Rehab from an injury rarely goes in a straight line.
After our visit last month to Dr. Bubeck at Tufts (New England’s veterinary school has a clinic) we had a clear plan of action for Tonka’s left foot lameness. Rest, rehab (slowly increasing the amount and type of exercise) and injections of IRAP into the joint. IRAP takes the animal’s own blood and concentrates it for the bits that promote healing. It’s then injected, just like one would do steroids and hyaluronic acids. The fluid originates in the individual, and it doesn’t have the deleterious side-effects of steroids, so – in theory – it’s the best option. It’s expensive (over $1,000 for 3 vials to inject) but worth it. That is, if it all goes according to plan.
Tonka had 2 injections, a week apart. These were done at our home barn by my superbly capable and careful vet, Dr. Monika.
Unfortunately, Tonka is one of those rare outliers who doesn’t deal well with IRAP. His coronet band got hot and swollen.
Tonka went severely lame. Worse than the mild symptoms that we were treating him for. I stopped the 15-minutes of rehab walking. Instead, Tonka got cold-hosed. (This, during a nor’easter in 40 degree F weather!)
I brought Tonka out of his stall to graze. But that was it. Even slow hand-walking was uncomfortable for him.
Tonka was a very good patient. Calm despite stall rest. He did take to nickering every time I appeared. Except for when I had my camera pointed at him so here is a video of his nice expression without the nickers!
The symptoms worsened. Dr. Monika put him on bute (reduces inflammation) and antibiotics. That made Tonka feel better, but it wasn’t a cure for whatever the underlying issue was. Some scary ideas about exactly what that might be were bandied about. Dr. Bubeck was called and she generously fit us into her very busy schedule.
Tonka looked genuinely happy to get into the trailer. He didn’t mind the two-hour drive to the veterinary hospital. Life had been boring and he likes this place! At Tufts there are veterinary students who dote on him and lots of interesting things to see.
After watching Tonka limp trotting out, and then doing an ultrasound, Dr. Bubeck concluded that Tonka’s body had reacted to the injections by forming too many proteins in the joint fluid. These needed to be rinsed out with saline. This procedure didn’t require an incision, (whew!) but needles were inserted into the joint, and those tiny holes are possible points of infection. Tonka’s leg was wrapped.
Here he is with one of the vet techs who adore him. Tonka looks good in red, doesn’t he? But I’d rather that color was a saddle pad and not a bandage.
After what Tonka considered to be a nice afternoon at Tufts, I loaded him back up in the trailer. Dr. Bubeck and crew were impressed with how willingly and relaxed he walks into the trailer on his own.
We’re back home, and Tonka is still on stall rest. However, Dr. Bubeck is optimistic that his rehab can continue apace. Next week I can get on and do our daily walks from the saddle. That last IRAP vial, though, is going in the trash!
Hope he heals up quickly! Enjoy the fall walks under saddle with him!
Alas, here in Maine the fall weather is just about over and we’re into the start of winter. But the indoor arena just had new footing put down, so there’s that at least…
Sorry to hear Tonka is having so much difficulty. Get well Tonka!
I just spent 4 weeks cold-hosing my mare’s knee twice a day to help get the swelling down where she got kicked right above her knee, (At least is was still summer here and not during a nor’easter in 40 degree F weather!) rubbed it down with liniment also. At least no fracture is there. After 5 weeks I got to let her out in a corral, now she is finally out in the pasture again. I’m not going to ride her until next spring. Once again, good luck with Tonka’s problem
Ouch. Knee injuries. Lucky the kick landed above and not on that joint.
How scary! He’s such a good, cooperative horse. No wonder he’s a popular visitor at the vet! Best of luck to you both to get through this setback.
Thanks!
Well, darn it all! Here’s hoping rehab can continue on schedule next week and beyond. Glad Tonka enjoyed his mini-vacation at Tufts. What a good sport he is, and what a good attitude you both have about setbacks.
If I wasn’t so bummed about this (and my bank account much thinner) I’t be funny. He had such a good time.
Hope Tonker is better soon. He is such a good patient.
He is such a good boy!
Oh man, that’s such a bummer that a promising therapy is a no-go for Tonka! So are you back to rest and rehab only now?
Back to stall and small run-out turnout and walking. Soon from the saddle, but it’ll be short sessions of walking on flat ground.
How scary! I hope the saline flush does the job. Is laminitis a possible side affect?
I’ve been wondering how Tonka’s rehab was going. We have a horse in my barn who has been very marginally lame in what seems to be her fetlock according to nerve blocks but she ultrasounds and xrays clean. Her owner is considering the MRI route. But in most cases a course of rest is what’s indicated first so wondering if it makes sense just to start there. I pointed her to your blog to follow Tonka’s saga. I hope you get steady improvement moving forward.
I wish that only rest were the answer. But if I did rest with normal turnout, he’d never get better. That’s where the additional diagnostics come in. Even with restricted movement, getting a horse to actually rest a joint is a challenge!
Tonka is really the best patient… and he is surrounded by a great team of healers who love him. A good thing you are so attentive at every little sign and took the decision to check further. Hopefully the next treatment will allow you to go back on saddle and you both slowly but surely come back to the best quality of being and enjoy your life together. Best thoughts and deep healing to lovable Tonka.
Thanks!
Never a dull moment with this guy. Well, some women go meet the ladies for lunch, and some men hang out with the guys for a beer. Tonka just heads out to Tufts for an afternoon with the vet techs for his socializing. (And red is definitely this black and white horse’s color!)
Hang in there, Terry. Good luck with him.
Tonka also likes the mild tranqs that he gets!