Friday, April 23, 2010

Clinic Visit - Part 1

When I rode Kaswyn on Thursday night, I knew something he was very off. Susan happened to be at the barn and said that it looked like he was lame in the left front leg. Now, you're probably wondering why I would ride him on Thursday if I was already planning on taking him to the vet on Friday. Well, Dr. G has told me in the past that when we are trying to diagnose a lameness by treating certain parts, like injecting the hocks, that I should keep Kaswyn working so that whatever still hurts him will hurt him while he's at the vet. If I completely lay him off, then he might get a little better and then we have nothing to go on at the vets. It's hard to diagnose lameness if the horse is not lame!

So my friend Z trailered Kaswyn and I over to the new vet clinic. Dr. G had been in the same small location for years, but has now partnered with many equine vets for form a fantastic team of horse health professionals. They had been working out of two locations, but then they built an outpatient clinic for Dr. G at the big clinic. It's a really nice place!

We arrived at the clinic and put Kaswyn in a stall to wait our turn to see Dr. G. On the wall of the lobby is a very nice photo of Dr. G. He's doing an ultrasound on a horses leg, and you can tell by the machine just how old the photo is.

The first order of business with Kaswyn was to do a lameness exam. First Dr. G examined his legs and palpated them. I wish I had thought to video that part, but I forgot! After the exam came the flex tests. With a flex test the vet holds the foot in the air, hyperflexing all the joints in the leg and then the horse is trotted to see if the horse is exhibiting lameness in that leg or not.

Here is a video of the initial trot, then flexing of the left front leg. I didn't get the correct angle on this so you can't really see how lame he is. But he comes up positive for lameness. Remember, this is the leg where Kaswyn had navicular problems, was nerved, and then had a splint bone injury.

Flex test of the left hind. Negative

Flex test of the right hind. Also negative. Between the tests Dr. G told me that he has never seen this horse travel so well behind. That made me feel good about injecting the hocks.

Finally, flex test of the right front. Negative!

Next up was to lunge him to find out if he was more lame trotting in one direction or the other. Here is video of the lunging. Kaswyn is clearly lame on the left front leg, more to the left than to the right.

So the next step was to nerve block the leg to find out where the pain was. So Dr. G started at the bottom with a low block, with the plan being to work his way up the leg until Kaswyn was sound. Dr. G actually blocked the foot below where Kaswyn was nerved, just in case the lameness was due to auxiliary nerves that may be growing back and providing some feeling in the foot.

Kaswyn was brought back into the exam room and his leg was shaved and scrubbed. Then Dr. G injected Carbocaine (a local anesthetic) low in the back of his pasterns. This should have blocked out any pain in the foot. You can see the injection sites in the picture, because they made big red welts on his skin.

Then we waited about 15 minutes for the block to work, and took him back out for flex test and lunging.

To be continued...

Part 2

1 comment:

buckpony said...

OWWWWW - those marks look painful. Poor fellow. I really hope you get some positive news.

Header Image from Bangbouh @ Flickr