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Tuesday 30 May 2017

Jack gets the all clear..... again 25/5/17

After 2weeks of box rest following his steroid injection to treat tenosynovitis in the off fore Jack was due his check up with the vet.  He was coming at 1pm and I finished work at 12.30pm so I rushed down like a bat out of hell from work to give Jack some sedalin and instamag before the vet arrived.  I didn't think I had a snowflake in hells chance of holding on to him for the trot up without it!  To be fair he's been pretty good for the 2weeks really, it was better than I thought but maybe I just wasn't there to see most of his antics.  I know some of the other girls had to give him the instamag when they were turning out so he hasn't been perfect!  The first couple of days of box rest were the worst as poor Jack couldn't understand why he wasn't going out at the end of the day like normal.  Every time I left him he was rearing and spinning round his box and getting pretty upset but luckily that didn't last after the first few days.  He seemed to accept that he wasn't going out after that and was much better whenever I was there at least.  The 2 weeks finally came to an end and so with Jack dosed up with sedalin the vet arrived and had a check of the leg.  He was happy that the swelling was much reduced and while I thought it had actually come back up a bit again in the 2nd week he wasn't concerned.  All his legs were a little puffy anyway from being in so some turnout and gentle exercise should improve things further.  Next up was the moment I had been rather apprehensive about, the trot up!  Even though I'd given him sedalin and some instamag I put a bridle on Jack and hat and gloves on me before I led him out onto the concrete yard!  I walked him away and back first and noticed he was sound on the turns which was a big improvement on pre injection.  I then did the trot up, Jack didn't trot very well so we had to do it twice but he kept it together and was actually very well behaved which was a huge relief!  Even better the vet said he's sound and gave the all clear for him to be turned out.  Hurrah!!!  I was so pleased!  So after a chat about rehab and another check of the leg the vet went on his way and I was able to turn Jack out.  I had already asked our YO to fence off a small paddock for him in anticipation so he was able to go straight out while still dopey from the sedalin.  He was keen to get to the field but as soon as I took his headcollar off his head went down and he set about munching with out a buck or a kick or even a roll.  Perfect!  The last thing he needed was to go tearing round the field and undo all the healing that's taken place over the last 2 weeks so for him to just get his head down and eat was exactly what I wanted.  I stayed a while to be confident he wasn't going to suddenly go nuts but he was so chilled still an hour later I left him too it.  I did go back later and put his grazing muzzle on as having been off grass for 2weeks only getting a hand picked bucket twice a day I didn't want him to gorge too much and give himself an up set tummy! The plan now is for him to have another week off, he will be being turned out at night and in during the day then he can begin some walk work.  Due to his history I'm going to take rehab very slowly and carefully!!  This will mean lots of boring walking for the next few weeks but I don't care, I will just be glad to be back on and determined to do everything I possibly can to get Jack back to full health.  I'm not bothered how long it takes.  The vet is confident we can back competing before the end of the season but I'm not aiming for that, I don't want to push Jack by putting a deadline on his fitness or entering any competitions.  I'm going to rehab according to how he feels.  There is plenty of time for eventing in the future, he's only 11 and he's not going anywhere!
Enjoying some much deserved chill time in the field :0)



Monday 22 May 2017

My Top Tips for managing Kissing Spines

I thought it would be helpful to others to share what products, exercises, management and therapies etc have worked well for my horse since his Kissing Spines Diagnosis and surgery.
You will need to discuss the best course of action with your vet and taylor your rehab and management to suit your horse but here is rundown whats worked for us:

Therapies:

Hydrotherapy - Jack was able to get the very best start to his rehabilitation by spending a month at a specialist rehabilitation centre with an aqua treadmill which he went on everyday.  This was recommended by our fabulous surgeon.  Even better the rehab costs were cover by our insurance claim although I did have to cover the stabling costs.  Bennett equine were fantastic with Jack and he came back after a month of rehab there fit and ready to begin ridden rehab.  I didn't have to do weeks of endless lunging which is so wearing on a horses joints.  It is also where we met our fabulous physio tamsyn who has been wonderful, an endless source of knowledge and a highly skilled physio.



Physiotherapy - as mentioned above I use a highly qualified and reputable vet physiotherapist who was recommended by both my vet and the rehabilitation centre we used.  She started working with Jack while he was at the therapy centre and we were very lucky that she agreed to continue to treat Jack when he returned home as she is otherwise so busy she isn't able to take on new clients.  There is a huge difference in Jacks work after he's been treated by Tamsyn, he is always more supple, forward and altogether nicer to ride.  He often gets tight in his hamstring and si area which stops him being able to use himself properly and Tamsyn is able to release these muscles so he is comfortable and can work properly again.  I believe we wouldn't be where we are without Bennett's and Tamsyn's help.
Be wary when choosing a physio as they are not all the same, it is best to get one recommended by your vet.

