury. Gogo's tendon is HEALED. There is nothing at all to be found on the ultrasound anywhere. The only thing of any remark was that on ultrasound both tendon sheaths of both SDFTs has slightly hazy margins, which essentially means nothing at all. Maybe it's residual, maybe it's just how she is. Either way, it is doubtful that it is or ever will be lameness causing in the present or future.

However, it's not so simple as a hop right back to work. She was still ever so slightly off RH. It was so slight that to me, she looked sound. Dr. Chope didn't seem that concerned about it, but had another vet that I wasn't familar with come over for a second look after she ultrasounded clean and I was getting ready to have a new rehab program outlined for her. We had already run the ultrasound over her fat hock and found some very mild joint effusion (possibly from recent trama?) but it wasn't bothering her that we could tell. When this other vet poked around at her, he also found she had very mild effusion in her right stifle - again, something I neither noticed nor could hardly see unless I got in there and felt both stifles several times, and even then I wasn't totally sure. What did concern me was how seriously reactive she was to palpation of both SI joint. She about sat down when he palpated her. THAT to me is indicative of a bigger problem, something I've actually long suspected given her chiropractic history. When we jogged her again and flexed her, she flexed positive to both full flexions on both hind legs. And again, I couldn't see any difference between any of the jogs. Me being a worried horseowner with insurance and this vet being a macho vet at a high-tech school, he "highly recommended" a bone scan and gave a long list of why exactly I wanted to spend about $2000 doing that. My concern at this point is whether or not Gogo's insurance will continue to cover her at all after this year. We've already been cancelled from another company, Markel (and I use the name so that you will all know to never use them), for making a single claim on Gogo - we scoped her for ulcers and she was clean. They made an exclusion, and then bam! Cancelled when the policy came up for renewal. What's the point of insurance if you CAN'T USE IT. We are with Broadstone now, and hopefully they will do what a sensible insurance company would do and make a temporary exlusion for a length of time, and charge me ridiculous amounts of money. Very irritating. Anyway, so I got some sharpness from my mother about it, got some more pep-talking by this vet who I am now convinced I don't like anymore, and decided to go ahead with it. I mean, it does make sense to me - we'll be able to know exactly what kind of bony trama we are dealing with in her entire back end, and know what we can rule out and what is/is going to be problematic. What irritates me is that this guy essentially is playing with my money by putting me in an emotionally unstable situation where I obviously want the best for my pet and will do what I have to to secure that for her. I could have said no but... what if there really is something going on that simple blocks and radiographs couldn't have told us? It just kills me that it's SO subtle I can't hardly see a thing. Are we finding problems that weren't there to begin with? I don't know. I mean really, she looks fine and sound to me, but I'm not an expert.

Dr. Chope is great. This other guy, not so much. I make it a point not to use male farriers/vets for this reason.

Likely what is going to happen is that something will pop up on the bone scan, they'll recommend a course of injections for Gogo the Pincushion, all my morals will go down the toilet and I will come back with a much happier and sounder horse and a much more miserable me.

We do what we have to, I guess. But this is the bad part of fancy diagnostic work. Would I have ever even bothered to have this looked at if I never knew it was there? Woudn't we be home and getting back to work already tomorrow morning if that other vet hadn't happened to walk through the room? Does that make it right or wrong?

I've written about all these morals before and I still feel the same way. There are plenty of horses doing just fine with way worse problems that we have. Hell, if they were to run me through some fancy diagnostic machinery they'd probably tell me I shouldn't do physical labor ever again. But I still seem to be getting along just fine. I hurt really badly some days but I do it anyway.

Anyway, in short, the news is essentially great. Gogo's tendons have healed and she is *almost* ready to start trotwork again. We just need to figure out if this is some sort of mild low-level joint pain or something else, and address it as needed. You still wonder though how and when this all happens, and why we continue to do what we do if this is what happens to our bodies and our horses bodies in the end. Are we creating problems where there aren't actually any at all? She could just be stiff from standing around in a stall for 3 months. That sure as hell would make ME stiff. It's quite likely we're just looking into this way too much and I'm spending ridiculous amounts of insurance money for no reason at all. We'll know tomorrow.

I guess I'm doing the right thing. Maybe. I don't know if I'm doing the right thing or just wasting time and money. All I know is that I really just would rather have her home than sitting radioactive in the ward at Tufts until Friday. That's just... creepy. And it makes me feel dirty, in a way.

Yes. That's how I feel about all the vetwork that has happened in the past year versus any other year for any other horse in my entire life. I feel dirty. I just hope this all gets over and done with quickly. I just want her to be able to go back outside and get filthy and run and just... be a horse.


