Monday, November 28, 2022

bridging the gap

Charlie had a check-in lameness evaluation with his longtime vet this past week. It's not our normal time of year for maintenance, but... As you may know already, Charlie's had what I'd characterize as intermittent hoof soreness for roughly 7-8wks at this point. 

gotta feed the meter!
I'm grateful to my vet for MANY reasons.... But chief among them are her practicality, availability, and general commitment to keeping Charlie feeling his absolute best and most capable for my goals as a rider, modest tho they may be. 

random flashback to the Maryland 5* for #ManCrushMonday lol
So this was kinda an interesting visit for us. Basically ended up being more or less an in-person consult. Sure, I jogged Charlie a bit for her, and she did some palpations and evaluations... But more than anything, we reviewed his history in conjunction with his current clinical presentation (which was, to be specific, basically sound). 

From this, my vet laid out her recommended plan of action. The working hypothesis is that.... Multiple mild systemic issues are happening all at once, compounding each other. 

First up... We suspect that the month off Charlie earned after getting caught up in wire fence contributed to overall loss in conditioning and musculature, which then contributed to Charlie's hocks losing the support and protection normally afforded by his fitness. 

another flashback to October, this time from Charlie's last appt with his #1 favorite wellness practitioner. god he loves her haha
So... He's getting a little hock-y sooner than we'd like (reminder: he received his last scheduled maintenance in March). This hind end weakness also contributes to the little bit of back soreness we saw prior to his last acupuncture / chiro treatment. 

Meanwhile, the weakened hind end results in Charlie traveling even more on the forehand than he's already inclined to do -- thus amplifying any front end hoof soreness. 

To be completely honest, I was already thinking about repeating the coffin injections we did back in 2019. Quick backstory: back then, we were pushing hot and heavy for a training level move up, come hell or high water. Along the way, I learned some hard lessons about the realities of conditioning a giant thoroughbred on hard ground, womp, thus the injections.

acupuncture needles all over his fence-caught RH leg (see the scars??)
Since then I've been way more careful about managing Charlie relative to ground conditions and hoof care. And it's worked, ya know? But he's a big body on very-slightly-too-small feet, and there's only so much I can do to protect him from drought-hardened ground and stomping at biting flies throughout summer. 

Actually, before his "tangle with tensile," I was pretty much ready to pull the trigger again. But then hoped that maybe the time off would do the trick instead.... 

Lately, tho, we've just been a little too inconsistent for my (and Charlie's!) comfort. When Charlie feels good, he feels really good. Soft swinging back, happy to be round and pushing. Forward to the jumps. All the things. But when he doesn't feel good... He's cranky about it, and very reluctant to move out. Iffy at the walk, and pretty fucking lame at trot. 

marinating while his barnmate gets treated
Upon first consulting with the vet a little over a month ago, she suggested a few weeks of rest plus 5 days of Bute. We did that, and he seemed better, but then right back to the on/off situation. 

Vet believes this is likely still reflecting an arthritic complaint with his feet, vs anything soft tissue etc. But she's not quite ready to pull the trigger yet on coffin injections either. 

mikey the manager was snoopervising, as always!
Her plan is to "bridge the gap" to bring his whole system back into better balance again: 

1) Start him on Firocoxib (generic of Equioxx) for about 2 months. He's still younger than she'd like to recommend it as a permanent daily Rx, but she thinks it's worth trying it to help him out right now. We'll do ~2mos and reassess at that time.

2) Let the NSAIDs do their thing for the next 2wks, while also striving to get more consistent under saddle to improve his musculature (to better support his joints). This means... Instead of giving him 4 days off or whatever every time he trots up sore, take it on a day to day basis. As in, the soreness may be more transitory than I've been treating it. So if he's sound up front, work him out (focusing on strength and muscling). If he's not sound, so be it.

