The Next Step

By Terry Golson


Tonka and Dr. Monika Calitri discuss his ultrasound results.

For the last four years, Tonka has been consistently inconsistently lame in his left fore. Most of the time there’s nothing amiss, some of the time there’s a slight unevenness to his stride, occasionally he’s head-bobbing lame. It’s hard to diagnose because – of course – whenever the veterinarian comes out to take a look he’s sound. Or at least not lame enough to be able to do thorough diagnostics.

Dr. Monika came out again this week. Two days before the appointment Tonka was limping lame, but when Dr. Monika arrived he looked fine. So I got on and rode for a half hour until you could detect an unevenness to the left. Also, Tonka refused to canter. Two weeks ago he was doing perfect walk to canter transitions. Now he wouldn’t budge. The inability to canter might be a learned behavior that has nothing to do with the canter itself – when Tonka balks, I stop asking him to go forward – or it might be that the canter itself hurts (sacroiliac joint?) What is clear is that there’s something bad going on in Tonka’s left front, likely originating somewhere from the fetlock on down. We’ve already done X-rays that showed that the bone angles and joints look fine. To try to isolate where the pain is coming from, Dr. Monika injected nerve blocks. First to nerves that go to the inside of the hoof. Then she watched Tonka go to see if there’s a difference. He was still lame on the first block, but when she then blocked Tonka’s leg further up it improved his way of going. This is far from exact, especially with a horse whose lameness isn’t pronounced in the first place, but it can eliminate some areas of concern and point to others that are more likely. An ultrasound maybe, or maybe not, hinted at his collateral ligament (which wraps down from the fetlock and into the hoof) as being the culprit.

The next stop is for more advanced imaging. He’ll get an MRI at Tufts (a clinic at that veterinary college). Scheduling an appointment is the first challenge. It could be weeks before they can see Tonka. In the meanwhile, what do we do? He needs to be lame to get a diagnosis, so keep him in work and hope that the inconsistent lameness becomes more consistent? On the other hand, if it’s a ligament, I don’t want to stress it more so that it’s impossible to heal later.

There’s no perfect solution. I think what I’ll do is get out on Tonka for walks. It’s perfect hacking weather. He’s always remained sound at the walk. A week before the appointment I’ll put him back into full work, assuming that he’ll go lame enough again to show the Tuft’s team what hurts. That’s the plan. It’s not ideal, but after consulting with my veterinarian and trainer it’s the best that we can come up with.

Horses.

Sigh.


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