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Sunday, March 31, 2013

Sorry

There's something wrong with my iPad blog publishing app and it's not letting me post anything right now with pictures so my cc and my conditioning story, which are done are going to have to wait until animals are fed(in the rain) so I have time to figure it out.

Thursday, March 28, 2013

CC - "Chester"

Today we have Wednesday's CC presented on....Thursday!  Like last time the CC was late, you have until SATURDAY to post your answer in the comments section for a chance to win a cheap (but awesome) prize. 

Today's we get to meet Chester.

Chester, a 15 year old quarter horse arab cross is starting his second career as an endurance horse, after retiring from roping.  He retired apparantly sound and has been in pasture for the last year. 

His teenage owner has been conditioning him for their first LD ride, which occurred last weekend. 

She was extremely disapointed when they weren't even allowed to start the race, as the ride vet declared Chester unsound, possibly in the right hind.  

You remember from vet school that flexion tests can be variable and so decide to skip that part of the lameness exam.  Your teenage client begs you to do this as cheaply as possible, as she is saving for a new saddle.  Thus you skip blocking and go straight to the xray machine. 
 
The following radiographs were taken - both in the right and left hind legs.  You labeled one view of the left leg radiograph as a teaching tool for your teenage client who hopes to become a vet, just like you someday. 

What is Chester's problem, and what is the impact, if any on his potential endurance career?

Left side



Right side



Monday, March 25, 2013

Happiness

This weekend I was reminded of a very important concept and I wanted to share with you.

I am responsible for my happiness.  On the flip side, I am not responsible for anyone else's happiness. 

This sounds very simple and on the basic, theoretical level is.  It's applying it to the real world where it becomes complicated.

If I am miserable and unhappy than it is important to evaluate why.  And those answers should reside in myself, NOT someone else.  Similarly, if someone else is miserable, the answer resides in them, not in me.

Note the shirt I'm wearing today - it very much matches my mood
(BTW - quick diversion back to my "soundness and balance post": based on this picture can you tell which is my convex and which is my concave side?  ie, which side is over stretched and which is contracted in the saddle?  One shoulder is dropped and behind the other even though I feel like I'm sitting in my chair square and straight.  This does translate into the saddle.)

One thing that helps me find happiness is to remind myself of the following truths:

1. Life does not change.  If you aren't happy now, you won't be happy later when you (insert the promotion, job, life change, money amount, goal, achievement here).  You can be happy with a crappy job.  You can be happy even if the specifics of your life (marital status, specific career, school, absence or presence of kids etc.) aren't how you would have chosen it.

2. Happiness if more a state of being than a result of anything concrete.  Concrete things and events can bring me a specific joy, but they won't make a long term impact on my happiness.

Hopefully by the time you are an adult you can put together a list of things that make you happy.  I think that this list is important because, at least in my life, those things that make me the happiness are although those things that are the most easily pushed to the margins of life.  When I'm feeling unhappy I refer to this list and ask myself when was the last time that I did these activities, AND how can I incorporate the activities more heavily into my daily routine in the short term.

Things that make my list are:
-Practicing a musical instrument
-Running
-Riding
-Writing
-Knitting
-Quilting

Music? Yesterday I took 2 of my fiddles and hung them on the walls in different areas of the house.  It's super easy to pluck one off the wall for just a minute or two and then replace it.  Waiting for something to heat up in the microwave?  Pick it up and run through a song a few times.

Writing?  I have designated Sunday's as my creative writing time - I won't do any content blogging, but will work on my novel, whether that's actually writing a chapter and posting it, or working on the plot outline (which is what I did this week).

Knitting?  Stash a project somewhere convenient and buy sock yarn I'm excited about.

Running?  Take a duffel bag with running clothes and shower stuff with me every day and find 45 minutes on the drive home or drive to school and just do it.  If I didn't run yesterday, than today is a run day.

Riding?   Put some rides on the calendar - example: I don't have school on Friday.  This will be a perfect opportunity to go up to the Auburn overlook and do a bit of riding.  Because riding involves another creature, it's important that I don't try to shove my goals, frustrations, and expectations into a riding opportunity.  My rule of thumb is that if I feel rushed and stressed about trying to get a ride in, I don't do it.  I violated that rule on this weekend Saturday morning and I regretted it.  Also, because I considered riding in many ways my part time job for many years, I even hesitated putting it on my "happiness" list along with the other activities because although it makes me happy, it's in a different way and of all the activities on the list, it is the one that can actually make my mood and state of mind WORSE if I'm not in the proper mindset when getting on the horse. I'm better off doing the other activities to increase happiness, and make sure the horse is regularly incorporated than to use the horse to improve my mood in the first place.



Saturday, March 23, 2013

End of the week catch up

I'm using today to catch up on any little things that didn't make it into last weeks posts, and respond to comments that are too involved to be constrained to one little box!  (you can tell I'm a vet student when I had to double check the last 2 words of that sentence to make sure it didn't say "litter box").

Rode Farley in the arena this morning and did a bit of dressage.....OMG it was awful.  We have so much to work on.  Wouldn't even get on the bit and come over the top in the canter, which is my secret weapon when she is sucking back in the trot.  I got the point where it was slightly less awful and stopped.  I am NOT going to be able to do Tevis this summer without some serious dressage work.  More on Farley when I talk about Jonna's question.

In response to "Figure" (comment on "supplement" post): 
Hay, because it is dried is by definition lacking in some nutrients such as vitamin E.  Aside from that, depending on how/where it's grown and when it's harvested the hay may or may not be balanced.  There are generalities that can be made about certain types of hay, which is what all these "ration balancers" tend to work off of.  For example, the Ca:P ratio in alfalfa is often skewed, something the alfalfa specific ration balancers try to correct.  There are other trace mineral imbalances (both in quantity and ratios).  It's important to note that what is the "typical" hay profile varies by region and thus I got a recommendation from a local equine nutritionist that I trust on a commercial ration balancer that does a good job for California grown grass hay. I think for most people it is impractical to test their hay and get custom ration balancers mixed, so this is the next best thing IMO.  In a horse without access to pasture, I think aside from a ration balancer and vitamin E, the rest of the supplements are on a demonstrated-need basis only.  For example, if I'm going to continue to compete Farley, she has a demonstrated need for selenium supplementation.  Fine.  Oil is something that I feed because of what I consider overwhelming evidence that is supports endurance horse performance, and it's something I would recommend if someone told me they were looking for something in the supplement category to feed and already did a ration balancer and vit E.  All horses need access to salt, so whether you feed loose or in blocks is your choice. 

The senior thing threw me too.  Farley is one year away from being a senior!!!!!!!  I think that no matter what the breed and how they look (ponies probably the exception) that 15 is a good age to consider a "senior".  It's not as much about whether they are still able to perform adequately and more about statistics of when you start seeing syndromes and diseases like Cushings.  True, these don't usually show up clinically until the early 20's, but can be affecting the horse's physiology for years before that.  Things like immune response, elasticity of tissues, water content in the blood, and teeth (and thus digestion) tend to march onward according to calendar age, even if the horse on the outside looks much younger. 

Regarding the ulcers.......I think it's really individual.  Horses produce acid all the time, not just in anticipation of a meal which makes them prone to ulcers, and is why keeping food in front of them most of the day prevents it.  I'm not worrying about it in part due to the infrequent trailering I do, and low number of events that I'm doing.  There's the added complication that medications that are proven to work against ulcers, such as gastroguard are not legal in AERC competition, so you must take the horse off of them before a ride (paying attention to the appropriate withdrawal times).  However, I was told that it was better to put them on medication and then take them off for rides, than not treat at all.  I think that Farley is probably low risk for ulcers, which is why I'm doing the wait and see and cross my fingers approach.  I'm not sure what I would do if I thought she had them.  I would probably approach it using a 3 step approach: 1.  Keep feed in front of her at all times.  Recheck.  If that didn't do the trick......2. Feed a supplement, as long as it was a reasonable cost.  If I couldn't find anything that had some research behind it, go directly to step 3.  Recheck......and if that didn't work 3. Put her on medication.  I like to change stuff through management first, only then consider supplements/medications.  Whether I chose to try and manage something nutritionally depends on the individual condition, the medications available etc.

Anyone else have any advice for Figure?

Jonna (wants to know what my conditioning plan is for Farley.....): 
So......in some ways I'm starting over, and in other ways I'm ahead.  Farley knows the trail, and she knows that it's a 100 miles.  Mentally she haven't lost much conditioning.  Physically she has!  I can mitigate some of it by being a good partner: by being super fit myself and getting off a lot, and by riding exceptionally well and balanced throughout the ride (ride balance and timing is a HUGE factor is how a horse looks at the end of a ride).  The most important thing I can do for her physical conditioning is lots and lots of correct dressage work between now and then.  The second most important thing is interval training.  Rides of about 10 miles where I do some short high intensity intervals followed by complete recovery periods (and then repeat).  And of course the third leg in the stool is long rides - which I will do on the actual Tevis trail (which is about 1 hour away from me), and on a handful of 50's. 