3) At some point in the near future when he has a more compelling clinical presentation for intervention, we'll do a full workup with flexions etc, and likely do his coffins again. Ideally I'll be able to choose a nasty stretch of weather to minimize guilt for the resulting stall rest. 

a lot of folks swear by their previcox or equioxx. we shall see how charlie likes it!
4) All of this should be wayyyy more than sufficient to keep Charlie cruising along happily thru the winter, plenty comfortable for indoor jumper shows, dressage tests, and even some xc schooling (perhaps in the arenas at Loch Moy?) if conditions allow. 

5) He'll also get another acupuncture / chiro session sometime early in the new year. 

6) Ideally we'll get closer to a full 12mos for his hocks, but nbd if it has to be sooner this year. We can live with it lol. We already know he'll tell us when he's ready, so it's just my job to listen. 

whatever it takes to keep charlie hummin along!
So. That's the plan, in a nutshell. Not gonna lie, it's a little hard to write this so publicly bc I can imagine all sorts of judgement about the medical interventions I deploy to ensure my horse is happy in his job. Why not just step down his work? Is that fair to the horse? 

But... Eh, I'm honestly pretty confident in this care plan. While I still have LOADS to learn in the management of a horse across his full life, I feel really confident and secure in my relationship with Charlie, and understanding how he feels in the work. 

imo he lives a good life
And if that little birthday xc ride was any indication, Charlie is a HAPPY HORSE out galloping around and jumping bigger jumps. And I'm more than willing to give him what he needs to stay happy. 

While all the rest he's had this year has maybe contributed to less happy arthritis, there has been some benefit. Namely: Charlie's muscles AND mentality feel fresh. When he feels good? He feels GOOD. And fresh Charlie is my absolute favorite Charlie lol. So we'll take it, and work the margins, as always. 




19 comments:

  1. No judgement here! I'm glad we have these medical interventions available to us. Your vet sounds awesome!!!

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    1. dude i seriously appreciate this vet. charlie is not necessarily the easiest case bc... homeboy has physical issues. but she's really zen and realistic about his "normal" while staying committed to his best interests and comfort in the work.

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  2. Hey Emma - I'm a longtime reader but super infrequent commenter. I also own a huge TB with chronic medical stuff (ours are worse than Charlie's, but all to say, I can relate.) I've had to rehab my guy from acute injury/illness many times, and it's such a hard balance to put the muscle back on while not feeling cruel for forcing them to work through some degree of discomfort (which is exacerbated by the lack of muscling...sigh.) What has worked for us is TONS of work in the walk in order to build topline/hind muscle back up, so by the time the primary complaint is resolved, the undermuscled wonkiness is also minimized. We do tons of walk lateral work, walk rails, and generally concentrating on roundness/connection in walk to achieve this. Just an anecdote for you to consider while you execute your excellent plan!

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    1. thanks Liz - yea i don't actually post much about my fitness plans with the horse anymore bc somebody always reminds me of the importance of walking and hillwork. which... i promise, the horse walks and the horse does hills! lots and lots and lots and lots.... lol. to the point that.... probably should just be assumed as a given, rather than advice. plus he's turned out for 12hrs a day on.... you guessed it, gigantic hilly pasture. rest assured, if charlie's complaints could be resolved by walking, he'd have no complaints whatsoever!

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  3. I think you'd be hard pressed to find an OTTB that doesn't just sit out in a field who doesn't need some sort of maintenance schedule lol. Fwiw we have multiple horses at my barn on equioxx for various reasons, and they've all been able to go from the daily 2mo loading dose to every other day with the same super results, so that might be something to discuss with your vet!

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    1. that's good to know about the equioxx dosage. my vet's biggest complaint about the drug is that it apparently has highly varying responses from horses -- and that it can be hard to predict how well it'll work. for whatever reason, i'm inclined to think it'll work well for charlie bc he's a friggin junkie (lol), but we shall see !!

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  4. My man crush, with his man crush lol

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    1. LOL better late than never, amirite??? ;)

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    2. I'm just glad its not framed on our mantle...yet...

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    3. i mean.... that can be arranged LOL

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  5. No judgement. I am sure some people wondered why Irish was still being ridden in his last year but, TBH, he was happier being ridden than not. You have done a lot to keep him going and I think it's great.

