An Otis Update

I haven’t updated my avid readers for a while about Otis, so here goes. 

About three weeks ago he was suddenly lame again in trot, so I rested him and rang a vet who had been recommended to me to get a second opinion. I was hoping for a more supportive and proactive approach.

If I’ve learnt one thing with Otis’s lameness it’s the sad fact that if you self-insure like I do, vets just aren’t interested in helping you. They think you don’t want to spend the money on diagnostic techniques, or that you haven’t got the money. They try and dissuade you from investigating causes, even if you adamantly say you want a test run. 

Thankfully, this second vet I saw was totally supportive of the idea that I have X amount in a savings account for Otis’s vet fees and I wanted to get to the root of the problem. 

The verdict on his assessment was that Otis was 1/10ths lame on the right rein and 2/10ths lame on the left rein on a soft surface and a bit lamer on hard ground. All of which points still to the sidebone being the problem, particularly noticeable when his left forefoot hits the floor left side first, as in on a left turn. 

Otis was booked in for an MRI last Monday, which all went smoothly and the hospital, or horse-pital, were very good with him.

Then I had an agonising wait to speak to my vet a couple of days later.

Basically the MRI showed that there is no damage to the connective tissue. Which is good. The best of a few bad options. But the vet thinks that the sidebone settled down after the fracture and Otis came sound – end of October time – and I was told to bring him back into work slowly. But this aggravated the sidebone which is why is went slightly off. Then was sound at Christmas, then the walk work in January aggravated it so he was off in February and then why he has off days and sound days. His recommendation is that I turn Otis away for a few months to allow the sidebone to completely chill out and settle down. 

Whilst he was very pleased with my farrier’s work on Otis, he did suggest egg bar shoes to provide greater heel support, so after putting my farrier in touch with him, Otis was shod yesterday and then I got out some over reach boots for him to wear.

I’m currently trying to work out what the best solution is for Otis, for me, for everyone, and putting plans into place. I’ll update you when they’re fixed but until then I’d appreciate it if anyone who wants to talk about him comes armed with chocolate because with everything else going on (that’s another blog post) I’m a bit of an emotional wreck about the horses!

Otis’s Rehab – Weeks 11.5-13

Last time I updated you on Otis I wasn’t feeling too positive, but I went away and decided that when I’d lunged him he was probably still tired from his couple of heavier days of exercise, so combined with the deep, dry arena, wasn’t feeling his best.

I gave him a couple of days off, then lightly hacked him, and on the weekend the arena was rolled. So I rode him in the school, on a much firmer surface and he felt much better. The odd nod, but when looking back at the videos I felt that the stride length was staying consistent, but he wasn’t quite connected so was dropping the contact and nodding his head – bridle lameness perhaps?

Since then I’ve found the balance between one lunge, one schooling session, and three hacks (with the odd trot around the arena if he’s not worked hard on the hack) a week to build him up slowly. Hopefully by increasing the trot work, by longer hacks or popping in the school for a couple of laps, his fitness will improve. I’ve been very conscious of getting him to take the contact forwards, and to create that steady connection. To help, I’ve also been using side reins on the lunge. There’s still the odd misstep, but I’m hoping as his strength improves this will disappear. I’ve also been focusing on the quality of the trot and canter, so that he uses himself most efficiently and will be less likely to injure himself as we progress. 

The positive thing I’ve felt, is that his left canter feels better than his right (although they were much more even today) and his injured leg supports his entire weight in left canter. So it can’t be that bad, can it? 

I feel that I’ve got a handle on his weight now. He’s not gaining weight, and his neck is no longer cresty. Hopefully by keeping a close eye on his grazing and the slow increase in his workload will start toning the muscle and burning the fat.

I did however, have the saddler out yesterday. I’ve been using my dressage saddle as this is the wider of the two. However, it had to be widened by two gullet sizes! Into an extra wide! The saddler then put my wider gullet into my jump saddle, which is still a little narrow and perched on top, but it didn’t move while I rode, even with my loose girth. So at least I have the option of both saddles, even if I don’t use the jump saddle for a month or so. 

Can you remember I did a blog about zoopharmacognozy a couple of months ago? Well I bought a sample selection pack, but Otis doesn’t seem to be fussy and eats all of the herbs that I offer him! So I’m just feeding him them one at a time, and if I notice a huge difference in his well being I will investigate further. One herb I bought, called Eyebright, is supposed to support the functioning of the eye. Otis’s right eye tends to run in the wind, or with flies, so I thought I’d give that a go. A pinch each day in his feed and there’s no gunk in the corner of his eye – I’m really impressed! 

