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2011 – Rock & Roll – 10-14-11 – ROCK EVALUATION/DR HAUSSLER

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October 14, 2011

Re: Evaluation of Rock for Meredith Hodges

Chief complaint:

Acutely lame on left pelvic limb with muscle spasms and heat in the area of the left hip or stifle region.  There is a possibility that he was injured while playing with his stablemate.

Medical history:

Rock was acquired in December 2010 with a chronic pelvic fracture on the right side.  It that time he was unable to use the right hind limb other than to circumduct the leg when walking.  Since that time he has undergone extensive rehabilitation and massage therapy in an effort to improve functional use of the limb and to increase muscling in the region.  He also has a history of chronic laminitis in all four feet that have been managed with regular trimming, support boots on the front feet and shoes on the hind feet.  Radiographs approximately 6 months ago showed significant rotation and thinned soles on both hind feet.  He has been managed without any pain medications until recently, when he was treated with phenylbutazone for 9 days (3 days at 2 grams twice a day; then 6 days at 1 gram twice a day), which did provide pain relief at that time.

Observation:

Rock was in overall good body condition; although, there was pronounced back and especially right pelvic muscle atrophy.  He has leg wraps on both forelimbs from mid-forearm distally to the pastern region.  He has a hock wrap with padding on the left hind due to decubital sores.  He also has superficial skin wounds at the left distal scapula and left elbow, which are treated with panalog.

He was alert but did not appear to want to readily move.  He is able to stand squarely on all four limbs when Meredith provides prompts, but he stands with excessive carpal flexion and tends to unweight the right pelvic limb.  There is occasional muscle fasciculations over the left mid-femoral region when standing still.  He has a reported history of possible shivers and/or stringhalt.

Gait evaluation:

Rock moves slowly and carries the left hind limb to the mid-line of his body in an effort to unweight the right pelvic limb.  There is a severe grade 4/5 lameness on the right fore with a noticeably shortened cranial swing phase.  Moderate lameness is also noted in the left forelimb.  He is unwilling to completely extend either carpus while walking.  He is able to navigate a 10-foot circle in either direction but does not have confident pelvic limb placement or motion.  He is reluctant to back up and is able to only do 1-2 steps with prodding.

Physical examination:

There is moderate muscle atrophy present in the cervical region with moderate stiffness in lateral bending at all cervical vertebral levels.  No signs of pain, inflammation or muscle hypertonicity are noted in the neck, wither or trunk regions.  The wither region is well muscled and has good tone throughout.  Palpation of the forelimbs reveals severely hypertonic and over-developed extensor muscles of both forearms (antebrachium), relative the flexor muscle group.  This is in response to him unloading the digital flexor tendons (normal antigravity muscles) and secondarily overloading the extensor muscles (not used to being antigravity muscles); likely due to an acute about of laminitic pain.  There is mild heat and mild digital pulses in both front feet.

Rock has severe generalized stiffness throughout his thoracolumbar spine.  There is restricted motion at the lumbosacral and sacroiliac joints; although, it is difficult to fully assess due to the presence of pronounced, periodic bone crepitus radiating from the pelvic region, which is likely due to an unstable or un-united chronic fracture site.  The right pelvic region has severe muscle atrophy, but no obvious signs of localized pain or bony instability.  The left and right pelvis and femur have readily palpable lateral bony landmarks with no pain localized to the bony prominences.  There is normal tail tone and perianal reflexes; indicative of normal innervation in the region.

There is a 6-cm wide fibrotic band extending along the cranial margin of the left biceps femoris muscle in the pelvic region, but other muscles on the left side palpate normally other than having moderate atrophy.  There is a region of heat and mildly edematous tissue about 10 cm wide and 30 cm long over the acetabular and greater trochanter regions on the left side.  Overall muscle tone is good in the thigh region on both sides.  Rock is willing to left his right hind limb and allow very gentle passive joint motion at his hip joint.  No crepitus or pain was induced.  He was not willing to lift the left hind limb to allow assessment of passive joint motion due to reluctance to fully weight bear on the right hind.

Assessment:

  1. Possible soft tissue injury to left hip region – secondary shifting of weight to forelimbs and exacerbation of chronic laminitis
  2. Acute bout of laminitis and pain – secondary compensation with his forelimb muscles
  3. Chronic right pelvic fracture and secondary muscle atrophy

Treatment goals:

  1. Reduce laminitis pain and continue to manage chronic foot problems
  2. Strengthen the pelvic muscles to help stabilize the chronic pelvic fracture
  3. Improve trunk mobility to support core stability and transfer of weight between the fore and hind limbs

Recommendations:

For the left hip region:

  1. Apply an ice pack over any areas of heat within the region, 1-2 times a day for 10-15 minutes, until the heat and pain is gone.
  2. Monitor muscle spasms and pelvic limb use on both sides.

