Monday, January 18, 2016

The wheels fall off the bus...

These wheels in particular. Related: Is this not the most awkward stance?
With the new year, I have started to turn my head towards my competition goals for the year. Before I can really ramp up the work, I knew I would need to have the vet out to evaluate Pig. This decision was made for two reasons:
  1. It's good practice to have your older medium-level competition horse sussed out by vet before putting him back to work in high-stress/high-expectation program.
  2. He's been lame AF. 
As I wrote about at the end of last year, Pig's hind end has increasingly been feeling like it is about to fall off the bus. His stifle has been sticky, his gaits have been lurchy, and his attitude towards work has veered from really excited to really NOT excited (sometimes in the same ride). Some days I've been able to really put him together and get him through whatever is bugging him. Some days I can't. It's been frustrating, but overall not something I've been too worried about.

Because: when you own an older horse, you get a good feel for what is a serious problem and what is just an age/fitness issue.

Obviously this sort of NQR-ness is not exactly conducive to ramping up for a competitive show season at Third Level. So, I called the vet to see what the options and diagnosis really were. I've been pretty lucky with this old horse. Though he has his issues, I've really never had to pour a whole lot of money into him. Sure, he's had injections but typically only once a year. And he is not on any sort of joint supplement or corrective shoeing routine. He's honestly been extremely cheap. As such, I went into this appointment willing to throw quite a bit more money into his maintenance.
My vet, working with another chestnut horse.
After a lengthy lameness exam, the vet was pretty settled on a diagnosis: Getting old sucks.

To break it down:
Stifles: Vet is pretty sure Guinness is suffering from some weakness in the stifles due to time off after his splint break and intermittent work since then. That weakness, manifesting in brief lockages during riding, is painful and causing resistance to additional work that would help him build the muscle support to stop the issue. This is something we've had before, and worked through. It sucks but is easy to fix.
Treatment: Estrone shots 1x weekly for 4 weeks. Lots of slow hill walking/trotting and walking/trotting over more poles. Additionally lots of transitions, focusing on stepping under and through. (Interestingly, something already on the training plan as we gear up for show season.) If after a the Estrone treatment and strength work we do not see improvement we will pursue stifle injections, but the vet doesn't think these are actually necessary.

Hocks: Oddly, Pig showed the greatest positive to hock flexions, specifically his left hock. He trotted off very uneven from these. As we watched him go, the vet pointed out how his left hind always swings under his body, no matter which direction he is tracking. I've noticed that his right hind is always swinging out, and thought that was the problem. I didn't think about the opposite being the issue, but it makes total sense. Now that I've had it pointed out, it's supremely obvious. I wonder if that was really the issue last spring as well.
Treatment: Hock injections. It's kind of awesome that my horse made it to 18 without needing these after a long career on the track and a few years as a jumper. I'm honestly impressed, and totally ready to throw some money into those joints.

Fetlocks: Zero response to being flexed in his hind fetlocks. This made me feel good, as his rear fetlocks have basically doubled in size over the last two years. I've been worried we'd be looking at the same issues in the rear that we had in the front. My vet assuaged those fears.
Treatment: Nothing.

Back/SI joint: Here is where I was really proud. The vet found zero issues with Pig's SI or back. He went so far as to tell me "this horse has one of the most supple and relaxed backs I've seen". He did find some positive sore points right over the point of the butt and over the SI, but he said these are not due to the SI joint, but instead are indicative of weak stifles, as those are the muscles a horse uses to swing his legs out to avoid putting pressure on the stifle. I found this fascinating, as this is a spot Pig pops up sore on a regular basis.
Treatment: Keep on keeping on. Whatever we are doing is clearly working for him.

