Now What?

My mind has been quite a whirl so I haven’t really had much energy in me to blog. First, I did consult with my vet again (a few times indirectly via Willy’s owner to update him and again in person). He confirmed that Willy’s problems are neurological, which was a relief to hear because that is what I thought was going on. He has suggested that we turn him out for 6 months to see if the nerves will regenerate, he says sometimes they will but it’s only about a 50/50 chance. The vet also cautioned that he might degenerate more over the next 6 months and if that happens the nerves aren’t going to heal and he is just going to be increasingly uncomfortable. So it’s wait and see.


The last week has been an odd mix of feeling like a huge weight has been lifted from my shoulders, sadness, uncertainty - you name it, I feel it at some point throughout the day!

I’ve barely been to the barn. I rode someone else’s horse last week and have a few more offers I can take people up on. I just don’t seem to be all that motivated to plod around on other people’s horses. Maybe I’m just coming down from my experience with Will.

I have been thinking a LOT about next steps in my horse journey. Here too, I am a bit flaky. In an effort to simplify things, I tried to dichotomize my choices.

Quit or ride? Ride (I think).

Half-lease or full? Hmm, full-lease because I like to have control be responsible for all elements of care.

Ok, full-lease or buy? At this point I started thinking about the logic of full-leasing a horse that I would be solely responsible for, paying full board, training etc., only to have the owner potentially not want to renew the lease after, say, a year of hard work. That doesn’t sound very appealing! Combine this with my husband’s desire to facilitate the cessation of my crying every night and I started to seriously think the time might be right to buy.

I still change my mind every few hours though, from excitement to terror. I think it’s so terrifying because I haven’t had the greatest experiences lately. Willy was both the best and worst horse experience I’ve had. I wish I could wait for him but I don’t think that is a wise or healthy option, as cold as that sounds. I also hesitate because obviously having a horse is expensive. Part of me was wondering if this was a good opportunity to invest in something else for awhile. But then the excitement of starting an adventure with another horse starts to take over and I long for that feeling again. At those times, it feels like a perfectly reasonable thing to do. (Besides, I don’t want to miss out on Fall riding! It’s my favorite time of year)

*sigh*

Day 6 and Letting Go.

I've been using the patches for 6 full days. Nothin'. No improvement whatsoever. I'm not surprised but I am disappointed.  Truthfully, I am also relieved. When you are desperate to do something to make it better, thoughts are not always rational. Thoughts such as, "what will I do if he does show improvement with the patches?"  Would I really want to continue with a horse like that? Would it depend on how fully he recovered? Probably not. So I am relieved that it's clearly not working and therefore I don't have more difficult decisions.

I've grieved and processed. I've cried and rallied my last emotional reserves. And now I am finally, finally, letting go. I am accepting that Willy is an idiopathic headshaker and that there really isn't anything I can do about it.

For the first time, I've started to feel angry. Not at Willy, poor boy, but just in general. That I had to have this experience. That this horse and I really do connect in a way that is hard to find. That I haven't been able to fix him. Still plenty of grief too. Also guilty. I was supposed to make him better.

So yes, I'm still an emotional soup but now that I have a certain level of acceptance it's easier to think about just letting go. He's tried hard enough for me over these last months, he doesn't need to work through pain anymore. I don't exactly know my next steps beyondtalking to the vet and Willy's owners some more.

It's been quite the ride.

Into the Breach...of Crazy or Cure?

Well, I've done it. I started a 10 day course of equiwinner patches. I know I said I wouldn't be chasing every last diagnostic but being faced with euthanising Willy, I find myself looking at anything and everything for an explanation. For a cure. Maybe we all need to experience that one horse who you do everything for to learn for yourself what "reasonable" is. I can feel my heart and brain having heated debates over options. They like to do this when I should be sleeping. I'm afraid my heart is good at making my brain think various ideas were brains all along. Pretty good marriage ;-)

The relationship I have with this horse is rare - I know enough good people struggling to find or develop a bond with their horse to know this is true. I've previously had nothing but those experiences myself. Sure, I've had ok working relationships with horses but nothing that remotely compares to this. I'm not talking some ethereal thing where the horse does cartwheels when he sees me or bows for me to mount. Just the sweetness of familiarity and commraderie and working hard for each other.