For the laminitis:

  1. Apply cryotherapy to reduce pain and inflammation
    1. Apply bags of ice around the front feet for 20-30 minutes, 4-5 times a day for 1-2 days, and then 2-3 times a day as able until the pain is reduced.
    2. Place all four feet in specially-made wading pool filled with ice at the same dosage as above.
  2. Begin pain medications – Phenylbutazone plus Gastrogard for the next 7-10 days.
  3. Recommend repeat radiographs of all four feet to assess any changes from the prior radiographs and subsequent corrective hoof trimming. Depending on the status of his coffin bone position relative to the hoof wall, adding sole support with blue construction styrofoam or similar product to help specifically increase sole support would be indicated.
  4. If you are able to position Rock in lateral recumbency with someone restraining his head and preventing him from standing up cautiously, do passive range of motion on both front limbs in flexion, extension and mobilization of the coffin, pastern and fetlock joints. Massage of the hypertonic forearm muscles would be good also, if able to do in a safe manner.

For the chronic pelvic injury:

  1. Tail pull exercises to engage and stimulate pelvic muscle development. Apply axial traction for 2-3 seconds to activate gluteal muscles.  Repeat cyclic loading-unloading for 20-30 repetitions, 1-2 times a day, for the next 4-6 months.  May pull slightly toward the left or right sides to specifically active muscle groups on the left and right pelvic regions.
  2. If able, apply electrical muscle stimulation (or electroacupuncture) to the middle gluteal muscles bilaterally at a frequency of 2-5 Hertz, amplitude until you can see visible muscle contractions or to Rock’s tolerance. The goal is to increase muscle strength and size to help stabilize the pelvis.
  3. Apply superficial heat (heating pad) or deep heat (continuous therapeutic ultrasound) over areas of fibrosis to loosen connective tissue prior to massage.
  4. Continue vibrational massage (Thumper) over areas of muscle hypertonicity in the trunk and pelvic regions.
  5. Continue low-force chiropractic care of the pelvic region

For core stability:

  1. Recommend carrot stretches by directing his head toward the elbow and stifle regions with Rock stabilized up against a wall. Do 4-5 stretches to each site, 1-2 times a day, for 3-4 weeks.  Make sure he does not lose his balance.
  2. Reinitiate proprioceptive training and ground pole exercises once the acute laminitic pain has been resolved.

Thank you for inviting me to consult on Rock.  Please contact me if you have any questions.

Sincerely,

Kevin K. Haussler, DVM, DC, PhD

Diplomate, American College of Veterinary Sports Medicine and Rehabilaition

2011 – Rock & Roll – 11-22-11 – MASSAGE

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11/22/11: Rock got a massage today. Since it was Thanksgiving week, Roll had to forfeit his massage this week…not enough time, but he is doing really well anyway. Rock is still having problems with the left hip, but he was adjusted by Dave McClain yesterday and he was happy to see him gaining weight again. He adjusted well and Dave instructed Joanne and I to do some traction exercises with him which we did today and will resume daily from here forward. We are also doing short traction exercises that Dr. Haussler recommended. We were short on camera people this time, so we do not have many still shots, but we do have more on video, including the traction exercises.

2011 – Rock & Roll – 11-21-11 – OUTDOOR ARENA TRAINING

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11/21/11: Rock had a good workout today and did not seem as sore as he was the last time. He didn’t clip any PVC rails today and gave me one shoulder-in for a couple of steps each direction. He is still chasing his balance, but I am pleased that he is inclined to correct it himself when he comes to a halt. He is still tracking the left hind behind the right front. Dave McClain saw him and adjusted him today after the workout and he was pleased to see that he has gained weight again and is happier in his overall attitude. I asked if he thought the left hip had been fractured and he said no, but that he had really hurt it so it will take some time and the right kind of maintenance work. He suggested putting him in 300 pounds of traction intermittently as we are able to do. That would help to open the left hip joint and promote healing. The regimen of allowing him his morning nap, then turnout into the sandy dressage arena and the gate open into the south pasture to encourage him to put his head down and graze and move (whenever it is not muddy or slippery) seems to be working well. I did have to wrap two places ion his left leg today as he must have reopened the scabs while getting up from his nap.