Magnetic therapy - I use a equilibrium magnetic back pad and equine magnetix hock boots on Jack (he was diagnosed with hock arthritis at the same time as KS) and I find they work really well, if he has them on prior to exercise his back is warm and the muscles soft and he works lovely over his back in a soft and relaxed frame with lots of swing.  It is especially noticeable in the colder weather.  The hock boots also seem to make a real difference with Jack more forward and engaged behind when he's been wearing them.  If I ride him when he has not had the back pad and hock boots on I notice a real difference in Jacks ability to work softly forward and it takes me a lot longer to warm him up.

Feed and Supplements:

Feed - It is important that every horse receives a balanced diet suitable for their age, temperament, workload, management, type etc.  Condition scoring is also important as weight gain or loss will have an effect on your horses shape, muscles, energy levels and ability to perform.  Too much weight can lead to many health problems even in otherwise healthy animals and is to be avoided, in a horse with back problems it is only going to add to their discomfort as they have to carry more weight around.
I consulted a nutritional specialist at a leading feed company for advice on what to feed Jack when I was bringing him back into work following surgery and they provided samples for me to try and vouchers for money off my first bags.

Supplements - I try to avoid supplements as a general rule, I think most are full of fillers/sugars that most horses really don't need.  The companies that sell them do a very good job of convincing us that our horses need their products!  When I have used supplements in the past I've not been convinced of their effectiveness. 
The only thing I feed in addition to Jack's usual food is some turmeric, I have only recently begun to use this but have heard some amazing results using it so if it works it is a very cost effective supplement.  I will review it in a few weeks and write a post on the results.

Equipment:

Saddle Pads - I use a thin square saddle pad with high wither clearance under a professionally fitted saddle, I also use a faux lambs wool half pad under the saddle which was checked by my saddle fitter to make sure it didn't affect the fit of the saddle.  Whatever saddle pad/numnah you choose to use it is important that it is checked by a saddle fitter to ensure it is not effecting the fit of your saddle and that your horse is comfy and not restricted.

Lunging aids - I lunge at least once a week in a Pessoa type lunging aid set up on the lowest setting so Jack works in a low, open and relaxed frame over his back.  I often use poles to engage his core further.



Exercises:

Pole work - I love doing pole work whether ground poles, raised poles or little grids.  They get a horses core working so well, keep lunging and flat work more interesting and get Jack thinking quicker about what he is doing with his feet!  I never use the same exercise twice in a row and enjoy thinking up new exercises to try out.  I hardly ever school without poles these days as they really help Jack use himself and without them he gets bored and switches off in the ménage.  Here are a few exercises we use on a regular basis:


Carrot stretches - I do carrot stretches with Jack everyday whether he is ridden or not.  Not always with carrots, I use apple's, lickit mini licks or horse treats to stop him getting bored.  Standing Jack up square I will do 3 stretches each side, the first to his elbow then to half way down his barrel and finally behind each knee holding each for 5seconds. Then we do between his fetlocks, between his knees and to his chest.

Hill work and hacking - I get out of the arena as much as possible and even in the Winter try to never school 2 days in a row.  Jack really still disliked the ménage when he first started ridden rehab so we just did lots of long slow hacks building up a little at a time.  He worked much better this way and it is easily the best way of getting a horse fit.  As he became fitter we introduced trot and then canter work on hacks first before asking him to trot and canter in the arena.  I try to vary the terrain and ground so all his bones, tendons and ligaments become strong.  Hill work was also introduced gradually to build fitness. 

Management - regular turn out is really important for both body and mind, the gentle exercise helps loosen their muscles and grazing with the head down stretches their back.  Jack is turned out daily, in the summer he is out at night and in the winter he is turned out during the day.  When the grass is at its richest in the spring and Autumn I often muzzle him when he is out to restrict his grass in take as he puts on weight very easily.
I feed from the ground in buckets too.

Time - My biggest tip is to take your time and listen to your horse.  Rehabbing successfully from Kissing Spines is a marathon not a sprint!  One size certainly does not fit all and it is very common to have problems along the way, there is no harm in taking a step back and doing more walking, hacking, lunging etc if your horse is still not happy going faster.  A 12 week fittening program is a good guide but don't be disheartened if it takes 16, 24, 38 weeks or even longer.  As long as you and your horse are happy!
 

