All together now: SIIIIIIIIGGGGGGHHHHHHHHHHHHHHHHHHHHHH!
Round and round and round we go, searching for the answers to Gogo's issues, traveling down all possible paths and finding ourselves always back at the same old place over and over again: hocks.
I don't want joint injections to be the answer here. No, no, no. I am fighting with all my might to see what else we might address first, making sure to exhaust all possibilities. But an eerily creepy sensation of deja vous washed over me yesterday after a particularly bad jump school, reminding me suddenly and sharply of a long-forgotten jump school I had last year just before her hocks were diagnosed with changes. Last year, I had a very bad week leading up to South Farm. We XC schooled at Bath the Sunday before, and she was bonkers but had gotten better by the end. Monday, as described by my calendar from last year, she was being "obnoxious and weird," but "settled by end." Tuesday, I trailered her to Lake Erie to get some coursework in, and she was completely crackers. Rail after rail, chipping everywhere, refusals... it was a right disaster. She had the following two days off, and off we went to South Farm... where I then scored a 22.6 in my dressage test, an all time record for me. However, we then had a rail the following day in stadium, despite our ridculously good dressage score still keeping us in first. But everything just felt all wrong. The following week, I trailered her to the Equine Specialty Hospital, where they localized it to her right hock.
Yesterday's jump school? I suppose it was destined to fail from the get-go. First of all, I have to admit, I HATE setting jump exercises. I hate schlepping poles and standards around. I hate measuring and remeasuring and STILL getting distances wrong (as I did today). I hate having to drag it all back to where it belongs when I'm done. Today was no different; I unknowingly measured my bounce exercise incorrectly. So of course, after we warmed up, we went into the exercise to give it a go. First time through, she flailed over the first tiny vertical (couldn't have been 2'), and then dropped her shoulder and spun at the second bounce. Of course, right? Tried it again, and she managed to flounder through the entire exercise but just barely. The third and fourth times through resulted in yet another spin out, and then finally a flat out grind to a stop refusal at the very first obstacle, at which point I readjusted the exercise, wanting to kick us both in the ribs. The exercise improved from there, as she went through it successfully every time without hesitation, but she jumped poorly despite the corrected distance, and what was designed to be a simple exercise with a focus on my position turned out to be little more than a giant mess. While I was glad to correct the behavior side of it, and felt that in that respect I had been successful, I just can't believe that my horse is being naughty without good reason. I might not be the best jock in the world but... I don't suck THAT bad on a regular basis, so much that I might make her sour over fences. I got off feeling dull and sad, even though the final run through the exercise had been the best.
It's just eerily familiar, is all. Last year, she started chipping, refusing (at home), and knocking rails (at shows). This year, she's started chipping, refusing (at home and shows), and knocking rails (at home). I'm willing to give the Doxy its chance, but in all honesty, I just.... think everything keeps pointing back to hocks. I don't want to inject. I don't. But I've exhausted my other options and I think I just.... need to do what's best for her.
One of the Salmon Brook vets is coming out to take a look at her on Monday (probably not Dr. O who I think is in Ireland, so it'll probably be Dr. C), and we're going to have a good flexy-poke at her. And we'll just.... see what they have to say.
What I have done in the past year (since preliminary diagnosis of mild arthritic changes) in terms of helping the issue:
Adequan (loading dose, then once monthly, now on twice monthly)
Cosequin (original at first, now on Cosequin ASU)
As MUCH turnout as possible (here we strrrreeettttcccchhhhh it... between handgrazing at night and turnout in the morning, she gets about 6-7 hours a day. Not as much as I'd like, but it's the best we can do.)
LONG warmups
LONG cooldowns
Cold-hosing/icing after hard workouts
Bute before/after hard workouts
Poulticing hocks after hard workouts
Liniment after medium-hard workouts
Have purchased a pair of Back on Track hock boots but they're not here yet
Ensured proper hoof care (long toes, broken angles, overgrown feet, etc. can all add joint stress, not to mention tendon and ligament stress!)
What I HAVEN'T done:
Legend (as it acts more like a short-term pain reliever than anything else and doesn't really last more than a few days... and it's expensive!)
Added herbs (unfortunately, herbs like Devil's Claw test at shows... but this can potentially be looked into for winter months)
Looked into magnets (inconclusive supportive data)
Looked into light therapy (only because one of my friends SWEARS by this stuff, but it's REALLY expensive and I'm not sure it's the right answer as it doesn't help to offset any damage, just relieves pain)
Injected (but that's obviously what we're talking about here.... sigh)
In the end, I think all roads seem to have come to one junction. I've delayed and delyaed and delayed this, and I've always known I'd have to do it someday. When you think about it, it's not really all that bad, I guess. The way I see it, the major cons of this are cost, starting down a possibly never-ending road (but I already knew I'd have to go down it), possibly contributing to a faster joint fusion (but not all horses fuse, and it's fine once they do fuse), going invasively into a joint (always a dangerous and scary thing), and corticosteroids can be hell on tummies. But the pros? Injecting helps to slow further damage to joints and instantly relieves pain, which, in the long run, is what we're trying our hardest to do and have been successful at so far, up until this point. I just think what I'm doing is no longer enough.
