Farley update
| March 3, 2011 | Posted by Melinda under Uncategorized |
First off – Doms – you are very kind! If you are learning something from all this rambling – I’m happy to continue rambling away :). The kindness of all of my readers and the list subscribers on the new100milers list has been really wonderful.
I’ve inserted a bunch of “side notes” throughout this post, because I had a realization last night, that while I may be comfortable throwing around “SDF” and “suspensory” and think *everyone* knows what those terms mean – there are many people who don’t know! My boyfriend was about ready to strangle me on the phone yesterday, when half way through telling him my woes he finally had to interrupt me and say quite sternly, “I don’t know what the HELL you are talking about”. And this is someone that has been around me for 10+ years and who is my sounding board for all things endurance and horsey!
So I know you’all are waiting with baited breath (except those of you who couldn’t stand the suspense and have already texted/e-mailed me!) to find out what’s wrong with Farley.
Shall I skip to the end of the story?
I think so – mostly because the diagnosis sounds bad, but there’s a good chance that it’s better than it sounds, and we’all like to end on happy notes hmmmm…?
Medial branch suspensory injury on the LF.
OK – I assume everyone has returned from wailing and gnashing of teeth? Good. Now let’s talk about the issue like the educated group of horsey people we are.
Let’s start with the facts. Farley is lame. Really really lame. Like a 2-3. It’s ~a 1 in the beginning of a trot out, and very shortly goes to hell. Worse when the LF is in the inside. Very consistent and visible whether she is on a circle or on a straight line. Doesn’t respond with much pain upon palapation on the suspensory. Filling is over the check ligament.
Doesn’t really sound like a suspensory right? Shall I see a show of hands? Oh look – I have 10 votes for check ligament and 1 for suspensory. (and the person that voted suspensory isn’t even a horse person! – and thus was guessing)
A side note – for those of you that aren’t as well-versed in soft tissue injuries – and let me assure you aren’t missing out on ANYTHING – *usually* suspensory injuries present themselves as a horse that is very slightly lame. Which is an issue because then you continue to ride on them and make them worse. Lameness is *usually* worse when that leg is on the outside of the circle. *Usually* they aren’t equally lame on the straight line. *Usually* they react to palpitation.
Fast forward to the ultrasound. My regular vets ultrasound was down, so he had a vet that specialized in ultrasounds come out to do Farley’s with her instrument. The only thing they found was a very small (between a 1-2 on a scale of 1-4) on the medial branch of the suspensory on the LF. Some evidence of irregularities around the bottom of an old splint. That’s it. The check ligament looks “wonderful”.
Mmmmm…..She really shouldn’t be so lame based on what we found.
We did some nerve blocks to confirm.
(again – a side note to my non-horsey audience – nerve blocks are done to block pain to a certain portion of the horse’s leg in an incremental fashion to pinpoint the location of where the lameness is originating from)
A block of the foot resulted in a still very much lame horse.
A block of the leg from the suspensory branch downward resulted in a very sound looking horse.
(side note – this doesn’t confirm that the source of pain is the suspensory – but rather confirms that it’s a structure in the area – including the suspensory branch).
Possibility 1 – The conclusion of the vets is that she’s a wimp and we are just looking at a suspensory injury. Being a wimp is a good thing and consistent with her past history. They are talking about her being back to regular work in 9 months (3 months of almost complete rest, followed by 6 months of ramping up slowly under close observation with recheck ultrasounds)
Possibility 2 – there is something else causing the pain and thus the lameness. If so – I’m darn lucky that I found the suspensory injury while there’s a very good chance of recovery. Any soft tissue injury in the area basically treated the same, with the suspensory perhaps being approached the most conservatively – thus by treating the suspensory, I should be addressing anything else in the area.
The good news – while she was in there the vet took a careful look at the SDF (superficial digital flexor) where the old bow was. She said that Farley did one of the best jobs of healing that injury that she has seen. I had been told in the past that the fiber pattern looked really really good, but I didn’t realize that on the spectrum of healing that Farley was in a very small percentage of horses that basically was able to heal the tendon to “as good as new” – and perhaps a bit better. The vets said this is a very good sign that Farley may be able to heal her suspensory in a similar manner, especially considering the small size of the lesion.
We talked a bit about some of the new emerging technology – specifically shock waves, Platelet enriched plasma, and Stem cells – but I finally decided that with the size of the lesion, my financial circumstances (quitting my job in 3 months, vet school), and risk of adverse reactions, I was most comfortable treating conservatively with the more proven therapies: ice, wrapping, rest, and anti-inflammatories.
The vet wasn’t able to tell me with any certainty whether this was a new injury, or an older one that reinjuried. There isn’t a lot of thickening of the suspensory – it has to be over 10% before it’s considered “significant” (and not because of tracing errors etc.) and she’s ~11%. There wasn’t a buildup of scar tissue to suggest that this injury was partially trying to heal and then being reinjured. Thus, the vets couldn’t give me any good answers in that direction, so I will probably have to rely on “my gut” and observations of people around me that I trust.