LiveToFly said...

What a prediciment! I agree with you in a horse is going to be perfectly healthy and have perfectly clean legs, just like no human is perfectly healthy! My hunter mare, Emmy, was still showing over fences at age 22 last year after a suspensory injury and I'm sure if I would have taken her to a good vet and had a full work up done they would have told me to never jump her again, but even if her back was a little out of wack and her legs hocks were a little bad she still LOVED her job and it made her happy, and thats more important then what any vet might say. I think that Gogo loves her job too and no matter how the results come out, there is some level of work that will make her happy and comfortable. Having said that though, you have a perfectly young, healthy mare who you've (presumably) already put quite a bit of money into to get her this far since her injury, and therefore I would say that if you've gone this far you might as well go the rest of the way and get the scan to see what pops up. Chances are, these are probably minor problems that Gogo's had her whole life that may have "flared up" after her initial injury. After Emmy hurt her suspensory it kind of had a domino effect and trigger all sorts of follow up problems because of the way she was compensating for her bad leg. There were weaknesses that she'd always had (i.e. her hocks) that had never really been a problem before and suddenly became a problem when she was changing the way she used her body. I wouldn't be surprised if the same sort of thing was happening with Gogo, but I have a feeling that it will all work out in the end! Keep us posted!!

B said...

Long time lurker, first time commenter. I can certainly sympathize with your moral issues, I'm dealing with that all the time with my retired mare. There are some days that I'm certain that I'm doing everything wrong and I should just end it all, but then she'll turn around and run hell for leather across the pasture and I just smile and return to my chores.

As for the positive flex on full flexion, I live in the Ocala Florida area, and my vet that sees lot of horses. He said that 95% of horses flex positive on full flexions. In fact, he told me that my previous mare was the only horse that flexed completely sound on both hinds when we did her pre-purchase. She turned out to be a fruit-loop, albeit a sound one. But really, think about it, if you hyper-flex a joint for a minute and try to jog out on it, you'd be gimpy too.

I'd go with my gut on this one. I can't make your decisions for you, but when I get the "off-color" feeling about something, I usually end up being correct. Sometimes your gut and heart beat your brain.

Good luck! I look forward to reading about your progress!

Melissa said...

You said "I guess I'm doing the right thing. Maybe. I don't know if I'm doing the right thing or just wasting time and money."

Get a second opinion. When someone hits you with a sales pitch and you don't feel right about it, go get a second opinion. If the person seems sleazy and you dislike him, go get a second opinion. Even if it's just a phone call to describe the situation and ask what another vet would do in your case.

It sounds like the only time she reacted strongly was when the vet palpitated her SI joints. Could it have been from surprise, or could she associates hock work with pain? How does she react when you do that? I hate to bring it up, but might the vet have deliberately pinched her in an effort to sell you the bone scan? Does this really have to be investigated now, or would it be reasonable to wait a couple of weeks and see how she responds to some light work first?

Sorry to preach. :-) I don't like to see people badgered into things, and that's how your post read. In the end it's your job to do right by your mare. That may NOT mean getting her every medical treatment possible. You're allowed to decide against the vet.

Best of luck to the both of you!

Funder said...

I'm so happy for Gogo! Yay for sound mare!

I would be pretty unhappy with that vet too. I'm glad you don't have to deal with him very often. Maybe you wasted the money on the bone scan, but it doesn't sound too invasive. It's not like you agreed to nerve her or do surgery or something - it's just money, and you'll get more.

I'd been smiling all day, thinking about you trying crazy stuff with Gogo - Gogo the cowhorse! - and now that her tendons are healed, you've made my day!

Alighieri said...

I'm going to have to concur with Melissa on this one.

GET A SECOND OPINION! Especially before you drop $2K on a bone scan.

Think about it. Your horse has had minimal turnout and work for the past three months. She may just be stiff. She may have tweaked something the other day when she threw a shitfest in her paddock. Give it a week. Go see the vet again. Better yet, go see another vet, and let them know the situation.

The biggest problem I have with a bone scan is that while yes, it may pick up what is wrong with her hind end, it will also show everything else under the sun that may potentially cause a problem in the future, causing you to drop more money into something that may never even create a problem. But because you know about it, you drop money into treating it.

I was in a very similar situation in August 2008. Something was NQR with my gelding. The barn vet (used to working with very, very affluent customers) first said something was wrong with his neck and to give two weeks off. Two weeks later, he said there was no improvement. This surprised me, as Dante would willingly bend his neck around to his elbow in both directions to eat candy. The vet told me that I should get a bone scan, because that was the only way we could figure out the problem. He also said it could be a career ending problem. I was devastated.

