Monday, February 29, 2016

Of Slow Feeders and Stall Toys

Boca continues to do awesome 10 days post surgery. So far, there have been no complications, which makes me happier than I can type about. The bandage came off on Friday to reveal 3 small, neatly stitched incisions.

Not Yucky
We're already finished with antibiotics and pain meds, which is great. I no longer need to make the twice daily trek out to the barn to shove oral meds into a reluctant pony.

The full rehab protocol is:
Week 1-4 Stall rest with daily handwalking
Week 5-8 Turnout in a small paddock plus daily lunging in a Pessoa rig.

At the end of 8 weeks, we'll take another set of x-rays, and if those look good, we will get the ok to start back up under saddle.

You know what is more boring than watching paint dry? Hand walking. In an indoor. Around and around and around, ad infinitum. Boca is on a low dose of Reserpine, which, combined with his good nature equals no shenannigans. Just the two of us, stumbling along. Not sure who is less entertained.

Speaking of entertainment, when my horse got bored of eating, I decided to rig some stall toys to break up the day. I really wanted to get the Nose-It ball from SmartPak. At least 3 friends who have had horses on stall rest swear by these, but I am too cheap to spend $45 on a toy. So I decided to rig a little DIY stall toy for him, using baling twine, an Uncle Jimmy's treat and a borrowed Jolly Ball. I was pretty impressed with the results. You can skip to :49 for maxium goofiness.

The stitches come out a week from today and we can move on to more exciting stuff, such as walking up and down hills and over poles and cavaletti.

Not sure how I will handle the excitement! In all seriousness, this probably came about in the best part of the year. I'm not missing any glorious riding weather. It's not snowy or icy enough to make handwalking dangerous, and it isn't warm enough for dirty, disease spreading, annoying flies. Bonus, I guess?

Friday, February 26, 2016

Why Surgery

Spoiler Alert: The surgery is already done. I shipped Boca up to Tufts Large Animal Hospital a week ago. I checked him in on Thursday 2/18 and surgery was performed Friday morning 2/19. Dr. Garcia called me at noon to tell me the surgery had gone beautifully and that Boca was a ROCKSTAR (his words, not mine).

Originally, the plan had been to snip the interspinous ligaments (if you want the technical term, it is a "surgical transection, or desmotomy, of the interspinous ligaments) and shave down the overriding dorsal spinal processes. However, once Dr. Garcia performed the desmotomy, the dorsal spinal processes opened up "beautifully" (again, his words not mine) and it was decided that shaving down the bone was not necessary.

7 Days Post-Surgery
I left Boca at Tufts for 2 nights and picked him up on Sunday. I could have taken him home on Saturday, but I opted for an additional 24 hours of medical supervision. For an extra $90, I decided having to make an emergency vet call on the weekend was something I wanted to avoid.

So, why surgery? When it was presented to me as an option, I didn't even hestiate. I had no reservations whatsoever.

While some horses can be comfortably managed with a combination of correct exercise, injections and medication, Boca is not one of them. In my initial consult with Dr, Garcia, it was very reassuring to hear that he was impressed with the measures Dr. C and I had taken in managing Boca to this point. Dr. Garcia said that if we had not done everything that we had, he would have recommended we try it before opting to have the surgery. That was nice to hear, as it made me feel like I hadn't wasted a year of our lives.

Without surgery, Boca is not capable of having even a low-level career without discomfort. There aren't a lot of options out there for an 11 year old horse that is limited to W/T.

Here is a video of Boca, post-injections, with a pro-ride. Out of 4 different pro-riders, this is the most successful out of the 4. Believe it or not, the others were a lot worse.

In an area of the country where land is at a premium, retiring and supporting an 11 year old horse is not a realistic option for me.

When presented with an option of a minimally invasive surgery, done standing without general anesthesia, one with a 95% success rate that is performed by one of the most experienced surgeons in the country, one that cost only $1,800 and that gives an 11 year old horse the option to have a pain-free, useful low-level career with a loving owner...
well, I'll take it.

