Final Update on Ava’s Stifle Injury

This is going to be my last update on Ava’s injury (unless something major happens). I had the vet out to do more ultrasounds last week. Previously, the vet was unable to see any signs of injury or damage, but this time he was seeing an enlarged medial Femorotibial pouch and flaring.

When I asked the vet his opinions on Ava’s chances of making a full recovery without surgery he just shook his head and said that wasn’t possible. He said the only possibility for her returning to her previous athletic ability would be surgery, and that would only be if the tear was small and the surgeon could fix.

If Ava’s tear is small, and the surgeon can reach it, the prognosis of a full recover is approximately 50%.  If it’s not a small tear, or not easily accessible, then Ava will be lame the rest of her life.

Costs for arthroscopic surgery: $3,000 – $4,000

I’ve been reading every article and forum I can find about stifle injuries and none of it is good. In fact, it’s thoroughly sad and depressing.

I found this article, “Meniscus and Meniscal Ligament Injuries in Horses” (bottom of page),  which I think sums up my research pretty well:

Arthroscopic examination is indicated in horses that fail to respond to conservative treatment (ie, rest and anti-inflammatory medication followed by controlled rehabilitation). Arthroscopy allows assessment of the extent and severity of injury, although only the cranial and caudal poles of the menisci are visible arthroscopically. Arthroscopy also allows torn or fibrillated fibers of the meniscal ligaments to be debrided and flaps of meniscus or fibrillated meniscal tissue to be removed.

The prognosis for return to athletic function depends on the severity of injury. Overall, ~50% of horses with meniscal and meniscal ligament injury return to athletic use. In horses with severe tears that extend beneath the femoral condyle and horses with concurrent osteoarthritis, however, the prognosis is considerably poorer.

From “Equine Sports Medicine and Surgery” book by Kenneth W Hinchcliff, Adnris J. Kaneps (2013):

Arthroscopic surgery of the femorotibial joints is essential to determine the extent of the injury as well as enabling treatment. The most appropriate treatment depends on the configuration of the tear. Loose or unstable tissue, usually at the cranial axial aspect of the meniscus, should be debrided. Longer more abaxial tears may disappear from view under the femoral condyle making debridement challenging and the resulting defect extremely large. For these cases, some method of repair is required. Two repair options include implantation of stem cells or intra-articular suturing, neither of which have been trialed in large numbers of affected horses. Stall rest for 4-8 weeks will minimize further damage to the MM and associated soft tissues.

Prognosis

Horses with lesions confined to the cranial ligament and cranial horn of the meniscus have a fair to good prognosis for returning to athletic competition following arthroscopic debridement and prolonged rest (6-9 months). Athletes with large tears involving the body of the meniscus as it courses under the femoral condyle, complete avulsion of the cranial attachment and concurrent CoL or CrL damage have a poor prognosis for athletic use.

Or this article from “Diagnostic & Surgical Arthroscopy of the Femorotibial Joints“:

The overall prognosis for meniscal injuries is around 50% return to function with the actual prognosis being greater or lesser depending on the severity of the injury.

Horses may have mild residual lameness after their rehabilitation which may respond to medication with corticosteroids once the horse comes back into work.

And this article from “Arthroscopy for Meniscal Tears” by Susan Piscopo, DVM, PhD (2004)

“There are two main difficulties with menisci,” says Tim Phillips, BVetMed, CertEP, CertEO, DESTS, Dipl. ECVS, MRCVS. “First, damage to them is hard to diagnose prior to surgery, and second, they are difficult to access during surgery. Only the cranial and caudal poles (front and back ends) are accessible.” Arthroscopic findings at surgery were graded by severity.

A successful outcome was defined as returning to previous work and remaining sound. Forty-seven percent of horses had a successful outcome. “Horses with simple tears confined to the front of the joint have a good chance for recovery,” says Phillips. “Horses with tears that extend out of view during surgery, however, and with tears associated with osteoarthritis, are more likely to stay lame.”

I’ve had some people suggest stem cell therapy. I’m going to check into that.  There’s also a treatment option called IRAP ( Interleukin-1 Receptor Antagonist Protein), but that is suggested for horses with OA or inflammation in the joint. And PRP (Platelet Rich Plasma), which appears to be significantly cheaper than the other treatments at approximately $1,000 per treatment. I’m going to ask about stem cell and PRP treatment to see if either are available, and if so, what’s required to do that.

