Saturday, December 01, 2012

If it's not one thing, it's three. Thing #3

Thing #3.  Kaswyn.

Kaswyn hasn't been right for the last few months.  I wrote about his last visit to Doc on Phil Boot Camp 2012 - Days 11 & 12.  After that visit Kaswyn still wasn't right.  So about two weeks ago I took him back to Doc.  After flex testing and lunging, Doc said (like I've heard him and other vets say a lot) "He's just not that lame."

I know he doesn't look lame while he's there, but trust me, he hurts at home.  I told Doc this and asked if we could block the foot and he said "Well, since he's not that lame we won't see a difference, but I know something that can."  

He hooked Kaswyn up to this lameness analyzer.  They put probes on his two front feet, the top of his head, and the top of his rump.  Then we lunged him, and the probes sent out signals to a laptop computer being held nearby.  When the data was collected the software spit out a diagnosis.  

The first diagnosis was lameness left front, and slight lameness right hind, which was probably just due to the lameness in front.  

Then we blocked the foot, and lunged him to gather more data.  This time showed much less lameness left front.  

I asked if it could be his knee, and Doc said he didn't think so.  He said what he wanted to try was injecting anti-inflammatories into the nerve endings because he thought they might be bothering him.  He said give him a day off and then resume work as usual.  The injection should have lasted 3-5 days.  

Two days later, Kaswyn was off again.  I called Doc and he said Dr. B. needed to come out and see Kaswyn at the farm.  Doc thought that just having Kaswyn brought out to the clinic was probably getting Kaswyn pumped with adrenaline and messing with the results.  

So I moved my horses to the new farm, waited 10 days, then had Dr. B. out to the barn.  His plan was to inject the ankle joint with carbocaine (removing all pain from the ankle joint itself but leaving feeling in the foot), and when that didn't work, nerve block the foot, and then when Kaswyn went sound, suggest an MRI. 

Well Kaswyn didn't agree with this plan.  He was nice and lame for the flex-tests and the lunging. He went sound after the ankle injection.  


So Dr. B. wanted more x-rays of the foot and ankle.  Luckily, I just happened to have the CD the clinic gave me of the 12 shots of the foot they did 6 weeks ago, so he only needed one shot of the foot.  

The foot showed nothing that should be making Kaswyn as lame as he was.  The ankle, however, showed significant remodeling of the cannon bone and the pastern bone where they meet to form the fetlock joint.  This is what Dr. B thinks is causing the lameness.  It's not an injury, but a degenerative disease.  

Ok, great. So now what?  

Dr. B has had experience with this before.  In fact, he was part of a study for a drug that is seeking FDA approval for just this sort of disease.  He has used it with great results in the past.  To show me an example, he pulled up x-rays of a horse he treated with the same issue.  First he put the "before" pictures up right next to Kaswyn's x-ray.  I could see how they were very similar.  Then he pulled up the "after" shots.  Not only did the x-ray look almost normal, but he told me it had been six months since treatment and the horse was still sound and going strong.  And this horse is in heavy dressage training.  He used this drug in combination with shock wave therapy and the horse has done very well.  Not only that, but this drug has been shown to help horses with navicular.  Whoa.  

He thinks he can turn this around for Kaswyn, and actually reverse the damage.  But first, he wants to come out one more time in about two weeks and inject the ankle again, just to be sure that he's correct in this diagnosis.  If he is, then it's not something that time off is going to fix.  But this drug will.  

So then it will be up to me to decide.  Retire him and do nothing?  Or use this drug alone?  Or use the drug with shock wave therapy?  Dr. B has had very good success with the combination of the two, but he thinks it will work with just the drug.  

I know many people would love to see me just retire this horse.  Just let him be out in the pasture.  But you could see today, after the ankle injection, that Kaswyn was walking much better.  Not only htat but he became much more chipper and he seemed even a little cheeky.  Like his regular Kaswyn self. So that tells me that just walking around in the pasture would cause him pain.  And I just can't deal with that.  Not if I have it in my power to make him not hurt.  

In about two weeks Dr. B will be back again.  I'll think about what my decision will be until then.  I'll think about it A LOT.  
Header Image from Bangbouh @ Flickr