The plan is to continue how we are, adding in five minutes more every few days and to get plenty of video evidence for me to reflect on. I have put myself down for a riding club dressage weekend in July. It may be ambitious, but I felt I needed an aim. It will only consist of one lesson  on each of the two days, so a far cry from the fitness demands of Pony Club camp. It should help my teaching as I can get hints and tips from other lessons, and if the worst comes to the worst and Otis isn’t up to it then I’m sure I can borrow a horse for the weekend. 


Otis’s Rehab – Week 4


Week four of Otis’s rehab hasn’t been  very exciting.

I spoke to my farrier on Monday about hind shoes, and on Monday took Otis out for a walk, avoiding the gravel path. On Wednesday I did the same, and then on Thursday I rode Matt and led Otis, finishing with a hill.

Then on Friday Otis had his hinds fitted, and I’m pleased to say he felt much happier on Saturday. 

Now I can start to lengthen the roadwork because with hind shoes he won’t favour his front feet which should mean less pressure on his dodgy foot. Which also means I can put in more hillwork to build his hindquarters up to help stabilise his pelvis and also with better muscle tone and posture he won’t be so much on the forehand… again taking the pressure off his front feet.

I also emailed my vet last Sunday, and spoke to him on Friday about Otis. He agreed that hillwork and building some muscle up would help, so I’m to continue doing that. He suggested Devils Claw as an anti-inflammatory, which will be my next supplement to try if this one has no effect. He did say that turmeric is often more beneficial to joint issues, not soft tissue, which is a valid point.

In terms of getting my vet’s views on red light therapy, he hadn’t heard of it, but does have a laser machine that he uses. So I guess I’m on my own in that area. Incidentally someone suggested, in another conversation, a TENS machine, and therapeutic ultrasound, which are avenues to consider. 

There was no answer to what soft tissue was being affected, and no suggestion of an ultrasound or other diagnostic techniques.

My vet did seem to take away from the email that finding out what Otis is capable of doing was important to me, and he ended up saying that whilst eventing in July was highly unlikely, we could probably find activities to suit him. He suggested coming out to Otis again and doing a careful nerve block with the idea of performing a neuronectemy. As I’ve said before, I really don’t like this idea. Which leaves me with more unanswered questions. 

Where do I go from here? Do I get a second opinion? Do I find a less invasive treatment? Do I leave vets to themselves for a bit, build up some muscle in his hindquarters to sort out the pelvis issue, then reassess his level of soundness? Should I demand an ultrasound or MRI to see the extent of soft tissue damage, or to see what tissues will be affected? 

Who knows. If anyone is a vet then I’d value your opinion.

I’m beginning to think that because Otis isn’t insured by a company for vet bills, just by a stash of money I’ve saved for him over the years, that the vets are trying to minimise costs and effort, where in actual fact I’m probably a better customer than someone with an insurance company because I know exactly how much I can spend and can pay the bill tomorrow, yet no one has discussed budget with me when discussing Otis’s treatment. 

In the meantime, while I pontificate, here’s a video of Otis showing L’Oréal that he has the max factor!

Red Light Therapy

As promised, here is my post explaining all about red light therapy. Finally. Yes, I know, I’ve taken my time, but it’s a post that requires peace and quiet. And access to my research!

With Otis’s not so great diagnosis a few weeks ago, I sat down to look at some management techniques. The first one that sprung to mind was red light therapy, because a friend of mine uses it regularly and successfully on her horse, who has lots of foot problems and they manage to do riding club level competitions.

My first port of call was Google, which informed me that red light therapy was developed by NASA to help heal injuries to astronauts in space. The technology was initially designed to improve plant growth in space, but then scientists realised it could benefit the human body too.

This led to successful experiments that found that this technology reduced pain and side effects of cancer sufferers.

Then the rest of the world sat up and took note.

Now you can find red light therapy in medicine, health and beauty, veterinary treatments, to name a few.

It’s important to remember that red light therapy doesn’t solve a problem, it just alleviates the side effects and makes the problem manageable.

How does it work? The red lights themselves are light sources releasing energy in the form of photons. Healthy cells vibrate at 660 nanometers a second (this is important as lower quality lights don’t vibrate at the correct frequency), and when tissue is injured the vibration level drops in cells. The red lights “jump start” the affected cells so that they vibrate at the correct level. 

The mitochondria within the damaged cells are accelerated, which increases ATP production, so the brain releases endorphins, serotonin, and anti-inflammatories. The blood flow is also increased which enables nutrients to reach the cells and for toxins to be eliminated quicker. By reducing or eliminating pain and inflammation the body will heal faster.