Front end: We didn't really look at anything forward of the withers. This vet is aware of Guinness' fetlocks, and said he agrees with me that they are probably as fused as they are going to get and clearly holding up fine to the workload. He did mention that Pig probably has some arthritis in his neck, but he qualified that with "most horses do, the way their necks are built really encourages arthritis in the lower vertebrae." He didn't seem concerned about it, and honestly Pig doesn't either. He checked on the (still huge) splint bump, and said it looks fine. He doesn't think the bump will really decrease in size, but seems to be just fine. He also did a once over on Pig's suspensory ligaments, which all came up negative.
Treatment: What isn't truly broken is obviously still working. Stay aware, but don't worry.
"Give me apples! And also preventative medicine!"
Because this vet is steeped in medical theory, and is really down to earth, I went ahead and asked him some other questions:
  1. What about Previcox/Equioxx for pain management?
    • A great option for a horse with long term needs for NSAIDs. However, my vet was confident that regular injections and a careful eye would be enough for now. Maybe down the road this is something we can look at to keep Pig in a lower level of work. He cautioned using it to keep a horse going at a high level. In addition: He mentioned that laws prohibit the prescription of Previcox for horses, unless there is a valid reason (like horse won't take pastes). This is because cross-species prescription is severely frowned on if a formulation exists for the species being treated. As Equioxx is formulated for horses, there is no reason to use Previcox, other than cost. 
  2. Thoughts on Adequan/Legend for maintenance. 
    • Vet thinks Adequan has shown some good indications towards use for arthritic horses. He suggested it may be helpful to do a session as prescribed (7 total shots given every four days, not monthly) in a couple of months. Legend he was not as positive about. I asked if the intravenous shot of Legend means that the HA is not in the system long enough to make an actual difference. After some time, he nodded and admitted that is very possible, but perhaps still worth trying.
With that said, we made a second appointment for this week to have the injections taken care of and other medications (estrone, dormosedan) dropped off. Until then, I was told to keep riding and working on slow build up of musculature around the stifle and hind end. Riding out on hills was specifically mentioned. Just like with all other arthritis issues with this horse, the suggestion has been "do what he is comfortable with, but above all keep him moving."

So, yep. Getting old sucks.
"I am ageless. I dunno what you're talking about."

37 comments:

  1. Poor Pig. Getting old does suck but it sounds like all things considered he is doing well.

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    1. This horse has seen some shit. I'm always surprised he has less scarring than I assume he would.

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  2. Overall that's a pretty good report for an 18 y/o sport horse though!

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  3. Sounds like overall pretty positive! The Previcox/Equioxx cross-species thing is a bunch of crap - it's 100% about pharma $$$, and that's coming directly from vets and exhibitors at AAEP when we asked around this year. Luckily when Luce was on it, our vet was cool about writing the Rx for "Lucy the dog" and just having us adjust the dosage. From limited conversations, it seems most vets are, so long as you have a good relationship there. Interesting about the Legend/Adequan stuff!

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    1. Yeah, I think vets are pretty aware the whole thing is ridiculous. But there's a legal issue they don't want to get tangled in, you know? I can respect that. No one wants to lose their license over something dumb like that.

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    2. Oh, definitely. We just lucked out having the vets in the family. It's hard enough to be a vet these days - I wouldn't want their job!

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  4. Mikey did that dosage of Adequan- the every four days thing. Since he wasn't working at the time, just healing, I can't speak to how it worked (plus we did a crap ton other things too). But I feel like that's a good report card for an older horse! Getting old is tough, but it's good that's the only thing really wrong.

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    1. I'm willing to try it once. But it's a big chunk of cash, so you can bet I'll be watching closely for benefits!

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    2. I got the 10 dose bottle and my trainer pulled each injection- it was more cost effective. After we finished the 7 doses, he got one every month after that until it was gone. Don't know if that's an option for you, but it made me feel a smidge better about spending so much!

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  5. Um yeah if C makes it to 18 with that little maintenance, I'd be thrilled.

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    1. Fingers crossed! Though, I probably could have done more maintenance during the whole "fetlock fusing death to all" stage, I don't think it would have made a single difference.

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  6. Pig is a tank to make it to his age with as few issues as he has!

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  7. Hooray for seniors with minor, manageable issues!

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  8. I also own an 18 (19 in two months!) year old horse in moderate dressage work (2nd level). She's been extremely low maintenance thus far but this summer she definitely wasn't herself and I felt similarly as you... Nothing very alarming but time to get the old girl checked out. She didn't flex positively anywhere however vet agreed she wasn't comfortable. 7 Adequan shots later and I had a different horse. She is right back to her old self, forward, and enthusiastic to work.

    Obviously every horse is different but my vet said when they get older and there's no joint in particular that's causing a HUGE problem, Adequan is a great option. Because it's IM it treats the horse all over and tends to be a great tune up.

    Just figured I'd throw that out there in case it helps :)

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    1. Interesting! Totally a great thing to think about. I know that Adequan acts a bit like an anti-inflamatory agent when you give it that way. So I can see how it would be very helpful.