2011 – Rock & Roll – 10-14-16-11 – LAMINITIS

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10/14/11: The saga of Rock continues. We had a powwow with our support team on Friday (Me, Joanne massage therapist, Dave Miller DVM, Greg Farrand DVM, Dave McClain Rock’s chiropractor, Kevin Haussler CSU chiropractor, Chad) and it was decided that Rock’s laminitis in front was causing a lot of the problems in his back legs. The best therapy would be to ice pack his feet 2-5 times per day. This posed a challenge if we were to put his feet in buckets of ice.

10/15/11: We tried bags of ice on his feet this morning, but that was kind of a hassle, so Chad and Steve spent the afternoon building an ice ditch for him so we could ice all four feet at the same time. We knew there would be a training issue, so we kept the water level a little shallow this time, It took about 45 minutes to convince Rock it was okay to stand in the icy water in the ditch…and not climb up the side…or go around it! He stood in the water for about 20 minutes, but after that is was past feeding time and he was ready to climb out.  We will do more tomorrow. I was so proud of him and of the fact that he trusts me enough now to do ask I ask without much trouble at all. What a good boy!

After being iced twice today, he does seem to have improved more than I would have thought. He was standing in a hunched position yesterday with both knees buckled in front. Today after the first icing, he was standing with both knees locked during the icing with some weight shifting from leg to leg, but after the second time he is once again standing with his knees straightened out and seems pain free this evening. It must have felt really good to him and I am so grateful to Chad and Steve for their interest and creativity in dealing with these kinds of issues. They really care!!

The second icing was a 45 minute exercise in training to get into the ditch NICELY. Once he got in, he stood well for about 20 minutes and then seemed to want to walk out. Of course, it was feeding time, so that may have had something to do with it, but he did stay in for 25 minutes.

10/16/11: Rock was iced twice today and went willingly into the ditch. I have discovered that he becomes uncomfortable standing in one position for more than about 20 minutes and 25 minutes at a stretch, so I let him out when he became really insistent. Better he enjoys this. He does do better in motion in the pasture and was happy all day. Rock did not exhibit pain after icing. He was grazing with both knees flat and both front legs straight. The left front began to buckle slightly at the knee by the end of the day, but is much improved from where he was just yesterday. I am amazed at the immediate results in the icing. He does not appear to need Bute right now and I would prefer to minimize anything that might compromise his digestive tract considering his condition last December. He did not lie down this afternoon. I know this because the skin flap on his shoulder wound was the same as it was this morning when I iced him (no new sand and dirt). He was out in the pasture grazing happily. Both knees were much straighter.

The boots Rock wears during the day seem to be okay (but not great and a little dangerous when he steps on himself) for the time being, but his new ones are due soon. Taking them off at night is helping the shoe boil behind the left forearm. It does seem to be healing…finally as are the others that are under the wraps.

October 14, 2011

Re: Evaluation of Rock for Meredith Hodges

Chief complaint:

Acutely lame on left pelvic limb with muscle spasms and heat in the area of the left hip or stifle region.  There is a possibility that he was injured while playing with his stablemate.

Medical history:

Rock was acquired in December 2010 with a chronic pelvic fracture on the right side.  It that time he was unable to use the right hind limb other than to circumduct the leg when walking.  Since that time he has undergone extensive rehabilitation and massage therapy in an effort to improve functional use of the limb and to increase muscling in the region.  He also has a history of chronic laminitis in all four feet that have been managed with regular trimming, support boots on the front feet and shoes on the hind feet.  Radiographs approximately 6 months ago showed significant rotation and thinned soles on both hind feet.  He has been managed without any pain medications until recently, when he was treated with phenylbutazone for 9 days (3 days at 2 grams twice a day; then 6 days at 1 gram twice a day), which did provide pain relief at that time.

Observation:

Rock was in overall good body condition; although, there was pronounced back and especially right pelvic muscle atrophy.  He has leg wraps on both forelimbs from mid-forearm distally to the pastern region.  He has a hock wrap with padding on the left hind due to decubital sores.  He also has superficial skin wounds at the left distal scapula and left elbow, which are treated with panalog.

He was alert but did not appear to want to readily move.  He is able to stand squarely on all four limbs when Meredith provides prompts, but he stands with excessive carpal flexion and tends to unweight the right pelvic limb.  There is occasional muscle fasciculations over the left mid-femoral region when standing still.  He has a reported history of possible shivers and/or stringhalt.

