Taco's Treatment... and mine (thanks Doc!)

I've covered many miles since my last blog post: a conference and visit with family in New England, a trip to Lexington with Taco and Carol, and most recently a trip to Atlanta to pick up a temporary addition to the Team Taco family.

I hated to leave town while Taco was in the acute stage of his injury, but I had committed to a conference for work nearly a year earlier.  So off I went, leaving Taco in the capable hands of Amy, Kate, and Terri.  Amy iced his leg twice a day with a cold pack that we kept in the fridge that Terri generously brought to the barn.  She kept the leg wrapped when it wasn't being iced, and also did (and continues to do!) Taco's extra stall cleanings.  She also met Dr. Tammy Perkins, our rehab specialist who came to treat the tendon with a laser while I was away.  Terri brought an extra little fridge (with a freezer!) for the ice pack, and took Taco on what she calls his "walking picnics" (hand grazing with a good bit of walking) each day.  Kate took him on short hand walks at feeding time late in the day, and also does some of the extra stall cleanings when Amy is away.  It truly takes a village and I was lucky to have these three devoted friends helping us out!

Immediately after I returned last week, Taco, Carol, the dogs, and I climbed into my rig and made the 4.5-hour trip up to Lexington, Kentucky, to the Sport Horse program at Hagyard Equine Medical Institute.  We went for a consultation with Dr. Duncan Peters, the same vet who volunteered at last fall's Midsouth T3D.  Dr. Peters did a brief lameness exam (news flash: Taco was still lame) and then brought him into the climate-controlled procedure room for an ultrasound.  To my dismay, the lesion in Taco's superficial digital flexor tendon was even bigger: almost 30% as opposed to the 5% that it was on Dr. Tony's ultrasound ten days earlier.  Dr. Peters explained that it is quite common for tendon injuries to grow as damage continues after the first insult.  I am very grateful to Amy for icing that tendon twice a day! In better news, he confirmed that there is no damage to the suspensory in that leg, putting my mind to rest.

Dr. Peters then outlined our options, and we decided to treat the tendon in two ways: with Platelet-Rich Plasma and stem cell therapy that will be grown from his bone marrow.  Both of these are in addition to the rest, non-steroidal anti-inflammatory medications,  and controlled exercise that are part of the traditional treatment for a tendon injury.  Dr. Peters extracted some bone marrow from Taco's sternum, a process for which Taco was sedated and given local anaesthetic, and it has been sent off to the laboratory at Cornell to grow the culture.  It will be sent back after a total of 3-4 weeks, and then we will all make the trek back up to Hagyard again so that the treatments can be injected into the injured tendon.  Taco's prognosis is good, according to Dr. Peters, but it will not be until the end of this year or the beginning of 2012 than he will be back in full work. 

Feeling verrrry sleepy for his procedure...

So, in the meantime, Taco is still hand-grazing.  I bought him an Uncle Jimmy's Hangin' Ball, which he consumed in less than a week, and I am trying to keep him to a routine of grooming and walking.  Amy has put up a small pen for him that has grass for now and allows him to spend time outside without being able to run. 

This view is becoming extremely familiar to me

Unfortunately, during the time that I have been working on this blog post, we have encountered a few potholes in to the road to recovery.  First, the skin just above the tendon injury blistered and developed a sore.  It's needed careful wrapping that doesn't put too much pressure on that spot but keeps it protected.  Next, he stepped on a nest of yellowjackets at the end of our evening grazing session yesterday.  He was grazing happily, and then started frantically stomping that left hind... the one with the injury.  I saw an insect flying around that leg and thought it was a bot fly at first.  But then a yellowjacket landed on my arm and I realized what had happened.  We beat a hasty retreat back to the barn, where he stood on three legs and dangled the left hind miserably, barely allowing me to touch it.  And the front of his leg, the side with the three-year-old scarring on it, had a pink raw spot where one of the scars was.  Oy, vey.  Icing and wound cream and oral tri-dex ensued... and several hours later it was clear from the swelling that he'd been stung on the inside of his ankle and possibly on the front of the cannon bone.

We hit the third pothole this morning.  The sting swelling seemed to have gone down, so I was feeling better. We grazed and then I groomed him and led him into his stall.  Now, every pony clubber knows to turn around once she's led a horse into a stall, so that the horse's head points toward the door.  I did not do this.  As is my habit, I led Taco over to his hay corner and removed his halter there.  He then spooked at a white milk jug that I'd placed in his stall as a toy, wheeled, and clattered down the barn aisle and outside.  I had a brief, cruel moment of hope that he would let me catch him when he paused to greet some pastured horses.  But it was not to be, and soon he zoomed to the top of the largest pasture on the farm.  I followed, swearing copiously.  I got within 15-20 feet of him and off he went again, back to the bottom of the field, where I'd had the presence of mind to latch the gate.  One more brief run and then I caught him, to my relief. 

