Veterinarians may as well come with a monocle, a magnifying glass, and a Meerschaum Pipe for all the detective work needed to figure out what’s wrong with a horse.
Raymond, a 10-year-old Quarter horse, presented Dr. Cassie Leiterman of Lodi Veterinary Care with a case worthy of Sherlock Holmes.
"Raymond was a ranch horse and was now in the hands of a kid for use in showing and riding," Leiterman said. "But then he had an episode."
The episode included sweating, rapid breathing and agitation that went on for a couple of hours. The horse also showed an unwillingness to bend into turns and lameness in the rear that didn’t respond to common treatment.
Investigative work began in earnest. Raymond got a complete body palpation and movement evaluations in an effort to locate a place or source of the discomfort. Detective work continued with nerve blocks and a flexion test searching for a source of lameness.
"Most of the tests were negative or unremarkable," Leiterman said. "That left us with the visual evaluation and the results of the palpation."
During the body palpation exam, Raymond showed stiffness in his neck and a pain reaction to pressure on his back with possible muscle atrophy. Leiterman wondered if a poor saddle fit was causing some of the problem.
"They were using three different saddles on Raymond," Leiterman said. "And the saddle the little girl was using was the worst. Two out of the three saddles fit very poorly, and that’ll often cause back pain."
Poor saddle fit alone didn’t fully explain the extent of Raymond’s issues. Through a process of deduction, Leiterman kept returning to his back, where Raymond continued to display sensitivity to pressure.
It was decided to take radiographs of the spine. A horse’s spine isn’t the easiest thing to get a picture of, Leiterman said, but you can usually get enough of a shot to view most of the structure. Raymond was set up and pictures taken.
The pictures revealed that the dorsal spine in Raymond’s back had a defect. Where there should be space between the dorsal spines, X-rays of Raymond indicated the bones were touching each other.
"We call this Kissing Spine, and it’s very painful," Leiterman said. "Now that we knew what was causing the problem; what do you do about it?"
Kissing Spine has no specific cure, but certain techniques can help with pain management. Common equine pain reliever Phenylbutazone (also known as bute) is one place to start.
Leiterman said there also are more aggressive approaches. An intravenous zoledronic acid treatment is among the new methods being used to restore bone tissue. Raymond also could receive steroid injections, mesotherapy, muscle relaxers or undergo physical therapy, chiropractic care or acupuncture.
"Raymond was born this way so he’s always going to need treatment and management of his problem," Leiterman said. "We came up with a plan and now Raymond is back to work, and the little girl is very happy."
The plan included the mesotherapy (a treatment that stimulates the mesoderm, or middle layer of skin), steroid injections and some shockwave therapy, along with patience and constant awareness of the condition.
"Raymond is ready to take the little girl to the shows this summer," Leiterman said.