I made it there about a half an hour early without any mishaps along the way and hand grazed Gem in the sparse grass growing along the gravel drive. The vet was out on a farm call and was reportedly on her way back.
I looked Gem over while she ate in the sunshine. Her coat has remained glossy if dusty, her mane and tail have been torn up a bit from her boredom in the stall and she has gotten very, very fat.
Eventually the vet arrived and I walked Gem inside. I mentioned to her that she is stocking up on the right hind only nearly every day now which began right after the shoes went on. I find the location to be unusual. If it was due to not fully loading the injured front right it should be the back left that is stocking up. She agreed and said she would look at it. I also told her of a wound that began once the cast was off and we switched to the smaller, less padded dressing. It is on the coronary band on the outside and I asked if we could stop the wrapping. She nodded and said she would look at it.
Once inside, she removed the bell boot and took a closer look. She thought the rub might be due to the bell boot, but there is no way. It is definitely from the elastikon. She agreed though that I could leave the wrapping off and keep a close eye on it. If it seemed like the boot was rubbing, I was to cover the area again.
Rub from the bandage. |
Wire sutures removed. The hoof wall is banged up more from the wires than the actual trauma. |
She poked and prodded at the injury site and was very pleased with how well it has healed to date. I was hoping she would let me walk and maybe trot Gem a little on the soft barn floor to watch her move, but she never offered and I didn't ask. She did look at the right hind and basically said she had no clue and to watch it as Gem got more motion and see if it didn't go down on its own.
At this point she seemed ready to walk away. I stopped her and asked her what was next in terms of her stall rest, outside time, working, shoes, barefoot, follow up....I swear I had to ask each and every question super specifically or I wouldn't have gotten any information out of her at all. So frustrating!!!
I didn't stop badgering her until I was completely satisfied with everything. The last question I asked was about her follow up and she gave me the best answer ever: no planned follow up. YEAH!! I could drive away and wash my hands of Tryon for good. If lameness or other issues pop up, I feel comfortable switching to a different vet knowing that the original injury and surgery had healed and we could deal with it elsewhere.
Ok...so now what did she say? In general, I tend to follow doctor's orders to a T. To date I have done exactly everything the vet has said to do exactly how it was supposed to be done. Part of it is just my natural propensity to do so, but a big part is knowing that the orders are there for a reason and that a) it is always better to do the time now than double time later after you have messed it all up and b) how insanely frustrating it is to be on the other side as the doctor with a patient who doesn't follow orders and then complains to you that things are not healing right. So. Very. Frustrating.
However, when the instructions make no sense I feel that I have every right to ignore them and to devise my own plan that follows a much more logical path. I will type out her exact instructions in bold followed by my thoughts.
The vet's instructions:
1) Stall rest to continue for 3 more full days without any hand walking. I didn't understand this at all. Everything is healing. The bar shoe is on to prevent any motion. What good would three days do? When I asked she said the sutures had only been out for a week, but I corrected her that it had been two. She seemed to back track after that but didn't ever really explain why theatre extra days. Given no logical reason, I chose to ignore this.
2) She can then go out for 2 hours in a small paddock or round pen for the next 2 weeks. After that she may have the time out increased by 2 hours every 2 weeks until she is out for a total of 12 hours for 2 weeks and then she can go back out full time. First, I do have a full time job and while I will bend over backwards to make sure Gem heals this is ridiculous and just plain not doable. Second, if she gets out for only 2 hours she is more likely to freak out in excitement and do something stupid. Third, according to this time line she would not get to go out for a full day for another 3 1/2 months. That seems insane when everything is firm, healed and doing well. Plus wasn't the entire point of the bar shoe to prevent any excess heel bulb motion? Why bother putting it on her if she is just going to stand around all day long? So I chose to ignore this too.
3) I may begin to ride her walk only in 1 month. I'm actually surprised it is so soon, but very happy as well. Come September we will begin slowly walking on the grassy barn trails only. I think I will start with some hand walking to see how she is moving and then progress to under saddle. She didn't mention for how long or how far, but did preface it with "you do endurance so your good with conditioning" I'm pretty sure that was a cop out. When you combine this with the above stall rest plan I think it makes even less sense to keep her in for so long. According to the above plan, Gem would only be out for 4 hours total when beginning under saddle work. Would her under saddle work count as her out time? Who knows.