I hate to say it - oh I HATE to say it! - but I think she's going to feel a ton better after we get this done. Goodbye, morals.
It sucks so bad. I mean, I was SO CAREFUL with her when she was younger, so careful. I always warmed up and cooled down properly. I only ever jumped her once every two weeks, for less than 20 minutes at a time, over fences that couldn't have been higher than 2'3". I took things slowly and carefully. And she was fine. Unfortunately, things like this can also happen: crazy trainer told me as a fact that she always, always lunged my horse for at least an hour in sidereins before getting on her, EVERY time. I saw the lunging area.... deep, rutted mud, banked up on all sides from the horses running, lopsided, and smaller than 12 meters. That, my friends, will kill a joint. I'm lucky it didn't break a leg too. I'm sure that had something to do with the formation of the arthritis.
Things like joint injections always get me thinking about morality.... WHY do we do things to our horses that make them hurt? WHY do we ride them hard, jump them big, ask for collection, ask them to gallop their hearts out, and then wonder why they break? Why should we NEED joint injections to keep them going? Sometimes, I honestly just don't know. But I do know that feeling I get when Gogo really locks onto a fence and pulls me to it. She genuinely, as much as a horse can, seems to enjoy herself, the thrill of speed and of leaping joyously into the air. As far as I can tell, she wants to do it. The second she loses that heart and it's unrelated to a physical issue, we'll stop. She's alive, and is an animal in my care, and she couldn't help herself otherwise. It's my job to make her feel as good and healthy as she can, and I take full responsibility for her needing whatever she needs to be comfortable. I want to give her body a chance to embrace that joy.
Will this limit her career? Probably. Will this stop her from going forward? No. When I think about it, the physical damages in my own body FAR surpass her own. Her arthritic changes are very, very mild, isolated to one tiny spot - hardly career or life threatening in any way. My own twisted, lumpy, out-of-alignment skeleton? Well, it's quite a miracle I'm walking without assistance today, let's say that. I'm giving myself a chance too, you know. I'm in pain every day but I love all this, so I'm not giving up.
I don't really know what life is all about but she and I are both alive, and she and I both have the right to live as comfortably as we can for our duration on earth. I'm very thankful for modern medicine in this situation but at the same time, I wish it didn't exist and nature could deal with us accordingly. We wouldn't have horses or people who need constant maintenance to keep shuffling through their lives. We'd have strong, healthy individuals. Then again, if we let natural selection occur I'd be dead right now, so there you are, really. My brain is all jumbled now, I don't really know what else to say.
Tuesday, August 4, 2009
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Proving her heart of gold and guts of steel at the 2009 American Eventing Championships
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22 comments:
Have you thought about giving your a month or two off? Just to relax and chill, and take the pressure off yourself?
I would try that before injecting. It's a personal opinion, but I just don't think they are the way to go before trying rest.
In my experience, giving time off to a horse with arthritis only aggravates the problem.
Like you, I was very against injected by gelding. I finally went ahead and did it after trying Legend, Adequan, Cosequin, magnets, saddle fittings, good warm-up & cooldown practices, etc. I don't regret it in the least. He is now moving the best that he has ever moved in the seven years I've owned him. Definitely worth it, IMO.
It's your call. But if it would make her more comfortable...then in my mind, go for it.
As far as your own crooked self? Girl, you may be crooked, but I just got diagnosed with inflammatory arthritis at 24. I'm hoping that I can get enough meds in me to keep my riding going (erm, staying successful in medical school despite the fatigue and the serious pain would be a definite good thing too!). Running? Bicycling? Pah. I can live without those. Now riding, I don't know if I can...
Have you thought about shockwave therapy? It's kinda expensive, but it might be something to consider.
I think you'll make the best decision you can, based on the best information you have. That's all you can do, and it's good enough. Only you can decide.
Didn't see chiropractic on your list - maybe I missed it . Chiro has made an amazing difference to my horses. If there is any unsoundness behind, say due to a hock, that may cause issues throughout the body, which can even make the original problem worse.
Good luck!