Is the tendon damaged even more than before?  I don't know.  I did not see any additional swelling or feel additional heat.  I did a couple of icings, and Surpassed the whole thing, and wrapped it.  We'll see what we have tomorrow morning, and I will call our vets to let them know about this development and ask whether I should do anything else.  And does anyone have ideas for alleviating stall rest boredom?

All of this has been admittedly stressful, and my usual way of handling stress is to ride.  Since Taco will not be able to be ridden at all for much of this summer, and when he does return to work, he will only be able to walk for at least the first month, I was horseless.  Fortunately, my friends have come to the rescue again with offers of horses to ride.  Eventually it worked out for me to borrow another horse from Annika, Taco's past owner.

Meet Doc.

(sorry about the dust on the lens)

He's a plain bay, ten-year old OTTB (off track Thoroughbred) who is the sweetest soul.  He was temporarily down in Atlanta with Team Taco friend Lynda, and he needed to get back to Michigan, and we all thought it would be wonderful if he stopped off in Tennessee to keep me company for a little while.  He arrived on Wednesday, and so far we've done some easy flatwork and hacking with Terri and Truman.  He is lots of fun.  I'm so grateful to Annika for lending him to me-- he is a bright spot of fun in what have been a few weeks of roller-coaster riding.

The bay boys together again

IEA T3D Part II: Happiness and Heartbreak

Cross-country day was possibly the best cross country experience I've had.

Make no mistake-- I was very nervous.  I worried about keeping track of all of the time on the four phases, although my experience at Hagyard Midsouth last fall was very helpful in that regard. Another thing that I was nervous about, of course, was steeplechase.  Even though I had already done one, I wondered if I could go fast enough again, and whether I could balance properly before the jumps if I did go fast enough.  Oh, and there was the grown-up version of the Pan Am Bank that was on Phase D.  It was a double step down, followed by two strides to a tall brush.  I hadn't jumped anything like that before!

Phase A started with a bang, because just about two minutes out from my start time, a loose Prelim horse came barreling down the road toward us.  Luckily, a passer-by was able to take a gentle hold of Taco's bridle for me, and kept us from wheeling around and bouncing too high in the air as the loose horse passed.  You can't tell on the video, but this really pumped Taco up.  Where we had been a little bit behind on the first two kilometers at Midsouth, we were up on the time this time, thanks to a little extra zing in Taco's step!  We arrived at steeplechase about two minutes ahead, which was perfect.  As I stood there, Mary and some other well-wishers greeted me and reassured me that I was going to have a great time. 

Then we were off!!  We got up to speed by the first turn, and then I began to bring him back slightly with my seat and upper body and wait for the base of the big brush fence.  1...2...3...4 strides and we were over!  It felt great!  A grin broke out on my face.  Same thing for the next two down the other side, and then we were around the first turn again and on our second lap.  Taco was in what I can best describe as "the groove".  He just found the ropes on the inside and galloped like he could hear a metronome.  We met each fence out of stride and what felt like perfect synchrony.  I can't think of a more pleasurable experience that I've had on the back of a horse.  It was all over too soon and we loped off the track, triumphant.


Carol checked for all four shoes and we were off on Phase C.  Because of the heat, the officials had put a mandatory ten-minute hold (which was different from the 10-minute box before D), about halfway through Phase C.  Carol and a friend, Lynn, met us there with water for both of us and a bath for Taco.  Then we continued on through the rest of C to the real 10-minute box.  Carol, Mary, and Pam, another friend, were a splendid pit crew.  Morley, the volunteer who was my timer, kept us on track.  I took of my helmet, had a drink, and went over the Phase D plan with Mary.  She warned me that Taco was now used to jumping out of a bigger stride and that I would have to be quite assertive about asking him to come back on cross country.  Then we trotted to the start box, the starter counted us down, and we were off!

He felt great out of the box, looking for the fences and up in the bridle.  The paths at the Hoosier Horse Park can be quite twisty and turny, and I worried about hitting trees.  But Mary had reminded me that it is Taco's job to avoid trees, and my job to tell him where I wanted to go.  When I jumped the third fence, a brush right before a 90-degree right turn into a path, Taco simply followed my eye and glided through the turn, and I knew we were on the same page.  We bounded up the Pan Am Bank and skipped off the two drops and over the brush.  That was easy!  Over a palisade, through the coffin, then a long gallop to the trakehner and the water, a down bank in with a bending line after the bank out.  Another long gallop to a three stride line, a cabin to a corner, nestled into the tree line, and then a series of four gallop fences down the long stretch of prairie.  This is where Taco got a little bit cheeky and decided that we didn't have to slow down.  But he was more respectful after he found himself having to put in a short quick one at a rolltop! He became easier to rate after that.  Through another S-curve that I just steered him through with my eyes, over a maximum two-stride combination, over another couple of rolltops, and we were home!  We had made the time (actually, I was surprised to see that we were 35 seconds fast), and he had been as game as I have ever felt him.  What a horse!  What a ride!