4) After 30 days of walking only, add in short trot sets and work up to longer trot sets to her tolerance for another 30 days. I can get behind this but again no specifics as to what pace or how long. At this point she would be out for 6-8 hours but allowed to trot under saddle. Hmmm....
5) After 30 days of trotting, she may return to canter work and go back out on trails. This is too aggressive for my likings and I will make a whole other post on my back to work plans for Gem. For now, I will say that I don't plan on taking her off property for real trail work until the first of the year and we will be going slow and steady throughout the fall.
6) Shoes. Maintain the bar shoes for 3 more cycles. Ok. I don't like the idea of shoes, but I will follow this recommendation closely.
7) After that she is to go into a regular keg shoe until the one year mark. Ouch. Way longer than I had hoped, but ok.
8) We can try barefoot at the year mark, but she wasn't too optimistic. The hoof wall was damaged in a very small section. There is a chance that this will form a vertical ridge that will run the entire height of the hoof wall. If this happens, she will be prone to cracking this and could lose the entire back quarter of the hoof wall. Not good. In this case, she would need to be permanently shod up front with this region floated in the shoe to prevent much weight bearing to the now weakened section of hoof. If the wall grows in fine, then she doesn't see any reason to not attempt barefoot once again. A bit of a bummer, but there isn't much to do about it. She didn't recommend a hoof supplement, but it can't hurt any so I will be researching this in the near future and adding it to her daily regimen.
And that was all folks.
I thought about her instructions on the way home and talked it over with Dusty. I just plumb don't agree with or really understood the excessively conservative stall rest especially when it is in stark contrast to her aggressive return to work. According to her plan she won't even be out full time when she is allowed back to basically full work. How does that make any sense?
So....
Out she went!
Finally getting to graze once again in the southern sunshine |
Happy mare! |
1...2...3...GRAZE! |
No clue the dimensions, but it is about the size of a medium round pen only square. |
I debated long and hard about turning her out during the night and bringing her in during the day with the other stalled horses, but in the end I decided to just let her out. It isn't big enough for her to cause much trouble and it is so much better for her to be out. I checked back in on her in the evening and her back right leg was nice and tight and the wound from the wrapping was dry and looking already a 100 times better. I left a message for the BO to feed and hay as he saw fit (probably a bad idea since he loves to overfeed) and if he thought she was too hot in the sun with no shelter to bring her in during the day. Otherwise leave her out. She will stay in this small pen for at least a month if not longer.
I can't explain how much of a relief it is to have her back out. I will keep a close eye on her and return her to partial solitary confinement the moment she seems off or something isn't right. For now, she is outside once again.
I am hoping that the lack of optimism re: barefoot stems from a relative lack of understanding of bare hoof care. I have found that a lot of vets don't seem to understand the extent to which a properly trimmed horse can go bare. I would think that allowing the hoof to move and grow and strengthen would be a good thing long term. Fingers crossed tight that she'll be bare again one day!
ReplyDeleteUgh, I am so happy you can wash your hands of that vet. Gah.
ReplyDeleteAnd YES. What a big sigh of relief to see her outside!! Keep us updated!
I'm with Dom and Liz on both counts! I got into a huge HUGE argument with my vet back in FL about keeping Lily barefoot behind, let alone all around! He insisted that low heels, necessary for boots to fit and normal for a long-term barefoot horse, were a bad thing...
ReplyDeleteLooking at how incredibly well that hoof is healing already, I'll reiterate what I had said in conversation with you: I'm willing to bet there is very little scar on the hoof wall. She might grow a vertical ridge of horn down from the coronet band where that blemish is right now, but that is not going to compromise the integrity of the hoof...I think you'll still even be able to get a boot over it just fine! Like I said, I knew and worked with an older Morab mare that must've sustained an injury similar to Gem's in the past. Her heel bulb scar was far uglier than Gem's, and she grew a vertical ridge down her hoof wall at the scar site. The hoof wall was actually *stronger* and thicker in that section. She was a gravel cruncher too: you could ride that mare barefoot anywhere.
So don't give up hope! ;)
And I think her body condition in those photos looks perfect! I wish Lily would grow a mane like Gem's!