You are right, that her being an arab makes a HUGE difference.  It was easier to get Farley through 100's than it was to get my standardbred through a 50.  The line between "fit enough to do a 50" and "overriden and hurt" was so very very very very thin with my standardbred.  You could have driven a semi-truck through the width of the line between "fit enough for a 100" and "overridden and hurt" with Farley.  It took far less miles to get Farley fit and to keep her fit than it did with Minx (the standardbred).  Not every animal in a breed follows the stereotype of course, but so far my horses have. 

Preparing myself for the event will involve a very similar "tripod stool" of training".  Weight training, interval runs, and a few double digit long runs (in the 10-20 mile range).  I have some ride and ties between now and Tevis that will provide me with some EXCELLENT hill workouts.

On the actual ride day, I will ride more slowly and a bit smarter (you can do that when it's your third time through the race.....).  I finished mid pack (45/~90) in 2010 (and that was with absolutely no trotting, just walking the last 6 miles from the last vet check to the finish) and was on schedule to do the same in 2009 before pulling at mile 65.  I can take more time during the gate and gos in the afternoon especially.  And if Farley says "no-go" we don't go.  Which brings me to my last, and most important point.  Farley is a very honest horse.  She doesn't hide anything.  She doesn't exaggerate it either, but if something is going on she tells me.  and that is the number one reason that I'm willing to try this.  She's not going to lie to me like Minx and tell me everything is fine, only to find out that I have a SERIOUS problem. 

I'm also considering a legend/adequan/IA routine.  Not something I was willing to do the first time around (she did have IA injections at the beginning of the year because of the dressage) but now, knowing that this is my one race of the year, and knowing that I won't have the conditioning behind me like I did before, I'm considering it.  It's technically legal, but I'm a little hesitant because of some personal convictions - which I regularly reevaluate and usually discuss here on the blog.  (But I'm not to the point yet I can write the post - must gather thoughts).

Liz Stout (who wants a video for the toe tapping exercise):
I'm going to make a valiant effort to explain more clearly, and if that doesn't work, than comment and I WILL post a video :).  Stand up.  Tap your toes and ball of your foot.  What happened?  Your weight went into your heels.  This is what you are going to do in the stirrup, except there's nothing under your heels.  You are simply going to tap the ball of your foot on the footbed of the stirrup while trotting.  On both sides at the same time.  Your weight has no choice but to go to your heels, AND (here's the beauty of the exercise), you won't be able to lock your ankle joint in order to "force" your foot into that position.  Weight in heels + a flexible ankle (and knees and hips) = beautiful rising trot. 

Was this more clear?

Friday, March 22, 2013

Buttercup CC Answer!

Good job anonymous! You guessed EHV-1, which was the correct answer.

CJ - EEE was a good guess - that's one reason I put a month and location - fever + neuro are very vague signs, however outbreaks that are occuring near you should be taken into consideration when trying to think of likely causes. EEE in Feb (mosquito bourn) with no outbreaks.......Or EHV-1 (direct horse to horse or through shared equipment) with known cases in the state you are?

Hannah - I left the city vague on purpose because although if the horse was in Gurnee, IL it would be a HUGE red flag for the vet and the owner, It should be a redflag even if you AREN'T in Gurnee. For those of you that haven't been following the EHV-1 cases, there were some cases of horses with EHV-1 specifically located in Gurnee IL.

EHV-1 is diagnosed all over the country all the time - it just isn't always associated with an outbreak. Thus, even when EHV-1 isn't at the forefront of our minds, it's still a reasonable differential diagnosis in a horse with a history of show travel, or use of facilities where many horses are coming and going. I was suprised to see on the CDFA website the number of CA cases over the last couple of years, most of which are not related to each other.

This week cases in California and Montana were announced that are related to the current outbreak. According to my source (Promed) affected states currently include Utah, Colorado, Tennessee, New Jersey, Florida, Minnisota and Illinois. Because of horse/livestock travel, non-vector bourn disease such as this one can make odd leaps and won't necessarily have a predictable march through the states. Don't assume that just because a particular disease has been isolated to the midwest, that it won't appear suddently on the west coast.

I've been keeping an close eye on the EHV-1 situation because although the vaccine isn't completely protective against this varient, I will pop Farley with a 4 way influenza combo if it get close since it may be partially protective. So far cases have popped up in LA and San Diego counties, which are so far away it's basically in another state, so I'm not worried yet. A single case in each county.

A bit about the disease

EHV-1 stands or "equine herpesvirus type 1". Transmission is usually via aerosols, when horses cough and sneeze, however it can also be spread through sharing equipment like bits and buckets.

The presentation of the disease an vary. A "rhinopneumonitis" (persistant cough, snotty nose) typically in young horses, abortion in broodmares, and the "neuro" form (incontininance, ataxia, incoordination, paralysis of hind limbs, fever, death). There is a vaccine available for the first two forms, however the vaccine does NOT seem to be effective against the neuro form.

The terminology can be a little confusing. The "neuropathogenic" strain/mutation is a form of the EHV-1 that can cause the neuro signs and death and is the one that we most worry about in the outbreaks. Sometimes you might see it referred to as "nEHV-1" to try and differentiate the neurotrophic form from the other type. The other EHV-1 "just" causes the typical rhino and abortion issues, however in a very small percentage of cases it can also cause neuro signs!

A confirmed case of EHV-1 is one of two scenerios:

1. A horse has compatible clinical signs (one or more: fever, recumbancy, snotty nose, ataxia, hind end weakness, diminished tail tone) AND a lab test positive for the neuropathogenic strain of EHV-1.

OR

2. A horse has neuro signs AND a lab test positive for any strain of EHV-1

For example, the CA San Diego case is a stallion that displayed mild neuro signs AND has a positive test for EHV-1 (a NON-neuropathogenic strain). Even though it was not the neuropathogenic type, in CA EHV-1 with neuro signs regardless of strain is still a "reportable" disease. The LA CA case was a more typical nEHV-1 that showed the typical clinical signs, and had a positive nEHV-1 test.

The current recommendation by state vets in states affected is to start temping horses that are going to an equine event 3 days prior to travel, and continue to temp daily until 3 days after the event. Horses with a temperature over 103*F should be isolated and not allowed to mingle with other horses (CA's cdfa website says 102*F and it wants you to contact a vet). Keep in mind that temperature can elevate in a horse that is being exercise, no you are looking for an increased temperature that is NOT related to working the horse.

The disease is edemic to the US, with the federal government becoming in involved when outbreaks involve multiple states.

This disease is an important example of why I do not allow other people's horses to say "hello" to mine at events. It's high contagiousand there's no effective vaccine. Horses aren't offended if their neighbor doesnt say hello and it might save her life and me a lot of grief.

Check in next Wednesday for the case of "Chester".

Supplements

According to Smart Pak, using their Supplement Wizard Farley should be getting:

"Comprehensive support" = $5.78/day

Gastric ulcer prevention supplement ($1.39/day)

Joint supplements ($2.11/day)

Multivitamin ($0.68/day)

Insect control ($0.71/day)

Essential fatty acids ($0.98/day)

 

"Enhanced support" = $4.17/day

Gastric ulcer prevention, joint supplement, multivitamin

 

"Basic Support" = $3.50/day

Gastric ulcer prevention, joint supplement

 

So how does my routine stack up?

Joint supplement: Not fed

Gastric supplement: Not fed

Ration balancer (multivitamin): $0.61/day

Oil (fatty acids): $0.31/day

Vit E (not suggested): $0.36/day

Selenium (not suggested): $.08/day

Electrolytes - Not suggested, but would have been because as part of the survey to determine Farley's needs I answered that I did feed electrolytes, which is why they didn't add to the recommendations above - cheap feedstore elytes or salt adds pennies a day to my supplement costs.

My current Total: $1.36/day


What I don't feed: Joint and gut/gastric supplements. This is interesting because (aside from the feed through insect control) I cover all the other bases suggested in the more "comprehensive" package, but ignore these 2 which are considered "basic" by smartpak. Why?

- the joint supplements that work usually test positive in the drug testing done by the organization that I compete within (AERC endurance). I would use Legend or Adequan if I was concerned, both of which are legal to give prior to rides and validated to work in horses.

- Although Farley is only fed 2x a day (which according to smarkpak is a risk factor) she doesn't often have absolutely no food in front of her, and she has no other significant risk factors (besides being a horse!).

How about the vit E and Selenium?: Smarkpak probably thinks that feeding their multivitamin will provide sufficient levels of vit E. However, because handling (exposure to heat and light is no bueno) matters so much on whether the vit E in a product is available to the body, I prefer to feed it seperately. Especially to a horse that isn't getting any natural vit E in it's diet (Farley isn't on pasture). Selenium supplementation is controversial and without absolute confirmation that the horse is low, AND considering that the multivitamin probably contains the maximum allowed selenium content in it (which is not enough to elevate Farley's blood levels to what I consider adequate for endurance) smartpak probably errors on the side of NOT recommending it.

How does smartpak stack up?

I was pleasantly suprised that smartpak, in general, seemed to be recommending an appropriate level of supplementation. I got the idea for the post after reading another blogger comment on how smartpak's supplement wizard recommended a ton of potentially unnecessary supplements for their horse, something that would not suprise me based on a SUPPLEMENT company's recommendation. However, for Farley, who is still in work (not retired) the recommendations seemed appropriate.