Gait evaluation:

Rock moves slowly and carries the left hind limb to the mid-line of his body in an effort to unweight the right pelvic limb.  There is a severe grade 4/5 lameness on the right fore with a noticeably shortened cranial swing phase.  Moderate lameness is also noted in the left forelimb.  He is unwilling to completely extend either carpus while walking.  He is able to navigate a 10-foot circle in either direction but does not have confident pelvic limb placement or motion.  He is reluctant to back up and is able to only do 1-2 steps with prodding.

Physical examination:

There is moderate muscle atrophy present in the cervical region with moderate stiffness in lateral bending at all cervical vertebral levels.  No signs of pain, inflammation or muscle hypertonicity are noted in the neck, wither or trunk regions.  The wither region is well muscled and has good tone throughout.  Palpation of the forelimbs reveals severely hypertonic and over-developed extensor muscles of both forearms (antebrachium), relative the flexor muscle group.  This is in response to him unloading the digital flexor tendons (normal antigravity muscles) and secondarily overloading the extensor muscles (not used to being antigravity muscles); likely due to an acute about of laminitic pain.  There is mild heat and mild digital pulses in both front feet.

Rock has severe generalized stiffness throughout his thoracolumbar spine.  There is restricted motion at the lumbosacral and sacroiliac joints; although, it is difficult to fully assess due to the presence of pronounced, periodic bone crepitus radiating from the pelvic region, which is likely due to an unstable or un-united chronic fracture site.  The right pelvic region has severe muscle atrophy, but no obvious signs of localized pain or bony instability.  The left and right pelvis and femur have readily palpable lateral bony landmarks with no pain localized to the bony prominences.  There is normal tail tone and perianal reflexes; indicative of normal innervation in the region.

There is a 6-cm wide fibrotic band extending along the cranial margin of the left biceps femoris muscle in the pelvic region, but other muscles on the left side palpate normally other than having moderate atrophy.  There is a region of heat and mildly edematous tissue about 10 cm wide and 30 cm long over the acetabular and greater trochanter regions on the left side.  Overall muscle tone is good in the thigh region on both sides.  Rock is willing to left his right hind limb and allow very gentle passive joint motion at his hip joint.  No crepitus or pain was induced.  He was not willing to lift the left hind limb to allow assessment of passive joint motion due to reluctance to fully weight bear on the right hind.

Assessment:

  1. Possible soft tissue injury to left hip region – secondary shifting of weight to forelimbs and exacerbation of chronic laminitis
  2. Acute bout of laminitis and pain – secondary compensation with his forelimb muscles
  3. Chronic right pelvic fracture and secondary muscle atrophy

Treatment goals:

  1. Reduce laminitis pain and continue to manage chronic foot problems
  2. Strengthen the pelvic muscles to help stabilize the chronic pelvic fracture
  3. Improve trunk mobility to support core stability and transfer of weight between the fore and hind limbs

Recommendations:

For the left hip region:

  1. Apply an ice pack over any areas of heat within the region, 1-2 times a day for 10-15 minutes, until the heat and pain is gone.
  2. Monitor muscle spasms and pelvic limb use on both sides.

For the laminitis:

  1. Apply cryotherapy to reduce pain and inflammation
    1. Apply bags of ice around the front feet for 20-30 minutes, 4-5 times a day for 1-2 days, and then 2-3 times a day as able until the pain is reduced.
    2. Place all four feet in specially-made wading pool filled with ice at the same dosage as above.
  2. Begin pain medications – Phenylbutazone plus Gastrogard for the next 7-10 days.
  3. Recommend repeat radiographs of all four feet to assess any changes from the prior radiographs and subsequent corrective hoof trimming. Depending on the status of his coffin bone position relative to the hoof wall, adding sole support with blue construction styrofoam or similar product to help specifically increase sole support would be indicated.
  4. If you are able to position Rock in lateral recumbency with someone restraining his head and preventing him from standing up cautiously, do passive range of motion on both front limbs in flexion, extension and mobilization of the coffin, pastern and fetlock joints. Massage of the hypertonic forearm muscles would be good also, if able to do in a safe manner.