Today, we’re going over to my brothers house to build a third stall in his barn. And then we’ll move Ava’s to her new home (hopefully before the snow really builds up). He has a few acres, and two older, quiet horses that Ava can hang with. Plus, his house is only about 15-20 minutes from mine so I can go see Ava regularly.

Ava with a shaved stifle

Ava with her shaved stifle

I’m heart broken.  And I feel terrible for Ava.  She didn’t deserve this.

And I don’t get how this happened. I watched her like a hawk the past four years. I was at the barn nearly every single day checking fencing, checking water, checking feed, checking everything.  If I had to drive out to see her twice a day then I did.  I was like the super horse mom nut that went overboard on protectiveness. If a barn started doing anything I felt was unsafe, I moved her. I don’t know what else I could’ve done to prevent this!  I tried to protect her, and I failed. I’m so angry at myself, and at the situation. I feel like I failed her.

But all I can do now is try to do what’s best for her both physically and mentally. I’m worried about surgery on Ava since she has a history of allergic reactions to some drugs. And although I would gladly put myself in debt to make Ava better, a 50% success rate (on only the small tears) doesn’t seem like very good odds to me.

Anyway…. If anything of note occurs with Ava I’ll be sure to keep everyone updated, but as of now, this will be my last post whining about Ava’s injury.  I’m tired of crying, and it’s not helping Ava, so from now on Ava and I are on a new “Pasture Puff Adventure”! I’m sure she will love her new career even more than her old one. And over time, she may heal up enough to be a light trail horse. She’s always been awesome on the trails. I know she would love doing that the rest of her life.

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Video of Ava trotting

I took some video of Ava today. I tried keeping her quiet, but… it didn’t work out so well.

I wanted to show you the lameness and see if any of you had any thoughts on it.

http://youtu.be/DUbzxHvQcng

I also wanted to document where she’s at right now.

After this video, I took Ava outside to graze for a few minutes. She walked out like she was the soundest horse ever. Serious over tracking on both sides. It just seems so odd…

I look like a dwarf next to Ava! Haha. She’s barely 15.2 hands.

Ava Update 2

After posting about how I thought Ava looked better, as of yesterday she is as lame (or worse) than she was 23 days ago.

I am devastated.

I don’t want a new horse. I want MY horse. I don’t want to ride other people’s horses. I want to ride MY horse. I want my horse back, dammit!

I keep reading up on stifle injuries, and nothing makes sense. She’s never had heat or swelling in the stifle. She’s nearly sound some days and then horribly lame the next (even though nothing has changed). She isn’t lame at the walk at all. She swings the leg way up under herself, over-tracks the front hoof print by a hoof length (which is the norm for Ava).  Shouldn’t she be lame at the walk too? I don’t understand that…

I don’t have $2,000 – $3,000 to do arthroscopic surgery. And it’s no guarantee that they’ll be able to fix the problem. The only thing it’s being billed as is a diagnostic tool to hopefully tell me what was wrong with Ava.  But maybe they won’t be able to tell me. Or worse, they find out that the joint is totally destroyed.

I am utterly depressed about this. It feels hopeless.

Ava’s progress

6 weeks since stopped all work.
3 weeks on stall rest. Going into 4th week next week.

The first day (day I moved Ava to this barn), Ava came off the trailer extremely sore even at the walk. She was immediately put on stall rest.

She’s improved significantly in three weeks. Left hind reaches more forward, with less stabby movement. The left still isn’t as freely forward and swinging as the right. However, I am seeing a good improvement in how she moves the leg. Before, she would appear more sound but it still seemed jerky. Now, she seems more fluid.

I’m hesitant to see this as a good sign though, because when I was still riding her (** God I feel awful for that) she had days where she didn’t look lame. And then a few days later she’d be so lame that even non-horse people could see it.

When I trot her out now I’ve had the barn owner (experienced with performance horses) take a look. The barn owner thinks Ava looks like she’s sore in the hip area. The latest vet stopped at the stifle, so it could be that there are a combination of issues going on.

I had the chiropractor adjust Ava two weeks ago in hopes that it would help fix any compensation issues. I don’t know if helped or not. I can’t tell.

The 30 days of stall rest end December 1st. I’m going to ask the barn owner to start turning her out in the round pen for a few hours each day and gradually lengthening the time. Maybe do that for 2 or 3 weeks, and then she’ll have to go out with a new herd of horses in a pasture she’s unfamiliar with. I can’t keep her on stall rest indefintely, and Ava would lose her mind if I did.