According to Smartpak I'm covering most of the bases, including a ration balancer/multivitamin, essential fatty acids, and electrolytes. What I am NOT covering is joints and ulcers. However while I think these are important issues in my horse management plan, I just choose to manage them in some other way than supplementation.

Have you used SP's Supplement wizard? What did you think of their recommendations?

 

 

Wednesday, March 20, 2013

CC #2: Buttercup

Get your answers in by Friday, before I post the answer and if you guess correctly you could be drawn for a (small) prize!

Buttercup is a slightly pudgy bay arab who is being conditioned for endurance. He's boarded at a public stable and often uses the public arena across the street, which is also the location of the local trail head.

He's going across the state line and needs a health certificate in order to do his first spring endurance endurance ride.

Buttercup's coat is shiny and in good condition with no ectoparasites. He pooped during the exam and has well formed poop with a good consistency.

He has a temperature of 103.2*F (elevated), heart rate of 36/min, respiration of 12/min.

Mentation: Quiet, alert, and responsive

Eyes clear, no nasal or ocular discharge.

As the vet, you explain to the client that you are concerned about the elevated temperature. She replies that because it is a hot day, he probably just overheated in the trailer on the way here.

She's upset that you won't issue the health certificate and as she loads Buttercup back into the trailer, he seems to have trouble navigating the step up with his hind legs and then once in the trailer, almost falls down.

What is your top differential diagnosis considering you are located in Illinois and it is February 2013?

Tuesday, March 19, 2013

Balance and soundness

Today is another convention post.

Funder (visit her blog on the side bar) did a great job of writing up my overall convention experience on her blog.....she thought she was writing about HER experience, but in reality it was all about me. I too ended up sitting in a booth and visiting with people more than doing any actual shopping.

And.....you all wont believe this but i actually stuck to my "must buy" list and didn't buy anything that wasn't on it. Ice-tight poultice? 5 bucks at the used sale. Sunglasses? 2 bucks at the same place. Found a saddle pad that fixes the potential wither clearance issue with my saddle, and picked up a bucket of electrolytes. Lastly i swung by evelyn's tight booth and picked up a pair if incredibly beautiful, glittery tights for my upcoming ride season......and like funder I'm wasn't quite ready to publicize my 2013 schedule (although I have since posted that the plan is Tevis. :).

So, with all the blah blah past, let's get on with another seminar post!

Donna Snyder-smith (I think - correction anyone?) presented a hodgepodge collection of advice, products etc in a seminar that was designed as an opportunity for her to share some tidbits based on a long history of both riding endurance and mentoring the sport.

She read an excerpt from (as close as I could hear) Mike Beasley's (?) "A study in Balance" that supposidly looked at horse "sideness" and how it related to endurance riders changing their diagnols etc. at an endurance ride. The caveat to this is that I have not been able to find the reference with some google searching, which was dissapointing. Apparently this guy evaluated 228 endurance horses 12 miles into an endurance ride and either told (or didn't tell) endurance riders that their horse was exhibiting stiffness or "sideness" at that point, at which point the rider, if aware could be more careful about switching diagnols etc. His conclusion was that these "lesions" were temporal and adopted by the horse based on the posture of the rider. According to this seminar speaker (again, haven't been able to find the paper she was reading from) he actually isolated the muscles that are affected by the imbalance in rider posture etc.

At the 12 mile point, the "sidedness" was showing up in the forequarters, not the hindquarters, but the hindquarters was where the most stress was actually being felt by the horse - medial hamstring, internal obliques/flank, gluteals, gracilias etc. were common muscles that the horse was using in a one sided manner to compensate for the "sideness" in rider posture.


I apologize if the above isn't totally clear. Without the original paper in front of me I have a hard time verifying the details and can only share what was presented in the seminar - the bottom line was that because we as riders have a dominant side (most of us are right handed), this will show up in our riding, and it will affect our horses.

Weight changes everything about the horses balance. A large point of "good riding" and how we condition our horses is trying to mitigate the "handicap" of placing a saddle and our weight on the horse's back and asking it to go 100 miles, something that it was certaintly capable of doing before being tacked up, but may be less able to now.....

The horses' back is a bridge and the weakest part of the bridge is exactly where we place that saddle! She did a lot of visuals with the point being that the horse's body (back and legs and locomotion etc.) works together best if the back can come up, so that the hind leg can swing freely under the belly. If the stifle can come freely forward, the foot comes forward and the butt can come down.


Lifting the horses back is done by stimulating the belly muscles....or at least this is how she put it. In dressage I've heard a lot of other terms used and there's a lot of different ways to think about it and visualize it - however you can manage to wrap your head around this concept and translate it to your riding......then good for you. Think of how when you properly ride how much stress that puts on your CORE. That's also how your horse should be running along - by using it's core. And however you chose to think about "back up", the corresponding part of the equation is HEAD DOWN. You cannot get the back up if the head is up. If you are unfamiliar or uncomfortable with getting your horse to work and motor along the trail with the head down and the back up, I would suggest you take a couple of lessons or attend a seminar that focusing on some dressage basics.

My take home was that during conditioning I'm going to be encouraging Farley to travel down the trail more "correctly" meaning I'm going to ask her to get her back up and not hollow her back. My philosophy used to be to work her correctly in the arena, and let her go her own way out of the trail - she travels fairly neutrally, and doesn't have any weird muscling from having a high head - but if taking the opportunity to build some of that back muscle gives us a bit of an edge for Tevis, I'm willing to do it. Notice I'm not talking about a "frame". The goal is to have her travel nice and easy with her head down, not all strung out. One thing I notice is that she can't go into that crazy extended trot that makes me feel like my teeth are going to get jarred out of my mouth if I don't let her get all strung out - she has to go into a canter if she wants to up the speed past a certain point. Farley has a longer back and a weak tie into the hip and so I feel this will be very beneficial for her, especially since we aren't doing as much dressage as in the past. Some horses that travel very naturally balanced (I'm thinking of the ride and tie horse I ride, Stashi) may not need as much work in this area as Farley.
The presentor said that a weak back can present as stifle problems, eventually hock problems --> all resulting from a tight, hollowed back. I know referred pain is huge in horses and I do feel like a lot of the "hockiness" I see in horses is due to problems in the back.

OK - so the point is that you want to have this nice moving horse underneath of you that has an elevated back and a freely moving hindquarters.......how are we as riders minimizing or maximizing this?

Every rider has a convex and a concave side. This doesn't go away until it's trained to go away. I happen to know through intensive dressage training that my left side likes to fall behind my right side. This is reinforced by many day to day activities including driving and using a mouse at the computer. Can you stand in front of a mirror and make your two shoulders completely level? The presenter claimed that 60-70% of people who try this exercise can't!

Here's the point. That sideness translates into your seat bones. One of your seat bones is diagonally in front of the other in the saddle. One seat bone will be resting on your horse's back in a more comfortable place than the other one. The side of the back that is the more comfortable will tend to stretch more and the side that is not as comfy will contract. Thus you have set up your horse to have one concave and one convex side just like you! The hind leg that is on the side where the seatbone is more "comfy" will travel forward more under the belly, setting up a "short stride, normal stride" scenerio that eventually manifests itself as stress in the horse's hindquarter muscles from compensating/reacting to the posture imbalance in the rider.

Thus it is paramount we get the seatbones straight!!!!!!! One thing that can help is to do exercises that loosen up the groin area. Nothing in "real" life opens up this area like sitting on the horse. As the presenter put it, you need to acquire groin flexibility --> you can either use your horse as a gym, or go to the gym to accomplish this.....The exercises were very pilates/yoga centered and I'm not going to try and go into them here. If you want to see them, stop me at a ride and I will gladly demonstrate!
So, maybe you were just confused by all this and want the bottom line?

bottom line: A muscle under pressure contracts. If one side of the horse's back contracts because of your riding and seat (and unless you have actively trained to get rid of your onesidedness, mostly likely you ARE doing this), you are causing the horse to travel crookedly down the trail, setting up uneven stresses on his muscles. A uncomfy back will hollow, the hind legs won't come underneath and the horse may or may not be stepping evenly underneath of himself. This affects the horse negatively over endurance distances.

Other points:

1. Dead last is a greater than Did Not Finish. Did Not Finish trumps Did Not Start.

2. Remember that endurance is a partnership. WE (the rider) are HALF the partnership. We cannot neglet our half of the deal. No matter what food we stuff down our horse, conditioning plans, tack we use etc, we cannot neglet the rider portion of the partnership. I agree. I think that dressage lessons was part of my obligation to Farley as her rider, just like not starting Tevis unless I'm as fit as she is part of the deal (no more riding 100 miles with me unable to get off and help her out on the hills!).

3. She spent a lot of time discussing grip versus balance. We should not be gripping our horses to stay on - it can be totally unconsious, especially if you have very strong thighs (I do.....), and you are greatly hindering your ability to condition your horse if your lower body has tension in it, and you are causing stiffness to occur in the horse that will definitely show up at 100 miles if it doesn't show up at 50 miles.

4. "No pain no gain" is bullshit. If you push your body (or your horse) past it's "fail safe point" than the body will protect itself by resetting that fail safe "backwards". However, if instead you honor that fail safe point and always stop shy of it, the body will respond by gradually moving that fail safe further and further along the path you want to go.