For the chronic pelvic injury:

  1. Tail pull exercises to engage and stimulate pelvic muscle development. Apply axial traction for 2-3 seconds to activate gluteal muscles.  Repeat cyclic loading-unloading for 20-30 repetitions, 1-2 times a day, for the next 4-6 months.  May pull slightly toward the left or right sides to specifically active muscle groups on the left and right pelvic regions.
  2. If able, apply electrical muscle stimulation (or electroacupuncture) to the middle gluteal muscles bilaterally at a frequency of 2-5 Hertz, amplitude until you can see visible muscle contractions or to Rock’s tolerance. The goal is to increase muscle strength and size to help stabilize the pelvis.
  3. Apply superficial heat (heating pad) or deep heat (continuous therapeutic ultrasound) over areas of fibrosis to loosen connective tissue prior to massage.
  4. Continue vibrational massage (Thumper) over areas of muscle hypertonicity in the trunk and pelvic regions.
  5. Continue low-force chiropractic care of the pelvic region

For core stability:

  1. Recommend carrot stretches by directing his head toward the elbow and stifle regions with Rock stabilized up against a wall. Do 4-5 stretches to each site, 1-2 times a day, for 3-4 weeks.  Make sure he does not lose his balance.
  2. Reinitiate proprioceptive training and ground pole exercises once the acute laminitic pain has been resolved.

Thank you for inviting me to consult on Rock.  Please contact me if you have any questions.

Sincerely,

Kevin K. Haussler, DVM, DC, PhD

Diplomate, American College of Veterinary Sports Medicine and Rehabilaition

2011 – Rock & Roll – 10-18-11 – MASSAGE/ICE

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10/17-18/11: Rock got a half hour massage on his upper two front legs and left hind and was iced only once yesterday morning. I was going to do him twice, but it was extremely cold and windy and basically unpleasant. He stood for the icing fine, but was anxious to get out after 20 minutes. I had all four feet in the ice for the full 20 minutes, but noticed he began to get very fidgety after 10 minutes and repeatedly tried to walk out every 2 minutes thereafter. When I went back to check him at 4:30PM, he had both knees locked and was standing comfortably, so I opted not to upset him by doing the second icing yesterday (17th).

I decided to have him exercise during the walk to and from the ice bath. He was put in his exercise rigging with the elbow pull and we started by going out his gate and into the dressage arena. He made a left turn after going through the gate with little trouble. I allowed him a wide berth to turn in (roughly 10 meters). We then proceeded through the dressage arena sand and over 4 1-inch PVC ground poles. He knocked 1 pole with the right front (17th) and 2 poles the next day (18th). We then proceeded through 2 more gates with two right turns (10 meters). On the return, the way through the gates was reversed and he did them easily. He did not knock any PVC poles coming back through on both days. He was then turned loose in his dressage arena/pasture turnout and did not seem to need to lie down as much at all as he had last week. I opted to keep him off the Bute because he was not exhibiting severe pain. Unless needed, I think it is better to allow him to be as natural as possible and live with some pain so he can let me know when things change…even slightly.

The second day, Rock went through the same exercise to and from the icing and knocked two poles with his front right foot going out and then no poles coming back. I opted to allow him to leave his back feet out of the ice until the last 10 minutes of his 20-minute icing (he starts to get fidgety every time at about 15 minutes). This worked well and he stood easily longer. I put the back feet in during the last 10 minutes and he was just beginning to tell me he didn’t like it when he was allowed to exit. We thought perhaps since he has shoes behind that the shoes and nails may be conducting the cold differently and could be causing pain in the hind legs. He seems brighter and happier with every new day. The sores on his body are healing very nicely both under the wraps and even the spots that are still exposed. The shoe boil is doing much better since we began taking off his boots at night.

2011 – Rock & Roll – 10-18-11 – MASSAGE WITH SUNNY

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10/18/11: Today Rock and Sunny got massages. Sunny was thrilled and Rock was confused that someone other than he and Roll was getting my attention. Rock has been having real problems with his hips  Last week he was able to lift each hind leg slightly off the ground more easily than he could today, but with Joanne supporting his left side, we were able to dress his feet with the Rainmaker and Thrush Buster again. The lower wrap on his fetlock was wet and the sore underneath had healed well, so I did not replace it. He did skin up his left knee pretty good though, so I did wrap that again. It is difficult to keep the wrap on the knee, but we just have to check daily. Rock enjoyed his massage work and liked it when we did some traction exercises on the hips. It does seem to help some, but I fear he is getting weaker behind as a whole. He is eating well and maintaining a lighter weight than he had in September. He has been on Bute for four days now with the first three days 2 grams morning and evening and then 3 days with 1 gram morning and evening. It does help to keep him from hurting. He is also getting Gastroguard with it to protect his digestive tract. The snow and ice prevented me from getting him to the indoor arena for more structured exercise which may or may not help at this point.

