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In Loving Memory...
~ Gogo Fatale ~

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

Thursday, April 1, 2010

Vet Discussion; End of March Analysis

My last post got me to thinking a bit concerning vets and following treatment orders. When do you follow exactly what they say, and when don't you? Several of you have mentioned turnout versus stall rest; whether or not that is right for a particular injury is hard to say. My personal belief with vets is that if you don't trust or like a vet, then you should find a different one, one who meshes with your particular beliefs, who is good to you and your animals, and will tell it like it is and give you a plan you can work with. And whether or not you like what they tell you, you should be able to trust that they know what they are doing and have you and your animals' best interests in mind. If you don't have that relationship, then you should find a new one.

The vets I work with now I really rather like, which isn't like me at all. I don't like vets - hell, I drive for hours to get to the vets I regularly use because I just don't like the several local practices very much - and a lot of the ones I'm regularly around have just been WRONG about several diagnoses made at my barn. In those cases, we have sought different opinions elsewhere, or done what we think is best instead. We didn't listen to those vets, because they weren't right. And vets sometimes aren't right. With Metro, my last horse, THREE different vets all told me that his problem was ringbone, and that I should move him and turn him out (and ride as well). So I did... for four months. I turned him out every day, and he ran and played and was adorable and free. I got him out as much as I did, even moving him over to 24/7 turnout. I finally sought another opinion at Michigan State after he continued to get lamer and lamer despite following all the vets' orders, and discovered the gaping black hole in his suspensory. Had I not been turning him out and moving him for four months, had we caught it sooner, he might still be alive today. I should not have listened to my vets, but I didn't know. I trusted they were right. They were wrong.

So where does that bring us? Vets are people with jobs, just like we are. Some are in it because they love the animals and the clients. Some aren't. When do you not listen to the vet? When they don't give you the kind of advice you can work with? When they don't give you a diagnosis you like? Who is to say who is right or wrong? Maybe you're right and they're wrong. Maybe you're wrong and they're right. Maybe if you disregard their opinions, you'll be doing the right thing. Maybe you'll be condemning your horse to a lifetime of pain, or worse. You are paying them for their diagnosis and opinion, and that is what they are giving. Like I said before, everyone needs a vet they can trust, whether or not they give you the information you want to hear. I didn't want to hear that my horse has a new injury. I would have liked to just press on with her training and pretend like nothing was going on. But how could I? Just because she was a little off didn't mean it was something major - or did it? In this case, it did. If I had continued to ride her and turn her out, who knows when a major breakdown would have happened? For any number of vet-related things, if I DON'T follow their advice, am I destroying my horse? If I DO follow their advice, is it the same? I trust my vets, and I trust that they are going to give me the best diagnosis that they can, and good solid advice for bringing her back. But I've been there with vets I didn't like and didn't trust. I moved beyond them.

She wasn't THAT lame. This was her jog-out the day after she went horribly off:

How many horses do you know that are *just* that lame? Are they okay? Or, like with Metro, is there something horribly wrong that you might not ever know about until it is far too late?

Readers, when do you listen to the vet? When don't you? And why?


And, sigh..... my March goals.

March Goals:
1) Start canterwork, building from 5 minutes for the first two weeks to 10 for an additional two weeks, then resume regular flatwork sessions in the beginning of March

Uh.... yeaaaa. Well, we were almost there. Mid-March, we were approaching real dressage work, and she felt amazing. She was cantering again 4 days out of the week for 5+ minutes, both directions, getting stronger every day. And then it all fell apart.

2) Continue to build our hacks up to an hour of walk work (revamp plan as well so we have a more concrete idea)
Well, we were almost there... again. We were at 45 minutes of walk with a minute or two of trot on the road. We would have reached an hour. I had a hack plan all figured out all the way through the end of May too. Sigh.

3) Move to the next incline level on the treadmill

Success! And now, failure. We aren't able to treadmill at all. But we were up to Level 3 on the incline. (There are 9 levels.)

4) MAYBE if everything goes according to plan and we are back to regular work at the end of the month, a trip to the beach!? (Just to walk around in the water and smell the salty air!)
So sad that we never got to do this. The beaches closed yesterday to horse traffic for the summer. But hopefully we can do in October...!