I don’t really know what to do at this point. Ava’s grumpy and getting irate with the lack of freedom. I’m worried turnout with a new herd will undo any healing that happened. Plus, everything is snow covered and icy to boot. Great combo for an injured horse. *roll eyes*

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Grumpy

Ava was thoroughly displeased with me yesterday.  Not one nicker of greeting, no happy ears… she tolerated me as long as I scratched her itchy spots and fed her treats.

** I was still riding her because the other vet said it was arthritis. And I stopped riding as soon as I realized he was wrong.

Lease Horse – Notes about current training

I thought I’d post an update on the lease horse, and write down the issues I’m having.

I’ve ridden Ellie about  8 times now, over a two week span. She’s still extremely out of shape, but her suppleness has improved tremendously. She’s no longer barging around on her left shoulder. She still falls in, but not as badly and it’s getting easier to move her shoulders back over.

I’m having issues with her curling under. If I push her up into the bit, she gets frazzled.

She doesn’t seek contact. She won’t go out of her way to avoid all contact, but she doesn’t go looking for it.  I have video below. Watch her head. I don’t ask her to put her head anywhere when I’m riding. The only thing I ask of her is to look in the direction of travel.  If I give her the reins, her head stays exactly where she put it.

I’m focusing on teaching seeking the bit at the walk right now. Just when I think she’s starting to understand, that’s when she starts rooting (shoving her nose down and out hard enough to jerk me). I don’t want the rooting at all, but I’m scared if I kick her forward for it that it’ll send the message that she can’t reach out and down for the bit. I’m indecisive on what to do about it.  I did kick her forward for rooting last time I rode, but then I decided just to avoid the situation entirely and we started working on leg yielding instead.

I’m concerned about the head and neck because it’s the symptom of the tight back. If I can figure out how to get her to relax her back and swing then the head and neck can relax and follow the bit. But I think it’s all tied together too. I can’t affect one without the other, and both have to be relaxed before I can get real relaxation. And I can’t get anywhere with her until she relaxes and starts swinging through.

So I’ve tried a few things to trick her into releasing the tension in her back. First I tried working her just slightly under what I believe is her natural trot speed. She was mentally more relaxed, but I felt like she was phoning it in body wise. Her hind end was out behind us somewhere doing it’s own thing.

Nov 7 Trot

Then I tried asking for a slightly more forward trot then she’s comfortable with. The idea being that she has to bring her hind end up under. It’ll build up her strength in being able to carry herself  with a level balance (weight evenly distributed between front and hind legs). The stronger she gets the more she’ll be able to relax the back and swing through.  The more forward she is the harder it is for her to duck behind the contact. Therefore it should allow her to carry herself in a more correct frame and build the correct muscles.

Nov11Trot

So I made a video of the slower/faster trot work. I know the quality of the video is bad, but look at the overall body of the horse and how she moves. She gets closer to actually tracking up when she’s pushed a little more forward. I don’t like that she seems a bit more tense with the more forward.

The more forward felt cool though. She felt very uphill on the straight sides. She still felt like I could do a ten meter circle at any point in time, or turn anywhere I wanted to turn. I never felt out of control, or like she was too unbalanced to be able to quickly change direction, speed, etc.

My riding is atrocious, and I’m horrifyingly embarrassed by it. I’ll have to work on that.

Video is 2:49 long. At 31 seconds you can see her curl right up. I’m just up there thinking, “Crap. What do I do now?”

Comparison

Kind of looks the same to me. But her right front in the “more forward” side is in a later phase than the right front in the slower. So she actually stepped more under in the more forward for it to be where it’s at now in a later phase then in the slower side. Maybe. I think.

Funny note: I dreamt I was riding Ellie last night. I was trying to prove that I really could sit the trot well (because I always blame my inability to sit the trot on Ava’s big bouncy trot)… and then I ended up flopping all over the place while sitting Ellie’s trot. I haven’t tried sitting Ellie’s trot in real life because her back isn’t strong enough yet. But now I’m have this compulsion to try to sit her trot.  haha

Why I’m a better rider than you

Because I pinned every meme ever created about George Morris on my pinterest.