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    1. honestly i think a lot of these horses just like the attention and like being part of the action. even when charlie was recovering from surgery and unable to really do anything, he still loved hangin out in the arena while his friends did a lesson <3

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  6. Am I correct in assuming that Charlie is 13 going on 14 years of age? And that he made 33 starts over 5 years? That's a fairly robust body of work before becoming a sport horse. I don't feel like the level of maintenance stated is out of line with his age/history/size. There are certainly a lot of hunter/jumper WBs out there that are getting a lot more maintenance than that at comparable ages.

    I definitely have been in the situation where letting a larger teenaged horse get unfit has resulted in overall systemic yuck. Believe it or not, it's worse with WBs/cold blooded horses.

    I really liked using my equicore to help support getting the whole system (back/hindend) engaged, while doing low impact work. I'd be happy to lend it to you for the cost of shipping. Although I'm sure they make decent knockoffs by now!

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    1. omgggg he IS turning 14 this year, arghhhh i've only just come to terms with him being 13, christalmighty charlie stahhhhp aging :'(

      ugh, ahem, cough cough... anywayssss. yes. lengthy career on the track, not-insignificant history of injuries.... he's a high mileage model who is a bit "older" than his age, unfortunately. so far i've been able to stay in front of a lot of his "normal" issues... but each passing year brings new challenges. siiigh.

      re: the equicore, i enjoyed resistance band training sessions for myself, tho legit wonder whether charlie would tolerate it. we have one floating around the barn tho so maybe i'll try it out? we shall see!!!

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    2. Worth trying. I have used it on a number of horses. Horses are remarkably tolerant of it. I have never had one react negatively to it.

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  7. I appreciate your openness. I've got similar going on with Bridget (same age as Charlie) and stepping down the workload worked for her, until this fall. Like you I'm trying to balance a need for keeping her fit to stay physically strong and mentally healthy, with the need to keep her sound enough to do so happily! Similar wins and setbacks. Your positive results and management have made me much less anxious about embracing some further veterinary intervention.

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    1. so....... i know B and Charlie have a completely different physical profile / history / special needs / etc..... but it feels really important to share: he's been on that firocoxib (generic equioxx) for all of 5 days and he is a DIFFERENT HORSE omg. i seriously never expected just a pill to make such an enormous difference, vs something much more invasive like an injection... but here we are!

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  8. Dude. No one should be judging you or your horse care choices. You're working with a vet and doing all the right things. Horses like having jobs. Sometimes they need a little medical intervention to make the job easier. There's nothing wrong with that.
    I hope the meds do the trick! I've had great results using equioxx on several horses. Shiny is on it now, and she's only 9. Every horse is different, and some age a bit faster than others. She's a lot smaller than Charlie (lol) but they seem so similar in a lot of ways! When she's feeling good, she feels amazing. And when she doesn't feel good... sheesh.

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  9. I will share that I have arthritis (in my foot). And it is difficult for me to manage in my own body. My experience is that how my affected joint feels on any given day is quite variable. I constantly play with the combination of rest/exercise/icing/topical over-the-counter meds and NSAID's to try to manage my pain. I will add that weather changes also affect my arthritic joint. Humidity and rain will lead my foot to feel a lot more tender. So does the weather when it gets below freezing. I now think I understand why horses might be on-again-off again when they also have arthritis, assuming they might be experiencing issues in a similar manner. As I watched my oldest horse, Bear, deal with arthritis, my impressions were confirmed that he also experienced pain in a variable way and needed me to constantly monitor and intervene in different ways to try to keep him comfortable. At one point, he started to drag a hind leg after getting up from laying down, and my vet recommended Equioxx. He stayed on it for five years until his death recently at age 27. Interestingly, I never saw him drag that hind leg again, although I did still do different things to try to keep him comfortable on days when he seemed a bit stiff overall (I imagine over time that if I had his entire body x-rayed, the vet would have found arthritis in more joints than just his hind leg). Very long story short, I hope that the Fibrocox and all the other interventions you obviously thoughtfully employ continue to help Charlie live his best life with you. I definitely find a multi-modal approach to be most helpful with managing a chronic disease like arthritis.

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