Recently reading your blog I feel like two things, first off, it sucks that there doesnt seem to be a really awesome trainer close by to you that could help you through some of this stuff both training wise and health wise :( Secondly, if it is a hock issue since you've now ruled out almost everything else injecting, while not ideal, is certainly better than letting her be uncomfortable which could turn these physical issues into mental blocks for her if she begins to equate jumping with pain or fear. I'd hate to see her lose confidence because of that, she's just too nice of a mare. She's lucky to have such a thorough, patient and observant mommy like you :)
GoGo is very lucky to have a "What's best for the horse" owner like you. I know a lot of girls who would've just at soon sold their horse so they get another "perfect" one.
I had one rescue mare with arthritis in the knees and we found the best thing we could do for her was to make sure she was in a pasture with other older horses that wouldn't run her around, make sure she wasn't on any hills, and having consistent trimming and vet exams, and consistent human attention - for psychologically beneficial reasons. She, however, was not a performance horse. Just my Barbie Doll until she got adopted. Her years of abuse and neglect and shortly being stuck hock-high in mud had done their damage, but she could still get around quite comfortably.
I do agree, comfort should be the utmost priority. So long as the injections are legal (which I'm sure they are!) I'd go for it as it looks like you've given this quite a bit of thought.
Really feel for you here :( My first dream horse, a super show-jumper I owe my best moments was diagnosed with navicular syndrome before our first Nationals. It started with loss of performance and knocking fences down and it gutting. We managed it as best as we could and I had a LOT of moral dilemmas back then.
I don't know much about hock injections but there is 7 year old gelding at my yard who had them couple of months ago. He also has mild changes which they discovered on MRI scan but the injections made amazing difference. His whole attitude to work improved 100%, he is jumping 1.15m tracks like a lion and his flatwork has never been better. I know one horse is no real evidence but thought it might make you feel better to know there are other people out there who love their horses to bits and who make similar choices with good results.
I don't know anything much about hock injections, but just want to send my best. You'll make the right decision and things will be better :). You're a great horse mum.
VL: No, I agree with Suzie, time off is likely to only aggravates this arthritic condition... I would only expect her to come back stiffer than ever, and if she loses condition then it will be hard to get it back if she's hurting. Also, she doesn't do time off well... starts breaking out of her stall and causing havoc. I am going to have a HARD time letting her down this year and keeping her stimulated at the same time!
Jesse: No, shockwave has not been considered and I wouldn't. I have seen it used with intermittent success on soft-tissue injuries, but a horse I know that had it done to his back came away with permanent nerve damage and had to be retired. It also has been used extensively in the illegal sense because, on a short-term basis, it nerves them... they can't feel the pain even though the source of pain is still there. Don't think it's worth it :/
Kate: Oops, yes, forgot to mention the zillions of dollars I shell out to have her adjusted all the freaking time! XD Her last adjustment was June 6th. I certainly hope she doesn't need another one already!!
To everyone else: Thanks for the encouragement. Nobody else seems to think injections are any big deal... people think I'm weird for getting all upset about it. It's just so routine and normal for SO many people and SO many show animals. Sigh.
I guess it might be because we just don't go for injections here, but I do think they are a big deal. See my previous comments.
Have you considered cranio-sacral therapy? We have a great local therapist and the originator is from California. They can achieve amazing results from pressure point adjustments and completely change the whole posture of the horse. Might be worth thinking about. Email me if you want more information.
I struggle with the "what we are doing to them is not natural" morality too. But let's face it, letting horses live in their natural state went out the window more than a few centuries ago. They are just as much a product of the modern world and subject to it's often whacked out priorities as we are. If GoGo were a rational being, would she prefer to have her hocks injected or remain in her natural state and go live outside with the bugs and forage for food? I think she sounds like a pretty modern career gal.
And natural selection always sounds like a great theory until it applies to me.
Hahaha SmartAlex, amen. Seeing as Gogo HATES bugs, heat, rain, snow, and anything that isn't 65 degrees and partly cloudy with a light breeze, and will run the fence til someone comes out to coo at her and bring her hay (even though she has PLENTY of grass out there) or bring her in, I feel as though letting her out to be a rugged wild horse wouldn't work out so well. Modern career girl, yes. VERY much so.
Coming from a show hunter background where people think nothing of injecting a 4-year-old's hocks to make them move a little better, I definitely don't get as worked up about hock injections as some people do (though I do think that there is a big problem with injecting a 4-year-old's hocks!). The main issue, as you've identified, is that it is a long-term committment in that if you do it once, you're going to have to keep on that road perhaps indefinitely. That said, I think the injections (when used judiciously, as would be the case with Gogo) can be very beneficial and can prolong a horse's useful life by enhancing comfort and reducing ongoing damage.