One website claims that red light therapy works by:

1. Reduces pain by increasing production of endorphins – a natural pain killer

2. Reduces inflammation by suppressing enzymes that create swelling, redness, and pain.

3. Boosts the release of anti-inflammatory enzymes to reduce swelling quickly.

4. Increases cellular regeneration and healing by stimulating the mitochondria within the cell. This increases the production of ATP which causes damaged cells to accept nutrients and eliminate toxins faster

5. Increases lymphatic drainage and circulation.

6. Relaxes tight muscles and quickly releases muscle spasms and cramps.

7. Strengthens anti-viral properties by increasing antibody production in the bloodstream

8. Improves structure of tendons, bones, skin, teeth, and cartilage by increasing collagen production.

9. Stimulates a strong heart beat by regulating serotonin levels. Serotonin helps to regulate inflammation and allergic reactions and plays an important role in blood clotting, stimulating a strong heart beat, initiating sleep, and fighting depression. It also stimulates the smooth muscle in the intestinal wall helping it to contract.

I haven’t enough knowledge to try to prove these claims to be wrong, but what I do know is that if NASA think red light therapy is worth studying then there must be some benefit of it. Additionally, it does sound like it will suit Otis’s condition by reducing pain and inflammation of the soft tissue in the foot when it gets aggravated by the side bone.

Armed with this knowledge, I started picking my friend’s brain. Interestingly, she has an issue of a tendon rubbing over a bony protrusion in her knee, which is very painful. But she finds the red lights very beneficial. This sounds like the human version of Otis’s problem. She has just qualified as a red light therapist so offered to come and assess Otis.

I decided that I didn’t have much to lose from trying this and booked Otis in for a session.

What I didn’t realise was that Eastern medicine has gotten in on the act and red lights are often used on acupuncture points instead of needles, with good effect. I’m sure I’d rather have beans of light pointed at me rather than being stabbed by needles, but apparently acupuncture doesn’t hurt (I’ve never tried it). So when my friend arrived she started with a whole body assessment.

I would be concerned if a vet or physio or anyone else, solely focused on the problem area and neglected the rest of the body in case they missed a causative factor or another sore area caused by compensating for the injury.

Anyway, Otis flinched slightly on his left brachiocephalic muscle, which makes sense as it’s his left forefoot that’s problematic and that side of his neck is involved in lifting that foot forwards. He also, weirdly, had a square of heat on the left side of his thoracic vertebrae and a bit of sensitivity over his sacro-iliac. There was a bit of heat in the sidebone area, but nothing else to note.

Next, my friend put him to sleep. He was somewhat reluctant, but after a minute of putting the two red lights on his spine (just above the wither and in front of the croup) his head dropped and he licked and chewed, a common sign of the release of tension. These points are to do with acupuncture, I think they reset his energy lines or something.


Some people will by now shouting at me, telling me it’s mythical rubbish. I don’t know much about Eastern medicine, but if acupuncture has been around as long as it has it has to be successful. And I was actually amazed at Otis’s response to the lights on those trigger points. 

Next, she put the red light pad onto his sacro-iliac to treat that area and she started making her way down the left side of his body, putting the lights on different points, again linked to acupuncture points. This was all about resetting his body and sorting out any niggles or areas of strain where he’d compensated for his injury.

While she did the right side of his body, she wrapped the light pad around the right foot, and put it onto the skeletal setting. If I’m honest, I don’t know how this differed, but I assume it’s a higher energy level because bone is denser than muscle.


Interestingly, in the right hock there was some activity. I put my hand around the point of hock while the lights were focused on it and could feel the hock bubbling. It felt like a simmering surface on a pan. Or what I’d imagine a simmering surface feels like as I’ve never touched one! Weird! But again, it goes back to compensating for the injury with his diagonal pair.

To finish, Otis had the pad on his neck, to release the tension in his left brachiocephalic muscle. 

Otis was almost asleep while all of this went on, and when my friend checked his pressure points again he didn’t react at all.

So did it work? I don’t know! 

From this treatment I twigged that his pelvis had rotated so for that treated. There’s not been any heat in the sidebone area since. And I can only presume he felt better the next day because he lost a shoe in the field … but the jury is still out. Otis definitely enjoyed the experience and it was non invasive so I know there won’t be a negative outcome … except for losing a shoe. And after his pelvis was corrected he did feel good. Possibly normal. But let me go and touch a big bit of wood.

I think I’ll see how he is over the next couple of weeks and I can always try it again to get a more definitive answer.

Keratoma

I apologise if you’re browsing my blog whilst eating dinner, or breakfast, because this post will have some gory pictures later on.

Today we’re going to talk about keratomas, which must be one of the worst ailments a horse can suffer from because of the lengthy recovery time and the difficulty in  keeping it infection free.

