Patience and The Nature of Healing

I think patience has got to be the number one quality one needs to see through the rehabilitation of a chronically sick horse. After doing 4 little light hacks, Lutine showed up with a minor, but noticeable, amount of head bobbing again in trot when being ridden on the road. She wasn't head bobbing in trot in the field minus a rider though, and she wasn't lame at the walk or even shortening her stride at the walk with the rider. Now, we've been long reining on the roads and the hard surfaces for weeks in the walk and with a little bit of trot with no sign of head bobbing and even without boots. So the addition of the extra weight of the rider had obviously had some sort of effect. I decided to write to some of the barefoot professionals that I know to ask about their experiences of rehabbing 'navicular' horses and whether there just are some horses that will never come sound. Bless them, to a man (or woman!), they sent me some wonderful, detailed and constructive replies. Here's some exerpts:

From Paige Poss, awesome lady who runs http://www.ironfreehoof.com/

Wendy, I have been reading some of the different things that you have done to get this horse well. I am learning a lot from you and Lutine. I think you are doing a fabulous job. I have to tell you that occasionally I do run across a horse that is beyond my help, but it is never just about the feet. You asked about navicular horses, but in reality, it is "sick" horses that are so hard to heal. I just gave up on a lovely mare that I have been trying to help for 2 years. I was just her trimmer for the first year, but I actually owned her this last year. I was treating her with many different modalities and was getting marginal results. The reason I gave up is that she felt terrible most of the time. The relief she got was always very short lived. Like you describe Lutine, Colleen was completely toxic. I think she had been compromised her whole life, but that is a whole other story. I think you have come much further with Lutine. It sounds like she is doing well much more that she is doing bad. That is great! OK, on to your real question. Yes, I do see navicular horses that take a very long time to heal. I mentioned this on the list a long time ago, but no one commented that they see the same thing. I think this may be what is going on with your horse. I have noticed this many times over the years. As the foot begins to heal and the horse begins to use the back of the foot more, the deep digital flexor tendon will want to work properly. Working properly means that it will need to slide over the navicular bone. What happens with a lot of navicular horses is that they form adhesions between the DDFT and navicular bone. When these start breaking apart, the horse gets sore. I think of this as a type of healing crisis. I don't want it to happen, but when it does the horse comes through it better than ever. If she likes having a job, then I would continue with light work even if she is lame. I don't know what your boarding situation is like, but if you can keep her working.

I am going to attach some pictures of a horse that clearly had issues with the DDFT. This horse also was a foundered horse. Many times the horses that are deemed "navicular" really are laminitic also. I think you already feed her like she is a LGL. Am I remembering correctly? This is a picture of the DDFT on the front foot. It does not look like it was stuck to the navicular bone, but it was clearly not healthy.

Here is the next picture. This is the same horse. It is just his healthy back foot. Isn't it amazing the difference in color? Clearly the front foot was not as healthy as the back foot. I think that over time with proper management these tissues would heal. I just wanted you to see what may be going on inside your mares feet. I would continue to have patience and let the healing continue. Paige

I am going to send you a few more pictures that show how much damage there really is to that foot. The bone on the left is from the healthy looking back foot and the right is of the unhealthy looking foot. This is looking at the top of the coffin bone and navicular bone, so it is a weird shot. What jumps out at me is that not only the tendon is an odd color, but all the tissue looks damaged. The bone is yellow, the tendons and lateral cartilages look yellow. I know that I often see a pumpkin or yellow tint to some feet that are compromised. I have often thought it was serum from an inflammatory reaction, but I don't know this to be true. It is just my anecdotal theory. Keep in mind that both of these feet were from the same horse. Both feet were kept the same way. One is not damaged from sitting out too long. Both dissections were done the same day.

Just to reflect a little on what Paige was saying, here is some information from an orthopaedic medicine website about tendon adhesions and their formation:

Problem: Precise digital function requires smooth gliding of flexor tendons within their sheath. Tendon adhesions following injury or repair limit gliding, thereby decreasing active range of motion of the digit as compared to passive range of motion.

Etiology: Violation of the tendon surface, whether traumatic disruption or from attempts at surgical treatment, results in production of adhesions via the normal inflammatory response. The limited space between the profundus and superficialis tendons and the theca, is a primary contributor. Once adhesions develop, tendon gliding within this confined space is affected, and active digital motion is diminished.
Pathophysiology: The process by which flexor tendons heal is debatable. The conventional theory is that peripheral fibroblasts from the surrounding connective tissue invade the zone of injury and serve as a source of reparative cells. In this theory, the tendon itself is believed to have no intrinsic ability for repair. New evidence seems to indicate that the epitenon cells migrate into and across the zone of injury along a fibrin lattice, and collagen fibers, formed by the epitenon and endotenon fibroblasts, bridge the laceration site. Vascularization of the repair zone is from within the proximal end of the tendon by proliferation of vascular channels. These studies suggest that the tendon possesses the intrinsic ability to participate in the healing process.
Peripheral adhesions attach to the repairing tendon, potentially limiting tendon excursion during flexion and extension. Although adhesions may add strength to the healing tendon, it is unlikely that adhesions are an essential component of the reparative process.

