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.

Showing off

I'm mentally preparing myself for the inevitable stall rest recommendation that I'm 99.9% sure will be coming on Wednesday.  I'm noticing that Nox is spending much of his time standing in his stall anyway, since he likes to play with his neighbors and escape the flies, so I'm really hoping he won't mind being closed off from his paddock.  It also appears that Nox and his neighbors are starting band.  Nox is learning to play the chain (video by Best Husband Ever):

In the meantime, while Nox continues his recovery and band practice, I have plenty of horses to ride at the new barn.  A grey mare named Ellie has recovered from an injury and illness and she's ready to be worked again, so I've been lunging her and will start riding her today (weather depending - it's raining as I type).  Another boarder has offered her horse for me to ride, as she wants him to get more exercise.  I'm also still working with Baya, who is for sale.  Baya is a very special horse and Penny wants her to go to a very good home, so she is priced high.  She has so much potential, she is easy to ride and handle, and she performed so well at her first show this past summer.  There was a professional photographer at the show and he took some great pictures of Baya and I:

This is my favorite photo.  I love the tail swish.

He decided he was done with the therapeutic shoe phase of recovery...

Look at those pretty gold dapples!

Nox looks good, doesn't he?  He's healthy and happy, he hasn't had a nosebleed in a month (he had 3 total, still no idea why), and he's a pleasure to be around.

He's also torn off two of his four shoes in the past week.  Nox needed a lift pad on his right hind leg to ease the pressure on his torn suspensory ligament, and to make sure he was balanced, he had lift pads on both hind hooves.  He also had shoes on the front for support.  Well, he stepped on the right hind shoe and tore it off, along with most of the hoof wall.  My farrier couldn't put the shoe back on because there wasn't enough hoof wall to nail it to, so I had him take off the other hind shoe (no point wearing it if the injured leg doesn't have one).  Two days later he stepped on the left front shoe and tore that off, so I had the farrier remove the other front shoe.  Now he's barefoot.

Nox has his lameness evaluation next week Wednesday.  I've already told Dr. Meg that he's barefoot and she was a little concerned.  It's almost been a year since he was diagnosed with the injury, and when I walked him around the ring today (just a short slow walk), he was still limping.  I didn't even need to trot him to see that he is still off.  Dr. Meg is going to do an ultrasound this time and look at the ligament - is it healing?  Did it heal wrong?  What the heck is going on?!?  It can take a VERY long time for these types of injuries to heal - a year is typical and more than a year is not uncommon - but I'm not seeing any improvement.  It could be that the paddock, while good for Nox's mental health, is not good for his ligament tear.  I'm guessing... speculating... expecting... that the vet will want him back on stall rest.  I'm hoping that stall rest in his new stall won't be as dramatic as stall rest in the old place.  In this stall, Nox can hang his head out into the barn aisle and play with his neighbors and the various barn critters.  He can also hang his head out the other door and look outside.  Hopefully, if he must go back on strict rest, this stimulation will keep him from going crazy.

I'll keep everyone posted and wish us luck at our vet appointment!  For now, enjoy these lovely early fall pictures...

Seriously, how does he have this much muscle after 11 months of stall rest?

Nox has a pet cat named Hutch.  She hangs out on his paddock fence and stall door, and she likes it when he nibbles her neck and back.

 

They are adorable together.

Recovery and Relaxation

Nox is doing well after his health scare.  Penny is always out and about doing work on her farm, so she passes his paddock and checks on him constantly.  She sent me this adorable photo of him napping in the shade the next morning after he returned from Cornell.  Poor boy must have been exhausted. 

Nox was even snoring a little!

Penny has also noticed that he's drinking more water than usual - she fills his bucket 5-6 times a day, whereas before the trip to Cornell, he was drinking 3 buckets.  The sedatives he was given make him sweat profusely, so we think he's a bit dehydrated and upping his water intake.
 
He hasn't had any more nosebleeds this week, so hopefully we're finished with that particular drama.  The coffin bone fracture and torn ligament are much easier to deal with emotionally - the emergency events are so frightening.  I've been through horse emergencies before, but this was the first time it happened to MY horse.

