Spice's vet visit
In the middle of August (two weeks before my accident) I made a decision to take Spice to the vet. I knew he wasn’t lame but there was a niggle in the back of my mind that I felt I needed to investigate.
When I purchased Spice in July 2020 he moved wide behind, this has always been his natural way of going but it’s different to what I’m used to. Not unusual for an Arab at all, but my horses have always been part-breds so I’ve never actually had a horse at home that moves as wide as he does. Specifically, he moves wider right hind versus left hind and I naïvely believed when I purchased him this was purely due to an un-balanced foot trim and that with time we could definitely correct it.
And whilst yes we have improved the right to left symmetry with trimming, ultimately I don’t think we will ever get him to move with 100% symmetry. Added to this, Spice has been challenging with the farrier since I’ve had him (though improving all the time) and had built up a resistance to lunge on the right rein versus the left. This isn’t to say that he is not sound because he certainly is, as approved now by my osteopath, physiotherapist and three vets - but this does give you a little bit more background into my headspace early August.
Having experienced quite a lot of heartbreak with Fern, one of my other horses, with a missed diagnosis for her kissing spine, I felt there must be a reason for his unwillingness on the right rein when lunging.
My aim for Spice this year was to do one of his novice rides (a 32 or 40km) so that did mean increasing the intensity of our training and I felt I needed to have a third and final sign off (on top of the physio and osteo) before I was ready to do this.
The mid-August vet visit was a little bit of a non-event I guess. I really wanted to have back x-rays and hock x-rays, and stifles and fetlocks if really needed, but my vet said I was being perhaps a little bit paranoid. After all, he was completely sound on the straight, on the circle, on the hard, the soft and to flexion. His back palpated beautifully as well as his hamstrings and gluteals - really there was nothing to find other than this preference for left rein lunging vs right.
I began to wonder whether it was perhaps me and that my body language wasn’t quite positive enough. He can be quite dominant in the field at times when poo picking too so I wondered whether if he had just got the better of me when asking him to lunge on the right – was it a communication issue. I don’t even lunge very often because I don’t like circle work – especially for young horses, so it’s not something we even do regularly. I prefer long reigning or in hand leading but still…
Anyway, I returned from the visit feeling relieved I guess that he really was okay but then also a little bit uncertain whether I should have just pushed for the x-rays anyway. I made a decision to continue increasing the work and that I would perhaps look into getting a more specialist person or instructor to help me with more groundwork with Spice.
At any rate, that was a fortnight before the accident and everything had carried on very smoothly with absolutely no warning signs.
On the night of the accident, Spice hadn’t been his usual self, being quite behind the leg when he’s normally very forward thinking. He’d been a bit fidgety to tack up and mount too which was unlike him. I knew he was due a physio appointment so I wondered whether his thoracic sling had got a bit tight again. We had already trotted three of four times but on one trot transition he just exploded into rodeo.
This was extremely out of character for him. I can count the number of times Spice has ever bucked since I’ve had him on one hand! Previous bucks have been so small I’d probably call them leaps more than anything. However, this outburst was a head between the knees “get the f*€>kk off me” type.
I landed so well, didn’t hit my head and was totally ready to stand up until I saw my tibia exposed - ouch! As many will know, I partially detached my calf muscle and had significant soft tissue damage. I’ve since undergone four surgeries to reconstruct and close up my leg and spent a total of 16 nights in hospital. I’m still immobile although starting to weight bear again.
Today is actually 3 weeks since the accident and a lot has happened for Spice since then. I felt immediately concerned that he must have kissing spine as this was the same response that Fern gave me last year which saw me in the head trauma unit with severe concussion.
My sister, Pheobe, called the vet first thing after the bank holiday weekend to get him booked in for X-rays. This time we would make sure to get all the images regardless of what we were seeing and feeling.
However, the back X-rays were a little inconclusive. There are perhaps 3 or 4 vertebrae that are close but not touching. One has signs of ossification which suggests that it perhaps had been rubbing but x-rays alone wouldn’t be able to tell us if this is new or old.