5. Stirrups are not for standing in. What's funny is that this is what they taught us in calvary school, which was the first formal riding education I got - stirrups were to be used as a aid for mounting, nothing else. The posting motion comes from the core, the horse's movement and by unlocking the hinge points of the body. You allow the horse to toss you in the air, lift your pelvis........and during both the down and up phase of the posting trot you should be able to tap your foot in the stirrup, NOT because you are gripping and bracing with your thighs and knees, but because your ankle is relaxed and the horse's momentum and your core is controlling the movement. I know this sounds like voodoo. Let me assure you it is practical and doable. Am I perfect? Nope. It's a constant cycle of me doing it correctly, and then getting all stiff - what I love about the tapping exercise is that for me, it immediately unlocks whatever tension I had and causes me to start doing it correctly - I don't have to analyze what's going wrong and then try to force myself to relax, all I have to do is tap! The seminar speaker said that 1/3 of your weight should be in your stirrup, and 1/3 of your weight should be on the inner thigh without muscle tension, which sounds correct to me - this can change depending on what manuevers you are trying to do, but in general, just motoring along and moving normally, this sounds right.

She made the point that the length of the thigh bone dictates the movement of the up phase of the posting trot. Teh longer thigh bone will equal a longer and higher up phase......these people match well with long strided horses. People with short thigh bones riding a long strided horse need to be careful not to come down too soon and put an extra pause/hang time at the top of their posting up phase - this pause comes from your core and position, not by extra pressure in the stirrup. What happens if you come down in your posting trot too soon? That leg, which was extending forward gets pressure from your seatbones, which causes it to reflexisively shorten which cause all those things we already talked about.

Take home point/exercise that I will do within 7 days:

1. tap my feet in the stirrups during long rides - this has already made a huge difference when I'm starting to accumulate tension in my ankles and hips but don't know how to release it. Just tapping my foot in the stirrup makes everything fall into place and makes me so much more comfy in the saddle.

2. ask farley to travel with her back up during trail rides. Bonus - she's less reactive.

3. Continue to critically evaluate my everyday activities (like driving) and do as much as I can not to exacerbate my one sideness any more than it's already a problem (my left side likes to fall behind, so driving with my right arm/right leg forward and my left arm in my lap and left food back doesn't do anything to try and eliminate that sideness!).

4. Make really really sure I'm not sitting down too soon in the trot. I have a really long femur (the thigh bone) which is good because Farley has a really long stride.......but I still need to be careful that I don't let sloppy posting create tension in her back. I've been putting a bit more hang time into my post and I think she really appreciates it - she seems so much more "swingy" and "relaxed" on the trail now that she knows with certainty that my seat bones are NOT going to interfere with her stride and seems a bit more forgiving when a miscommunication results in my sitting down a bit soon or hard. Combining this with making sure I can tap my feet in the stirrups I think has already made a difference in our conditioning rides - we seem to really be working together instead of against eachother. We have a great base in dressage, but these little tricks make sure that I'm not falling into bad habits.

That's it for this one folks! There's one more seminar post to go and I've saved the best for last - Endurance 101.

Monday, March 18, 2013

Proper boundaries

Alternate title: How not to make endurance into a god.

Much like the Lord of the Rings "ring of power" I find that any activity that comes to consume your life, has a way of perverting best intentions. Endurance is that activity for me. Endurance can come to occupy a place in my life in such a way that it pushes away everything else, and when it does so,it isn't acting for the better.

I need Balance. I need family, friends, relationships, running, and all those other things that represent a balanced life. This isn't a new revelation - if you have been a reader since the beginning, than you have been reading "I need balance" posts from the very beginning.

For five years I put my "all" towards endurance, and accomplished some really cool things. Then, for the last 2 years, no matter how hard I tried to make endurance happen for me, I couldn't make it happen.

Now it's starting to look like 2013 (and in reality, starting in the fall of 2012) could be a big year for me and Farley.

As in, we might have a shot at Tevis this year.

And already I can feel the familiar tendrls of unhealthy addiction and obseccsion grabbing ahold of me. Because that's how important endurance, and especially Tevis, is for me. It's such that I would sacrifice almost everything to do it.

And so I've made a committment. I will only do enduance if I can contan it to it's proper boundaries. Tevis will only happen if I can make it happy along with school, keeping up my running, and seeing friends and family.

One change Ive already made is a dedication to one ride only. While I would LOVE to be able to go back and do what I did before (competing in mutliple 100's year round), I think preparing for and riding one hundred a year ( plus some prep rides) is probably all that I (and Matt) can take. A good friend of mine in endurance does something very similar to this plan.

I'll have to ride slow, more carefully,and be completely honest with myself and motivations in order to make this work.

I'll constantly be assessing whether endurance is occupying its "proper" place. ie, am I skipping class and church to ride? Blogging or doing "horsey" research when I should be studying, in class or church? Am I gone so many weekends for training rides and prep rides that I'm missing out on significant family and friend events? Am I not keeping up with my own fitness because I'm too buy riding? Am I gone every evening until after dark at the barn doing horsey stuff?

Not everyone who reads my blog is going to agree with some of my following statements. I think God took away endurance for 2 years because it became too big and central in my life. I believe he's giving it back to me now, starting last fall, because I was finally puttng horses in a healthier, less all consuming, place in my life. I think that this year and the tantalizing promise of Tevis is a test, can I do significant endurance and have it not consume me? I don't believe in coincidences (other wise my life has been an extraordinary string of them). I'm convinced enough that I'm going to do my darnest to keep everything balanced as I persue Tevis this year. Picking 1 major race instead of a season was a big step. Recognizing the signs that endurance is reaching unhealthy proprotions is anther.

Maybe you have gotten to this point in the post and think, if she has the time and money, what does it matter? Her friends and family should support her darn it! If they really loved her they would see how much joy this brings her.......and this is where I get to point out how completely unbalanced my participation in endurance really has been

Did you know that I've never gone to a ride and just volunteered? Oh sure, I've helped out, but it's always been after my ride was done. I've never crewed for a friend, marked trail, unmarked trail, or worked on a trail crew. I've been too busy riding and achieving *my* goals.

There's a ton of different things I could do that would keep me connected to the endurance community, and make my participation more balanced, that would have a positive impact on me and the sport. I could put on endurance 101 clinics!

So what about Tevis?

I have to admit that I'm not sleeping well at night since deciding to do Tevis this year.

This plan smacks of me trying to get Minx to Tevis my first year of endurance - a season that ended in diasaster.

I keep trying to remind myself that there are significant differences between 2006/2007, and 2012/2013. It's a different horse. I'm a different rider.

But it still hasn't stopped me from flashing back to that year, where I had a plan that gave me 300 miles in endurance rides so that I could qualify and ride in Tevis, in the beginning of one season. I started my quest in April and by the of May, just 3 rides in and zero completion miles accomplished, it was oh-so-very-obvious what my ignorance and amibition had cost me.

I try to take comfort in the fact that by havng such fears, I will resist making the mistakes of the past.

I've already alluded to some of the changes I'm going to have to make in my ride strategy - must ride slower for one. Part of my strategy when I've rode Tevis before was to have enough fitness on my horse that I had a lot of reserve in case things went bad. This year it will be riding smarter and having myself be as fit as possible that's my reserve. I'll have enough horse to get through Tevis (I wouldn't be doing the ride if I thought otherwise) but I might not if I have to go faster on a section to make up for lost time because something happened. I probably won't be able to canter into the gate-and-gos during the afternoon and be pulsed down by the time I dismount. I'll probably have to take extra time at the checks, and get off more (the year I finished I had a busted knee so Farley dragged my ass the entire 100 miles). I'll have to be careful in my prep work and rides that I don't try to put an impossible amount of conditioning on Farley in the short time I have that results in a too tired horse July 20th (part of my problem Tevis 2009 when I didn't finish). I have a lot going for me. Farley and I have started 5 100's together. We've had 2 pulls - 65 miles at Tevis, and 92 miles at a different 100. She's a proven 100 mile horse. She likes 100's. We both know the Tevis trail well. Tevis plays to her strengths - heat and rocks. The 92 mile pull was directly attributable to freezing temperatures and sand. We've learned a lot together over the last couple of years. I know that she needs selinium supplementation (a major cause in our 2009 65 mile tevis pull). And that rest is the most important part of my training program. I've had 2 years of dressage training and am very aware of how my blanace and timing in the saddle can affect her ability to move along the trail efficiently and soundly. (there's a seminar right up on this subject coming up). In summary, Farley and I have what it takes to make this happen - but it's going to be about training smarter, not harder. I've spoke before on my experience on the difference between riding an arab and nonarab in this sport. I've mentioned before that getting Farley through a 100 like Tevis was far easier than any of the 50's I did on Minx. I have a feeling that my "management experience" of getting Minx through 50's is going to be vey helpful come this July.....

It's going to be an interesting next couple of months. I've been working towards Tevis since the end of last season, but haven't been brave enough to say so on the blog. There's something very humbling about publically announcing an intention to do something like Tevis not knowing what the ending is going to be, and having lived it both ways (one pull and one finish), it's very tempting to keep it a secret until it's over and done with!