I seriously think you are over-thinking this a bit. Joint injections are NOT the devil AND I am a firm believer in a horse is either going to need them or their not. It has nothing to do with how hard they are worked as babies (I've seen changes on 4 yr. olds that have sat around doing nothing. If arthritis was caused by exercise, why do big, fat, sedentary people get it???). It is all about genetics and the horse itself.
AND, if we're going to talk morals, the moral question you should be asking yourself is "if I'm going to ask my horse to be an athlete, shouldn't I give her everything she could possibly need and deserve to perform at her absolute best and most comfortable?" Human athletes get joint injections (and feel like a million bucks because of them). If you want to do compete, school your dressage, jump, etc, you owe it to her to give her what she needs.
PS- better to treat the problem then try and push through it. At some point, the stopping is going to become a permanent problem if you let the discomfort go on too long (seen THAT happen, too).
Amanda, I agree with you and I've had a lot of similar comments from a lot of people who routinely do injections (needed or not!). It's about making her comfortable in whatever way I need to, and this just happens to be the most effective way to treat the problem right at the spot where it needs it most... the systemic thing is just no longer enough. I'm just constantly surrounded by people getting EVERYTHING under the sun injected on their horses that are lame for other reasons (hocks, coffin joints, navicular bursas, stifles, knees, fetlocks, low and mid backs, necks, hip triads, SIs, etc etc etc, all in one go!!) and are only going around for 20 minutes at a time in a rubberized indoor arena, so my views on injections certainly have soured over the past eight or so months from what I used to think about them. It feels a bit like I'm getting the whole "I KNEW you'd come around someday!" thing from some the people here!
Andrea,
Lurker and admirer. I owned a Training level/Modified jumper horse, an OTTB for 15 years. When he was 12, he had a mysterious "offness" which involved refusals--very odd for this very honest horse. I took him to 5 different vets, including a former olympic vet. I got different diagnoses everytime. Finally, I had his hocks and wither area injected. No difference.
I gave him some time off, got him on 20 hour turnout on hills (not easy to do, I know), bought a better fitting saddle (and maybe borrow another saddle even if yours seems to fit, never know how it might bother her even if it looks right) and did chiropractic. I also taught him to bow and did back stretches before each ride. He was sound for the rest of his life (he died at 19 of a brain hemmorage--second level dressage at that time)with not another injection. In my horse's case, it was the back, not the hocks, that was likely the problem. (Riding bareback helped me figure it out--he walked, trotted, cantered and jumped beautifully without a saddle. With a saddle? Not so much) Not saying that that's GoGo's problem, but I am saying that injecting once may or may not lead to long term injections--it just might help you diagnose what's really the issue.
P.S.
I, too, was very hesitant about injections. I totally get your reluctance--remember, you can go off injections in the future...injecting might help her become pain free, which will help the way she travels, which might help her recover from some other, primary problem that is causing the hock pain...you never know. Lameness is mysterious. Not even vets can explain why some horses with ugly x-rays travel beautifully with no help, while a clean x-rayed horse will be lame with all the injections in the world. Things can change--my horse's problem went away completely, and I'm not totally sure it was his back, that's just a guess.
Thanks McFawn. Worst part? She's not lame. If she was this would be an easy choice!
Sorry to hear about your mare's problems. Best wishes to you both. Don't beat yourself up for things that are out of your control. Feel free to speak your mind to the trainer that regularly lunged your girl for an hour in side reins
I *KNOW* you are big in to barefoot, and so am I if they can. Recently I had my VERY wonderful footed pony shod....I first started with front shoes because he had some bruising and was uncomfortable.
We recently put hind shoes on him to increase the breakover. I was concerned that he could develop hock issues and wanted to keep the stress on that joint to a minimum.
I know you do your own feet and they look GREAT....but if you put a shoe on you can increase the breakover factor more and it might take some stress off the hock.
Just a thought.
Sarah,
I will politely disagree with you :) I don't feel that putting a shoe on will increase the breakover. Her toe is very short and rolled, and phyically could not get moreso, and quite frankly even the simple addition of half an inch of steel on there increases the length of the foot, and therefore increases the load on the actual lever-arm of the lower limb, not to mention the additional weight that adds stress to the lever-arm, no matter how simple and light the shoe is. Perhaps the leg will move more simply because of the sheer mechanical change in the weight of the leg, which MAY make her feel slightly better, but it may make her feel way worse. The risk of a longer toe (which adds enormous stress to joints, tendons, and ligaments of the hind limb) which physically would happen anyway simply due to the nature of a foot's inability to wear off once a shoe is on, on the hind limb is FAR too great for me to want to put shoes on her. I would consider booting but this is only because I can take the boots off at the end of the day.
My polite disagreement :)
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