My friend convinced me to get a second opinion before doing the bone scan. The second vet came out, bent Dante's neck each direction, and told me there was nothing wrong with his neck. Turns out, thrush up in his heels (which I was aware of and trying to get rid of) was affecting his movement.

Needless to say, barn vet is no longer my primary vet.

On the other hand, that same friend was having problems with her horse's soundness this summer. For three or four months, they tried everything, took the horse to several different vets and clinics, before finally ending up doing a bone scan in September. Turns out, the horse had a bone bruise on his P3 and needed four months off.

However, the bone scan was a last resort after she tried everything else.

I would really hate to see you drop $2K on a bone scan, only to have the lameness clear up on it's own two weeks later without any other treatment.

Albigears said...

Ach, that's a really tough situation to be in. I agree with what's been said, but to play Devil's advocate I will share this story. A good friend of mine has a huge warmblood that she's been doing beginning eventing on. He did a few odd things- sometimes he'd put his head down and it looked like it got stuck. Sometimes he bucked. Sometimes he seemed a little off, but vets couldn't figure out exactly what was wrong. Different vets guessed different joints. She finally had a bone scan done on him, and it turned out he had a broken neck. And he'd had it for a long time. 3 months later in a stall and in neck traction he's healing.

Anyway, I believe that it's up to you to decide what's best for your horse. Then it's up to your friends ("real" and internet alike) to support you in your decision.

AND I think it's awesome you're doing to do all those un-eventer like things with Gogo- me too! We've gone on a couple of overnight camping trips, and I'm planning on doing a competitive trail ride this summer. May go to a gymkhana too, just because I think pictures of my little TB doing barrels in a dressage saddle would be priceless.

Amy B said...

great news about the tendon... and good luck with the bone scan. As far as the insurance, I think you'll be fine with broadstone, my old horse ended up needing a bone scan for his back followed by work for a bowed tendon and they kept him on through it all.

Anonymous said...

That is great news that Gogo's tendon(s) look good! As for the rest of it, keep in mind that sometimes vets at high level veterinary hospitals get very caught up in fine tuning horses simply because they know they CAN. They have the equipment, they have the expertise, and gosh darn it, they want to get that horse going as absolutely perfectly as they can! I don't think it is malicious. To the contrary, I think it is often that they see all of these problems (some minor, some not) that they could correct given enough diagnostics, time, and money. It is hard for them to leave something at "good enough" when they think that they could correct it to be perfect or close to perfect, which would, of course, benefit the horse in the long run. Sort of like an "angels dancing on the head of a pin" concept.

Of course, in the context of real horses and real owners, that's just unrealistic sometimes. Most owners (and most horses) are willing to accept some degree of slightly imperfect because most working horses are just that - slightly imperfect. Maybe not 100% pain free every day of the week, but certainly comfortable enough to do their jobs at the levels we ask of them.

I've found that the key for me is to listen to the vet and try to absorb what they are telling you about your horse as though you are an outside observer. Try to look at it as objectively as possible and with the concept of "the perfect horse" in mind. Forget she's your horse for a minute and look at her as though you have never seen her before. Listen to the vet while in this frame of mind. Get as much information as you can about the problems or potential problems and the possibilities for addressing them. THEN, step back and evaluate the situation for what it really is. Realize that this is YOUR horse - not some "ideal" horse - and then decide what you would like to do.

I normally will do whatever diagnostics are recommended (within reason - not sure I'd do a $2,000 bone scan, but I might), and then decide where to go from there. I like to know about potential future problems, even if my choice is to live and let live for the time being. But that's just me.

Sorry for the novel - hope there is something useful in it for you.

Anonymous said...

I chased around to 5 vets (including an Olympic Games vet) trying to pinpoint a subtle lameness in my eventer. Eventually, I was told to put him on a brutal no turn-out regimen and after a month of that, he was such a maniac that I said "screw it," turned him out, forgot all the gibberish the vets told me, got some chiropractic and the horse was sound for the next 9 years (til he died). Lameness diagnostics are a vortex. As other commenters have said, go around looking for lameness/trouble and you'll find it in almost any horse. If she looks good to you & the first vet, I'd slowly put her back into work and forget about the bone scan--which will probably present MORE questions than it will answers.

coloradobecs said...

wow,what a story. With a horse you love and chrerish sometimes it is hard to know what to do, especially with vets telling you one thing, insurance breathing down your neck.... it is much the same, as you said, with human emotions and debacles. I hope you can get to work as soon as possible and put lameness and injuries behind you and we can see more of you two flying high!