Here is a video montage of a few moments that Carol was able to get on video.  It's the start of A, me galloping by on B, and the first fence of D.



Then it was back to the D box, which was the same as the 10-minute box, where we swing into action cooling Taco down.  He was released back to the barn on his first recheck, and Carol walked him back while Mary ran me and our equipment back in her Mule.


Taco relaxing in the D Box (links to photos by Amy Lopez)

Cooling off

Carol headed home with the champion

We washed him when we got back to the stall, iced his legs, and then let him take a well-deserved nap under his fan.

We were double clear, and had hung on to first place.

After a few hours of quiet time, I pulled Taco out of his stall and we went for a walk.  We ran into a fellow competitor, and I asked her to watch him jog.  I could hear some unevenness in his gait, and she said he looked a little stiff.  Hmmm.  No obvious swelling anywhere, or soreness when I palpated his back and hindquarters, which might have indicated hock soreness.  I decided to proceed as if his hocks and feet might be sore since the ground had been a little hard.  I poulticed all four legs, packed his front feet with Magic Cushion, and re-iced his hocks a couple of times, plus administered a gram of bute (legal under USEF rules).  I went to bed, hoping that some rest and the various treatments would find him feeling well in the morning.

I iced his feet and hocks while he ate his breakfast the next morning, and then put him on the lunge line.  He looked OK, I thought.  After some thought and consultations with people I trusted, I decided to present him at the jog.  I strongly suspected I was dealing with mild stiffness from arthritis.  When I did jog, the ground jury held us for reinspection.  The treating veterinarian, Scott Thompson of Jannsen Veterinary Clinic in Sheridan, Indiana, conducted a short exam, and this is where everything changed.  Scott palpated his left hind tendons and zeroed in on a spot just below his hock.  Taco has had a small thickening there for as long as I can remember, and because it was familiar, I had not probed it further.  Now Scott was getting a reaction that most definitely was different from the one he got when he palpated the right leg.  Also, a low flexion test made Taco more lame, but one that flexed the hock made no change.  After he finished his exam, Scott looked me in the eye and told me that he thought Taco had sustained some kind of injury that would likely be harmed by proceeding on to the show jumping.

My choice was clear.  I informed the ground jury that I was withdrawing. I was incredibly disappointed and worried about the injury, and upset that I had missed it myself, but very glad to have such a proficient veterinarian give me his honest opinion.  Knowing what I know now, Scott's and the ground jury's astute assessments prevented me from making the injury worse and ensured that I got immediate treatment for it.  I walked Taco back to his stall, where one of the veterinary delegates, Lani Gilliam, immediately treated him with a laser.  Then we iced the leg and Scott applied a gelcast for the trailer ride home.

I must say that everyone at the competition was incredibly supportive.  The T3D and N3D organizer, Lee Ann Zobbe, stayed with me during Scott's exam and gave me a hug when I had to withdraw. Another veterinary delegate, Katy Ivester, sought me out once we were back at the stall and hugged me, too.  The other competitors, from four-star veterans to fellow ammy riders, were very sympathetic.  And I was beyond honored to receive the Five Star Tack Sportsmanship Award, a gorgeous leather halter, at the T3D awards ceremony.  I literally was rendered speechless when they announced my name.  Taco also won the OTTB Dressage award from Friends of Ferdinand, of which I was very proud.

We got back to Taco's barn early that evening, but his trailer travel was to continue the next day.  We hauled up to our local clinic for an ultrasound around lunchtime on Monday.  Tony Kimmons, our wonderful vet, unwrapped the big wrap and gelcast to reveal a more swollen tendon.  Now it truly looked like something was wrong.  Flexion tests revealed no real change from baseline, so he moved on quickly to the ultrasound.  As he scanned, the suspensory and Deep Digital Flexor Tendon looked fine, thankfully.  But there was a 4mm core lesion in his Superficial Digital Flexor Tendon, about 5% of the total area of a cross section.  This injury has a relatively good prognosis, but it still means 4-8 weeks of stall rest, followed by a rehab that will last until at least November.

So our season is over, but Taco should return to competition next year.  Right now he is getting iced and receiving NSAIDs, and hand-walking with a wonderful team of friends at Panther Springs Farm while I am traveling to a conference and visiting family.  Next week, we'll make a trip to Hagyard in Lexington, Kentucky for a consultation about any further treatment options that might make sense.  Annika, Taco's old owner, is sending us a laser to use.  And we have a local veterinarian who specializes in equine rehab, Tammy Perkins, working with us.