5) Near the end of the month, reevaluate show season - where we stand, where it looks like we'll be, and what we will need to do to have a successful show season (finances, opening dates, rejoining organizations should her soundness continue)
Except... her soundness did not continue. We have a brand-new injury, and therefore our show season is almost totally shot. I have hopes that maybe this fall we can do some little things, but we will just have to wait and see how it goes.

April Goals:
1) Not break down/freak out every time I get a little too emotional over this horrible blow!
2) Start to build from 10 minutes of handwalking to 15, then 20, then 25 by the end of the month
3) Near the end of the month, start treadmill work again on Level 1 (flat setting)
4) Stay positive!
5) Start handgrazing a little every day

I know, they're kind of lame goals. But you have to start somewhere, right?


chantel said...

hi andrea, first I want to say - I am really sorry for GoGo's re-injury. This really sucks. I truely believe a good life has its peaks and valleys - unfortunately you have hit the grand canyon as far as horse luck. But atleast you are in a place to be able to take good care of your girl - you got that going for you. And she will get better and come back stronger - look at Nicki Henley - one of my fave advanced horses. Back with a vengance. Also wanted to say - Love your post on finding a vet you can trust - and stick with them. Even if you get a diagnosis and treatment option you dont like. I am very lucky where I am to be blessed with amazing vets (you know who I mean), but there are to many people out there - when the hear stall rest - chuck them out in a field. And its never a good ending. Some times horses need to be locked up woth controlled handwalking! Anyways -If you havent read the book back to work you should check it out. You probably wont learn anything good old LEC and your own research hasnt told you - but its also full of stories of people in the same place you are in right now - all right - better get to the barn - got fluster in an amazing self care barn, If you get to rolex - look me up - you know what tent!!-chantel

Anonymous said...

In choosing vets, I want someone who has a "feel" for the horse, and isn't just a technician - I want them to pay attention to what the horse is saying, and to handle the horse with respect and not just as an object to be fixed. If you are a knowledgeable horse owner, the vet should also pay close attention to your observations and thoughts about your horse - after all you know the horse a lot better than they do in only a brief visit.

We use two different vets - one is a lady who is excellent with the horses and does our regular care - shots, emergency calls for colics, wound care, scratched eyes, etc. She's part of a small practice group that is good for us on emergency calls. We also have the ability to refer to two very good equine clinics nearby. This vet also doesn't charge for phone consultations, and sometimes we're able to resolve things like minor colics without a vet visit just following their instructions over the phone.

We also use another vet/chiropractor for things like regular chiropractic, saddle fit and endocrine matters (she's got a specialty in endocrinology which is very good for us as we have a number of senior horses).

I've found many regular vets aren't all that good at detecting odd lameness or subtle soundness issues, and have learned to rely on my own feel/judgment on a lot of these issues. I think trusting your gut is important on these things, and if something doesn't feel or seem right, just as with a human doctor, we have to speak up and question things.

Good luck with GoGo's recovery plan!

Daun said...

I guess I have always found the "technician" vets. I had vets that told me to stall rest, but even if I did, the horse would never be sound, so I should put the horse down anyway. This particular horse has a bad stifle, and I knew stall rest may help the leg but would ruin her. I did turn her out. This vet looked in her big book of horses and said, gee leg injury, stall rest. There was NO thought to the whole horse, the age of the horse, her fitness level, her brain, her ability to handle turnout vs stall rest. Mare came out just fine. That injury was 8 years ago. Sometimes, vets are WRONG, just as you said.

Different vet, different horse. Horse was bilaterally lame up front. 10 year old draft mare, been sound barefoot her whole life in huge turnout. Brought to new barn in wet, tiny paddocks. Horse goes lame. I do a lameness workup for the new owner, take the horse to a wonderful vet who is awesome at whole body stuff, but apparently DEAD WRONG on lameness.

We do the workup, take xrays, she says the mare has side bone, and since she's a draft, she is doomed so we should PUT HER DOWN and the vet will use her skeleton for teaching. Um, no.
I take horse, disclose information. New owner decides until she can move horse out of muddy paddocks, to shoe. Horse goes great. Horse is moving to a new, non muddy, open area soon. Horse recently won high point of the year with her new 12 year old little girl and she is greatly loved.