A keratoma is a tumour within the inner layers of the hoof wall. They are benign and therefore do not spread to other parts of the body.

Keratomas originate at the coronet band, and grow down to the toe, extending out to the white line when it reaches sole. They are usually situated at the toe, occasionally the quarter, at any height between the coronet band and sole.

No one knows what causes keratomas, but it has been suggested that chronic irritation of the internal, sensitive laminae from injury or infection could be the cause.

Due to the fact the tumour is encapsulated within a rigid structure a keratoma cannot be easily seen or felt. The first sign of a keratoma is lameness, possibly with a bulge of hoof wall at the coronet band. Depending on the rate of growth of the keratoma, the lameness can be sudden onset, progressive or intermittent. 

To diagnose a keratoma, the vet will use hoof testers to find areas of pain, check the white line for flaws or signs of separation. X-rays and MRI scans provide a definite diagnosis and allows the vet to identify how advanced it is and if there is any damage to the pedal bone. They can also take a biopsy too for confirmation.

The next step is to remove the keratoma. This requires surgery, when the hoof wall is cut out and removed over the keratoma so that the tumour can be taken out completely. Afterwards the vet will pack the wound with antiseptic gauze, and fit a hospital plate to the shoe (I actually have one of these!) to help protect the foot. A bandage around the foot helps to keep the wound clean and dirt-free. The patient then needs a course of antibiotics.


Post surgery, the horse has to stay on box rest, in as clean a environment as possible, with the wound being checked and re-dressed every couple of days until a hard layer of horn has formed. Once the hospital plate and bandage are defunct, then the horse will need remedial shoes to best encourage the hoof to grow, and to stabilise and support the weakened area. The foot needs to be kept clean and dry until the hoof has completely healed, which takes many months when you consider that it takes twelve months for hoof to grow from the coroner band to the sole, the recovery rate for a keratoma is slow to say the least! The prognosis is usually good, and providing the keratoma is completely removed, the risk of reoccurrence is very slim. You just need a lot of patience, a good farrier, and a horse who likes his stable!

 

Bridle Lame

It`s a phrase quite often bandied about, but it can be difficult to explain.

Bridle lameness is an asymmetric movement in the horse that simulates lameness either when the horse is ridden, or wearing tack. Bridle lameness can be psychological from the horse – they don`t feel comfortable in their tack, or they lack confidence in either rider or tack, or are remembering a painful experience. Or it can be a result of resistance from the rider`s hands or resistance to the leg and seat aids.

Bridle lameness is different to a true lameness because it is not caused by pain. A true lameness causes an irregularity of gait due to the horse trying to “save” that leg and consequently transferring more weight onto their good limbs. Bridle lameness can happen in the fore or hind legs and can either be seen by a horse rushing through the bridle or raising his head, hollowing his back, and not going forwards.

Sometimes a horse, especially a nervous one, can appear bridle lame under a new rider, until he builds his trust in their hand or body language. Perhaps a change in bridle or tack can cause the bridles lameness, especially if the bit is harsher and the rider`s hands do not compensate by becoming lighter.  A horse ridden from the hand instead of the from the leg can develop a swing in his head and neck, causing him to bob up and down and look lame.

Sometimes just warming the horse up, and encouraging them to move forwards on a loose rein can help eliminate any bridle lameness because the horse does not feel restricted and can relax his muscles so that his hind legs come under and he works correctly.

If a horse is presented lame, and bridle lameness is suspected then it is a good idea to strip him of his tack and lunge or trot him up on a hard surface. I read an article about a horse with extreme bridle lameness who still appeared lame when lunged in a bridle, however it became sound when lunged only in a headcollar, which means that there is a psychological factor in this problem.

If a horse shows up lame when ridden by just one person it may be the rider who is causing the lameness, so another rider hopping on can be useful in finding the root cause, and then the original rider can work on the causative factor.

From here, I would strip the tack back to the bare bones – snaffle bridle, cavesson noseband – and perhaps hack the horse for a couple of weeks to get the horse confident, and help them forget about the arena and school work, which could be the triggering factor. During this hacking time it is a good idea to get the usual checks done; saddle, back, dentist, etc.

Then the school work should be introduced at the horse`s pace. Firstly just trotting around a couple of times after a hack. If all is well then next time a light contact can be picked up and work can begin slowly so that the rider, or observer, can pinpoint the moment that causes bridle lameness – is it a particular transition, or one rein more than the other, or on a corner or bend. Then the rider can work on improving the horses ability and confidence in that area. Sometimes professional help is needed for both the horse and rider!

Fixing a bridle lame horse can take a long time and requires lots of patience as you are not just fixing a physical issue and waiting for tissue to repair, but retraining the horse`s psychological response to the rider and tack.