Small Improvement

Dr. Meg came today to evaluate Nox's suspensory ligament injury.  Here's a short timeline/description of all of the evaluations so far:

• Oct. 2013 - I noticed that Nox seemed more lame (limping) than usual, and I stopped working him for three weeks, hoping to see some improvement.  No improvement, so I called the vet.
• Nov. 15, 2013 - Dr. Meg came out to evaluate him and diagnosed him with a tear in the right hind suspensory ligament at the origin.  Nox was put on stall rest.
• Jan. 6, 2014 - Small progress but Nox needed to stay on stall rest.
• Mar. 5, 2014 -80% improvement.  We continued modified stall rest with very light lunging at the walk and trot (Nox could not stay calm and he was going crazy in his stall and in the ring)
• Jun. 27, 2014 - Evaluation showed major setback.  Nox's injury was much worse and Dr. Meg recommended stall rest with no work, or moving him to another stall that had a paddock.  I moved Nox to the new barn in July, where he has a larger, more open stall and a small paddock.

This brings us to today.  Dr. Meg watched Nox move at the walk and trot and performed a flexion test.  Nox, as usual, jumped around and bucked through most of the evaluation.  He just gets so excited when he's allowed to do something other than stand around.  He looks just like a Lipizzaner Stallion performing "airs above the ground".  If you've never seen the Royal Lipizzaner Stallions perform, I highly recommend googling videos of the "airs above the ground".  My parents took me to see the Lipizzaner traveling show and it was one of the best nights of my life.  Nox shows natural talent performing the capriole - he would have make a great war horse, apparently.

Anyway!  Dr. Meg noted that he is still sore on the right hind, indicating that the ligament is still injured.  She did an ultrasound so we could see what was actually happening in there.  She gave Nox a sedative and set up the ultrasound.  Everyone gathered to help and observe.

Dr. Meg, Best Husband Ever, Penny, and Robin gathered around the ultrasound machine.

I squatted in the corner, held Nox's head, and whispered sweet nothings in his ear while keeping an eye on the screen.

Nox gets nervous if I move too far from his head while he's sedated.

The ultrasound showed that the original tear has healed a little bit - it's about 1 mm smaller than it was 10 months ago.  There is a second smaller tear that is new - Dr. Meg thinks he may have done that back when he was going crazy on stall rest and may explain why he was so much worse in June.

So, there is a small improvement to the ligament tear and he is healing, but very slowly.  As I expected, Dr. Meg would like to restrict his access to the paddock.  The sand is a bit too deep and he is moving around too much in it.  Since he's so much happier having access outside, she suggested that if the paddock can be modified, we can make the paddock smaller.  He can have just enough room to step outside and turn around.  Penny immediately said that they will make any modifications needed to keep Nox happy.  I'm pleased with the evaluation and encouraged, as is Dr. Meg.  Any improvement, no matter how small, is good news.  We might also try a round of shockwave therapy, which may help speed things along.  The shockwaves irritate the soft tissue and promote healing, but it isn't always as effective on older injuries, but I think it might be worth a try.  

Nox came out of the sedation slowly.  He was still a little drunk and woozy and wanted to lean on me, so I let him.  We stood like this for about 5 minutes, he resting his head on my shoulder, while Dr. Meg wrote her notes and I checked my work emails.
     

   

He was snoring a little.