Monday, 27 February 2012

"Look after his left hind leg. It's the good one" ...Kingsley's Lameness Investigation 2012: The X-Rays, Trim & Observations

“Impossible only means that you haven't found the solution yet.” Jim Rohn

Kingsley says: Bring it on ladies

It was a slightly surreal day which started as planned but pretty quickly turned itself upside down. I arrived at the yard about 9:30am and lifted all the bedding in Kingsley's stable to prepare the area for Rachel the vet and Kate, the hoofcare practitioner. 
Kingsley seemed very bright and alert as well as unimpressed with the fact he wasn't being turned out. There was no swelling or heat in his right fore and the rest of the legs looked good too. 
At about 10am Rachel arrived with all the equipment and the long process of lameness investigation started. 
First, she nerve blocked the back of the hoof in both front feet to make sure this was indeed the area that was causing the problem.


It took about 10 minutes for the local anesthetic to start working and by the time we were ready to get going, Kate arrived too. 
The whole idea to get both hoofcare and feet investigation & x-rays done in one day was to allow for some discussion between Rachel and Kate and to establish where the internal structures of Kingsley's feet are and whether the trim can be adjusted accordingly. 

I walked him to the field to lunge him and he was still a little careful on the hard surface and stones despite the nerve blocks.
On Wednesday, Rachel described him as 1/10 lame (left fore) to 2/10 lame (right fore) on soft on circle in trot and 7/10 lame on circle on hard surface in trot on both fronts.
Today, he trotted off very well in a floaty, big trot, nice and free through the shoulders on both reins. However, there was not much change to the canter, no lameness as such but rigid way of moving through the back and underpowered use of the hind end was quite the same as on Wednesday. He also cantered laterally with no clear three beat rhythm.

We then proceeded to walk and trot in straight lines on hard surface. He was very eager to go but not fully comfortable.
Rachel flexed his hinds and off we went up and down the drive again. As I was the runner I couldn't watch him but he felt a little slower to move off after left hind flexion and a bit reluctant to go after right hind flexions.

Next, on circle on hard. He was much happier to go than on Wednesday without nerve blocks. In fact, he was quite eager to keep trotting even though he was noticeably lame...about 2/10 on both fronts and some lameness on the right hind. Rachel did say though it's a tough test and driveway is very uneven and stoney as well as hard so she didn't expect him to be sound in such conditions.
On the right rein in trot he attempted his "bunny hopping" a couple of times (canter like movement in front and trot like movement behind) to avoid trotting entire circle.

Rachel then examined his legs for any tendon/ligament issues that might be possible to feel for like thickening of the area or certain reaction on palpation.
He had no obvious signs of injury that she could feel. He didn't react on any prodding either in front legs nor in back legs, sacroiliac joint of back. All reactions were either normal or he just didn't react.

Observations after the above:

  • Fairly serious footsoreness on all 4 feet, most pronounced in front 
  • Degree of lameness on both fronts and right hind
  • Degree of pain/discomfort at the back of the feet - sound in trot on soft surface after nerve blocks
  • Rigid back in canter and some stiffness through the back in trot
  • Limited bend to the right/through right side of the body

We then moved on to prepare him for X-rays. Rachel gave him some sedatives to make sure he remains immobile during the procedure. He duly drooped his lip and stood like a oddly quivering rock on top of wooden stilts. 

We got everything ready, aprons on, plate in place and...the machine refused to play! It turned out the laptop was not communicating correctly with the plate's cable. Rachel tried her best to get it going for almost 30 minutes but eventually had to admit defeat as even the software/hardware help centre could not assist.
We had a very sleepy horse ready for action and no cable power.
There was no option but to pack everything in and we agreed that the vet will keep me informed and tries to come back with another X-ray machine about 3pm.
Kate and I waited for another half an hour until Kingsley woke up enough so she could trim him. His toes grew really long in the last 10 days which just proves how very, very important regular work on varied surfaces is for barefoot horses.

Although there was a lot of unnecessary horn at the toe there was almost nothing to take from the bottom of his feet. They generally look well and the white lines looked tighter and healthier than last time. Nothing overly out of ordinary...

Here are his front feet after the trim:

Right Fore

Left Fore

Kate gone, I killed some time putting together all the info in our diary and transferred it all in form of short notes to a wall calendar I bought earlier this year. In between feet soreness, kick injuries etc we managed 11 full proper work days in February so far. Not even half of the month. The rest was spent on cold hosing, wrapping and short in-hand walks. Sigh.

I also took some photos of Kingsley's back end and here you can see the uneven muscle development. His left side has more muscle bulk whilst the right side looks much flatter and seems under used. This is of course reflected in his way of going.

When I looked at the photos I also noticed how light (?) appears to bring out a dip in his left hindquarter...It's not noticeable in real life or at least not enough for me to notice that before. Perhaps it's hair being brushed at an angle, I will have a look at his bottom again on Wednesday...

About 3.30pm Rachel and another vet (who fixed the X-ray machine!) arrived and the whole procedure started all over again.
This time Kingsley got much less sedative but was drowsy within minutes anyway.

All X-rays proved to be unremarkable. In fact, they turned out to show very healthy bone structures with no worrying changes. Including navicular bones. I don't know whether this machine has a different imaging process but to me the bones looked denser, whiter and much less porous than on the 2010 X-rays.  

The hock X-rays showed clean and healthy structures with not a single area of concern.

I am to receive all images by email so there will be no odd angles and light tricks. Rachel is going to look through all the X-rays at a large screen at work to double check in case there was something she missed when looking at the small screen.

Just out of curiosity I put together lateral left fore image from 2010 and put together with today's left fore lateral image. Proper comparison isn't possible because the 2012 image is taken from the side so distorts the view but nevertheless it is easy to see how different shape the foot is. There is a huge amount of heel at the back which wasn't there in 2010. The 2010 hoof profile has a bull nose - like shape to it but Rachel felt there was too much toe showing on today's X-ray which causes difficulty with correct breakover.

So here we are. No "navicular changes" as such but a footsore horse with one good leg. We agreed with Rachel the plan of action for the next several weeks and I will write all about it in the next post. For now I am in desperate need of some sleep!


jenj said...

Well, at least his x-rays look good, that's GREAT news! Did they say how much sole depth Kingsley has?

I am very curious as to the plan with Kingsley moving forward, having been in a similar situation with my own horse. Keep us posted!

GAiA ViNCENZi said...

Hi from Italy =)
I'm a show jumping lady rider
really nice blog!

keep in touch

Val said...

Thanks for posting the trimming video. I enjoyed watching your trimmer care for Kingsley's feet.

At least you did have some good news. I hope there is more to come with his plan of action.

Wiola said...

Hello All - I am sorry for delay with next post, very busy with work and slightly taken over by a cold but will try to update asap.

jenj - vet was happy with Kingsley's sole depth as such but that doesn't mean it works ok for him I guess?