Nicku said...

This has nothing to do with your vet stuff (although I am SUPER excited about the tendons healing up so fast!). I was at the store today and came across a Vitamin Water 10 flavor named Gogo! Have you seen it?!

Netherfieldmom said...

It seems like you have more on the side of "don't do it" than on the side of "do it". Make a list of pros/cons...wait a week, get another opinion. It won't hurt to wait a few

Chelsea said...

I really feel for you with all that you've gone through with Gogo. I've been following your blog for quite awhile and I think you are an excellent rider and horse-person. If only there were more people who cared for their horses the way you care for Gogo.

Also, I just wanted to point out that I have had problems with Markel as well. They insured my last horse for colic, and covered most of his surgery when he did colic. They then said that they would reinsure him for colic if he went a year with no problems. He did, but when the time came around to re-new they said that they would not reinsure him for colic (although he went around 16 months without issue). We re-newed anyway, but after a few months he coliced again, but way worse. We had no option other than to put him down (a second surgery wasn't even an option because we didn't have the money and he sustained several injuries while colicing..broken hip, severe eye injuries, etc).

Needless to say.. my new horse is NOT insured with Markel. We weren't impressed with them at all when they went back on their word. My horse is under REIN right now, but I'm not happy with them either. They don't cover colic that well and at this point if my horse coliced badly he would have to be put down, we can't afford the surgery even with the insurance.

I really hope everything turns out well with Gogo. I'm sure it will. You have put so much work into her training, soundness, and longevity.

Checkmark115 said...

Hey! So I just started a blog here on blogspot, and I am really confused...I am an eventer as well and hope to get my story out there (like yours) and was wondering if you could give me some helpful hints. I know you have lots of bloggers who read and comment to you...but I was hoping you could help since you have so many followers and a sweet blog. I found it 3 days ago and have read about 20 of your posts. I was sad to hear about all the tendon issues Gogo has been having (in your post-a year in review-I think). I will continue to read your blog as often as I can!
I was really hoping you could tell me how you got the "Stats" thing on the side and all the pics.
THANKS! And good luck in Gogo's healing!

Ambivalent Academic said...

Oh Andrea - i really feel for you on this one. I've been in a similar situation with one of my own. Thankfully, the injury was acute and apparent so there was no second-guessing what was wrong. But the pressure to spend the money...painful. We were offered several surgical options. We chose the (vastly) more expensive one given the success rate and activity level. The cheaper one might have been fine for a more sedentary critter but mine would likely have needed a second op in a few years if we had gone with that.

Our regular vet was advising the cheaper surgery, but I went with the surgeon's opinion and my own gut. I'm glad I did - no regrets, but I'm still crawling out from under a mountain of debt. And our insurance wouldn't pay for the first op, then dropped us before the second one (on the other leg). Bastards.

As far as how much we physically push ourselves and our horses, my thoughts are that this is a very fine line to walk, particularly for our animals - they don't always tell us when they hurt. On the other hand, it is clear that Gogo really loves her job, and you don't want to take that away from her either. The fact of the matter is this: bodies are finite and they do wear out, regardless of whether we let hem hang out in a pasture for two decades or gallop around a cross-country course. The best thing we can do with that situation is to make decisions about comfort, well-being, and long-term outcomes with the best information we have available at the time - you're doing just that. Hang in there. You'll both come out OK.

RuckusButt said...

Sometimes peace of mind is more important than whether we are wasting time and money. At least that's what I told myself when spending $1000 on xrays for my dog who has a mild chronic limp :-/ It allows you to eliminate the number of things you are worrying about, and that's a good thing. Good luck!

Lexi said...

I am a strong believer in some of the fancier diagnostics. I have had bone scans done on both of my prelim event horses, and have learned a lot about what I need to do to keep them sound. I have a mare who was never really lame, but just didn't feel quite right, so the vet recommended a bone scan. Not only did we find a detached tendon in her stifle, but we also found arthritis in her upper back. The tendon was easily fixed with shockwave therapy and some time off, and we are managing the back problem. She has improved so much under saddle since then! We only found these issues because of the bone scan- she never would have been whistled out of a ring or failed a jog, and the vet couldn't pick out anything specific. My opinion is that, yes, the issues you find may delay your return to working, but you can find things that you can fix or manage so your horse's soundness and competition career can continue as long as possible!

Lexi said...

My horses are also insured with Broadstone, and they have payed for both of my bone scans.