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La Tee Dah

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My riding career in a nutshell:

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How I see it when people try to compare their dressage results against me, or anyone else:

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The costs of owning a horse:

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When I have to listen to people talk about their imported warmblood that cost more than my house:

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When the GMO board tells me the website I built for FREE, and won an award from USDF for, has to be completely thrown away because WordPress is “too difficult” to use:

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When I asked for a boarder meeting to discuss their free roaming horses, and inability to feed consistently, and they started the meeting off stating they were raising board:

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And in the car, after the meeting:

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And how I felt after that barn owner said she’d miss me:

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How I feel every year at the GMO banquet, which lasts 3 hours:

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And how I felt this year when I dropped off my stuff for the banquet, and then left before the banquet started:

🙂

Blog hop for fun

Viva Carlos

I’m late posting this…. by about a month. 🙂

October’s 10 Questions

“If you always put limits on everything you do, physical or anything else, it will spread into your work and into your life. There are no limits, there are only plateaus, and you must not stay there, you must go beyond them.” – Bruce Lee

1. How many pairs of breeches/jods do you own?
Two cheap pair. Finances restrict me.

2. How many horses have you ridden?
Gosh, I’m not sure… at least 30 that I can name. There are a lot of horses I can’t name, but have ridden over the years. I spent a solid three years being guinea pig, catch rider for my trainer. and for a long time I used to have a lot of people ask me to exercise their horses while they were out of town (I cost nothing and they trusted me not to be crazy). Plus, I’ve owned 7 horses over the years.

3. How many trainers have you had?
6 trainers – includes before dressage time.
* 2 dressage trainers (not including clinics).
* 1 western trainer.
* 2 HJ trainer.
* 1 all purpose trainer (4-H type trainer)

4. How many barns have you ridden at?
7 barns (includes barns from childhood). I got kicked out of one. Ha.

5. What is the name of the horse you consider yourself to have the greatest bond with?
Victor Victoria. My NSH gelding that I bought as a green broke four year old. I had him for five years and we spent a great deal of time together. He had a quirky personality, was extremely intelligent, and had a huge heart. Ava’s a very close second, but it’s hard to compete against a childhood pony.

6. What is your favorite show name you’ve ever encountered?
“Your Girlfriend” was the show name. So it was announced “Mike X riding Your Girlfriend”. Haha

7. What do you consider your greatest weakness or flaw in riding?
My seat is subpar to where it needs to be skill wise. And I still fall back too much on strength to get things done when finesse fails. I’ve been working really hard to break this habit.

8. What do you consider to be your greatest strength?
My feel and timing are pretty good. And I’m patient and flexible in adapting to what the horse needs (usually).

9. Have you ever leased a horse?
Not really. Most people let me ride their horses for free. When I was a kid, if I couldn’t get a ride on a trained horse, then I convinced people to let me break out and train their unused horses – which was a huge learning experience for me. I’m thankful I had those opportunities.

10. What is the name of the first horse you rode?
I don’t remember the horse’s name. He was an appy with a beautiful blanket, and he seemed huge at the time. The instructor was a wiry lady with weather worn skin. I was 9 and very small for my age. My parents had to push the lady to let me take lessons. I remember how it felt on the horse the first lesson. I thought I was in heaven!

It’s a lot of driving for a hobby

Ava’s doing well. I had the chiropractor adjust her Tuesday. I didn’t realize the chiro gave the horses vitamin b shots. If I’d known I would’ve warned them about Ava’s aversion to shots. Everyone survived, but I felt like the parent who was told that her kindergartner bit the other kids. 
BO: “Your horse was naughty today.”
Me: “How bad was she?”
BO: “Nothing we couldn’t handle, but he must’ve hit a sore spot on your mare.”
Me: “A sore spot? Oohh, riiiiiight. Yeah, must’ve been that.” *shifty looking*
O_o

The vet I took Ava to for her stifle called me the other day. He said he might have another option to try with ultrasound. And in addition we can try treating Ava by injecting the stifle and then attempting to bring her back into work slowly. The other option is take her to MSU, have the stifle scoped and hope the surgeon see what’s wrong and determine if he can fix it while in there. If I go with treat and see, then I can’t have the stifle scoped until 8 weeks after that. I’m indecisive about which avenue to take.

I rode Ellie again tonight. What a fun mare! She’s still stiff and bulges into my left leg/rein. She’s actually the exact opposite of Ava… Ellie wants to lean on the left shoulder and bulge her barrel into your left leg.

My main concern is that Ellie isn’t able to come over her back while she’s crooked and leaning. She holds herself stiffly in a ‘frame’, but there’s no back involved in it. I’m not quite sure yet how to really get her to unlock.  For now, I work on moving the left shoulder to the right, leg yields to the right to get her weight more on the right shoulder, and lots and lots of bendy lines so that she can’t lock and brace around the middle of her body. Then I ask for as much forward as I can get without losing balance so that she’ll step under herself as much as possible. I worry she’ll pull or pinch something with how stiffly she carries herself right now.

