Say It Isn't So

As I watch Elvis slowly limp into the barn at the therapy center, my heart just sinks. His hind leg is enormous, like a tree trunk, the swelling is so bad. He won't put any weight on that left hind foot and is in fact only walking on the toe. Like some poor imitation of a ballerina.

Dr. A. and his assistant get the digital xray equipment set up and quickly start taking images. While all of this is going on, I can hardly think. I hope it's not broken but what if it is, then what? As the images of his hock start to accumulate, I'm able to breathe a bit easier because they look pretty good. "No breaks" Dr. A pronounces. In fact, he has pretty nice hocks for a 15 year old, I'm told. So we got that going for us...

Now for further examination. Within what seems like less than 30 seconds, Dr. A says, "Betsy, I have your diagnosis." That quickly? Really? Is that good or bad? He has me place my hand so that it is cupping Elvis' hock while he has his foot down. He slowly raises the leg and suddenly I feel a heavy thump on my hand. "OK, that's not normal", I say.

No, that would be his superficial digital flexor tendon that should be staying on the point of the hock as it's flexed. The ligaments that should be holding it in place have been so torn from the fall that they no longer serve their purpose. The official diagnosis is lateral luxation of the superficial digital flexor tendon of the left hind leg. I stand up and ask "what's next, what's the treatment?"

The answers Dr. A gave me were mind-numbing. Surgery is not very successful since there is really nothing that can be stitched to. We could try keeping it bandaged hoping to keep in place and let scarring sort of lock it in position but that hasn't been very successful either. There's no way to know if the tendon has slipped out of place unless I'm willing to wrap and re-wrap many times a day.

Elvis is looking at 2 months of total stall rest, then gradually increasing walking starting with 5 minutes/day. No turnout for at least 2 more months after that and then in a very small paddock until we're confident the scarring is complete but the tendon will always stay on the outside of his hock instead of on top of it. OK, I think to myself. I'm not happy, especially since we just got back into work after his suspensory injury on his front leg, but we can do this. We have to do this.

And then came the really bad news. His career as a dressage horse is going to be very limited at best, Dr. A tells me. Collected work will be out of the question because of the biomechanics of his hind leg and he probably will have a mechanical lameness that will make his gaits irregular. Just what you want in a dressage horse...

Dr. A told me I could take him back home if I wanted but there was no way that I was going to put that poor horse on the trailer again. He was in so much pain and I had no idea where I would take him for his lay-up. Bruce Jackson came in at that point and quickly came up with a plan.

Elvis can stay at the facility. We'll put him in the cold sea water spa twice a day for at least a week and then once a day for the rest of the month and re-assess from there. He can go in a stall that is very close to the spa so he won't have to walk very far. Dr. A gave him Equioxx for several days to help with the pain and the swelling and will follow up with ultrasound examination the next day to check for any further damage.

Great idea! Having used the spa last year for Elvis' suspensory injury, I knew how effective it was. And, as important, I knew that he would be in the best hands until I could find a place closer to home for his long-term rehab.

I went back up the next day before the second round of snow started so I could watch the ultrasound examination. Nothing further was found, which I guess was a good thing. I was still reeling from what his long term outlook was that anything else would have seems almost inconsequential at the time.

What I wasn't prepared for was how good his leg looked. He had been in the spa the day before, right after Bruce came up with his plan and they put him in the spa first thing in the morning before the ultrasound exam. The swelling was down dramatically! Elvis still wasn't putting much weight on that foot but he looked more comfortable which was a huge relief.

As my mind was quickly spinning through all of the possible future problems, thinking of everything that could possibly go wrong, Bruce just calmly told me, "Betsy, let's just take this one day at a time." Great advice.