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2011 – Rock & Roll – 10-24-11 – WALK TO ICING PIT

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10/24/11: The regimen of integrating his walk to the ice ditch as a workout is maintaining his muscle tone just fine. He still doesn’t want to be immersed in ice longer than a total of 20 minutes with the fronts in 10 minutes earlier than his back feet. So the back feet are only in for 10 minutes. The wraps are staying on for an average of 3 days and the pressure sores are healing well.

2011 – Rock & Roll – 10-27-11 – VETERINARIAN/MASSAGE

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10/27/11: Rock and Roll had a brief massage session today. Dave was not here to do Rock, so I did half of him and because Rock was getting sore after being in the tack barn for an hour prior to his massage for front foot x-rays. When we tried to put him on Dr. Farrand’s 4-inch blocks, he would not put his foot down and leave it there because the polyurethane finish was too slippery, so we successfully got him to stand on the 2-inch blocks that Chad made. The results of the x-rays showed that he has side bones in both front feet, seedy toes that are worse on the left and he is rotated a quarter of an inch below the level of the coffin bone in the left front. Dr. Farrand conferred with our farrier and it was decided to take off a lot of toe this time around to help with the white line problem. We are cleaning the feet several times a day and are treating them with both Thrush Buster and Rainmaker to keep the bacteria from getting too deep into the area between the hoof wall and lamina until we can get these feet grown out. If this is chronic, we may not be able to prevent future occurrence, but there is hope that he could stabilize after two or three more trims.

2011 – Rock & Roll – 10-28-11 – FARRIER

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10/28/11: Rock got trimmed on the fronts today. We opted not to do the rear feet since Dean did not think he would be able to get the shoes back on if he got them off. Rock was just much too sore today. We are going to try doing the backs next time and then every other time after that. Dean was a little more conservative about how much toe and heel he took off, but stayed within the parameters that he and Dr. Farrand had decided upon. I removed Rock’s wraps entirely since it has been wet and snowy and they were staying much too wet. When he came in later today, he seemed fine. He had not done any damage to the sores and he had been lying down, so I think we are good. We will continue to keep an eye on the pressure sores and if need be, I will wrap them again and just rewrap more often.

2011 – Rock & Roll – 11-2-11 – INDOOR ARENA TRAINING/TURNOUT ROLLING

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11/2/11: I was very concerned about Rock last night when we brought him in from the dressage arena for feeding. Not only was he tracking with the left hind behind the right front, but now the right hind foot was turned to the outside and had very shaky balance. This is the leg with the fracture, but it had never been as rickety and unstable. He was having muscle spasms in the area just in front of the flank from the spine to the lower flank. I suspected because of the time it was done and what happened thereafter, that the A-stim that was done on Rock’s hips has actually significantly aggravated integrated muscle performance in the left hip area and has adversely affected his proprioception. This was validated by his workout today. When he came into the tack barn his hips listed to the right and his front end alignment was to the left.  He allowed me to manipulate his body back into a balanced stance several times before we left the building. We treated his feet with thrush buster again for the white line problem.

Rock did attempt to right himself while he was turned out in the dressage arena. There were tracks he made in the sand in the hourglass pattern on one side and then he just cut straight across the arena and the PVC poles had been moved as he tracked along the edges of them instead of straight through the middle. It is clear to me that he was trying to do what he had been doing with me. This was probably because he knew he always felt good when his workout was done.

The custom boots (which were very late in arriving) actually made things worse when we put them on, so I took them off for the workout and he seemed more comfortable almost immediately. I only did one pass through the hourglass in each direction with five times over the 4 PVC ground rails and he only hit one rail once. After the first stop and square up, he began to square himself up properly and corrected the listing to the right by moving his front end himself.

With the way he was acting, I believe the A-stim may have done some good on the atrophied musculature in the fractured hip, but probably did mess up the firing of the muscle groups in the healthy hip. Rock was doing noticeably better after his workout and I believe I will need to do this workout 2-3 times a week to bring him back into correct balance. Even the front feet gave him less problems as the workout progressed. Afterwards, he did roll in the dry sand and seemed to have much more overall strength to get down and back up again. He is no longer falling over onto his left side and doesn’t rock back and forth on his knees to get back up.