Let me back up a little. I spent many hours doing some research in veterinary journals on headshaking. What I found was not even the least bit encouraging. I hadn't looked this deeply before because there were still clear options from my vet and when those petered into drug options, I sought a chiropractor first. That had some success (over 4 weeks!) and then a return to headshaking just as sudden and inexplicable as the first time. An "emergency" chiro visit did not identify anything that would explain this. She said if he didn't get better she would come out and watch him go under saddle.

I had no aversion to the chiro watching me ride Will beyond the usual weird feeling when you know someone is trying to see if you're doing anything wrong. But everyone at my barn has been doing that for months anyway, so I am somewhat used to it. The coach I'm riding with now (when we have been able to) has seen him go when he doesn't headshake and when he does and I know she would correct anything I was doing to cause or encourage it. And she absolutely has the skill to know. She's actually had me try a number of things and aside from being as flabbergasted as I am, she is complimentary in how I ride through it.

So the only thing with the chiro is I don't particularly think she will be able to identify anything by watching us ride. I'm 100% willing to try when she's back in town next week, I just don't see it being the answer. He was fine for months with me as the only rider, then suddenly developed headshaking, then had 4 good weeks, then suddenly came back (during a hack, no less). So if I'm the only constant, I think that rules me out, logically.

So this lead me to focus more on research in veterinary journals. Since I'm no longer at the University of Guelph, I can't access full text vet articles as I used to (yep, I developed quite the hobby of this during grad school in human psychology, lol). University of Ottawa uses the PubMed database but must be able to opt out of most veterinary journals since they don't have a vet program. Some I can get but the rest I have to rely on abstracts and sometimes doing some sneaky googling helps find articles.

Essentially, the research shows that if you don't find the cause for headshaking with physical exams, blood work, endoscope, or xrays than you will never find the cause and it will be determined to be idiopathic headshaking. So my vet has recommened everything exactly as per current best practice for Willy's presenting symptoms. 

The next steps in the literature would be drug therapies. These are not cures but have some success in managing symptoms. Initial success doesn't tend to last and drugs tend to lose effectiveness over time (varies).  At 6 years old, even if the drugs stayed effective that would be +/- 20 years on drugs for this condition. They aren't without their side-effects. Drugs do not seem to me to be a reasonable or ethical option. There is also a surgical option - compressing or severing the trigeminal nerve in the face. I'm not considering this as a reasonable or ethical option. 

This lead me to be willing to try a reasonably priced option that at worst would do nothing at all (described in this post). It helped that I found someone in this area who used them for the same issue with success. There are real people behind the testimonials!

In his first night with the patch, Willy drank his whole bucket of water (it was full at 9:30pm and checked at about 5:30am) when he usually does not drink much during the night. He hasn't ever drank more than half a bucket during the year I've been with him, and even that much is rare and pretty much only when he's had a good ride and then in his stall for the night, without any turnout in between. If he's turned out after the ride he drinks right away but won't have much overnight. Last night, the first night of the patch, he drank his full bucket then went straight to the waterer when he was turned out. It seems like something might be happening. Needless to say, I have him on night check for water.

I feel like a bit of a nut-job for trying this but it is worth a try, given the alternatives.

Plea for Opinions - Equiwinner Electrolyte Patch

If anyone out there has heard of these patches and has some experience - whether it's first or second-hand, positive or negative - I'd like to hear about it! Please!!

A couple weeks ago, Willy took a huge leap backwards in terms of his headshaking after 4 good weeks. It was sudden - one day he was awesome, one day off, next day shaking as bad or worse than ever. I had the chiropractor back out and she didn't find anything to explain the sudden regression but we had some ideas like backing off the soft tissue work I was doing just a bit, in case he is ultra sensitive and she also showed me another TMJ adjustment technique. It hasn't helped, though he definitely gets something out of it.

