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Rethinking permanent lameness
 Moderated by: DrDeb  
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shawna
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Joined: Wed May 9th, 2007
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 Posted: Wed May 9th, 2007 05:40 am
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My wonderful Appy was diagnosed with Seasmoiditis last December, and the vets I have consulted all agree that the prognosis is not particularly good.  It is possible that, in time, I might be able to return him to light work.  It is also possible that I will never ride him again, as I refuse to do anything that will agravate his condition and cause further damage.  This has saddened me, but I continue to interact with him on a nearly daily basis; stopping by to brush him and feed him treats and give him a good scratch.  Up until now I have found this nice, but no real consolation for not riding.  I will do everything I can to keep Dreamer as healthy and happy as I can for as long as I can, but there has been a part of me that contemplates the next ten years or more (he is 15) of having a wonderful but unrideable horse with some dismay; I board and can't afford to have two horses.

The Ranger article has helped me think about things in a new way.  The list of things a well started horse should be able to do before riding has made me rethink the type of interaction I have with Dreamer.  I really can be doing more than simply brushing him; we can still be in "training" as it were, and honing his ground skills sounds like an excellent way for us to maintain a more involved relationship. 

Thanks for reminding me that horsemanship extends far beyond what we do in the saddle. 

Annie F
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Joined: Wed May 2nd, 2007
Location: Princeton, New Jersey USA
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 Posted: Wed May 9th, 2007 03:59 pm
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Shawna,

I'm so sorry to hear about Dreamer.  I was thinking that one thing you might enjoy doing with him over the years if you cannot ride him, in addition to the groundwork and in-hand training, might be teaching him to drive.   I don't drive myself yet, but have always had in the back of my head that it is something I could do if and when I'm no longer able to ride.  I'm at a barn where several people drive, and it looks fun!  Even if you could not do long drives or go on roads, just learning it could be enjoyable and could expand Dreamer's mind. 

Annie F 

shawna
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Joined: Wed May 9th, 2007
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 Posted: Thu May 10th, 2007 10:47 pm
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Annie,

Thank you for these good ideas; I hadn't thought of driving.  I will definately start ground driving him.  I've been trying to figure out if actually driving would place as much stress on the fetlock joint as riding does.  It seems to me that the weight distribution would be quite different, and that it might in fact be easier on him than riding.

Does anyone know?

Shawna

DrDeb
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Joined: Fri Mar 30th, 2007
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 Posted: Fri May 11th, 2007 12:36 pm
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Shawna -- yes, you're right to wonder what to do with a horse that can't be any good to himself or you. There is a cost to owning a horse, sometimes a considerable cost. So finding a new and engaging way to interact with your horse is a fine thing.

You do need to be sure that you actually understand how to longe and ground-drive. There are aspects to both these things -- the two activities are actually ONE activity at the most essential level -- that you need to be aware of. Not to be cryptic, I mean that most people do not know how to longe correctly, and because the thing they do that passes for "longeing" (or "ground driving" quote-unquote) is incorrect, they wind up doing just what you don't want to do, which is re-irritate the sesamoiditis. On the other hand, if you do longe or ground-drive correctly, it won't hurt the horse one bit and will benefit him. So if you are not sure about how to longe (or ground drive) correctly, then you are certainly welcome to write in and ask more about that.

Beyond that, but related to it, I also would like to know more about how the horse got sesamoiditis. Do you mean he has a fracture of one of the sesamoids that has now partially healed? Or was there a severe ankle injury involving the tendons or collateral ligaments, or perhaps parts of the sesamoid apparatus? In short, what, exactly, caused the vet to tell you that the horse would be OK for light use only?

I'm also wondering if, as many people have happen, there might not have been in your case some kind of fairly scary accident scenario. Did the horse, prior to his injury, ever whirl you off (cause you to do a "starfish") or buck you off? Or might you have fallen off?

I ask these last two things because so many people have them happen, and somewhat from the way you worded your original post, I thought they might also have happened to you. If so, this will also affect any advice or decisions. I do want to remind you also that you can, indeed, have every dream you ever dreamed....but for that to happen, you will have to go about things in a certain way.

