Harsh Realities

I think it's time I really sat down and took a serious look at the entirety of Gogo's eternally long and depressing rehab. Over a year and a half has gone into endless fruitless attempts to bring her back, and we are just a few months out from the two year mark (Sept. '09).

The original injury to both hinds occurred during a slip on XC at the 2009 AEC, with tenosynovitis in both hinds and a small distal core lesion on the LH SDFT. Rehab went smoothly and traditionally (stall rest, wraps, coldhosing/tubbing/icing, handwalking, treadmill, medical turnout pen, back under saddle at 2 months at the walk, trot under saddle month 3.5, canter month 5), and then she blew an adhesion between the sheath and the SDFT on the RH in early March '10, taking a good piece of tendon with it. This new injury went through an even stricter rehab (stall rest, wraps, coldhosing/tubbing/icing, NO turnout, treadmill only, back under saddle at 2 months at the walk, trot again at 4 months, canter again at 6 months and hacking outside of the arena, turnout again at 7.5 months, small crossrails at 7.5 months), and everything was going beautifully until one small misstep one day during a hack out in mid-November '10. She reinjured the RH in the exact same spot as before, only now there was annular ligament involvement. The vet advised turning her out for a year and seeing what we had at the end of it. Six months into 24/7 turnout, she was seen by the vet here in TX (June '10), and multiple adhesions were found in the RH tendon sheath, along with disorganization of the scar tissue in the SDFT (both hinds had some extend of this but she was sound on the LH, slightly lame on the RH). The tendon sheath on the RH was injected with Kenalog, and the vet advised sitting on her again at the w/t/c for 15 or so minutes a few times a week. About 5 or so rides into this, she came up pretty lame RH, with fairly significant swelling in the area of the tendon sheath. This improved slightly in the days following. Following the Kenalog injection, the leg had been looking really quite magnificent. Now it looks about like it did when she reinjured in November.




There is no way to know if she just blew an adhesion or if she has reinjured the tendon without another ultrasound. I haven't even called the vet yet to let him know though. I'll leave him a message I suppose, and see what he thinks, but at this point is there any point? I'm still going to just keep her turned out, and I don't know what the point of trying any more aggressive therapies might be. What am I trying to do here? What kind of horse am I trying to bring back if she just cannot stay sound? Adhesions have to go, it's true... and it might not be that bad. But it might be, and the fact that she now has a chronic injury with permanent remodeling to the SDFT and annular ligament leaves me with a horse that will have questionable soundness in the future. There is pretty much no way she'll ever jump again, much less event... and even if there was a chance, I couldn't bring myself to risk it. Will she ever do dressage again? I had thought so, until a few days ago. Now I'm not so sure. Will she even be able to be trail ridden? Will she do anything at all?

I'm not trying to be pessimistic or mopey in any way. I'm trying to be realistic. I have to be. I have to evaluate this with a level head or else I might not make the best decision for her... I might be making a decision for me. And I just can't do that. I know too many animals out there who are hobbling painfully around, medicated and kept alive for their owner's own selfish needs and ways when they really need to either be retired or let go. I owe it to her to put her needs first, always.

This is unfortunately the depressing and harsh reality of turning a horse with a soft tissue injury out. Without keeping an injury such as hers confined with controlled exercise, you risk the horse doing additional damage to the original injury, or laying down a tangled mess of scar tissue instead of a decently aligned pattern. There are of course exceptions... some horses heal in turnout perfectly, and some horses on stall rest totally fall apart. I guess you just never know. Do I regret turning her out? Well... no, I guess not. I didn't really have an option at that point though. Obviously the stall rest/controlled exercise thing just wasn't doing the trick. She was healing amazingly, then reinjuring... what was the point of it?

On turnout, she is not really doing a good job of healing. She's just sort of toodling around, doing her thing. She's not doing poorly, but she's not sound. The leg stays down until she stops moving, then it fills pretty dramatically. That's indicative of acute damage.



At this point, I don't really know what to think, or what to do. What is there to think or do? Maybe another year and a half of turnout is just what she needs. Maybe then we'll see what we have. Right now, we don't have much of anything.

But she's happy and she's comfortable walking around, so at least there is that.