Wednesday, July 29, 2009

The Lameness Exam

Today was the big lameness exam with Dr. Turner to find some answers to "Louie's sore leg." Well, I hope we did find some answers. He was definately off on his left hind today at the trot, both in a straight line and in circles, and he didn't really want to canter, but then again there was a guy with a brush-hog driving by as the vet tech was trying to canter him on the lunge. He flexed positive in the hock/stifle, but not super sore, just slightly worse than usual.

He had a bit of swelling in both hind fetlocks (he has had that since our accident, and being on basically stall rest), as well as his left stifle. So they sedated Louie with a very small amount, but about enough to make him fall over- he was resting his face against a concrete wall as if it were a down pillow. We all thought this was rather comical. Dr. Turner was a little bit concerned about him possibly having OCD in the fetlock, so we X-rayed that but it turned up negative. He was more convinced that it was in the stifle, so the X-rays of that joint were critical.

He pointed out a small "divot" in the femur, which may be the cause of Louie's pain. He said this was a small divot as far as divots go, and could possibly be considered on the same spectrum as OCD, but this is much smaller than what would typically be seen with that. He diagnosed Louie officially with "gonitis," which is just inflammation of the stifle, but thought that that divot could represent a few different possible things- a little bit of unabsorbed cartilage, a cyst forming, or a defect in the cartilage. Here is his x-ray, I have added a red arrow to point out the area of concern (being in the human medical profession, I'm amazed at how much this really looks like a human knee, with the exception of the chestnut):

So Dr. Turner injected Louie's stifle with Hyaluronic acid and cortisone, and instructed me to give Louie 2 days off, then return him to our regular work program and report back if he's not any better. He suspects that this probably happened in some sort of small traumatic event in which Louie's legs slipped out from beneath him- so this could have been at the field trial on the stake out, in the pasture with his buddies, running through the neighborhood, or even just slipping in the indoor arena on some wet footing. Dr. Turner thinks that there probably is some degree of muscular/soft tissue injury along with this, and says he's not even sure if this little tiny divot is what is giving Louie his troubles- many horses with similar findings on x-ray are asymptommatic. So when we return to work, we are to treat this as if he has a muscle strain (as I have been with a long slow warm up) in addition to a stifle injury. He gave me a few things to work on to help strengthen up the hind end and the quadriceps to support the stifle joint. Things like working in more straight lines (avoid excessive circling- good thing we have a ginormous arena at Melodee), driving (ha! we're working on it), trotting over ground poles (or with chains on the hind feet- when I suggested this, Dr. Turner was like, "oh yeah, duh, he's a Saddlebred- perfect"), and doing a lot of the reverse direction (backing up- and more than just a couple of steps).

So starting Friday or Saturday, I will probably long line Louie to take a look at how he's moving and continue back with the regularly scheduled programming. Dr. Turner says that if this doesn't make him any better, let him know, we can come back and move on to the next step of diagnosis (not sure what that would be, but I'm sure he's got lots of tricks up his sleeve). Well, though it's hard to predict the future and the prognosis for Louie, I'm hopeful that this will help and that everything will go away and he'll be back to normal eventually. Only time will tell.

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