In any case, Nox is healthy and I'm spending plenty of time with him this week, since I'm off work.  Best Husband Ever has been coming with me and took the silly photo below: 

Cheese!

      

Update on Nox

Nox is home.  After 24 very scary hours, we have a diagnosis: nothing.  The radiographs yesterday morning were examined by several veterinarians and radiologists, including a sinus/nasal/throat specialist and they didn't find any masses, tumors, or anything suspicious.  To be sure they weren't missing anything, Dr. Hill and her team scoped his nasal passage and throat again.

The good news is they can't find anything that would cause a nosebleed and there is nothing life threatening going on in Nox's head.  The frustrating news is they can't find anything to fix.  Dr. Hill said that the next step, if they had found something suspicious in the radiographs, would be to put Nox under general anesthesia and perform CT scans.  However, since they haven't found anything worrisome, the risks of putting Nox under anesthesia are too high to warrant that step.  I agree.  Horses as a species are very risky to anesthetize - their huge body mass makes it difficult for them to lie on one side for too long without injuring organs, tissue, and bone; and the awakening process is fraught with hazards, as the sedated, confused horse attempts to stand up.  Some horses develop colic days later and can become very sick.  Sometimes anesthesia is unavoidable and the vets must weigh the risks with saving a horse's life.  Since we have ruled out all life-threatening issues with Nox, Dr. Hill doesn't want to take these chances.

So, at this point, Dr. Hill has to guess that he might have bumped his head just right to rupture some blood vessels in his nose.  It happens.  My Dad theorized that maybe Agnes the Goat head-butted him while they were sharing grain.  It's possible, Agnes does love to play the head-butt game.  He also likes to play "nip the nose" with his neighbor Ellie over the stall doors.  Maybe he got too excited and banged his nose.  He is a klutz.  Who knows?

I'm grateful that there is nothing seriously wrong with him.  I can't express how terrified I was on Sunday, thinking he might have Guttural Pouch Mycosis and I was going to lose him.  It brings tears to my eyes now, reliving that fear.  I haven't had enough time with Nox; I'm not ready for him to go.  But, a small part of me wishes I had a concrete explanation and something to fix, but... it is what it is.  Dr. Hill told me that if he has another nosebleed in the near future, I can give her a call, but it won't need to be treated as an emergency (unless the bleeding won't stop after 20 minutes or so), since we've ruled out the fatal conditions.  It takes months for horses to develop the damaging fungus that causes Guttural Pouch Mycosis, and we've seen that his guttural pouch is clean and clear.  However, if he has another major nosebleed next year, we might have to do all this again.  In the meantime, I can hold his head at shoulder height, wait for the bleeding to stop, and wipe his nose.  There's not much that one can do for a horse nosebleed.  Hopefully, he won't have another one.

The other positive outcome of this whole experience is the horse trailer.  When Penny, Best Husband Ever, and I arrived at the hospital yesterday to pick up Nox, he nickered as soon as he saw us.  He looked so happy that we were there.  Dr. Hill gave the technician a syringe with a sedative in it, because he needed to be sedated to get on the trailer to come down.  She asked me if I wanted to try to load him without the sedative first, and I said, "Sure, why not?", but I didn't have much hope that he would load.  I hooked up his lead rope and walked him out of the hospital and into the parking lot.  Penny opened the trailer door, I walked Nox up, and he just stepped into the trailer like it was no big deal!!  We were all so shocked that nobody said a word for about 5 seconds.  I could not believe he just did that!  I patted his neck, told him what a good boy he was, and tied him up.  My guess (and I realize that I anthropomorphize a little too much) is that he did not want to stay another minute at the place where they kept sticking things up his nose and when he saw me, he realized that he could go home to his paddock, grain, and sunshine - so he just stepped into the trailer because it was the easy path to freedom.  No more pricks and prods, just get me home!

So, Nox loads into trailers now.  That was an expensive trailer loading lesson.  Silver linings.      