That lead me to start going through the bookmarks I've accumulated on headshaking, just deperately looking for, well, anything really. That's when I re-discovered a link (http://www.signal-health.com) to this Equiwinner product that claims to help with headshaking, anhydrosis, EIPH bleeding, tying up and a few other things. There is some science there but it's hard to assess the logic as I'm not a biologist. Further, even if the science is sound, I don't know if this patch actually is effective at producing the effect they describe. Yes, I would probably be better spending my time searching journal articles rather than posting but let's call this the public opinion phase of my research!

To give a brief summary, the idea with respect to headshaking is that electrolytes don't always function as they should in the body, regardless of overall levels. The cells don't uptake the ions properly or in the correct proportions. We know many ions are vital for the proper functioning and repair of soft tissue. The claim is that this leads to an increase in blood pressure at rest (apparently high blood pressure in resting horses is rare) and therefore blood pressure increases well beyond normal levels with exercise. This increase in blood pressure can lead to cellular damage.

Now we need to consider the fly response in horses (bare with me!). Over the horse's body, they have panniculus muscles which are the ones responsible for that fast twitch reaction to rid flies off the body. The head and neck of the horse do not have these muscles and, as we've all witnessed, the horse shakes it's head to rid flies in that area. 

Back to the cell damage.  When the damage occurs around the hair bulbs, the sensation to the horse is like that of flies irritating them, eliciting the headshaking response. As stress (exercise, and hence blood pressure) increases, the sensations likewise increase, eliciting more headshaking. 

Still with me? So this patch apparently is designed so the body recognizes the ions more effectively (some dude won a nobel prize for the discovery that the cells recognize the molecules around the ion, not the ion itself, therefore mode of delivery can effect whether or not the cell allows the ions to pass through. 

I know enough biology, especially cell biology, to know that it sounds reasonable. I'd prefer to see come clinical trials assessing effectiveness of this particular product. They might be out there, that's my next step. 

In the meantime...anyone?? Your thoughts would be greatly appreciated.

 

Garden Picture Spam!

I have been quite negligent about posting anything related to food or the garden. I'm short on time but thought I'd do a picture post by way of catching you up on where things are. Most of these photos are a few days old and already it looks completely different out there.

I need to do a seperate "insects/pests" post because we've been inundated this year. So in this post I'm only including the beneficial or non-harmful bugs.

Horsehair worm on hydrangea. Horsehair worms are parasitic

to other bugs and cause no damage to plants themselves. Here,

it parasatises the hydrangea leftier and helps us out a bit.

The theme this year seems to be "suckers."  The tomato suckers are out of control - normally I only pinch the very early ones and then leave the plant alone. Last year I went completely au-natural and regretted it as I had tomato plants that extended horizontally from one side of the 10' bed to the other. Yeild was great but harvesting was difficult and, in a less forgiving year, the lack of air circulation could have encouraged fungal or other problems.

The strangest thing. Even the peppers have suckers! I've honestly never seen them produce such huge suckers. By the time I realized it, many were too thick to remove. And they're flowering like crazy. I guess we'll see what transpires. At least the peppers don't vine out like the tomatoes!

Pepper sucker with bud.

Ok, these next ones are supposed to be a sheppard pepper ("Carmen"). The visual distinguishing feature between them and my Crimson Red peppers is that the blossom end of the Carmen are rounded, whereas the Crimson are very pointy and the overall pepper is narrow and pointy. Hmmm. Either we messed up or we are inadvertently cross breeding a lot more readily than last year. While this cross seems a match made in heaven, I would like to have some peppers with no heat. You know, for guests. ;-)

This kind of fruit set in June?? 

They are now about 6" long!

They are already much larger than this and could be harvested soon. I don't think the temps will be warm enough for the next few weeks to ripen them but I'm hoping to at least get a blush before I pull them. They are tasty even when green, but you know...