So here's me checking pride and ambition at the door. I may not finish a single ride this year, but it will be because it will be filled with RO's, NOT a lame horse caused by me listening to the Bad Idea Fairy. Because being willing to fill my ride record with RO's is the only way to make this season, and possibly Tevis, happen.

Let's hear it for an endurance season that is not measured in miles or rides, but but the diversity of things I was able to do within the sport and within my life. By being able to balance endurance in such a way that it is affordable in both money and time, maybe I can do enduance always, not just in my early 20's, single, wth little commitments and a large disposable income.

Saturday, March 16, 2013

CC - Abby Answer!

And the answer to this week's CC is......Atrial Fibrillation!

Congratulations to Dom who was at the writing of this post, the only commentor. Dom got very close to the answer because they identified it as an "arrhythmia" and pointed to low Potassium as a possible contributor.

What is A fib?

There are 2 phases in the heart cycle. During the filling phase, the heart is filling with blood - blood passes through the atrium (top part of the heart), through a one way valve into the ventricle (bottom part of the heart). When the heart contracts, the atrium contracts slightly before than the ventricle. The last bit of blood is squirted into the ventricle, and then the blood in the ventricle is pushed into the great vessels to the rest of the body.

A complex electrical system coordinates when the heart contracts. There is a natural "pacemaker" that is located near the atriums of the heart. This is the dominant pacemaker under normal situations, however there are other pacemakers in the heart that can take over if this dominant one becomes damaged, or with damage to the heart, cells can become abnormal and start to function as pacemakers.

The pacemaker gives electrical signals to the atrium when it's time to contract, and then those signals travel to the ventricle (after expeiencing a slight delay as described earlier). Due to some physiological mechanisms that we are NOT going to go into here, there is a limit to how soon you can ask cells to contract right after a contraction ie there is a period after a cell contracts that matter how nicely you ask, it won't contract again.

During A fib, this system gets all messed up. During a signal to contract, some cells in the atrium are ready and so contract, other cells are in that refractory period, and so don't contract. If another signal comes right away to contract, the cells that were in the refractory period are now out of it, and do, but the other cells are now in the refractory period and don't!!!!! This sets up a situation where some population of cells in the atrium are always excitable and ready to contract, meaning that some parts of the atrium can contract whenever a signal tells it to do so.

Now lets combine the scenerio where some cells in the heart are always ready to contract with another - an abnormal etopic pacemaker (ie some damaged heart cells have developed pacemaker abilities) or a normal pacemaker that has decided to abandon it's orderly way of life. It pumps out a signal for cells to contract much more rapidly and since some population of atrial cells are always ready to contract......you get very rapid, uncoordinated contraction of the atrium. The atrium never relaxes or contracts properly.

What about the ventricle? There is a delay system that pauses signals that travel from the atrium to the ventricle, to make sure the atrium contracts slightly before the ventricle. Additionally, the ventricle is still normal in that all of it's cells are excitable and refractory at the same time - it doesn't matter if it's getting a signal to contract really fast - the cells can only respond to that signal AFTER they are done with their refractory period.

So even though your atrium is going crazy, your ventricle is still managing to pump blood out to your body in a fairly coordinated fashion.

Which is fine until you try to exercise........then that little bit of extra blood that the atrium normally pushes into the ventricle before the ventricle contracts becomes really important (not just because of the volume of blood but what it does to the stretching of the ventricle wall - a concept that is REALLY cool but that I won't go into here).....and without that the horse develops "exercise intolerance" which is the most common presenting complaint for a horse in A fib.

Who gets AF?

There are 3 classes of animals that get AF - those with heart disease (because like I mentioned, heart dz can damage heart cells and cause them to behave in weird ways like start acting like pacemakers, or disrupting the coordination of refractory and excitable phases in populations of cells), young to middle aged race horses with no heart failure disease with an acute (sudden onset) presentation of exercise intolerance, and middle-aged large thoroughbred (or crosses) with no heart failure disease, but a vague history of exercise intolerance.

Besides heart failure, other factors that can increase the chances of AF developing include some viral diseases, low potassium levels, anemia, colic etc.

Once the AF has started (ie - an event happens that causes the AF) it can persist (ie, NOT cure itself). Fun fact - in horses that are OVER 15 hands, the heart is large enough that once it gets started it will persist instead of reverting back to a normal rhythm. Bummer for large horses!!!!!!! Thus while it MIGHT be true that your little endurance horse who developed an AF during a ride because of an electrolyte inblanace might revert and be fine, be cautioned that your larger horse, OR your small endurance horse with underlying cardiac disease that results in an enlarged atrium (and don't assume that just because you have a stellar athlete 100 mile horse that it doesn't have cardiac disease) WILL NOT NECESSARILY REVERT. And may need to have treatment for it to do so.

What does AF look like?

Number one clinical sign is exercise intolerance. In the horse, the heart rate may be normal, or even below normal! As long as the filling phase of the heart cycle is long enough than you will get a quality pulse (ie blood being pumped in the body). The "R-R" (think of it as the time it takes to complete one heart cycle which = filling+pumping) will be variable - this "arrthymic". The heart rhythm will be irregular - in contrast to some other conditions, the heart rate is irregularly irregular.

AF is different in horses than other animals. Horses have an ENORMOUS cardiac reserve, which means often AF and other heart issues are undetectable until you ask the horse for a large effort - like racing, polo etc.

Some more unusual presentations can include the horse becoming uncoordinated and collapsing during exercise. That sounds like intolerance to me!!!! But more likely the AF horse without heart disease is getting tired fast and doesn't have the stamina, decreased recoveries etc.

My horse has AF - what now?

Successful treatment depends on whether there is underlying heart disease that is causing it, or if the AF has been going on for longer than 4 months (remember that if the heart is big enough - such as horses over 15 hands that an AF can't correct itself once it gets going). These horses are more likely to have a relapse in the future, even if the initial treatment was successful.

In addition to a physical exam, a blood panal (to look at potassium levels etc.) and other heart tests such as an ECG and cardioultrasound (to look at whether the horse has underlying cardiac disease in addition to the AF) may be necessary.

Treatment is aimed at returning the heart to "sinus" (normal) rhythm. Oral (through a stomach tube) doses of quinidine sulfate is used....Doses are repeated every 2 hours until sinus rhythm is achieved or when toxic side effects are seen......Being a second year vet student, I am not as familiar with treatments as I am with physiology and mechanisms, so I'll leave a detailed explanation to my reader's google searches :).

Treatment is not without it's risks and the decision of whether to treat depends on the precense of underlying heart disease. If AF is found as an incidental finding (which it often is) and has been there for a prolonged time and the horse is performing to satisfaction, it might not be worth it to treat. In acute onset AF in a horse showing exercise intolerance with no underlying heart disease? May be a good candidate to treat. Horses with AF "should not be used for arduous competition and the level of work for which they are used should not be increased from that of which they were previously known to be capable without tiring, unless treatment is successful". (From Provet)

Prognosis

I took this information from Tufts vet school website.

In horses whose resting heart rate is less than 60 (Increased resting heart rate can indicate heart disease), and the AF has been present for less than 4 months, and there is no heart murmur (or a very minor one) --> prognosis is excellent (95%).

If any of the conditions are present in the previous paragraph.....prognosis is guarded to good (80% chance of reverting the AF to normal sinus rhythm, BUT 60% chance that the AF will return).

So what about Abby?

Let's assume that Abby is a big girl over that 15 hand mark (she is a standardbred after all). She doesn't show any other signs of heart disease, no murmurs were heard, and she falls into that category of young racehorses that acutely present with exercise intolerance. Based on this information, I think that she is a good candidate for treatment, with an excellent prognosis. Since low potassium is associated, perhaps suggest that Abby's owner do some research into electrolyte replacement both before, at, and after the ride that will help Abby keep her electroytes balanced. If Abby's owner is secretly using Lasix ( a loop diuretic that causes potassium loss and is used in race horses to control "bleeders").....than that should be discontinued!

Friday, March 15, 2013

Control freak

You were going to get a seminar post today, but as it seems I have forgotten my seminar notes at home, so instead you are going to get a post recommendation and my thoughts
Mugwumps posted something quite nice......

It's about her dog, but it's also about her horse. Expecting perfection and then correcting from there. Seems like a simple concept.

"If I anticipate and try to avoid problems with Brockle, I am not successful in communicating what I want.
If I assume everything will be perfect, give plenty of room for mistakes,and don't hang on too tight, I get my message across very quickly."


During a seminar at the convention we did an exercise that involved using our hands on the ribcage of a person in front of us, guiding them like we would guide a horse with our legs. Relaxed and comfortable got the message across very clearly.......gripping did NOT.

No body likes to get bucked off and yes, it pays to be prepared, but let's not be the thought police. If I'm paying attention, I know when Farley is ready to have a naughty moment, but if I anticipate it before she's even thought about being naughty, I will actually cause it. She's not a green untrained horse. She deserves trust. If she's not being trust worthy, than maybe I should chose an alternative plan that day. Example: If I can't trust her not to buck during the canter and thus give her some freedom in my hands and legs, I shouldn't canter that day. If she's ready to explode in the arena because she hasn't been ridden in 2 weeks, then we work on walk/trot until she is relaxed.