Vacation to Staycation

As I write this, I am supposed to be sitting on a plane somewhere over Ohio on my way to visit my sister for a week of relaxation and auntie/niece bonding time in Santa Cruz, California.  Our plans have changed.  Horses often have impeccable timing.

Yesterday, just before noon, Penny called me and said that Nox was having a terrible nosebleed.  She told me that his stall was covered in blood and it was pooling at his feet in the paddock.  I abandoned my suitcase packing, asked her to call the vet, and jumped in the car to head over.  By the time I arrived at the barn, the bleeding has slowed and Penny had spoken to our local vet, who recommended that we call the Cornell University Equine Hospital.  I talked to a vet at Cornell named Dr. Hill and she recommended that we get Nox on a trailer and get him to the hospital as soon as possible.  Penny already had the trailer hooked up to the truck.

Nosebleeds in horses are a symptom of a couple of different conditions.  One is very serious and fatal, called Guttural Pouch Mycosis.  This is where the horse develops a fungal infection in the guttural pouch, which contains arteries and nerves, and the fungus erodes the arterial wall and causes bleeding.  Sometimes the horse has a few minor nosebleeds before the artery is completely eroded and the horse eventually has a catastrophic nosebleed and essentially bleeds out and dies.  The only way to know if a horse has this condition is to put a scope up their nose and into their guttural pouch to see if there is an infection. 

A screen shot of my frantic Google search for Guttural Pouch Mycosis. 

Nox, as I recently related in the post about moving him to Penny's barn, refuses to get into trailers these days.  I asked my local vet to come sedate Nox so we could hopefully get him into the trailer.  As she was injecting the sedative, she told me that a few months ago, another one of her clients ignored a nosebleed and her horse ended up having a catastrophic nosebleed a few days later and died on the trailer on the way to Cornell.  This may be a rare condition, but it does happen.  I tried to stay out of panic mode as Nox slid into a drugged state and I hoped we could get him on the trailer quickly.  After a few minutes of tugging, pushing, and pulling, Nox drunkenly stumbled onto the trailer.  Best Husband Ever was able to get the day off at the last minute and he accompanied us on the 2 1/2 hour drive to Cornell, driving my car while I rode in the truck with Penny.

Dr. Hill and a whole team of veterinary students met us at the door to the state-of-the-art hospital.  The facility is amazing and the staff are so incredibly nice.  The floors are all covered with rubber flooring, but the flooring changes colors from room to room.  Nox did not want to step on the different colored flooring and I ended up having to back him into various rooms and hallways, even after he was sedated again.  He is so stubborn.  We weighed him first and he weighs 1,325 lbs!  I had always guessed 1,200 lbs... he's a big horse.  Dr. Hill and her team scoped Nox's guttural pouch and to everyone's extreme relief, everything looked clear and normal.  Nox did not have a guttural pouch infection.

However, we are not out of the woods yet.  He was bleeding heavily and there are other conditions, though not as life threatening, that cause nosebleeds.  Nox is scheduled for radiographs this morning to see if there are any masses or tumors in his sinus cavity that may be hemorrhaging.  These masses and tumors are treatable through minimally invasive procedures.  I'm waiting now for a phone call to see what Dr. Hill has found and what our next steps will be for treatment.

I canceled our vacation to California.  I'm not sure how long Nox will be at the hospital and what kind of decisions I'll need to make over the next couple of days, and so I had to stay close.  We were able to get credit for our next booked flights, so all is not lost, but I'm terribly disappointed to miss seeing my sister, her husband, and my beautiful niece.  Best Husband Ever and I are scheduled for another trip to California in November for a family wedding, and now we are looking forward to that trip even more.

I will keep everyone updated on Nox's progress and in the meantime, please think positive thoughts for him and throw out some good vibes for his speedy recovery.    

   

Show Time!