We then got referred to the Newmarket Equine Hospital (NEH) where Spice would undergo a full body bone scan. The benefit being that this would show active bone remodelling and provide timeframes that the X-rays couldn’t give.
Spice was dropped off on Monday and collected Wednesday. He was assessed under Fran James who found a less than 1/10 lameness in his front right in the initial assessment but sound elsewhere with nothing else of note. The bone scan was performed on Tuesday and then nothing can be done for 24hrs since they are radioactive afterwards!
So Wednesday was the day of discovery. The bone scan showed up activity in both front feet, front fetlocks and hocks. But nothing in his back.
Fran and her team then worked methodically through, either applying X-ray or ultrasound to each of the areas of interest.
Starting with the good news - his back. Since we already had X-ray images of his back, an ultrasound was performed to see if there was soft tissue damage in his back that could’ve caused any pain. Luckily everything was all clear and the ossification that we could see proved to be old. Therefore, at some point in his life his vertebrae was actually touching however we can only assume that because I do such long and low and correct postural work with my horses that I have inadvertently actually ‘rehabbed’ him out of a state of impinging spinous processes!
It’s crazy to think how much pain he would have been in at some point in his life but I’m really glad that this isn’t the case anymore. Now that I know that we have some vertebrae that are a little bit close I will obviously now pay even more attention to his back health and will likely perform regular x-rays to keep on top of this. Regular physio and correct saddle fit will be paramount.
As to his fetlocks and hocks my immediate panic was then that he must have arthritic changes which filled me with doom given that he is only six years old and therefore the prospect of a long-term endurance career would surely be out the window. However, his x-rays came back crystal clear and therefore Fran has suggested that the activity we are seeing is actually growth plate bone remodelling - it just goes to show how important it is that we don’t overload young horses. Perhaps he will make 15.2 after all 😂
Thus, the only find that actually needs some remedial action are his front feet. As I mentioned earlier he’s not been the easiest for the farrier and I feel that this has therefore caused a lack of attention to detail in pursuit of perfectly balanced trims. It has been difficult to talk to my farrier about his hoof conformation and growth against the context of his behaviour.
However, I recently changed farrier to someone who is more dedicated to barefoot performance and I feel more confident that going forward we are going to have more precision and dedication to our long-term goals. His most recent trim was what was seen under the X-ray on Wednesday and this is already showing a move in the right direction. With the X-ray images to hand, we can make even greater tactical changes.
Due to the imbalance and uneven wear against his front pedal bones Spice has been recommended no loading for 3 months i.e. paddock rest. This works well with my own rehabilitation timeline! The plan is to re-X-ray in January before recommencing any work.
The final factor to consider is whether ulcers have been at play. Statistically it’s more likely that a horse will have ulcers than not, despite all our management and dietary endeavours.
Therefore, it’s for this reason that I don’t really buy into the scoping money-making process. My bottom-line belief is that pain or stress causes ulcers and unless these are addressed no amount of omeprazole or sucralfate will cure the long-term issue.
The summary now is that Spice has been experiencing pain in his front feet, for probably quite some time. This pain has consequently caused an ulcer flare up. Without a scope we will never know if the theory is 100% proven but I would be willing to put money on the table (not £3000 worth of scoping and treatment though) that this is the case.
I know that from a dietary and management perspective I can do no more for him to support his digestive health.
I’m going to chat to the vets again about pursuing a course of omeprazole now or in January without scoping or what my options/alternatives are. I’m also going to use the next few quiet days of bed rest to research and read up some more on the latest papers relating to ulcers as it’s been a good year of more since I last really put time into this area of interest and things are always moving on.
I am so happy that we went ahead with a full body bone scan as I’m not sure we would have found the foot pain so soon. Though Fran spotted the mild lameness I hadn’t seen it myself and neither had the two vets at my home practice so even just being at the NEH opened up new possibilities.
I’m also over the moon that he doesn’t have arthritic changes anywhere and his back is currently okay and can be managed in the long term. By January, his feet should be significantly improved. Without getting carried away, I’m still hopeful that Spice will be a 160km horse one day albeit our Novice season is going to start later than planned.