Wednesday, April 28, 2021

The chaos in my mind... saved in text format

I had a long conversation with my best friend in Delaware yesterday about Yoshi. She is an equine vet and does a lot of PPEs for a woman who buys OTTBs to market as sport horses. She talked me down off the ledge of frustration, confusion, and hopelessness. We both came to the conclusion that the intern who was with the surgeon went back through the diagnostics later and wrote up the report. Not confusing at all there, but I know the intern wasn't there for at least one of the conversations I had with the surgeon, so I guess it was all open to their interpretation later. She felt that doing the ultrasound without blocking out the left front lameness was not a super useful thing to do. She said that if you ultrasounded the suspensory ligaments of a decent number of sound performance horses, you would find things you could be concerned about if they were lame. Which he was. But he could have been lame due to his left front foot, we don't know because he wasn't blocked to the location of his lameness on that leg. The only part that doesn't fit with foot is why this started with a mild left front lameness when the right front foot is worse. She also said that regardless of whether or not the suspensory ligament is the problem, the current recommendations for a suspensory ligament with enlargement but no tear was pasture rest. She recommended getting his feet right and then if there is still a lameness, working it up with a lameness exam with blocking to localize where the problem is. Makes sense. Also is a cheaper route. Interestingly enough, in the last week or so, there has been mild to no effusion in the fetlock - maybe that palmar osteochondral disease is resolving? He's now had pasture rest for 60 days. 

Armed with that information, I palpated his suspensory ligaments in all 4 legs. Starting with the left front. He did not palpate sore over the branches, but did palpate sore on the proximal half of it. Uhoh. Moved on to the right front, same thing. Repeat on legs #3 and 4. Hmmm... consult with BFF. Yeah, really unlikely he has high suspensory problems in both front legs and high suspensory/hock problems in the hind. Probably doesn't appreciate your pinchy little fingers there. Really? This is normal? Even though I can palpate the SDFT and DDFT without a problem? Yes.

I feel like I keep flailing around in this lameness quagmire. I thought taking him to a boarded specialist and agreeing to all the diagnostics he recommended would get me an answer. Ha. Turns out unless I find a professional I can put all my faith in (would love if my BFF just moved back down here) I'm going to have to keep synthesizing all this information and coming up with a plan with the help of professionals rather than blind faith in them. But putting the whole picture together is hard.

In performance reviews at work, I consistently get called "calm" and "thoughtful". There was one week where between reviews from peers, students I teach, and my managers, I was called "calm" four times. Makes me feel like a cow placidly chewing its cud in the field. Over the years I haven't puzzled out whether the hamsters that run around in my brain truly run at a more relaxed speed than average or whether I am just not an emotive person, so no one sees them doing back flips in there. I think it is some combination of both most of the time with certain faulty areas. Usually when trying to digest information like this, the hamsters run rapidly in circles for a while, sometimes tripping and falling; I talk to my husband, I talk to my BFF, and I talk to my good friend out at the barn, the hamsters slow down to a jog. I come up with a more logical and reasonable conclusion than the half-thought through mush that was there at the beginning, the hamsters climb off the wheel and curl up for a nap. Now though, I've decided to blog, so instead it spills out onto the blog in an undigested form that has to later be ruminated on and corrected. Interesting. Documenting the thought (or lack thereof) process. 

Panicking at high speed... and all the good that does me

In the digesting process....

Ideally I end up here. Pretty damn relaxed and at peace, not flailing and falling off the wheel. 


  1. 1) nobody has EVER accused me of being calm, so i envy you that LOL, placid cud chewing or no haha....
    2) for real tho, that's so awesome that you have such a good friend who can talk through all this stuff with you from a veterinary perspective. IMHO, horse people are always gonna be horse people -- it will always ALWAYS be "ask 3 people; get 4 answers." so ya know... checking in with various trusted advisors and/or getting referrals from the board certified folks and comparing / contrasting all that input to see what feels like a good fit is kinda my preferred method too. esp when some of that feedback is reaffirmation that what you've been doing is probably a good course of action no matter what.

    in any case, glad your friend could add some clarity, and here's hoping you see big improvement just from fixing the feet alone!!

    1. Yes, I don't know what I'd do without her!!! Definitely agree with your assessment of horse people too. With less emotional subjects it's easier for me to remember that, I just wanted to put all my faith with this guy and think that if I followed his exact directions then I'd end up with a sound horse.

  2. Food for thought re: palpating - The last horse I owned was the soundest creature I've ever had the pleasure of knowing. Like gets himself stuck in a fence for an hour and trots off fine. I thank my lucky stars for that one everyday. When he was getting a PPE when he was sold he flexed positive on all four limbs and the buyers vet chewed me out.. like dude if it's positive on all four limbs and it's the same amount positive on them YOU FLEXED IT TOO HARD. So yeah I'm glad your friend could talk you down off Yoshi not being fond of your fingers lol

    1. Ha, interesting to hear your experience there! My friend had even said that about flexions before his PPE - if he flexes positive on one and negative on the other, that's bad. But if he flexes mildly positive on all? NBD. Interpretation of all these tests is not straightforward for sure.