In both cases, I got a diagnosis and treatment that I didn't like. Am I a bad horse owner for going against my vet's wishes?

If you trust your vet, kick ass. You've found much better ones than I have. Even my current vet is only good for doing lab work, getting me information and then I make the call. No one knows my horses better than I. I see their faces every day. I know if they are ok or not. A vet staring at an xray and NOT at my horse for 18 hours a day can only do so much.

For Brego, two months of stall rest might ruin him. He might literally go insane and become a danger to himself and to others. I would have to weigh that very carefully, as you have done. Vets don't know his personality when they come out to give shots. You have to look at the whole animal and how they will respond to the treatment, not just how well the treatment will fix a certain problem and the probability of success. Just my thoughts.

Vets are not Gods, and I am glad you, Andrea, think about everything they say and don't blindly follow them. You are the one to best judge Gogo's well being.

Amy B said...

I always used to try very hard to follow vet advice, but I spent a whole lot of money that was pretty much money down the drain following vet advice with my last horse. I was told "navicular" even though he was unsensitive to hoof testers and had no significant changes in the bone, not to mention the fact that he showed no signs EVER of acting like his feet hurt... treated with corrective shoeing and when that didn't work, an injection. Still didn't work. Eventually I went to another vet (I feel like I should add that I got stuck with a different vet than I usually use for all of this because my vet was out of town and I didn't really like this guy at all even though he's supposedly one of the best). I was then told he had lyme disease and a very sore shoulder. Ok, fair enough, he probably did have the Lyme, so that was worth the money, but it certainly didn't fix him at all. Finally I buckled down and took him to the fancy clinic. I immediately liked the vet (unlike the "navicular" vet), and he didn't seem rushed at all... he took the time to go over all the horse with his hands and then took him out to watch him go. We found the issue (which, I may add, had DEFINITELY been there all along) with a suspensory flexion. I just remember thinking "how could NONE of the other vets think to do this simple thing?" Hell, none of the other vets even really palpated the entire leg. Would it have helped the horse if we had found it sooner? no... but it would have saved me a LOT of headaches. At least I was able to find a vet that I trust after all that.
It sounds like you've also found a good team of vets that are working hard to make Gogo sound again, and that's a really great thing to find.
Good luck to you and Gogo, it might be a long road, but at least there's a light at the end of that tunnel!

PruSki said...

I agree with the vet situation. Being a veterinary technician, I have worked with a number of vets and I don't always agree with how the diagnose and treat. It is sometimes something that you have to weigh the pros and cons. It sounds like you have been debating in your mind for a long time. Not that my opinion matters too much in this situation, but I agree with you and your vet. Good job trying to do the right thing and evaluating ALL the information. Good luck on you new April goals. Hang in there. Gogo needs you!

Meghan said...

I feel your pain. My mare seems to be falling apart too. I knew she was a project when I bought her, I did not have a prepurchase exam done, and we went through a lot during the first 6 or so months. But we had a few good months where she was happy, sound, and learning to use her hind end properly. Then last month she started falling apart. She started rushing again, being hard to steer and wanting to go back to the barn, which I thought was a training issue, but she couldn't handle going through the deep snow anymore (I had started riding her out in the yard since it was warm and she loves getting out of the arena). Then one day she slipped on a patch of slick snow while I was trotting her in a circle, her hind end went out from under her and she fell on her right side. She was a little reluctant to trot under saddle, and resisted it a bit, but she seemed to work out of it and I had a couple successful light rides on her.

Then I had a lesson with an overzealous trainer who didn't listen to me at all when I told her my horse was off, that she doesn't resist or act pissy just because she's a mare, etc. She had me ride her for an hour and fifteen minutes at a trot with not enough walk breaks, and had me work on straightness, leg yielding and getting her to use her hind end. It got Sofie overtracking at the trot and using herself correctly, but she was not happy with that level of demand, and I wasn't either. It. Was. Too. Much.