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  9. Getting old may suck but NOT get older would really suck. :)

    I would HATE to have to paste my horse that frequently. I gave Irish previcoxx crushed in his food- much easier.

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    1. Yeah. I can see a horse getting really resistant to paste after a few days of it...

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    2. One of my friends tucks hers in Rice Krispie treats and her horse gobbles them right up.

      You know, weak stifles are something that A LOT of thoroughbreds suffer from, even when young, and I would be REALLY INTERESTED in more than "step over big things" to help with that. For example, I don't always have big things to step over. I feel like loading the stifles with a touch more weight could be helpful, and have always wanted to try putting weights on my pony's hinds (taping coins to bell boots maybe)... so maybe I will just try that.

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    3. Maybe add more backing? Transitions help, too. If you can keep your horse super straight and stepping under. Specifically, I would think, Halt/Trot and Walk/Trot. As those require the horse to really lift up his hinds.

      But really. You have poles. Right? I mean. You have jumps. Right?

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  10. The cost difference between previcox and equioxx is significant though. I think the large container of previcox I got makes it cost about 60c a day to feed previcox while one tube/1 day of equioxx is $5+

    I'm really impressed you got to 18 without having all of these problems. I have two 12yr olds that need injections and other arthritis treatments. Although my gelding who doesn't jump and only does trails is probably 18-19 and doesn't have arthritis.

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    1. I mean, we had problems. They just haven't required a lot of crazy maintenance. I think my horse's particularly strong work ethic and pain tolerance are probably to credit, too.

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  11. "Because: when you own an older horse, you get a good feel for what is a serious problem and what is just an age/fitness issue."

    SOOOOOOOO true. All day, every day.

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    1. Yep yep, resounding, yep! Getting old sucks

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  12. I had amazing almost immediate results with Pentosan or rather the generic version on my 19yo mare. As in, the second shot in, I very nearly got bucked off due to the sheer joy of feeling really awesome. What I like is that it doesn't just block pain, because I don't want to ride a horse I've just numbed, but it is medically proven to reverse damage done. I think it does better than Adequan in addition to being much cheaper. It is VERY affordable and available with a prescription through a compounding pharmacy. If your vet doesn't like it, try picking it up at horseprerace.

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    1. I've thought about Pentosan. I'll have to ask the vet about going that route.

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  13. Not a bad visit for an older gentleman. As an owner of an older gentleman myself (he's red, 20, and jumping around), I have gone the route of supplements. Cosmo is not un-sound without them, just stiff and grumpy and clearly not excited about working through stiffness/being old. I put him on a joint supplement that was working really well for my dog, and then I took him off previcox and put him on a mushroom based anti-inflamatory. I did notice a big difference once he was on the mushrooms. They are show legal which is also nice. It's a newer company, but they are exploding right now. (They also happen to be on sale -thought not advertised online- at Mary's until the 25th)
    I know not everyone loves supplements, but they are working for us, so I wanted to share with you in case you might be interested. Here is the link for the anti-inflamitory/recovery/old man special http://mushroommatrix.com/store/equine/equine-matrix/mrm-matrix/mrm-matrix.html if you are interested in the joint supplement I can share that as well.

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    1. Huh. Interesting. Thanks for sharing!! Pig has never done well on feed through supplements, unless they were chocked full of super USEF illegal anti-inflammatory herbs. :(

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  14. yay for cautious optimism! i like the way your vet thinks - hopefully his treatment plan will get Pig feeling much better asap!

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  15. Your vet sounds awesome! My vet at the equine hospital just tested his hocks and when they were bad he just didn't go onto anything else

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    1. To be fair, I started off by asking about the stifle. Still, this guy is great. He didn't stop until we were reasonably certain we had all the trouble spots. Then he never pressured me to do anything more in-depth (like radiographs). This is great, because my horse is older and I really have stopped caring about the specific details of his joint wear. That's just going to depress me at this point. All I want is to keep him comfortable for as long as possible.

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  16. Wow- Foster and Pig's issues are very very similar. Except of course that Foster's experiencing them at the ripe old age of 9.

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    1. I know. I feel so awful for you and Foster. I remember how devastated I was when Pig's fetlock issues came to light when he was 12. I imagine it only gets worse if they are younger.

      I feel for you. With the old ones it's a totally different eye you turn to it. :(

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  17. He looks ageless/timeless/immortal. I'd believe him if he told me so.

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