This week both horses had appointments with the Traveling Vets who come through town twice a year. Since the appointments need to be made nearly three weeks in advance, I had tacked on a lameness exam in conjunction with the normal Spring teeth floating and vaccines.
And when the Vet showed up this morning for our exam and asked if I still required a lameness exam, I stopped and thought for a minute and decided it wouldn't hurt to get a professional and formulated opinion. We would be limited to what we could do, since this was a "farm" call and not all equipment is mobile. (The Vets travel 5 hours to get to our little equine community)
|I rode her Tuesday evening - just a short walk ride around|
The appointment began with me showing the Vet the span of several hundred (I wish I was kidding) videos from the last month, a detailed recap of her chiropractic appointments and the stretches and such I have been completing daily with Suzie. I felt quite confident in the prognosis we had achieved through the body work, but I certainly was not expecting the finality of the diagnosis the Vet gave.
Let me preface by saying that the appointment did not go the way I intended.
To begin the work-up on Suzie, the Vet utilized a hoof tester and found that she had incredibly sensitive heels despite her well-balanced hoof structure (the vet actually commented how nice her hooves looked). With an unfortunate confirmation of soreness in her hooves, the Vet watched her walk off and mumbled something that sounded a lot like "navicular". The hairs on the back of my neck stood up, and the Vet quickly addressed the concern that had now etched my face.
Based off of the videos, the unsteadiness in her left front leg and the failed hoof tests in both heels, the Vet diagnosed Suzie with "Heel Pain". I asked why she had initially spouted navicular and she had said that "it isn't called navicular anymore" and that Navicular is not as easily diagnosed as it was before. Apparently, the reality is that a lot of things and none of them cause navicular. However, the diagnosis of "heel pain" is supposedly a real and correct "disease name".
From thehorse.com, the following excerpt was found
(thehorse.com brings peer reviewed articles from actual Veterinarians as opposed to COTH forums and HGS forums where personal owners discuss their own thoughts). Educated and formulated opinions with scientific data? Sign me up.
"the commonly asked question, "Does my horse have navicular?" is not as simple as it might seem at first glance."
"Not all of the imaging modalities need to be used on every case to come
up with an appropriate working diagnosis and treatment plan. Also, some
cases can develop heel pain and have no detectable changes using any of
these imaging modalities, even if all of them were available and were
employed. Used appropriately, however, they can provide important
information on selected cases, particularly those that might not have
responded as expected to treatment."
I asked the Vet immediately if this was a Farrier issue, or something else. And unfortunately for Suzie, it is more or less conformation... She has heavily Halter (Coosa and Impressive) bred on top and has those teeny tiny dancers feet most Halter QH's have.
So, in a nutshell. She has Navicular - but it is not commonly referred to as Navicular anymore based off of new information in Veterinary medicine. The age old "cure" for Navicular way back when in the early 2000s was simply to perform a neurectom, which basically meant a vet would remove a section from the nerves that serve the heel region of the foot,
thereby at least temporarily removing the sensation of pain from this
region. More and more this practice is being phased out and no longer looked upon as a satisfactory "solution".
At first, I thought "no, that can't be right", but reviewing even more articles, specifically this one by the Practical Horseman
. How interesting that a lot of the key points are things that Suzie has been doing - specifically the resting with one hind toe hitched and one front leg splayed forwards. The whole "gets better/gets worse" thing strikes a cord with me, too.
Managing a horse with heel pain is difficult, but a lot of the times it can be helped through corrective shoeing. Mostly, farriers will come and use what is called a "natural balance shoe" which basically creates a false, but supporting break-over so it reduces the stress on the horse.
|A natural balance shoe being placed to achieve |
an appropriate breakover.
In addition to the heel pain diagnosis, the Vet performed flexion tests. She flexed both fetlocks and knees and Suzie failed all of them. She was uncomfortable, and moreso lame after the flexions on the left side and moderately so on the right side. It was noted that she had absolutely awful range of motion in her left knee and didn't have much ability to bend it fully during the flexion test.
The overall diagnosis after the flexions was something I wasn't necessarily surprised ot hear, but the conversation that followed certainly was.... The Vet confirmed arthritis in her fetlocks and knees - remember that bump that mysteriously showed up on her knee in January? That is called a hygroma and is formed due to high stress in the area - the Vet figures it was caused due to her poor range of motion and that Suzie had to "crunch" down on her knee and had given herself the hygroma that way.
The conversation that followed the findings in Suzie was.... disheartening and dismal.
Basically - the Vet does not feel she will be an "arena horse" anymore. She said that Suzie will not hold up to the demands of an arena horse, especially bend to the right and tracking right on a circle. The Vet agreed that the body work has helped, but the ultimate diagnosis is the heel pain and arthritis which is a bit of a double edged sword... Mostly because horses who are arthritic should be kept moving... but horses with heel pain do not make good trail horses.
In fact, the Vet said to me, "She just can't do it anymore. She physically cannot put up with the riding you want to do with her. If you want to do that riding [showing, etc], you will have to buy another horse."
So that's it.
It's the end of Suzie's career as an arena horse and until we test out these natural balance shoes, it is highly undetermined as to whether or not she can be a trail horse with the occasional easy jogging and loping.
For now, my heart is heavier than the weight of lead and my head is spinning with so many thoughts.
We had discussed the possibility of injections and this new drug called Tildren, but as much as I'd loe to explore injections and new medicenes, reality is a hard truth. The Vet and I mulled over the tentative cost for injections (I would have to haul to the clinic to have a sanitary environment and Suzie would have to stay for a few days to ensure the sites do not get dirty... Injections themselves cost about $350/leg and prior to injecting, the Vet said she would need to perform a scan to see where she would inject to get the most "bang for my buck".) and at a staggering $1000-1200 for injections that may or may not work, I had to opt out. The drug Tildren also runs about $1000 for a month's supply, and it is not conclusive if it helps much with the heel pain or not.
The vet was quite sympathetic and basically told me that I am not a shitty owner for being realistic, and it's not life or death to get injections or otherwise. My priority is Suzie's wellness and like I had said to the boyfriend, if she required injections to be sound in the pasture, I would do them. To have her endure injections just so I can ride? That's selfish.
So for now... I am tentatively hanging up my riding bridle and going to cry over the unfortunateness of my mare growing old. I am going to think about all the wonderful things we achieved last year and I am going to thank my lucky stars that my mare is still living and breathing and that I am still able to love her every single day. She deserves so much peace and love - she has done her fair share of carrying riders around and has had her fair share of wet saddle blankets. My own need to ride may only become a little 20min hack around the neighborhood once in a blue moon, but I think I will be okay. It's going to hurt for a while, and I'm going to ache with longing.... but Suzie deserves love.
She will be with me until the day she crosses over. I had made that promise to her when I brought her home, and I am not one to make bad on my promises.