Wednesday 17 May 2017

Finally a diagnosis 15/5/17

It's been over 6 weeks now since Jack first went lame.
Following 2 vet visits and numerous x-rays last month we were unsuccessful in identifying the cause of his lameness.  It was very frustrating as I had a similar experience last time he was lame, and it took 3 visits wasting weeks and £££ before we got a diagnosis and the correct treatment.  I really didn't want to be in the same position again but there didn't seem to be anything more I could do so once again he was prescribed 2 weeks off on bute and then see how he was.  As we didn't know the cause, along with the fact that being stabled made the lameness worse, the vet agreed he could do the 2 weeks rest in the paddock rather than being stuck on box rest.
Jack at this point had been barefoot for about a week as the farrier had been due just after Jack had gone lame so when he came we decided to leave his shoes off until he was right again and back in work, no point wasting money on shoes that wouldn't get used!  Sadly this ended up causing a bit of a problem as he became so footsore on hard ground in all 4 feet while he was on rest that it became impossible to tell if he was actually still lame!  He seemed ok in the ménage but on the yard he was very uncomfortable.  After discussion with my vet they requested his shoes go back on before we did anything else, unfortunately my farrier couldn't come for over a week so this ended up delaying his reassessment and hopeful return to work and he had 3 weeks off rather then the 2 in the end but I reasoned the extra rest would be better for him, at any rate it certainly wouldn't do any harm.  He got the shoes back on last week and the next day I lunged and rode him in the ménage and on the car park.  I was so pleased to find Jack looked and felt good.  I updated our vet and they were happy for me to begin bringing him back into work however we did book an appointment for them to come back as wanted to try to get a diagnosis for insurance claim purposes as much as anything and for my own peace of mind as there was still some swelling to his fetlock which was bothering me a bit.
The vet said it would be ok to start riding him for short hacks, in walk only, until they saw him later that week so I hacked him out for 20minutes the first day and he felt great, very keen and forward and most importantly sound!  I continued to take him for hacks the following few days building up to 30 mins while waiting for the vet visit on Friday but as the week went on I started to feel the odd bit of unlevelness from Jack, mostly while on a turn, and wasn't sure if I was just imagining it or if he really was still not right.  I didn't worry too much as the vet was coming anyway.  On the Friday 2 vets came, the original vet who gave him the nerve blocks and x-rays, plus a lameness specialist.  They looked at him trotting up and turned on a tight circle where the lameness I had been feeling showed.  They then performed flexion tests which made it much more obvious.  At this point it was decided to scan the ligaments and tendons as he still had the swelling above his fetlock which has been there from the start, its not got any worse but not improved either.  First job was to clip the area to be scanned around this fetlock and pastern, the vet asked me if he was ok to clip to which I replied "yes he's fine" (He has always been easy to clip and I clipped all his legs myself a few weeks ago when he first went lame to be able to see any swelling more easily).  Jack was not fine, he wouldn't hold still even when I held up the other leg to stop him snatching the foot up!  As he was clearly agitated even just by the clippers he was sedated.  I don't think he has in anyway forgiven or forgotten the last vet visit when they tried to block the coffin joint.  Once sleepy they began to scan the leg finding a lot of fluid in the synovial capsule and after a very thorough scan, which meant more sedation as Jack still wouldn't hold still, of all the ligaments and tendons in the area finally we had a diagnosis of Tenosynovitis. 
At this point the vets wanted to nerve block again to see if he responded completely but despite the 2 lots of sedation Jack was not co-operating at all and after a couple of attempts this plan was abandoned.  Instead they decided to just go straight for steroid injections into the affected area.  As this involved another needle and needed to be in a specific area they gave poor Jack yet another dose of sedation!  I was holding his head, one vet holding up the good leg and the 2nd vet administering the injection and we still struggled despite him being doped to the eyeballs feisty little monkey!  They were quick though and managed to get it done without too much drama.  Jack was then bandaged up and prescribed 2 weeks of strict box rest before they return to reassess him.  I hate box resting him and he hates it too but at least now I know it is the best thing for him so I can justify doing it to him.
As he was so heavily sedated he couldn't have any food until he was properly awake again so I had to stay with him for a while.  The vet advised soaking his hay to help avoid impactions and he is allowed some hand picked grass.  I am also to keep up carrot stretches twice a day to help keep his back supple.  That night when I left Jack in his stable on his own he was not happy and as I walked away I could see him rearing in the stable - naughty pony!  He was the same the next night then on the Sunday a new pony arrived which caused some excitement so I have been using my instamag instant spray on calmer to help keep him from getting too loopy.  It's been working well and the other girls at the yard give him a spray on his neck just behind his ears before they turn out their horses and he does calm down - I have to say I am impressed with this product and so are they having seen the results so one or two of them are thinking of purchasing a bottle themselves!
It has been 3 days now since their visit and I am pleased that Jack has settled down, the swelling has also gone down so it looks like the injection is working.
I'm looking forward to the vets returning when, hopefully, if Jack responds as well as he did last time to the injections he can begin to be brought back into work - keeping everything crossed! 
In the meant time he's been getting lots of cuddles from his biggest fan 😍