Best wishes -- Dr. Deb

shawna
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 Posted: Fri May 11th, 2007 01:55 pm
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Dr. Deb,

Thanks for your reply. 

First, let me give you as precise a history of the leg as I can. 

I purchased Dreamer in 1997.  At that time the pastern of his left fore was considerably thicker than the right fore; the people told me that he had abcessed due to a stick that had somehow gotten into his leg.  My vet did a thorough pre-purchase exam because he was exteremely worried, but Dreamer passed all the flex tests and his ex-rays were clean.  In the written notes on the prepurchase the problem is noted as an "old abcess subsolar."  Although I had been warned that the thickness would probably always be there, it disappeared within a couple of years.

I never had any lamness problems with that leg (there was a horrendous ordeal with EPM three months after I bought him). 

No problems with the leg, however, until last May, when it suddenly swelled.  No heat, no lameness, just some swelling, enough to be noticable but not enough to panic anyone.  After a couple of days of cold hosing the swelling almost entirely subsided. I felt throughout the summer that he was carrying just a bit more fluid in that joint, which worried me, but there was no lameness and nothing really to pursue.

In October he became slightly uneven on the left fore, without more swelling or any heat.  I'm talking faintly off, not lame; no head bob, just not quite as free on the left as the right.  When I showed my farrier (with whom I board) she agreed with my assessment, but we both labeled the difference as subtle. I rested him and within a week he was apparently back to normal. 

On November 5 he suddenly went very lame while I was riding him.  We had been out for about 15-20 minutes; I had started with a long walk around the pasture and had just started into some fairly informal dressage schooling (5 minutes or so of trotting).  No spins, no sudden turns, no hole that I know of, just suddenly lame, enough so that I dismounted and walked him back to the barn.  His leg was hot, very painful--with an inclination to hold the foot in the air--and swollen. 

The vet x-rayed the leg and said that there was inflamation of both the bone and the connective tissue; he also seemed to think that the tendons felt twisted below the fetlock joint. He thought, and this was something of a suprise to me, that the current problem might relate back to that abcess all those years ago.  He talked in terms of Dreamer's condition being permanent and degenerative, said that with injections he might have periods of soundness, but that it was impossible to predict how long the effectiveness of an injuection would last.  He did not seem optimistic about my suggestion of leaving him off for six months to a year as a means of improving things, reinforcing the point that this was a degenerative condition and that nothing would change that fact. We injected the joint, at which point we discovered that he had very little fluid left in his fetlock.  The injection did entirely reduce the swelling and Dreamer went sound--for three weeks--then both swelling and some lameness returned. 

I have him on a number of support therapies--MSM, Fluid-Flex, Aspri-ease, and pads that raise his heels a bit and he has been a wonderfully contented pasutre horse since then.  He is now apparently sound, moving with more confidence and playing with the other horses, displaying some big trots from time to time and often choosing to canter up the hill to the middle pasture. Most of the inflamation is gone, but I am convinced that this soundness is tenuous and that I could easily reverse the progress if I tried to do too much with him.  I have not ridden him, and do not plan on riding him unless he maintains at least this level of comfort for a good six months, at which point I would consider perhaps getting on for a five minute walk.  Right now I have a happy, mostly healthy horse.  My primary concern is to do nothing that would change that.  I fear that anything that leads to more swelling might also lead to calcification (do I mean ossification?) which might in turn reduce his comfort level. 

That is why thinking about the ground training, and by this I mean even the little things like making him very attuned to my body and playing at stopping, turning, backing based on very small cues from me, came as such a god-send to me.  I don't know why I hadn't thought of this sort of thing as a way to maintain a closer relationship with Dreamer on my own, but I hadn't until I read the Ranger piece. 

Personally, I would be very leary of lunging, as too many circles might tend to stress the fetlock.  Dreamer is pretty good on the lunge line (he doesn't fall dramatically onto his inside shoulder, but I won't swear to perfect straightness), but long lineing him seems like it might be okay, although I haven't done it before.

I'm sorry for the excessively long post, but I wanted to give as much relevant, accurate information as possible, as I figured that would be the best way for all of us to learn more. 

Thanks again for your response and for this wonderful site.

Shawna


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