2011 – Rock & Roll – 11-3-11 – MASSAGE

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11/3/11: Rock and Roll were not really all that enthusiastic about their massages today. It looked like Rock had a good roll in the mud! It was a hard week for both of them. Roll had not been worked for 2 weeks because of the snowstorms and although Rock’s workout went well the day before, he just can’t seem to get comfortable on the hard floor in the tack barn even with towels under his front feet. We are getting a gel pad for him to stand on for future massages, etc. in the tack barn. It should help until his front feet are grown out and we hopefully will have more healthy feet later. Rock had muscle spasms the day before in the left flank and upper forearm which appeared to be better today. I put heat on them today for about 5 minutes and Rock seemed to like that. Joanne worked on both places and it did help. She and Dave both worked on Roll and it probably helped him even though he was antsy. He tends to be very impatient when he doesn’t get worked before his massages.

2011 – Rock & Roll – 11-7-11 – INDOOR ARENA TURNOUT/FEET

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11/7/11: Rock just got up from his nap and was a bit sore walking to the tack barn, but seemed pretty good when we got there. He does have a new sore midline just in front of the girth area, but the others are still healing nicely. I treated it with Panalog ointment along with the others. His hips seem to be more level today and he even let Chad clean his front and even his back feet and prep them with Thrush Buster and Rainmaker. I then took him into the indoor arena for his workout through the hourglass patter and he did very well except over the poles. He kept hitting one pole each time, but his stops were pretty well-balanced and he squared up easily each time. A couple of times, he corrected himself with no cue from me. The when we finished, I realized that I hadn’t attached the elbow pull…it was still hanging around his neck. So, I put it on and went clean over the 1 inch PVC poles 3 times! He does walk very badly when watching from behind, but the fronts are moving correctly and when he stops, he does correct the balance. His feet are much improved. Kristen was not here today to take still shots, so I only took a few, but we do have video.

2011 – Rock & Roll – 11-14-11 – OUTDOOR ARENA TRAINING

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11/14/11: Roll’s feet are doing much better and he now has a nice “cup” to the bottom of his feet! Roll had a fairly good workout after being off for 3 weeks. At the start, he must have smelled the mules from the north barn because he offered to stretch down for the first time and continued with his head down for almost two full rotations. He just bobbed up for a few steps and then was back down again. He was a little sluggish once he got moving, but not too bad. At least he wasn’t making me push him all the way around. He is taking more responsibility for his own body these days. He did five walk and five trot both ways and the last stop was square.

Rock was sore on all fours today and not really settling on any of his legs. He was shifting his weight around and walking, though difficult, looked okay. I noticed that the left hind is tracking straighter behind the left front than it was last week. He let us take care of the bottoms of all his feet except the left hind. He tried, but just couldn’t hold it up long enough to get the jack stand under it, so we did not do it. Because of the soreness behind, we decided to put heat on the left hip again and he did seem to enjoy that. Then we hot packed the left front forearm and he began to lock up his knee on that side, then bend it slightly and lock up again. He stood still behind for the duration. He did do a turn on the forehand to the right VERY SLOWLY at the hitch rail when I asked. He did okay in his workout, but knocked rails with the left hind over the PVC poles. The last couple rounds over the poles he improved. To help balance his body better, we tried a shoulder in along the wall both directions and Rock was able to do a few steps each way which I found to be extraordinary considering he had no idea what I wanted from him. We did drift away from the way, but he did maintain the shoulder in position while traveling forward. Then we went back to the tack barn and we iced his front feet for 15 minutes which he also enjoyed after he figured out what we were doing. Again, he locked the knee on his left front ass well as the right front which stayed that way throughout. Rock is improving however  slowly!

2011 – Rock & Roll – 11-17-11 – MASSAGE

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11/17/11: Rock and Roll had their massages today. I was unable to be there for most of it, but when I did arrive, Rock looked very happy to see me and rubbed his head all over me. In an attempt to stay squared up he was going in circles, but I was glad to see him trying to keep himself in alignment. Rock’s hips were hot packed today before his massage and he seemed to like that. We got him a soft mat to stand on since he was not able to tolerate the floor for more than 30 minutes at a time lately. His left hip is still very sore and he was really tracking badly with the left coming in behind the right front again after the massage, but this is to be expected when he is totally relaxed. He had been tracking a little better before this after he was able to be turned out in the pasture to keep his head down and graze all day. There is no substitute for the lowered head and consistent walking.