Near bed: Beets (red neareast, yellow far), garlic down centre line, 

cucumbers at far right, to be trained up trellis. 

Far bed is "normal" peppers, Crimson and Carmen.

 Red beet "Merlin".

Raised bed: Carrots and some tomatoes. 

In behind are two first-year grape vines.

Little lovely, destined for my salad. I can almost taste it.

 Itty bitty grape clusters.

Zucchini have started up. Mostly female flowers to start, 

the males are now waking up. Not sure yet if this lovely has

been fertilized or not - we should know within the next day. 

 Bartlett Pears.

 Mystery Stuff! These were on our apple tree. 

They look like a cluster or seeds or eggs. 

Weird little fringe around them, any ideas?

 Close-up. Resolution isn't great but does 

anyone have any ideas of what these could be?

Therapy for the TMJ and Nuchal Ligament.

BrownEyed Cowgirl requested some more information on what I work on to help Willy's TMJ and pole ligament issues. It sounded like a great idea for a post that might do some good, so here it is. I fully intended to take some pictures while I was at the barn yesterday but it was SO stinking hot that after attempting to ride (25 min, mostly walk) I gave up, hosed off the horse, grazed, and rushed to the a/c in the car. I did manage to pull some "stock" photos from my computer and some off the net, so hopefully that will help the explanations.

I want to start with a little disclaimer. I am not a vet, or a chiropractor, or an expert in any other area that pertains to horses. What I am describing in this post is what I'm doing for my horse, based on a thorough assessment, recommendations, and instruction from my chiropractor. Your horse might have very different underlying issues. That said, I think it's very unlikely that any of this could harm any horse but again, I'm not an expert. I know you're all smart and I don't need to say this but I wouldn't feel right if I didn't.

The Temporomandibular Joint (TMJ)

The TMJ is the joint of the jaw between the temporal bone and the mandible, hence it's name. There is actually a fair bit of information on this joint, and various disorders of it, online. Therefore, I am not going to go into the biomechanics of it and all the possible issues. Suffice it to say that many things can lead to problems in the TMJ such as how they are ridden, dental work (or lack thereof), and even the simple fact that they eat all day can lead to tightness. This can lead to a whole host of behaviours (like Willy’s headshaking) and soreness in seemingly unrelated parts of the body, such as the sore back (closer to pelvis) Willy has on-and-off. The good news is Dr. J assures me that these secondary areas of soreness begin to resolve as the TMJ begins to function better. She also works on the area to provide some immediate therapeutic benefit and relief.

Interestingly, TMJ tightness is known for causing issues at the pelvis. Although Willy’s pelvis showed plenty of “spring” and was very supple, he was a bit body sore. Furthermore, the TMJ and atlantoaxial joint have very intimate relations. The atlantoaxial joint is where the atlas (aka the first cervical vertebra, C1), articulates with the second cervical vertebra (C2). So, TMJ issues will often present with atlas/pole issues as well. Wish I knew all this 3 months ago! It still amazes me how all the pieces fit together so completely.

In my search for pictures, I found this site and found the article very good article that is (mostly) in line with what my chiropractor has told me. For more information, check out Equine CranioSacral Workshops.

This shows the articulation and some structures of the TMJ.

Ok, so what do we do about it? Body work! It’s so simple and produces such amazing results that I intend to always do some TMJ massage from now on, just with lessened intensity for preventative maintenance.

First, we need to locate the TMJ. Look for the big bone that sticks out at the top of your horse’s cheek. It’s shaped somewhat like a flat-ish chevron ^ or boomerang.

Here you can see the area quite clearly as Mr. Will has a drink.

In normal head position, you would see vertical striations from his

TMJ down through his cheek. Here, he is drinking so they are parellel to the bone.

Run your fingers side-to-side under that bone. You will probably feel some ligaments that run vertically into the cheek. You might be able to see them, especially if it’s very tight. Yes? These are what you want to be working on. Apply pressure/massage across the ligaments, so your movements are perpendicular to the way the ligament runs (you can work in the same direction too, but it should mostly be across the grain).

