Wednesday 27 June 2012

Its a start...I think...

Well, we've got ultrasound on M, Dali and Eva. I can't tell you a whole lot more, at the moment...

If that sounds odd, its only because we won't know - till we do repeat ultrasounds - whether we are able to identify any measurable changes. I'll tell you what I can so far...

First, the good points:
  • Its relatively quick and inexpensive - 3 horses took us under 2 hours and our vets are going to work out a fixed fee basis so the cost is predictable - important because I'm funding it - at least until we know whether its worthwhile or not(!) 
  • Its non-invasive and the horses are pretty relaxed with the procedure. Most won't need sedation and its not uncomfortable for them [but see also the bad points, below...]. 
  • Its repeatable, so we can do horses at the start and end of rehab.
  • I was really impressed with the level of interest shown by our vets. Since Anna and I spoke, she had been researching and trialling techniques and called me on Sunday to discuss them, and she turned up with not only a vet student but her colleague, Gordon Sidlow, which made testing the whole thing much more effective. 
  • As a fringe benefit, we've agreed it would be sensible for Anna to do a quick lameness assessment (trot up on a hard surface) for each horse at the same time as the ultrasound. This means that effectively I will have a veterinary assessment which I can use for Project Dexter at the beginning and end of rehab, which will be beneficial.  

Now the imponderable:
Are the changes that are happening in these horses' feet measurable using ultrasound? This is the $64,000 question.

From what we saw today, its possible to identify calcification on the DDFT, holes in the tendon and distension in the navicular bursa.

That's great, but even when horses become sounder, 12 weeks may just not be long enough for the changes to be measurable using ultrasound. We just won't know - at least until we've done many more horses - whether its worthwhile.

And finally, the bad point:
Here is the irony - to get the best (the most credible, from a veterinary point of view) ultrasound images of the navicular bone and DDFT within the hoof capsule, you need to ultrasound through the frog.

That sounds OK, but to get a clear image the frog needs to be pared until it is relatively thin. You can imagine what this would do to the soundness of a rehab horse, who is depending on a healthy frog and correct frog stimulus to build a healthier caudal hoof. Anna and I discussed it, and I've vetoed it because it will adversely affect horses' soundness which to me is the holy grail. As Gordon said, it would set each rehab horse back by at least a week each time it was done, and that's just not acceptable.

How ironic that the "best" way of scanning with ultrasound to assess navicular and DDFT damage involves a procedure that will almost certainly lead to a horse landing toe first and stressing the DDFT - talk about a self-fulfilling prophecy!


Val said...

That is an outrageous Catch-22. No other way to put it.

Great about the measurable data if the frog business can be avoided!

Nic Barker said...

Thanks Val. Frog paring is certainly not going to be done on any horse here, that's for sure. No point making them lame in order to get data to confirm they are lame(!).

cptrayes said...

I was afraid that you'd say that. I've had a lot of ultrasound experience lately, courtesy of Ace's huge vet bill, and I did think that they would have to pare the frog flat to get a decent image.

What a shame.

Roll on DIY MIR kits, eh?


M's mum said...

What a catch 22. You are definitely right to veto the paring of the frog (only a week's set back sounds optimistic to me after paring the frog that thin?)

Why are these things never simple??!!

Nic Barker said...

C - its only a matter of time :-) You and I remember the 80s when GPS was so expensive that a whole battalion of tanks (so Andy tells me) would have one per £x million tanks, as opposed to now when GPS is in every phone and camera :-)

MIR kits sound fun in any case :-)