After that she was extremely resistant to going into the trot, and she did not work out of it even with firm but soft, encouraging riding and reward when she did go forward. It got to the point where I was afraid she would start bucking. And even at the walk, she was dragging her right hind a bit and occasionally tripping.

I had a vet check her who is supposedly good at lameness. I never liked or trusted him, but I thought in that moment in time he could help me. All he did was watch my horse move on the longe and do hind flexion tests (which she failed). Then he recommended hock injections, which we had done. It was WAY too expensive and hard/stressful on my horse, and they have made absolutely no difference in how she moves and feels. In fact she is even worse now. She is very stiff behind, and is not happy or comfortable even doing light groundwork. I don't know what's wrong with her at this point, and I'm extremely concerned about her future. If we can't improve her quality of life I will have to have her put down.

I'm going to have my local vet take x-rays so we can hopefully find out what the hell is going on with her hind end. If there is a possibility of salvaging her then I may have to move her to a different barn where she can have more turnout with a more active herd on a pasture with hills. She gets at least 10hours/day out at her current barn, but she is only out with three other mares and they don't move her around nearly enough. I love her and I want to do the best thing for her, whatever that is.

Golden the Pony Girl said...

I have had vets that were wrong as well. I think it is the nature of the business though. There are some variables in horses you just can't account for. I think getting second opinions is key, but I have seen many people who ignore vet opinion make things seriously worse.

About Daun's comment on stall rest. My first horse went positively insane from stall rest. He was never the same. It was the most horrible experience in my life with horses

Val said...

Very interesting post, Andrea. I am glad that you are remaining positive and I hope that you will find a horse or two to ride while you care for Gogo.

I really feel for all the readers who shared their stories. I am always amazed by the dichotomous nature of these animals: powerful yet delicate.

I think that I am very lucky to have my vet. I like watching her in action at my two barns. She is a small women who has had to prove herself in a profession dominated by men. She juggles the opinions and information (or misinformation)of the many people who work with our horses. I do not think that I would be able to keep my patience like she does.

And if I have a problem or concern with my own horse, she always takes it seriously and always makes me feel like my horse is important to her.
For example, she spent twenty minutes on her knees searching for an embedded splinter in my horse's neck. Some individuals told me that it was a tick bite and that I should ignore it. My vet took me seriously, and finally found the shard of wood surrounded by fibrous tissue. It was not an "I told you so" moment; I was just so grateful to have her as my vet.

Chelsea said...

The only time I remember not following what a vet said was this past summer with my new horse. I know my horse and know his movement, so when he started looking a little funky I got it checked out. The vet and my trainer agreed to keep riding him and he'll come out of it (he was never limping, his movement just wasn't right, but most couldnt tell.) I did follow what they said for awhile and I saw no improvement in my horse, so I decided to take him back down to little work but still on turnout. He was on vacation for about two months. During that time he got better then worse when I increased his work level, so I kept him on vacation. After two months he finally started looking tons better and staying that way so I gradually increased his work back to normal. We never found out what was wrong, despite xrays and lameness examinations and bute regimens and everything. My thought was that he was body sore from growing. He was in a huge growth spurt during the time. There are still days when his movement doesn't look quite right, and I will never know what that is probably. But, he always comes out of it after some warm up so I continue working him. The vet I use I do trust, but it was just one of those situations where I felt like I knew my horse extremely well, and knew he wasn't right, even if nobody else saw what I was seeing. Maybe he would have been fine had I followed their orders, I don't know. I didn't risk it. It sounds like you also know your horse extremely well, and I know you will do what's right by her. I wish you and Gogo a full and speedy recovery.

McFawn said...

Here's the problems I've seen with vet advice:

1. The vet makes a diagnoses based on assumptions, half-hearted diagnoses, etc. For example, when my 13 year old TB eventer was slightly lame, I was told it was hock arthritis, and that his hocks should be be injected. This was before the vet even really looked at him. Ummm...sure that may be the problem with many 13 year old OTTB eventers, but it was NOT the issue with my particular horse.

