Danny Cook is the CEO of Animal 360, and together with Gary Wells, the conceiver and developer of the Horse and Dog 360 range of mobile Apps. He is striving in his life to become a Horseman, Equine Muscle Therapist, Businessman and Human Being.  Tough one! 
His great belief in his Horses is “Being a practical man, I think     you have to know how something is built before you can     understand how it works.”
 

 

I went out to the paddock the other day, and found a lame horse. How many expensive conversations start with that little cracker of a sentence?

Meet Casey, my 8 or 10 year old mare. This is the horse I have committed to for 2013.  She deserves it, and I am going to learn something……… Anyway she is just out in the paddock-  Then comes 700+mm of rain in five days or close to 30 inches.

I find her carrying the off-side front leg badly, and resting it right on the toe of the hoof. With all the water around, my mind is leaning toward an abscess in the hoof. A fairly reasonable suggestion, so I thought.
Closer inspection shows swelling on the back-side of the knee. It is really only on the upper outside of the knee (carpus ) itself.

Injury offiside

Good Knee nearside

 

 

 

 

 

 

 

 

 

I check her pulse rate, respiration rate and temperature, and they all seem to be in the normal range.  (Normal 37-38 degrees C, 30-40 beats per minute and 15-20 breaths per min) I double check the hoof for an abscess because you never know, and it all seems clear.  The normal temp suggests no infection, not yet anyway.  So I am back to muscle injury.

Lateral Carpal Flexor

The injury is really at the base of the of the Lateral Carpal Flexor.   The muscles that runs down the back of the forearm on the outside of the limb, and connects below the knee.  The swelling is really localized. It was late on a Friday, and the vet is shut. I managed to dig up some ‘Rapigel’ and bandages. I have not used ‘Rapigel’ before, it is an off the shelf gel with Comfrey and ethanol that is used as an anti-inflammatory.

I apply the ‘Rapigel’, wrapped it up in cotton wool and vet wrap bandages. Give her some ‘Bute’ (Horse panadol) and left her in the yard.

Two days passed, and I have checked the wrap a number of times.  The swelling is coming down gang busters, and it is starting to look really good. The ‘Rapigel’ seemed to work. She is walking without a limp and keeping weight on that leg. No hesitation. I am feeling like the world’s greatest Horseman, and I let her out in the paddock for a feed and a walk.  This turns out to be a schoolboy error.

I head back to the paddock the next day, and I find the same lame horse carrying the same leg in the same way. (I am no longer feeling like the worlds best horseman…)

I find the knee looking like this. The swelling is different this time.  It is all around the knee and it is hard as a rock.   The tenderness is still at the rear of the knee not above it this time. It feels like it is in the accessory carpal at the rear of the knee.

The boney bit poking out the back.

Why didn’t I leave her in the yard for a few more days? 48 hours is only just the beginning of the healing process as far as muscles go, and I know the best way to get rid of fluid/swelling/inflammation is to keep the area wrapped up, secure and under compression. I could have walked her if I wanted blood flow.  Not smart. Not good Horsemanship.

I don’t think that Casey has given herself another injury, but I do think that all that swelling would have been gone in a few days, and the real lameness may have shown.  It is hard for me sometimes to work out the difference between lameness from inflammation, and swelling and lameness from the injury. So my main method is to try to remove the swelling… then you only have the other left to deal with.  That is how I try to approach injuries generally (not open wounds).

I wrap her back up.  More cotton wool, more ‘Rapigel’, and leave her in the yard.

Three days pass this time.  After three days that knee is more swollen, and it is beginning to spread down into the cannon. Now I am thinking broken bone in the knee because it is a lot more tender then it was two days ago.

 

So I get the Vet out.

 

 

Deb Thorne from the Maleny Vet comes out. Has a good look, a good poke around, and takes some X-rays.

 She sends me an email that reads like this.  ( this is the best explanation email I have ever got from a Vet. )

As you can see from her attached Xrays, there are no fractures of the carpal bones.  We get a really nice view of the accessory carpal – the bone closest to the area that you indicated was swollen.  Of interest though,  just above the AC ( in the lateral/ sideways view), you can see a couple of things.  There is an area where the soft tissue above the AC bone appears slightly more radio-opaque ( whiter) that the surrounding tissue.  It’s roughly an oval shape.  I think this might be a bleed – a bruise of some description.  Associated with the bone just adjacent to that there appears to be an area where an area where a small strip of white is separated from the underlying bone.  This is not a fracture – but I am suspicious that this is an inflamed periosteum, which is the thick fibrous lining around a bone.  It looks as if she has had a good whack to the area and we have some periosteal inflammation, although she was surprisingly not too sore when I gave that spot a good poke ( it’s usually ridiculously painful).  The other alternative is that is what we call an “artefact” or something that looks like an abnormality, that is created by the way the bone margins were superimposed, the way the Xray was taken, or mild movement during the shot.  I am more inclined to say it is the former.

 At any rate, GENTLE exercise, massage and possible some Rapigel will help the swelling work it’s way down the leg and gradually away.  It may take another week or so.
P.S. I have had another go at attaching the Xrays and this one has a better view of further up the leg.  WE have had four vets look at the leg and the general consensus is that the fine white line seen adjacent to the suspected bruising is NOT periosteal separation – tho it may be bruising as we suspected.”

 The Xrays are not brilliant in so far as positioning (light, movement, overlapping, cropping etc) which is always difficult with an unsedated horse in the field.”

 BRUISED MUSCLE- BRUISED TO THE BONE!!!

 Basically Deb has helped me find out what I saw in the first place. Injury and local swelling to the base of the Ulnar Carpal Flexor Muscle.  That is what we can see in the first photos. I did not pick the bruising of the bone ( periosteal inflammation). Not that I could.
I leave her in the yard for another two days with only light walking once a day.  This makes a total of five days in the yard. The swelling in the knee, which is spreading to the cannon is just the fluid trying to work its way through the body.  So although it looks bad, it is just only blood and inflammation trying to get away. Five days later.  Still swelling in the knee and cannon, but it is changing because she is walking out in the paddock and feeding out herself now.

Lessons to learn

No Short Cuts – What I did wrong was to take a short cut and let the mare out of the yard in 48 hours, when only the main part of the swelling was gone.  But looking back, I know that muscles injuries do not heal in 48 hours.  I should have given her at least four or five days, so that the swelling I could not see was gone, and the muscles was starting to mend properly.  Had I done that, I would’ve put Casey out in the paddock more substantially healed, and she would’ve suffered only a few more days of discomfort, instead of the two odd weeks that it will take to get the residual fluid out of the knee.

Money – Had I taken proper care of the inflammation, I don’t think I would’ve needed to get the vet. The lack of lameness would not have made me think “broken knee”

Periosteal Inflammation –  You can always learn something new.

And I found a good vet, so not all is lost.

Thanks for reading.

Danny Cook, Horseman on a Journey and CEO Animal 360

 Horsemanship is Animal Welfare = Animal Welfare is Horsemanship

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Intro Blog – Back to the Start

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