I hope as she gets more fit, and she becomes more flexible through her body, that her back will naturally start releasing. I hope.

I need a good exercise for her canter to trot transitions though. She slams hard onto the left shoulder on the downward tran. She refuses to trot and will either quit and balk, or continue in a bunny hopping like canter that is walk speed (it’s not pretty). If I can just get her barrel to bend around the left leg then she could make the transition into trot more easily…  it’s going to take a bit of finessing though. I tried leg yielding to trot, and it did help, but not as well as I had hoped. I have heard it takes some time to fix this, but I would like a few more exercises to try. I’ll have to research that.

Anyway, it takes me 45 minutes to drive from work to Ellie’s barn. It’s 35 minutes from Ellie’s barn to home. It’s an hour drive from Ellie’s barn to Ava’s barn, but only 20 minutes from home or work to Ava’s barn. It’s a lot of driving… but I can’t afford to board Ellie near me so I’ll just have to make due for now. I was really going into withdrawls not riding. It’d been 3 weeks… too long in my book. 🙂

I’m just happy to be riding again. It’d be even better if it were Ava… no wait… it’d be awesome if I could ride both and they were at the same barn. That’d be the perfect scenario. =D

The lease horse

The lease horse, Elie,  is a pretty, bay OTTB (Off the track Thoroughbred). She’s small, standing about 15.2h, but is well put together. The mare was antsy in the cross ties as all her buddies were taken out to pasture, but she wasn’t ill-behaved. Actually very pleasant to brush and pick out feet.

The owner told me that the mare hasn’t been worked in about 10 months. I was expecting airs above the ground.

We tacked her up, and the owner lunged her for a few short minutes to see how the horse was going to behave.  The mare was excited, but not unruly.

So the owner hopped on and put the mare through her paces. I could see the mare was stiff (expected after 10 months off), and a bit bracey/hollow.

So then I got on. We had to wrap the stirrup leathers twice, plus put the buckle toward the top holes. I get so embarrassed having to do that.
My friggin’ dwarf legs! Ha.

I get the horse walking forward. The horse is very stiff. Tighter muscles on the left. She was jazzed up after the owner had cantered her, but listening well. I asked her to trot and we took off in a lopsided, odd canter with lots of head flinging. So I brought her back down to walk and tried again with less leg and she picked up a nice trot.

I think the owner likes her to go slower than the mare is actually built for… just a general impression. And the mare has a weird way of holding her head and slightly ducking behind the contact. Which is at odds with her barging into the bit when you ask for a downward tran or a halt. So she’s not quite comfortable with the bit, nor with seeking the contact, right now. I think part of that is lack of muscles and stiffness.

And last impression, the mare was happy to calmly walk around on a loose rein. She was overreactive to some aids, but not hot (bouncing off the ceiling) like I assumed she’d be after 10 months off. The mare has an odd way of tuning out some aids while being overly dramatic about others. Oh, and she doesn’t understand the outside rein at all.

Over all, this lease horse is AWESOME!  I didn’t want to get off the horse, and I can’t wait to go ride her again. Once I get her back in shape and loosened up some, I think she’ll be even more fun.

After riding the lease horse I swung by and saw Ava. She was happily eating hay in her stall. The sun was shining in on her (it was barely 50 degrees so the sun felt good). I hand grazed her for a while and we walked around the barn a bit.

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Ava's stall.

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Grazing. Barn with indoor arena behind Ava.

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Stalls. Ava's is the first stall on this side.

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Trying out a horse to lease

I’m pretty excited today. A friend of mine has offered to let me ride her mare while mine is healing. I’m going to go try her out this morning to see if we click and whether I can handle the horse.

The mare is a OTTB, with a couple years of dressage training. The mare hasn’t been in consistent work in at least a year, but prior to that I think they were working on First Level. I’m very lucky to have an opportunity to ride a horse that already has some dressage training.

The drawback with this horse is that the mare is very hot, opinionated, and athletic. The plus side is that the mare is hot, opinionated, and athletic. 😉 I’m good with hot… I seem to mellow them out. Probably my boring personality puts them to sleep. Haha

I’m so excited to be back on a horse. It’s been three weeks since I’ve ridden and I’m going through severe withdrawls!

I hope this goes well.