I mused out loud the other day, "sometimes the good that comes out of a bad situation is that you realize just how many people care."  The more I think about this, the more I believe it to be true.  It was heartbreaking to withdraw from the competition, and to learn that my horse had a season-ending injury.  But the caring from friends has been heartwarming.  Thank you all, from Taco, Carol, and me.

The highlight of Taco's day, twice a day (photo by Kate Watkins)

Indiana Training Three Day: The Beauty and Sorrows of Eventing

Fans of blues music will tell you that its brilliance lies in a musician's ability to hold love and sorrow-- both the bitterness and the sweetness of life-- together in the same place.  Fans of eventing will tell you the same thing.  The sport gives you the best feeling imaginable, and can also bring great emotional pain, sometimes simultaneously.  This is exactly my experience this past weekend in Indiana.

For those who want the short version:  Taco was perfect all weekend, and for once I feel good about how I rode.  We had a nice dressage test that scored well (26.3) and put us in the lead of the division, and we maintained the lead through a wonderful cross-country day that I will never forget.  Heartbreakingly, Taco got injured, most likely on Phase D, and we had to withdraw at the final jog.  As of this writing, we have not yet completed the diagnostics to know exactly what happened, but I should know more by the end of the day.  Meanwhile, Taco is comfy and safe in his stall at home.  He is a winner to me, and the real prize of the weekend was the seamless sense of partnership that I experienced with him. 

For a more detailed version, read on:

We left Panther Springs Farm on Wednesday morning, with a great sense of anticipation and adventure.  Carol rode shotgun and the two dogs had the luxurious crew cab back seat all to themselves.  All went smoothly except we hit some traffic near Cave City, Kentucky, and then I closed my left index finger in the truck door when we stopped for lunch south of Louisville.  Ah, the intelligence and coordination of eventers!  (Well, at least this one.)  The upside to the physical pain of this mistake was that I was spared the emotional pain of braiding all weekend.  I was forced to hire two braiders, both of whom did a great job.

We rolled in to the Hoosier Horse Park and got Taco nicely settled in and ready for the activities of the next day, Thursday.  The educational component of the 3D (three-day) started with a briefing by the officials over lunch, followed by a tour of Phases A through C (Roads and Tracks and Steeplechase) by one of the volunteer clinicians, Melissa Miller.  Then it was back to the barns to primp for the first jog.  I must say, Taco looked great.  He has been building muscle and his coat is glossy, thanks to the Pennfields Fibregized Omega that he has been eating and the APF herbs I have been giving him.  Carol helped me shine him and his bridle up, and then we were ready! I was so proud to lead him down the jog lane.

We were accepted and moved on to the dressage.  I wasn't able to bring Amy to Indiana with me to coach, but I was extremely lucky to have Mary Fike fill in.  Those of you who know Mary know that she is truly an encyclopedia of eventing knowledge, and I also found out that she's great at sports psychology too.  Even though she wasn't familiar with Taco and my riding, she had some very helpful pointers as we got ready for our test.  And then we went in!  Taco felt fantastic.  He wanted to show off, it seemed, and he gave his all to responding to my aids brilliantly.  Our practice really paid off and we put in an accurate and energetic test. 

I think that went Ok!

 
Next was the steeplechase school, which I really needed, it turned out!  As at Hagyard Midsouth last fall, veteran 4-star eventer Dorothy Crowell was our clinician.  She is a huge supporter of the classic format and, with Melissa and Cathy Wieschhoff, was generous enough to donate her time to us.  She had us practice moving from a gallop to a preparation position several times, and then had us gallop to a triple bar, which mimics the shape of a steeplechase fence.  These first exercises went well for me (especially after I made a bigger effort to get OUT of the saddle at the gallop and then SIT in it on the approaches).  Then we were to jump the triple bar again and move on to the practice steeplechase fence.  This is where I had some trouble.  First, I made too short a turn to the triple bar, and never had the right pace.  After I fixed that mistake, I proceeded to jump ahead of Taco at the practice steeplechase fence.  Dorothy helped me fix that, too, and then she was satisfied we were ready to go.

Ready for steeplechase school (practice fence in the background)

I had already walked the Phase D (cross country) course twice by myself.  I was impressed.  It was truly a championship-level course, with five combinations, which was one more than the AECs had had last fall. It was also in the somewhat twisty-turny terrain of the Hoosier Horse Park, with a variety of wooded paths and open meadows, and it was to be run a maximum Training speed, 470 mpm.  Mary and I walked it again, and she helped me puzzle out the questions.  One of the most helpful things that she did was reminding me to be assertive with Taco.  Yes, he knows his job, and he knows it well, but he must take his directions on pace, line, and balance from me.  She showed me places where I would need to make my instructions loud and clear, and places where I could let him work out what he needed to do.  I felt much more confident after our walk, and ready for the next day.  Another quick bike ride around phases A through C, and it was off to bed to rest up for the Endurance Day.

To be continued...