Sometimes the amount of trust I have in Farley changes throughout the ride. I can remember that ride that I celebrated as the "first ride of 2013". I spent the first 40 minutes wondering when I would EVER have enough courage to canter this horse, because I didn't see it happening for the next YEAR based on the amount of trust I had in her. Fifty minutes later we were doing the most beautiful canter you could imagine. It wasn't on my "list of things to do during the ride", and I didn't let her do it until I could do it a relaxed, trusting way.

I give Farley as much freedom as I possibly can. Since she's allowed to walk/trot/canter/gallop under saddle she doesn't often try to bolt. Because most of the time I allow lots of rest and walking when she's tired, she doesn't try to stop on me, or go back to the barn - our trail rides are FUN. The more freedom and trust I can give, the more she lives up to my expectations. The more I try to hang on, correct, and anticipate, the naughtier she is likely to be.

Same is (more) true for Tess. The more I try to hand on and control, the more she resents it, and the more she looks for an "opportunity" to do what she wants to do, with or with out permission. This concept is what hampered our off leash work for the longest time - she wanted to run and bolt, and leap, and carreen around at top speed. I wanted her to stay close, within a 5 foot radius, and constantly look at me.

As a result, if Tess got an opportunity, she would go into "puppy runs", dissapear from sight, and scare the crap out me. Result: more control, less freedom, and an unhappy puppy.

It was only after setting some solid guidelines, taking some precautions so that I could keep my mouth shut and let her do her thing, that our off leash work progressed. She had a solid recall - it was just unfair for me to keep using it every 20 seconds everytime she got further than 5 foot away.
Another important point that mugwumps makes is that by practicing less control, our message to our animals comes through much clearer. By allowing Tess or Farley to do what they want.....it's very clear when they are being corrected. If I'm constantly correcting and micromanaging, then do they ever truly understand what their job is? If Farley gives me a nice trot but I'm still hanging on with my thighs for dear life and pulling on her, is she convinced that she has given me what I had wanted?

Probably not.

Tess didn't necessarily deserve my trust off leash a year ago, but at 2, with a solid history of wanting to please me and listening, my lack of trust in her was holding our training back and causing her to resent the situation. It was only after giving her the freedom that she deserved and was asking for, that I saw my puppy truly turn into the dog of my dreams.

Similarly with Farley, after literally thousands of miles over the years, and never once "pulling a sneaky" one on me, it really is unfair to ride her in a manner developed in me by Minx, a horse that did not earn as much freedom/trust as Farley. I tend to revert back to riding like the horse below me is about to skid to a stop, dissapear below me, and do a pivot bolt at any moment when I haven't ridden in a while. This is unfair to Farley who has NEVER pulled that move and she rightly resents it! We are going on a pleasant trail ride and my thighs are telling her that there is a dragon around the bend that's going to pull a move any minute!

I'm a self-admitted control freak. I have to constantly remind myself of this concept of less is more. Once you get past that green horse or true puppy, at some point you have to relax, you have to let go a bit. You can't expect the worst because you will get it, and your animals need some way of knowing when they have done right - and for Farley and Tess, that is a bit of freedom and relaxation.

Btw, yesterday I tried the heat treatment on the poison oak. It pissed it off, although it doesnt itch right now. Almost as a good an idea to give myself pnemonia. That prescription of pred in my cupboard is starting to look darn good.

Don't forget to submit you CC answer from yesterday before tomorrow morning when I post the summary!

Thursday, March 14, 2013

Wed Clinical Consult - Abby

Updated 6:33pm - ECG is now showing up!

Disclaimer - obviously it is no longer Wednesday and this is posting on Thursday....so get your answers in by Saturday!

I'm in clinics today, and I've decided to start a new when-ever-I-get-around-to-it-semi-regular-possibly-every-wednesday series. I'll give you a case presentation, and then on Fridays I'll give you the answer. Post your guess in the comments section and you *might* get a small-depends-on-how-broke-I-am prize.
Some disclaimers so that school administrators don't call foul on my blog and force me to shut it down. These are not real cases. These are made up from my head as typical cases. The images (if provided) are not from the VMTH. They might be my own animals. They might be random google images. Medical images were certainly stolen from the internet.
And yes, I did get this "medical mystery" series idea from another blog. Check out "MD to be" - she posts a Monday Medical Mystery every week.
OK.....I present "Abby".
Abby is a 9 year old Standardbred mare who is being used for endurance (50 mile rides). She's been competing in endurance for the last 4 years and in the last 18 months has started top tenning in rides. At a ride last weekend (24 hours ago) during the last half of the race, Abby took longer than usual to recover at the vet checks (normally Abby's pulse is within criteria less than 5 minutes) and she seemed more tired than usual. Abby's owner told you that the ride was very hot for this early in the season and that she felt that Abby looked a bit more tired than usual and so elected to not continue the BC exam at that point, even though she came in fourth.
Upon physical exam you have a beautiful, bright, alert Standardbred mare in front of you. Temperature is normal, HR 36, but Abby is a bit reactive to being touched in the girth area so you didn't get a really good listen to the heart, but you think it is irregular with no discernable pattern to the irregularity. Respiration 20. Skin is in good condition. Pin firing scars on her legs - upon questioning the owner she acquired Abby off the track with the scars. Her history before acquiring her 4 years prior is unknown. Abby's neck and shoulders are clipped. Ears are clean. Gut sounds heard in all 4 quadrants. No occular or nasal discharge. Found 2 ticks attached to the inner thigh. Submanibular lymph nodes are slightly enlarged. Upon questioning owner, she says that Abby often has slightly enlarged nodes this time of year (spring) when the trees are blooming. Abby is a 4 on a body condition scoring system of 1-9, which makes her a bit thinner than the steriotypically "ideal" of 5. Abby's owner says that she keeps her on the thinner side on purpose because she's nervous of metabolic disease based on her experience with her previous horse, a welsh pony.

Diagnosistics
1. CBC and chem panel - slight leukophillia, slight hypokalemia, all other parameters within normal limits.
2. ECG


The question
What does Abby most likely have? Can she continue as an endurance horse or must the owner retire this beautiful mare to the pasture or another sport?
For those vets out there - you probably know what this is and I would LOVE to hear feedback on how realistic my scenerio is, especially once you see my write up on the "answer" in 2 days. It was as much a learning experience for me writing this up and trying to create a typical clinical presentation, as I hope it will be for my readers who are reading through this.

Tuesday, March 12, 2013

Lyme disease

Why am I up at 4 in the freakin' morning? That would be becuase of that gosh dang blankety blank rash on my arm.

Remember when I sad that it was similar to a poison oak reaction? I said that because very few other contact dermatitis reactions (and trust me I've had a few....) are uniquely as infuriatingly itchy followed by chemical like pain and burning. Not to mention it's going through the typical cycle. A few bumps here and there the first 2 days that are itchy and annyoing.....patches of intensely painful itching rash (at day 3)....oozing and crusting (at day 4)....and finally at day 5, the panic that this is just going to continue to get worse, even though there is like NO WAY possible for it to hurt/itch/burn more but if it does life will end becaise I'm already NOT sleeping because of it, am a complete grouch, and am on just-this-side of horrible self mutilation.

It's usually on day 5 that I go in and get a shot of whatever they want to give me.

Of course, that's usually because it's on my face or my face is swelling lke a chipmunk.

This is on my arms. I can be a big girl. I can deal. I can stay up until midnight slathering all sorts of creams (given to me by doctors for previous dermatitis reactions - I'm convinced they are all placebos) and repeat at 4am.

As I lay there last night, I decided that of course this is poison oak, I just needed to figure out how I got it. It's not something that grows where I live, work or play - and I hadn't been to an area either hiking or riding that might have exposed me. It's completely limited to my forearm and back of one finger - which is really really really odd since usually I'm sensitive enough that it would be all OVER if it was on my sleeping bag, pad, camp pillow, car etc..........

In the daylight I couldn't make out a pattern to the rash on my arms but laying there in the dark not scratching (much) I had a revelation!!!!!! The odd stripes and criss crosses were from something being wrapped around my arm. Like a leadrope.

It's worse on the right than the left because Farley runs on my right side. It's on the back of my left hand because if I carry the rope while running instead of having it passively on my arm, I carry it in my left hand with the rope across my body.

I had gone running Wednesday afternoon with Farley which make it exactly 24 hours before the bumps started to appear (which is when they will appear if I'm going to have a reaction like this - bumps etc. that show up in the more typcal 3-5 days will be much milder).

I use a cotton leadrope that I make myself. It's dropped, dragged, thrown over hitching posts and rarely carried, tied, or held. The lead rope is on that horse just long enough for me to throw the clip on bridle with clip on reins and then it remains dangling from the hitching post or on the ground until I'm done.

Except when Farley and I go for a run. Which hasn't happened FOREVER. Until Wednesday. When I went out for a 3 minute, 30 mile, hot sweaty run with that rope in constant, rubbing contact with my arms because if I can I drape the rope across my arms etc so I don't have to carry it.