Thursday, February 25, 2016

Kissing Spine X-Rays

When my Sports Medicine/Lameness Vet first introduced the idea of Kissing Spines and X-rays to me, I have to admit I was pretty dismayed. To me, Kissing Spines were a game chager and a potential career-ender. The husband and I had a vacation booked, so I took a few weeks to get used to the idea, plus break the husband in to the idea that more vet bills were looming on the horizon. By the time I got back from my trip, I was ready to do the X-rays and hopefully learn for sure exactly what we were dealing with.
I want to take a moment to talk about my vet. Dr. C is a lameness and sports medicine specialist that is highly regarded by the local horse community. As such, day in and day out, he sees many horses with high-level careers that are worth $$$TheBigBucks$$$. But he has never once made me feel that me and my little bargain basement horse are anything less than equally important or worthy of his time and expertise. He has been sensitive to my financial picture without compromising the quality of his care. He has given me honest, frank guidance and his services and practice have been much more affordable than the services I received from my former small practice vet. I am so grateful to be in an area of the country that is on the forefront of medicine - both human and animal.
I scheduled the X-Rays for Friday, Feb 5th. It just so happened that we got a snowstorm that day that dumped 8-12" of snow on our area. Dr. C was still game to come out, and I was determined to get the X-rays done, come hell or high water.
At this point, I had heard the term "Kissing Spines" tossed around in horse forums online, but I really didn't understand what exactly it was. Horses have dorsal spinous processes that extend vertically from their vertebrae. In some horses, these proceeses become too close together and impinge upon each other. The most common area this occurs is with the Thoracic vertebrae - directly under the saddle - but it can also occur in the Lumbar vertebrae as well.
I have attached a link to an article in the UK publication of Horse&Hound that I found extremely helpful. KS can be hard to diagnose, because the symptoms are largely behavioral and not always specific.
Dr. C started the X-rays at Boca's wither. This is an example of a healthy spine. There is good space between the processes and the bone shows a solid density throughout. No light spots or dark spots. The changes at the top of the first two processes I was told are normal.
Further down the thoracic spine and everthing is still looking good. No interference.
And then we get to the third Xray. And there it is, kids. Impingement of the dorsal spinal processes, AKA Kissing Spines. You don't need a doctorate to see it doesn't look normal.
When we reviewed the X-rays, Dr. C pointed at that spot and said "That is the cause of all your problems". I don't think I've ever heard a vet say anything quite so definitive before.
More good news followed. This was not the career-ending scenario I pictured when I first considered Kissing Spine. Dr. C continued on, saying that there were only 2 vertebrae involved. Due to the process we had followed of injections and exercise that had proved to provide short term relief, and the minimal number of vertebrae involved, Dr. C thought Boca was an excellent candidate for surgery. Dr. C went so far as to say that he believed with surgery, Boca 'would be a new horse."
Surgery for Kissing Spine is very new, and was only introduced in the US in 2013. Prior to that, Kissing Spine had mostly been managed through injections and physical therapy, with varying degrees of success, based on the individual horse.
The surgery is minimally invasive, is performed while the horse is standing and the success rate of the surgery has been reported as 95%. On top of that, a local equine surgeon, Dr. Jose M Garcia-Lopez at Tufts University, has done a number of KS surgeries and is very experienced with this type of surgery.
Armed with this information, surgery is the option I decided to go with.

Wednesday, February 24, 2016

So THAT explains it

It has been quite some time since I last posted but this post has been brewing in my head for a few weeks and I decided it was time to blog about it.

You may remember this time last year, I was struggling with some unwanted under saddle behavior from my normally steady-eddie, good soul Boca.
Remember us?
In fact, ever since the day I bought him, Boca and I struggled mightily to canter. One might think walk/trot/canter was a fairly simple goal - one of the basics. But the canter was our nemesis. Many people thought it was a strength issue. Many thought it was a greeness/training issue. Some thought it was a behavior issue. But I thought it was a pain issue.

My main reason for believing pain to be the underlying issue is my relationship with Boca. I've had him coming up on two years now, which is the longest I have ever owned a horse. In that time, Boca has always, always, met me at least halfway. He has always come through for me - sometimes in situations where I really didn't deserve him to. The trust bank is strong with this one. 


Some of the process I have outlined in earlier posts on this blog. But to see the full spectrum of what we have gone through to get to this point, I figured I'd outline it here.

  • Aug 2014 - Saddle fitter - Re-flocked wool saddle to custom fit. Thermal imaged Boca's back. Was assured he had no back pain.
  • Sep 2014 - Chiropracter - Was told he was weak, stiff, and under-developed, but zero back pain.
  • Jan 2015 - Saddle fitter - Adjusted wool saddle.
  • Mar 2015 - Saddle fitter - Added 1/2 pad. Thermal imaged Boca's back. Was assured he had zero back pain.
  • Mar 2015 - Had a cowboy ride him.
  • Apr 2015 - Vet - Wellness exam. Test for lyme.
  • Apr 2015 - Vet - Endoscopy for suspected ulcers
  • Apr 2015 - Full course of Ulcergard
  • May 2015 - Sports Medicine/Lameness Vet exam. Found significant back pain.
  • May 2015 - Back Injections
  • Jun 2015 - Back Re-check/Further Injections
  • Jun 2015 - New Saddle
  • Oct 2015 - Back Re-check/Surpass topical cream
  • Jan 2016 - Bute/Robaxin Trial
  • Feb 2016 - Xrays
Along the way, I have been taking weekly lessons. I have been through 3 instructors, 4 different pro rides, 2 farriers, 2 saddles, 2 veterinary practices and 3 feed changes. And a partridge in a pear tree.

And that, my friends, leads us to our diagnosis. Boca has Kissing Spines.

I was very relieved to finally have a diagnosis, one that is definite, treatable and has a positive prognosis for Boca's future as a riding horse. Once we did x-rays, it was very obvious even to the untrained eye, exactly what the problem was.

I'll get into more detail tomorrow, but I'll end today's post here. This feels like a long post for someone who is out of practice.