Yesterday, I rode in a horse show!  Since Nox is still on rest, my friend (and owner of the new barn we're boarding at) Penny has graciously let me ride one of her horses for fun and for lessons.  Baya is a 4 year old warmblood mare (warmblood means she's part draft horse/part Thoroughbred) who Penny rescued a few months ago.  Back then, Baya was thin, sick, and recovering from having twins too young.  She was in need of some love, attention, and exercise.  Now, she's cute as a button and an absolute joy to ride.  We only started jumping her about 6 weeks ago, and she's a natural.  Penny and my trainer Beth suggested that I show her at the next horse show and after a week of mulling it over, I agreed.

I haven't shown a horse in 14 years.  I remember always being so nervous and feeling enormous pressure to do well for the horse's sake.  That nervousness always transferred to the horse I was riding and I never placed very well.  In fact, the last time I rode in a show class, the horse and I were so out of control that the judge actually had to jump out of our way to avoid being run over.  Needless to say, we came in dead last - I'm pretty sure the judge muttered something about the ring gate hitting us on the ass on the way out.

Over the years since, I lost interest in showing.  I didn't really have any opportunities to show anyway.  I was moving around the country, galloping through sage brush in Wyoming, and riding friend's horses sporadically when I had the chance.  It wasn't until I adopted Nox that I started thinking about horse shows, but I wasn't convinced that I'd have fun doing it again.

Through all the moves (I've lived in 5 states since graduating college), I kept two things with me: my riding dress boots and my stock pin.  My mom bought the boots for me with I was 14.  They fit perfectly and made me feel like a real rider.  I've kept them with me because classic riding boots never go out of style and I always thought I'd wear them with jeans or something.  It turns out that my 14 year old calves were much slimmer than my twenty and thirty something calves and I could never wear them with jeans - but I kept them anyway because just looking at them made me me feel like that 14 year old rider who felt special in her boots.  The stock pin was also a gift from Mom.  I've kept that with me for the same reason - it's a nice memento from my horse days that made me feel better about not having horses to ride.   Who knew that 14 years later, I'd be able to wear them in a horse show once again?

When I decided to show Baya, I pulled my boots out of the closet and my pin out of the jewelery box.  They both needed a good cleaning and shine.  Best Husband Ever offered to do a Marine Corps spit shine on my boots.   They came out perfect and wearing slim riding breeches, I was miraculously able to put them on!  I bought a second-hand show coat, a pair of breeches, gloves, and a show shirt, and I was all set.

Baya has never been in a show before and she's very young, and after my long hiatus from the ring, I went in to the show with no expectations.  My only goal was to stay on my horse, get her over the jumps, and have a good time.  I just smiled and rode for fun.  Once I saw that Baya was calm and responsive, any trace of nerves I had disappeared.  Baya and I placed 2nd in a jumping class - her first show and she earned 2nd!  Best Husband Ever and our barn buddies cheered wildly and clapped when our number and names were called and I couldn't have been prouder of this sweet little horse.

2nd place!

By the end of day, Baya and I earned 6 ribbons - mostly fourth and sixth places, but we beat a few people in most of our classes and frankly, I was just ecstatic to be out there.  I had so much fun and Baya performed beautifully.  We have a few things to work on before the next show in a few weeks - jumping over flowers boxes (she was a little worried about the flowers and hesitated a bit), picking up the right lead at the canter (I had to correct her a few times), and I need to make sure I keep my eyes up and shoulders back.  All in all, it was a great day! 

Best Husband Ever cheered us on and buffed my boots between classes (he really is the best). I received lots of compliments on my shiny boots!

Horse cuddles and more ribbons!

Oh yes, and my trainer volunteered me for an interview with the local news:

http://www.wwnytv.com/news/local/Horses-Jump--268805381.html

Oh boy. I don't have much to say about that, except the happiness and excitement were real.  And I'm kind of a dork on camera. 

Nox had to stay back at the barn, of course, but he's happy to stand in the sunshine, snort at the pigs, share his grain with Agnes and the chickens, and play with his neighbor Ellie.  After the show, I returned to the barn to unload horses and tack, and spent some time grooming and sitting with Nox. I've got the show bug again, and hopefully in a year or two I can show Nox.  He'll look so pretty all braided and tacked up.

Nox and Ellie