I make my own leadropes for a couple of reasons. a. I can't find a good cotton leadrope with the hardware I want that isnt too soft without paying a ton of money. You've already seen how I use my leadrope. Why would I pay $50+ for something that I'm going to use as a tool? b. Farley used to pull back and even mediocre leadropes get pricey (and I haven't had one of mine break.....). c. I can throw it away without guilt when it's used up but non worn out. I counting getting poison oak on it as "used up".

So, it's off to the hardware store (again...but more on that story in a future post) to pick up new rope, and while I'm at it, I'll probably make 2 leapropes - one for my routine stuff and another one just for running..

OK. Since placating my arms with attention, placebo creams, and the like, I think I can get through one of my convention seminar posts without too much distraction.

Lyme disease - this was a very cool seminar because it was co-presented by a medical doctor and a veterinarian. It's a format being used more and more in the veterinary schools (called a "one health" approach) and in fact, my classes this afternoon will consist of small group meetings with my class and 3rd year medical students and working on some cases with a one health relevance.

Normally this isn't a seminar I would have made time for, but since I'm in the middle of my infectious disease block, and I was having SCAVMA paying my hotel and convention fees, I figured I could go and call it studying......

I'm not going to go into the disease and pathogenesis much here - that information is readily available from a bunch of different places. Somethings to consider/keep in mind for the "typical" lyme case:

Horses:

  • Typical clinical signs usually include shifting lameness and uveitis. However can be a variable presentation.
  • Poor recoveries during competition.
  • May or may not see ticks - the nymph stages can be very tiny! This goes for your dogs, cats and yourself. Typically you will see ticks on them at some point if you have ticks in the area.....but keep in mind that you cannot say with confidence that your animals are not being bitten if you are in a tick area and they aren't on prevention.
  • Lyme is everywhere. There are areas of lower risk, but lyme is everywhere.

The veterinarian that presented lives in an endemic area and has been treating Lyme for a long time. I think many of the details of the presentation were based on her personal experience - she mentioned starting protocols on her own horses before trying them on clients horses. I have a family member with chronic lyme so it was interesting to see what was recommended for treatment. I don't intend on giving you a complete treatment picture, BUT I wanted to share with you the kinds of things involved in treating lyme n horses.

  • treat with tetracycline - IV is best and you are looking at 30 days of treatment. An IV catheter is placed in the horses neck and the protocol is administered by the owner with the vet checking in about 1/2 way through the treatment. The protocol wasn't horribly expensive - somewhere in the neighborhood of $500-800, but Lyme isn't one of those diseases where it's a one shot deal and now it's cured. I must admit that I sat there wondering whether I had the fortitude to treat and deal with a horse that was chronically showing symptoms of Lyme. The good news is that a lyme horse can be treated and be useful. The bad news is that it isn't as simple as 1. vet comes 2. vet cures.
  • Mitroionazole added to the protocol is very good.....but very expensive right now. A figure in the $1500 range was thrown out. This drug belongs to a class of antibiotics that can target all sorts of atypicals, protozoan parasites, etc. and she's currently trying another drug in the same class to see if there's an effect at a lessened cost.
  • Oral DMSO at 2 and 4 weeks (stomach tube) which corresponds to the middle and end of IV treatment. This vet felt like administering DMSO helped get the medications into joints and tissues that weren't highly vascularized. She did mention that it's a dehydrating agent that can be caustic (which is why it had to be given via stomach tube) which made me wonder whether that is why it's being used in Furacin/sweat wraps - it's pulling water out of the skin in a dehydrating effect. For those readers that read Which would explain why it makes the leg look better - however I'm still on the fence whether it's a reaction that is physiological helpful or a placebo effect that helps us horse owners stick our heads in the sand (ie - by dehydrating the skin and making the injury look better, are we actually making it better?)

Don't treat asymptomatic horses - their immune system is handling their disease. An important point in vetmed (and other industries) - tests are information and you should know what you are going to do with the test results (positive or negative) BEFORE you run the test. Testing shouldn't be a shot-gun approach, let's see what comes up, thing - testing should be done for a REASON. Testing has a cost and it isn't just a monetary one. My experience in the food industry has made me very aware of this concept. There are protocols of what and when to test, and what happens when those results are positive or negative. Veterinary science is no different. Why is the test being done and what are you going to do with a negative or positive result? One thing that frusterates me in a teaching hospital (especially in the small animal side) is the lack of ability to make a decision without what is called "the minimum database". Which consists of blood work, chemistry (+/- urinalysis), throacic radiographs, abdominal ultrasound. We are told as students that in reality we will make diagnosis's without this "minimum database" in the real world, and certainly in food animal medicine! Yes, it provides a lot of information, but to what point? Are we using a shotgun when a .22 would suffice? Are we treating numbers or the animal? Testing the entire herd for Lyme doesn't make sense. What are you going to do with a positive result in a asymptomatic animal? Treat it until it's asymptomatic (again)? That makes no sense whatsoever. Know why you are testing and what you are going to do with the results before you test.

A side note here - this entire post was DONE and then my blogging software crashed. I am NOT happy, so if I seem a bit grumpy right now, I AM. Rewrites are always better right? You are more decisive, communicate clearer......sure.

The point about testing and treating was a sticky point for the audience. In the horse world, you send blood off to Cornell for their "multiplex test" and get a result back. You treat, and retreat if necessary. In the human world, inconclusive results are the norm, you can start treatment for Lyme and be negative, and then halfway through treatment be positive. The guidelines of the I-forgot-the-name-but-they-are-important organization that prints such guidelines says that while treatment for Lyme (humans) is often incomplete, reteatment is not indicated. And that's how it is folks - There are many differences between vetmed and human med, but I find that often the tests and technologies and protocols that I get to use are in many ways ahead of human med. The validation and testing that is required to bring a animal medication/vaccine/test to market is way less than on the human side and as a result the technology in many ways is further along.

The vet suggested vaccinating horses with Lyme using the dog vaccine. Specifically the Merial OSP A vaccine recommended. This is off label use, the vaccine is NOT approved for horses, and as such it is up to the individual owner to decide what they want to do!!!! What was interesting is that the vaccine was suggested as both a prevantative AND as an adjuvant (no pun intended....) to therapy. The first use I'm familiar with, but typically once an animal is sick, vaccination isn't going to help....However after understanding the pathogenesis of Lyme better, I can see her point. Without going into the excrutiating details of immunology (and after having 8 weeks of it, I am NOT going to subject you to that) here's the basics. The lyme organism "expresses" a certain thing in the tick - let's call it "OSP A". Once it enters the animal the lyme changes expression to "OSP C". Thus acute infections will be characterized by high levels of OSP A, while more chronic infections will have high levels of OSP C. Vaccinating against OSP A will cause an enhanced immune response against OSP A......hopefully clearing it so that it never gets to turn into OSP C! Thus vaccinating against OSP A will prevent new infection and more spirochetes entering the body system, just leaving the OSP C from previous infections for the animal and the vet to deal with. Because effectiveness of treatment is measured as OSP C levels, which have not been messed with by the vaccine, you can still use the multiplex test to monitor treatment. Not all horses respond to the vaccine (response can be measured by looking at the amount of OSP A titer levels before and after vaccination) but a significant proportion due. In this vet's experience, she's never had an adverse reaction to the vaccine. Protocol recommended was a 2 dose series - given a couple of weeks apart, followed by re-vaccination every 6 months.

Like most conditions, prevention is the best medicine. Keep the ticks off. Tick repellant can be added to vasaline and smeared on susceptible areas of the horse like around the tail, muzzle etc. Another control strategy suggested was tick tubes. A property is seeded with small plastic tubes stuffed with fluffy stuff that's been impregnated with a tick killer. The small mouse like rodents collect this fluffy stuff and use it for bedding/nesting, where it kills their ticks.....breaking the life cycle of lyme! Very cool idea. Apparently this works on a smaller property (10 acres or so) but not on the larger ones.

I came into the seminar late so missed much of the human medicine portion of the seminar, but one concept that I remember is that if you are going to treat human lyme disease after a tick bite, before the onset of symptoms, do it right or don't do it at all. Right = antibiotics for 3 weeks. Anything less and don't bother.

One last thought - remember that your older horses are more susceptible to Lyme. Many horses older than 20 years of age have some sort of Cushing's like syndrome that results in increased circulating corticosteroid levels in their body - which is an immune suppressant. Although many horses won't show symptoms until 20+, immune compromise could be present years before that. I would pay close attention to horses in their late teens in my herd and assume that they are more susceptible to all sorts of diseases, not just lyme. It's a paradox - titers may be high from years of vaccination, however at the same time they are more suceptible to disease.

I know I have readers that have Lyme disease, and I would be curious to hear your thoughts on this information. Has anyone had a Lyme horse? It isn't terribly common in this area, but I'm super careful about keeping ticks off me based on a family member who has Lyme.

 

Monday, March 11, 2013

Home from the convention

Home from the convention!!!! I had an AMAZING time, please consider going if you've never been. There's nothing like being able to see and talk to all those people that you have an "internet relationship" with. I met several people for the "first time" after reading their blogs and corresponding on line for YEARS. It was totally worth the sleepless nights, overeating every night, missing 2 days of school, and weird contact dermatitis rash I ended up with. :) (looks very similar to what I get with poison oak, started when I drove into Reno, all over my forearms, obviously rested them on something my skin didn't like!).