How much pressure? Back in March I had encountered some information on the TMJ and discovered some Cranio-Sacral people (like the link above but not that exact one) that emphasized using only the lightest touch. I tried it and it did nothing as far as I could tell. I remember not being able to keep my hand in the right spot with such a light touch because he was headshaking so badly. Because of what I had read online I was afraid to use more pressure and abandoned the idea. I was told by Dr. J to use as much pressure as I can muster for this and I have strong hands from years and years of rock climbing. I use a lot of pressure when I'm working deep and have nothing but good results. In fact, I think the more muscle I put in, the more he gets out of it. You’ll have to test this out for yourself, I guess.

I generally start with a med-light general massage of the TMJ and full cheek. Then I work up to medium with more focus on the specific ligaments, and finally full pressure on the ligaments. Once I think he’s had enough, I basically do the same thing in reverse and end with firm but gentle total cheek massage. I do most of the work one side at a time but end facing him and massage both cheeks at once. This is the droopy eye and lip stage!
You are looking for him to yawn or open his mouth, move his jaw side to side, lick and chew, and drop his head, as low as he wants, no cross-ties! Now that I’ve been doing it awhile, I don’t always get strong reactions, sometimes just a head-tilt and a slight opening of mouth.

Some other points:
- I work the atlas area first because it’s actually more aggravating to Willy. I like to finish on the relaxed note that the TMJ massage provides.
- You can use a curry to do this if you want. I personally prefer to use my hands so I can feel everything but I imagine this might be hard for someone with arthritis, for example. I blew a tendon in my hand two winters ago and I have to be really careful how I use my fingers when I’m massaging, so I can relate.
- Listen to your horse. You’ll start to figure out how much is best to do before/after the ride. I generally take a more “relaxation massage” approach before a ride and really work deep after the ride. However, lately I’m finding it better to do a bit deeper pole work before the ride as it’s helping him relax more under saddle. It changes day by day and I just try my best to interpret the cues he’s giving me.

The Nuchal Ligament

This is the ligament that attaches at the atlas and runs down the entire length of the neck.

In yellow.

Tightness here can cause many of the same issues as disorders of the TMJ and problems in one are associated with problems in the other. In my case, I have the added bonus of some scar tissue in the atlas area. Willy has never been worked over-bent or forced into a frame, so our best guess is that he suffered some trauma to the area. It isn’t much and Dr. J thinks it will completely break up as I continue to work the area.

It’s a little harder to describe how to locate this ligament. Start at your horse’s head, right where the skull attaches to the neck, right about where the crown piece on your bridle rests. Just behind the bony protrusion that is the skull, run your fingers up and down the top couple inches of the crest. Again, you are working each side separately, so you’re probing to each side of the vertebrae, not on them.

You should feel something similar to a fat guitar string somewhere in there. Similar in feel to the ligaments in the TMJ. Some days I have a harder time finding it, which is a good sign.  It can also depend on their head position, so see if you can get your horse to raise or lower its head. I find it best if it’s level or a bit above level, but that’s not easy!  It can be easier to work from the off-side, so standing on the right when working the left side, and vice versa. I do a combination and still try out new ways of positioning myself.For the first 4 to 6 inches, you will be able to follow it along on either side of the cranial vertebrae. Right about where the muscle groups really differentiate, you probably won’t be able to find it any more.

Work it the same way as I described for the TMJ, mostly massaging crosswise to the ligament, going back and forth over it. Pay special attention anywhere where you feel “crunchies” as it’s a trouble spot. It can be scar tissue, previous sites of sprain, inflammation, muscle knots, etc. Either way, it needs to be worked. You won’t get rid of it all at once, just give any spot like that some extra time.

You can expect the same type of reactions from the horse; yawning, dropping the head, etc. During this work it’s especially important to let him stretch down.

I finish up with some carrot stretches to stretch out that ligament.

Any questions?