2. THIS IS THE BIG ONE: The vet finds a problem with the horse, but it is not the primary issue. For instance, one of the problems with diagnosing lameness is the "what came first" question...i.e. Did back pain CAUSE the uneven use of the frontend, causing a leg injury? Or did the injury result IN the backpain? How many injuries are caused by other, more primary problems? This is where I think a lot of vets fall short. When my horse went through all his diagnostics, they did find a minor injury in his front leg using the ultrasound. However, treating that injury wasn't something feasible (stall rest to the max) nor did I think, knowing the horse, that the injury was really the core of his was his back. One I had chiropractic work done, turned him out on hills, and worked on saddle fit, he came around. The front leg injury was never an issue again, and perhaps was not the issue THEN. The point is, its hard to figure out what injuries are primary, and which are the result of another, underlying issue.

3.Lameness is mysterious. Some horses with clean xtrays/ultrasounds are mysteriously off, while some horses with xrays/ultrasounds that spell doom are sound as a whistle. I bet if you ran full diagnostics on a bunch of sound horses, you'd find a "lameness" issue. We've all heard of horses bouncing back that shouldn't have, and horses never recovering fully from small injuries. Vets can only do so much, and their prognosis is often way inaccurate. Maybe # 2 is to blame?

Sophie said...

I have found a vet I really like as a person. But I don't trust the opinion of any of them. Sad but true.

Unfortunately the 'horsemen' of old are not produced by vet schools anymore. They fill their heads up with protocols which they follow regardless for fear of stepping out of line and/or lawsuits. Vets that try to pursue a more imaginative line of thinking get excluded by the remainder of the vet community.

No one knows Gogo better than you. Listen to your horse and follow her lead.

I've lost count of the number of horses that I am aware of which would have been euthanised if vets advice followed. These horses are now sound and working.

As an aside - I've never known box rest to work. A small PP with suitable quiet companion has for me been more successful. Scary for me initially but I can only say it worked for me.

heater a. said...

It's so nice to hear someone else say this. I used to believe that a vet is a vet and you ALWAYS do what the vet says. Then I became a horse owner.

My horse, Finn, had a very odd problem. He used to skip at the trot. He was never lame but something just wasn't right. It's very hard to describe, but he would take two steps with his front feet in the time his back feet took one, while planting his head in the air like a camel and hollowing his back. And he's a paint. It's not like he's gated for goodness sakes.

My trainer and I hemmed and hawed and scratched our heads. We thought it was a training problem, so we pushed him harder, because he wasn't actually lame. He never limped. It didn't get worse but it didn't get better either. Finally, we called the vet.

Now most people would have called the vet out first thing. Not this vet. Of course his first suggestion was x-rays, which would have been followed by most likely injecting joints. The horse was 5 at the time, but the vet would have injected him anyway. We know he would say that, because we knew this vet. It's what he always does, and I was NOT about to inject the joints of a 5 year old horse. X-rays however, were a good start.

The day we called the vet to schedule to x-rays, Finn decided to kick another horse through the fence. He tore himself up pretty badly, and my x-ray budget went to stitches and naxcel instead.

After 2 weeks of stall rest, hand walking, and light turnout, I started to evaluate everything about my horse. When we finally moved back into trotting under saddle, the problems were still there as if nothing had ever happened. If he had been lame, the rest would have done him good.

He was a big, bulky stock horse living in a barn full of TB's, so I changed his diet. A found a saddle (Duett) that was actually big enough for him. I found a barefoot specialist farrier. All of these things together have changed Finn's attitude immensely. He hasn't done his strange skipping trot thing in months. Knowing our vet, and what he would say helped me save tons of money and stress.

Needless to say, I don't use that vet anymore (even though he did an amazing job with the stitches). But I have yet to find one I do connect with, and who wouldn't have called me crazy for giving a more holistic approach to my horse's "lameness".

Val said...

This is in response to heater a. and the odd problem she described. My horse was doing something similar during the walk to trot transition. He would hop and the hopping became more dramatic the longer we worked in my previous saddle. After working with my trainer and a tack shop specializing in saddle fit we found a saddle that fit him (and me!). The hopping disappeared and my horse's musculature looks the best that it has in his life. What a relief. Thank you for mentioning saddle fit as I feel that it is so often overlooked and at the expense of the horse and rider's comfort.