I have full seminar reports for you that will be INTERESTING and RELEVANT. And I promise it won't take me as long as last year to write them up :). As a preview....the topics I'll be covering are: Lyme disease, Endurance 101, Balance and conditioning, a vendor review, new to me products, and a pair of WILD tights :).

Thank you to all the readers and clients that came up to me and said hi. It was wonderful to put faces with names.

To those of you that I didn't get a chance to say goodbye to before slipping home - I had a low grade migraine (too long in the "touch tank" + dehydration), the afore mentioned itching-burning-drive-me-crazy rash on my arms, and TWO assignments due by Monday at 8am, so I slipped away Saturday night to get some stuff done......

Plus....by going home early I got to ride my horse on Sunday. Did you know that when given the choice between a gravel road or the soft grassy shoulder she now chooses the gravel road? And that I had to buy a new power tool in order to trim her feet since she is now burning up my dremmels and I am NOT rasping that horse's feet? But I digress......those stories will have to wait until after seminar reports!!!!!

And I can't finish this without mentioning Tess. Yesterday was her 2 year old birthday and I was assured by many people that she was a gem worth keeping. She gave many people a "dog" fix and didn't do anything too naughty - pretty good for a Brittany on a leash for 3 days. :). She tries so hard to please me - a gift that I don't take for granted since she is definitely her OWN dog.

Photo taken by the awesome Lynn Glazer who was working the Reactor Panel Saddle Booth

 

Thursday, March 7, 2013

Welcome to the AERC convention

I have now been up for over 20 hours. I am exhausted. Why I am writing a blog post instead of sleeping or drinking beer with girls down stairs? Not sure.

I got a piece of advice from a veterinarian at the last conference I went to: when going to a convention, chose one subject and learn all you can about that one subject. Become an expert on that subject. This applies mostly to the bigger conferences that have a million different topics, but even at this smaller AERC convention I've decided instead of going to all the talks, I picked my top 4 or 5 and I'm going to do a really good job listening, asking questions and taking notes in those 5.

The second piece of advice was: take something you learned from the conference and apply it within 7 days. You will better retain it and use it in the future.

So, in those 4 or 5 sessions, I will find 2 or 3 things that I can apply right now, or at my next ride (which is in about 6 weeks).

If you look at the AERC schedule and there is a session that you especially want a report for on this blog, please comment or email and let me know!!!! Otherwise I'll just be going to the sessions that interest me and you are stuck with what I thought was important :)

 

Tess is with me. I feel bad for her - she's been in confinement almost all day and then she had to be on duty.....a Brittany with very little exercise is a....wild thing. She has mostly been able to control herself except when let off leash in the hotel room where her brains leaked out of her eyeballs and she went bat crazy for a wee moment. It appears that the brains have mostly returned and other than being a bit put out that she isnt sleeping on the bed, seems to be resigned to her fate. I have promised her a nice big walk tomorrow, which considering the amount of all of you can eat sushi that I shoveled down tonight isn't a bad idea for me either. Tonight I was reminded that while two is considerably better than one, theres still a lot of puppy underneath those fuzzy ears!

Bath before convention

Tess at the rest stop in snow.
 

 

 

So tired!!! Going to bed and pretending that's it's possible for me to actually get out of bed early and walk, do homework, and then do a million other little tasks that need to get done like putting my used tack in the tack swap......

 

Man versus Horse

Or rather, 4 legs versus 6 and a leadrope.

But first, I must share in my misery. Because of the lack of home internet this won't post until later, thus unless I tell you, you won't KNOW that it is currently 3:07am (I'm not exaggerating) and I'm contemplating such things like "really, the amount of hours that I spend in bed should be sufficient to dry my short hair". Yes, I have a test this morning at 9. No, I haven't studied half as much as I should have for it (thus the early hour of the morning). And before you fear that I have suddenly become overzealous and am looking for some incremental points inconsequential in passing, never fear!!!!!!!! I truly do need to actually do some studying...after all I'm in VET school and am going to be a DOCTOR in 2 years (yes, it's appropriate to laugh or quake in fear - your choice).

It makes my posts less "finished" to have random thoughts like this in front of the content, but I've decided it's worth it in order to keep me writing - if I know I have to edit posts and that I can't share what I like because it doesn't match content, then I'm less likely to be motivated to write right now - after all I have lots of stuff that I have to do "well" right now and not a whole lot that can be done how I wish.

Thus, I introduce random-thouht-before-content-number-2! As part of my "one small change at a time" philosophy that I started this year with, I bought a pedometer. I've gained back almost all the weight that I lost over last sumer, and from tracking my food and exercise in myfittnesspal.com, I can blame much of it on increased calorie intake, BUT I wanted to make sure that some insidious reduction of movement wasn't to blame........With a goal of 10K steps (which is about 5 miles) I was pleasantly surprised Saturday and Sunday when, without any extra effort, I had 5K by noon and 10K by evening. Piece of cake! Then came Monday....wow. Even with extra walks and being conscious of trying to take extra steps that 10K did NOT come easily. Nor the next day. I skipped school on Wednesday, and combined with a rededication to Martin (my walking treaddesk) I managed to eek out 10k yesterday. (Runs and rides don't count towards the 10K). The conclusion? Going to school, (or probably any other traditional sitting activity) takes a HUGE hit on activity level. Until I have a job where I can be on my feet, I am going to have to be constantly viligant to make sure that I move enough during the week and don't have my spine molded into the shape of a chair, something Farley would be VERY unhappy with, come our first ride of the season (oh yes, there is a ride season "plan", one that isn't being published just yet so that the gremlins of ride seasons can be held off just a bit longer.

If you are a face book follower of mine, you probably have seen this route posted several times.

 

Notice 2 things. 1. I am so not making up the ridiculous time that I'm up writing this blog post. 2. I'm using "Map my run" app to log my running and riding routes. Really have been happy with this (free) app and recommend that you give it a try if you are looking for something similar. I like to use Maymyrun for routes that I do regularly so that I can check mileage, not necessarily for formal rides where I already know the mileage - using the GPS on my phone uses up too much battery.

I call this the "Short orchard loop". Said loop is 3.1 miles. There's a levee in the middle of it that I have to climb and then descend, but other than that, it is a flat, dirt and grass, packed but not hard, currently-with-wildflowers-oh-my-gosh-aren't-I-lucky loop.

Up until yesterday everytime this loop was posted in my feed it was a 4 or 8 legged loop. Meaning I was mounted, +/- Tess. People were amazed at my times until they realized it was on a *horse*.

Let's call Farley's PR here 22 minutes.

Farley: Actually......

Mel: Shut up.

Farley: Remember that one time? that I bucked you off?

Mel: Don't go there

Farley: I'm pretty sure that I did this under 22 minutes.

I attempted a 6 legged loop yesterday, which was Farley's first leadline run in FOREVER, between thunderstorms and logged a paltry 32 minutes.

Farley: I helped by stopping and eating grass.

Mel: that was NOT helping.

Farley: but then I let you grab my mane handle and bounce along beside me at an extended trot.

Mel: touché

My run strategy was similar to my ride and tie one, except less motivating because the horse was with me instead of tied somewhere ahead: Run at a tempo style pace until I felt like I was going to die of a heartattack, then walk. When snot was no longer leaking down my face and Farley stopped being concerned about my welfare, run again.

I'm pretty sure I can beat the Farley 22 min PR

Farley: it's not a PR!!!!!!

Mel: I'm going to explain why you don't get to gallop the whole thing and call it a PR if you'll just stand there quietly!

In contrast to me hitting the pavement literally at a run and then dashing through the orchards at top speed, finishing with a kick (that's what they call it when you are on the ground kicking yourself for getting this out of shape right?) back to the stable, Farley has "guidelines" for our rides.

Farley: more like dictator-like commandments

Mel: When horses decide to stop being so delicate, be sure to tell me. Alternatively, when you learn to communicate anywhere but here, and we can have a discussion about how everything feels, you let me know. Until that point, I call the shots and we can pretend this is a partnership.

1. We walk about a point about 10-15 minutes into the ride.

2. There shall be no cantering until the half way point.

3. Hand gallops are allowed, BUT the ride must be finished with Farley cooled down enough that within 1-2 minutes she's below 60.

 

I think I have a shot at beating 22 minutes and not having Farley substantially raise the bar as long as I

a. do this BEFORE she sheds her winter coat

b. don't ride this loop with her too often.

Will Man beat out Horse? Or is 4 legs supreme to 2?

Farley: snicker

Mel: Be quiet! Or you will be going up and down EVERY hill this season with me on your back!


It's 3: 44! Time to get to studying, packing for the convention (which involves a Tess bath), and compulsively checking the weather report. Truck or car? I don't own chains for either. The car would be cheaper if I did have to buy them, but it would make long term sense for the truck to have chains - not to mention the safety of a bigger vehicle (and the embarrassment I will have to face if someone climbs into my commuter car full of Tess hair), but my truck gets squirrely with no weight in the back end (thanks to it being a standard cab long bed 3/4 ton). mmmm.......Things to contemplate AFTER the test! Now off to contemplate vector borne diseases, mechanisms of CNS entry, and adverse vaccine reactions!