I know this is getting a bit long, but hang in with me just a wee bit longer.
Although it’s a totally bummer that Farley is injured and I’m having to deal with the financial implications at a not-so-great-time, as well as an unknown competition future with Farley – there’s also lots of silver-linings.
One of my boot clients (and rapidly becoming a regular e-mail “pen-pal”) pointed out just how exhausting endurance can be. You have to be so diligent, all the time. You are constantly watching and evaluating and planning and doing and worrying. Even during the off-times, you are still in “training-mode” – because the amount of rest and type of rest is part of your conditioning program. Even if I don’t have a ride on the calendar, because she *could* be competition ready, I find myself looking at her with the possibility of future competition in my mind’s eye. With everything else going on in my life, this is actually the PERFECT time for Farley to be out of commission.
For 3 months she basically has to stand there and look pretty. Of course, she’ll be under close observation, but it’s different from the stress and worry and observation I do when I’m looking towards the next ride. There’s very little I can do at this point beyond give her body the support it needs to heal itself. She has a home whether she heals well enough to do 100’s again, or not – so as long as I can get her painfree and happy, I’m not worried about her endurance future at this stage. I’ll do the best I can right now to allow her to heal as completely as possible, and what happens, happens. This 3 month period actually coincides with the exact period of time that she’ll remain at her current barn, while I’m still employed I’ll be employed, and during the time period I’ll be busy moving my life.
Then, for the next 6 months she’ll need to be lightly ridden with a gradual increase in duration/difficulty. Again – this is perfect. At this point she will be at my parents and will have lots of time for short, local riding around the place and since I will not be working I will be able to be very consistent.
The end of her rehab will coincide almost exactly with when I need to focus on school and will have less time to ride. She’ll be ready to be conditioned if I have the time and if she stays sound enough, or she can hang out and be my buddy.
It’s sad that it took an injury to give me the summer I wanted with Farley. One without pressure and going for short, relaxing rides and just spending time with each other. There is a lesson to be learned from this situation that doesn’t necessarily just relate to how to prevent and recognize suspensory injuries. I would have liked to think I could have resisted the pressure to compete this summer when I would have preferred to take it easy, but I’m not so sure.
Your attitude is amazing! Here I am crying over a flesh wound, some stitches and a couple of weeks of stall rest for my horse when you’re dealing with “the real thing…” Thanks for putting things in perspective and for your positive thinking.
I will miss you and Farley on the trail (I was already looking forward to our next outing…) and wish you both the best for this long road to recovery. I know she’ll be great throughout and she will have the best caretaker out there.
Hugs to both of you!
Silver linings. There are always some of those…good for you, for finding them!
I think that any horse person who competes can empathize with the drive to always be making the most of a sound healthy horse by doing stuff (and not always taking a breath and just enjoying the sound healthy horse). It sounds like you are in a good head space about all of this. You might just be putting up a front, but even if you are the ability to put up a front is still a lot more than most could manage.
I actually did not freak out when I read the diagnosis. It seems totally healable to me. It does suck, because as you know it could make the area more susceptible to injury, but since you clearly have a conservative rehab and healing plan with a horse who has been proven to heal herself I think that this is totally just a pause in your plans.
My Gen had 18cm of black (i.e. no tendon) out of his 23cm of Superficial Digital Flexor tendon and with enough luck, time, and money he can run around his field pain free, which is enough for me. If you ever want to know about stem cells or plasma from an owners perspective I have been there and done that for my pony. With such a small injury area I think you don’t need to worry about any of that stuff.
((((HUGS))))
In his time at the track, Ozzy had two blown suspensories and a bowed tendon. The suspensories were in each hind leg. One presented normally. One presented with immediate three-legged lameness that made us all say, “Well F***!” Thankfully, my boss was the type to let a horse rest and heal and get back to normal so Oz made a full recovery. I’m keeping my fingers crossed for you because I’ve known horses who never recover, but I’d like to be the voice of hope on this time.
Hugs and lots of good thoughts for a quick recovery for Farley!
As horse owners, we all have to deal with injuries at some point(unfortunately). It is nice to hear that you have a plan and that Farley will be able to be at your parents place for rest and rehab. You have a lot on your plate right now…so glad that you can see the silver lining! Good thoughts to you and Farley for a speedy recovery.
did you take radiographs of the old splint to make sure it’s not a ‘blind splint’?
I ultrasounded it but didn’t radiograph it. What would be the advantage of getting the radiographs? I don’t know what a blind splint is so I’m off to google :).
I think it’d be more for peace of mind than anything, tho your vet may feel that it’s not even a possible issue (so no use spending $$ if you don’t have to). Just mentioned it because when Bo got a slight ligament strain the vet radiographed to make sure he didn’t have a blind splint.