Chiro Follow up

We had a follow-up appointment with the chiropractor today. I’ve been trying to write an interim post but never quite managed to finish it, so this is a bit of everything. For simplicity I’ll add a few updates in [square brackets]. Then I need to do a garden post!!

Dr. J saw a lot of improvement today, both in his demeanor and how everything felt. She could tell that I was diligent in doing the prescribed work and seemed pleasantly surprised by just how much he’s improved. It must be an awesome thing, to help horses and people like she does.

My usual approach is to do all the soft-tissue work before I ride but not as deep or strong as I need to for full benefit. My idea with this is I want to relax the TMJ and atlas areas before I ride but I don’t want to do the deep work in case it’s still making him a bit sore. With that in mind, I work deeper after the ride and do carrot and leg stretches, followed by some hand grazing and then he’s in his stall for the night or back out until bedtime (depending on time of day). I don’t know if this approach is necessary but it makes sense to me and is working very well for us. [I described this to Dr. J and she thought it was a great approach].

Willy is one happy horse these days. He’s still playful and mischievous but he is a much more content version of himself. It’s hard to articulate. The obvious difference is he no longer constantly tosses his head while on cross-ties. Picture the sounds that head tossing would make in the ties. Now imagine that for 30+ minutes at a time. The barn is a much quieter, peaceful place! I honestly think I forgot what things were like “before” and now it seems so novel to have him standing quietly, often so relaxed he has droopy eyelids and lips.

Happy horse.
We've been working pretty well considering our set backs.

One ride, I didn’t do the muscle work before I rode. I wanted to ride with someone who was already mostly ready and it was mid-morning and I had done a full work-up the night before, so I figured it wouldn’t make much difference if I did the work after the ride. I noticed the difference right away. Although he was overall still much better than he has been for months, he did some headshaking on the crossties and a bit under saddle while walking. Considering I hadn’t seen ANY of it since our chiro appointment, except while actively working the atlas and TMJ areas, it was telling.

Last week, I didn’t go out 2 days in a row. I am there at least 5 days a week and never skip 2 days in a row except for the few times I’ve been out of town for work. This time it was because Alex was going out of town for 13 days and I decided to spend the nights with him. The difference was clear the next morning. He was still better than he was pre-chiro, on average, but he was tossin’ that noggin around a fair bit and not very relaxed. Probably akin to his “good” days during this whole ordeal. Since we were seeing the vet for vaccinations that morning, I took my time doing his muscle work and really got some good reactions from him (dropping his head, yawning)

Dr. J asked, during an email exchange last week, if she could use parts of my update email on her testimonial page. Um, hell ya! I am happy to help her spread the word about the work she does. She offers a more complete service than the status quo chiropractor around here, so I’m all for promoting her. I offered to write something specific for a testimonial, too. Laura and I laughed about what a sob story it would sound like, “I was on the verge of putting my gelding down and Jen saved his life” or some other dramatic summary. Although we laughed and I’m not the drama type, it has to be said that it’s not far off the mark. 

I had been preparing myself for weeks that it was something BAD. The worst of the bad was the lack of diagnosis despite trying. We were quickly realising that reality. Chiropractic work was my last gasp. I’m SO glad I had done a ton of research on practitioners in my area prior to this AND so glad I didn’t go with the status quo chiro for our area. I suspect that particular practitioner, good as she is, would not have identified Willy’s problems. They are pretty simple but could be easily missed by someone who doesn’t look beyond the vertebrae. 

My vet is one of the most respected in our area and still he missed the TMJ/atlas issues. He might have even been a causal or contributing factor.  I didn’t see anything during the float that would indicate it was poorly or harshly done, not that I’ve seen all that many.  So, I don’t really know what to think on that front. Personally, I think the vet exacerbated some pre-existing issues in both areas but he didn’t cause the scar tissue or tightness in the ligaments at Willy’s atlas/pole. Regardless, the float was obviously the tipping point.

I’m having the time of my life again, with a renewed appreciation for how awesome it is to ride through the fields or do some schooling on a happy horse. I have also gained a healthy respect for how fast things can go wrong and how deeply it affects me.