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bicipital bursitis
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minimitts
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Joined: Fri Apr 27th, 2007
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 Posted: Thu Jan 29th, 2009 03:00 pm
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Hi Dr Deb, Pauline, and anyone else who may have dealt with this,

My horse was just diagnosed yesterday with bicipital bursitis, most likely from a blow from another horse.  (definitely not from riding, as he's had the last couple months off due to really bad weather)  The vet prescribed bute, Surpass, rest... I'm just curious if you may have some words of wisdom in regards to physiotherapy as he gets better.  (the vet had no information in regards to this) I'd like to help strengthen him (when the time is right) appropriately, and I've been searching for information about this and haven't found much of help. 

I've used the search function on this site, haven't found anything really pertinent ~ but if I've missed something, please direct me.  Thanks  for your time; I appreciate any input.  Best regards, christina

DrDeb
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 Posted: Thu Jan 29th, 2009 07:04 pm
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Christina, you'll be wise to just let this one take its own course. You're telling us that your horse was kicked on the point of shoulder (that's where the bicipital bursa is), and that this has created bruising accompanied by irritation of the bursa and surrounding membranes (that's the "bursitis"). The bute prescribed is an anti-inflammatory that will gradually knock down acute pain and will help to prevent internal proliferation of the injury through inhibiting swelling and what is called 'tissue reaction'. I am not familiar with the other drug you name -- it might be a muscle relaxant.

In inhibiting inflammation and proliferation, the drugs will help the animal not stiffen up. Since he won't hurt nearly as much, he won't "guard" so much. "Guarding" in general tends to reduce the range of motion, not only at the affected joint but at all joints involved in locomotion.

So you allow enough time to go by that there is no longer a visible or palpable bruise -- anywhere from a week to three weeks depending on how forceful the blow was and/or whether the kicker was wearing shoes. During this time, you just have the animal going through its whole normal routine without riding, mainly to ensure that he spends some time each day just walking around. Then when the acute reaction subsides, you go back to riding him, and that itself is the physical therapy.

Of course, when you go back to riding him, if you want the riding to be therapeutic, then you follow the universal protocol of lameness detection, which in a nutshell is: if he ain't limping, he ain't lame.

1. Ride the horse at a walk, spending time to both hands, turning all the time, and allowing yourself to be on the 'track' of the arena (up near the fence, going along the fence) only one or two steps at a time -- just long enough to hit the track and make a turn away from it. The intention is to have you turning, spiraling, serpentining, and riding from point to point out in the middle of the arena. Is he limping? If he is limping, stop -- he needs more time in barn routine and/or metered hand walking. If he is not limping, continue.

2. Ask the horse to first lengthen the walk steps. Does the animal respond willingly? When you ask for the steps to be longer, does that provoke any limping (i.e. asymmetrical movement)? If it does, stop and go back to an "ordinary" length of step that does not provoke limping. If it does not, then proceed to 3.

3. Ask the horse to shorten the walk steps on the lightest possible rein. Maintain short steps for ten steps, then ask for maximum step length. You want to go from short to long smoothly but promptly. Does this provoke limping? If so, stop and go back to 1. If not, proceed to 4.

4. Ask the horse to transition to trot. Do this by encouraging him to take longer and longer steps, until he cannot maintain the walk any longer but must break into trot. This technique assures a gradual "up" transition. Does this provoke limping? If it does, go back to 1. If not, continue to ride at the trot.

5. Trot the horse in short bouts of not more than two 20-M circles at a time, then transition back to walk. Any limping? If not, then continue, repeating to each hand four or five times. There should be a combined total of no more than five minutes of trotting in a half-hour ride -- so use your circles wisely. Completion of this is the end of the first workout, whose main purpose is assessment, but whose secondary purpose is "stretch and massage through intelligent riding".

If you find you need to go back to 1 at any point, just stay at 1 for as many days as necessary, until you can go to 2 without there being any limping. If you find that the horse still cannot go to 2 after two weeks, consult with your vet; there may be issues other than the initial injury (i.e. shoeing, trimming, saddling, other injuries) that are contributing. -- Dr. Deb

minimitts
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Joined: Fri Apr 27th, 2007
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 Posted: Sat Jan 31st, 2009 01:57 pm
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Thanks for taking the time Dr Deb to reply; I appreciate it.  I was concerned if there was anything in particular I needed to watch out for, but it sounds like fundamental good riding practices are what's needed.  That's a relief!  Will definitely follow your recommendations when he's better.

By the way, "Osama bin Llama" is almost ready for you!  :) christina

DrDeb
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 Posted: Sat Jan 31st, 2009 04:55 pm
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Yay! OK, Christina, we will be very glad to receive him. Now, when you mail the item, you must be sure to label it as follows: "Scientific specimen. Bones of DOMESTIC animal." That way, you are telling no lies at all, and if it is labeled this way, it will go through customs/ag inspection without a hitch. You do not have to state what the species is, and I would advise against it. They will very likely X-ray the box, and they can determine the species themselves if they care to. 

The U.S. has very strict laws on bones or other bio specimens coming in -- so you also need to inspect it to be sure there are no insects, live or dead.

Your generous gift is a very valuable addition to the ESI teaching collection, and I want to be sure that it all arrives safely. So the last thing is, to be sure you pack it in such a manner that the jaws cannot touch or bang into the skull; especially the teeth, which easily can fracture under pressure. And pack all of it so that it can't rattle around in the box. Typically small-bubble bubble wrap works well; wrap each piece in bubble wrap, and then you can nest it in either more bubble wrap or foam packing maggots.

Thank you again -- this is just SO excellent. Another example of how our students sustain us! -- Dr. Deb


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