2011 – Rock & Roll – 11-18-11 – FARRIER

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11/22/11: Rock got a massage today. Since it was Thanksgiving week, Roll had to forfeit his massage this week…not enough time, but he is doing really well anyway. Rock is still having problems with the left hip, but he was adjusted by Dave McClain yesterday and he was happy to see him gaining weight again. He adjusted well and Dave instructed Joanne and I to do some traction exercises with him which we did today and will resume daily from here forward. We are also doing short traction exercises that Dr. Haussler recommended. We were short on camera people this time, so we do not have many still shots, but we do have more on video, including the traction exercises.

2011 – Rock & Roll – 12-7-11 – FARRIER

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11/25-27: Rock was getting a little sore, so I iced his feet over the Thanksgiving weekend for 15 minutes at a time. It did seem to help, but the last two times I only keep his back feet in for 5 minutes after the fronts had been in for 10 minutes. It seems to get cold and go up his leg and aggravate the bones in the hips. He is really hunched over in the rear and is having difficulty walking. I think we may need to make the effort to trim his feet. I consulted with Greg Farrand and he suggested putting him on Bute for three days before the farrier comes for the best chance at getting the job done. The angle on his hind feet is juts getting too steep and is putting pressure on the hip joints. He has almost 1 inch more heel than he needs behind. I will have to let Rock do the best he can for the next week because I have to have cataract surgery. I did change wraps on December 1 because his knees were getting skinned up again and it was so cold and snowy, he has to miss his massage. (no pictures or video)

12/7/11: Dean Geeson came out today and we had Rock on Bute for two days before he arrived. Rock was still not standing well though he stood better than he moved. We assessed the situation and decided that he really did need about an inch off his heels. Chad and I consulted and decided the hoof jack was too high for Rock and was putting too much pressure on the hips, so Chad designed a six-inch hoof jack and built it so he only had to lift his hind feet to a minimum and it worked great! Rock was really visibly happy when he realized that he only had to lift his foot a little bit. After we got him trimmed, he stood significantly better with his hind legs straight underneath instead of bowed like a scoop shovel. Even walking, he did better on the way to the indoor arena for some leisure time in the sand. On the way, he did slip a little on the ice, but both back legs slid at the same time and only a short distance before he was able to regain his balance. It did not seem to bother him at all. When in the arena, he didn’t want to lay down and roll. He got playful and was picking up blocks of wood and boards and strewed them where he wanted them. He even dragged a board a short distance and played with the door handle on the west walk through door. Rock is a happy camper again!

2011 – Rock & Roll – 12-8-11 – MASSAGE

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12/8/11: Rock and Roll really enjoyed their massages today. Rock was skinning up his fetlock again and had to be wrapped. With the snow, I have to keep him wrapped, but check it daily to make sure it isn’t wet all the way through. Rock was particularly happy after getting his feet trimmed, especially the hind feet. His balance was much better and he was able to relieve the pressure on his front feet. He really moved into the massage on his left hind hip after telling Joanne he didn’t want her to start on the left front. He ended up sitting on the hitch rail for about 30 minutes. Afterwards, it took awhile to get the circulation back in his leg, but we did and he was a happy camper once again!

2011 – Rock & Roll – 12-15-11 – MASSAGE

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12/15/11: Roll was much better during his massage today after having his workout this morning. He seems to enjoy the pressure approach more than the thumper or rubbing action according to Dave. He was behaving much better and his body has improved remarkably. His top line is looking really good and he is standing squarely by choice now.

Rock is really into massage on the left hind leg now after the last time when he was able to lean on the hitch rail and take the pressure off it. We didn’t want him cutting off the circulation in that leg like it did the last time, so I stood him backwards against the hitch rail and that worked fairly well. He still wound up rotating to the right and needed frequent re-positioning, but he is trying to keep himself squarely placed in his stance which is really helping. The right hind seems to be pointing his toe more and more to the right side rather than forward, so we have decided to have him start doing 5 circles to the left in his pen each morning after breakfast and before he is turned out into the indoor arena. Then he will be brought in for lunch and his gate left open to the small pasture, so he can be outside, continue to move around and ice his front feet in the snow which he will also do by himself. Turning out into the indoor arena twice a day like we were doing for awhile got boring for him after the arena construction was done and he had no more boys and toys to play with. He was pawing at the gate. We feel this will be a good balance for him. I think he was missing the sunshine as well! He seems happy with the arrangement today (December 16th). The sores I cannot wrap are not getting worse and the ones I can wrap are doing well.

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