I find this interesting too because this is from a website about adhesions in the tendons of human digits (i.e. fingers) and actually, here we're talking about the equine digit - after all, the DDFT is the 'deep DIGITAL flexor tendon'.

We're off the lead rein. :-)

The first few hacks I had with Lutine, my husband has walked beside us and kept a long-ish lead rein on us, just as a safety net. This was for a few reasons: it's not ideal to take a young, green horse out on the roads, even very quiet roads, on its own - would be much better with an older, steady horse as nanny; plus Lutine has a cow phobia that already caused one accident with my other horse and she's been nervous about being on the lanes ever since that car hit us just before New Year. But OK, I will admit - since getting hit by the car whilst walking her out, my confidence took a bit of a rattle too. So the lead rein was my psychological safety net. But on our little hacks we'd had some spooking and the odd bit of jogging and jumping about but she remained well under control and my husband said he was leaving slack in the lead rope all the time, so it was her rider she was listening to.

We did our hack out last night without the lead rope though my husband came along on his bicycle. Even having the bike there seems to help these young horses get a little bit of confidence and having my husband there seems to encourage the drivers to slow down for the horse. They take more notice of him than they ever did of me! (blimmin' chauvenists!) Just after the place on our lane where we were hit in December, another car came down the hill with a clanky trailer attached. Both of us were feeling tense - but we were in luck. It was a neighbour of ours who was very obliging and stopped the car while I turned Lutine, walked her back past the trailer and then proceeded to follow him down the hill. And bless her, she really did hold herself together and listen to me.

So another little step - we're off the lead rein and recovering our confidence.

The Healing Crisis

At last, I found the references to the process of healing Chronic Illness. Here's the link: http://www.shirleys-wellness-cafe.com/philo1.htm#healingcrisis

Some of the relevant stuff I found:

"Constantine Hering was a German Homeopath who emigrated to the U.S. in the 1830's. He observed that healing occurs in a consistent pattern. He described this pattern in the form of three basic laws which homeopaths can use to recognize that healing is occurring. This pattern has been recognized by acupuncturists for hundreds of years and is also used by practitioners of herbalism and other healing disciplines.

According to the first of Hering's laws, healing progresses from the deepest part of the organism - the mental and emotional levels and the vital organs - to the external parts, such as skin and extremities.
Hering's second law states that, as healing progresses, symptoms appear and disappear in the reverse of their original chronological order of appearance. Homeopaths have consistently observed that their patients re-experience symptoms from past conditions.
According to Hering's third law, healing progresses from the upper to the lower parts of the body. For instance, a person is considered to be on the mend if the arthritic pain in his neck has decreased although he now has pain in his finger joints.

As the symptoms change in accordance with Hering's Law, it is common for individual symptoms to become worse than they had been before treatment. If healing is truly in progress, the patient feels stronger and generally better in spite of the aggravation. Before long, the symptoms of the aggravation pass, and leave the person healthier on all levels."

"Understanding The Healing Crisis Ginger Chalford, Ph.D
The body has an inherent desire for perfect health. We have the ability to earn our way back to that state, no matter how "normal" or bad our health is now. But in the meantime, the body must go through an elimination process to achieve good health. The elimination process is often referred to as the "healing crisis." Once the healing crisis starts, reactions may be mild or severe. Expect ups and downs as it takes awhile to get good health back.

In a healing crisis, every body system works together to eliminate waste products and set the stage for regeneration. Old tissues are replaced with new. A disease occurs when the body cannot make it through its natural healing crises for one reason or another. The body is "locked" into a destructive and shut down place, physically, emotionally, mentally, and spiritually.
Symptoms of the healing crisis may at first be identical to the disease it is meant to heal. But there is an important difference: elimination. A cleansing, purifying process is underway and stored wastes are in a free-flowing state. The body, mind, and spirit are no longer "locked." Sometimes pain and symptoms during the healing crisis are more intense than that of the chronic disease, but it is temporary and necessary. "

Our First Hack Out!

And we're off! I have been long lining Lutine in the field and around the lanes and also having little rides in the field. She's just been feeling so well and strong - you really get a sense of her carrying you now whereas when we first got on her last September, she just felt that little bit weak and I wasn't happy carrying on. Anyway, along with my husband I walked her down to the bottom of the valley, past the neighbouring farm and then rode her home. Just a little 15 minute ride home but she felt so great and was keenly striding out and offering the trot all the way home. The ideal way with such a green horse would be to take her out in the company of other, more experienced horses but we don't have that facility at the moment. When we get a trailer big enough to take Lutine, we'll start trailering her over to our local riding centres and go on some organised rides.

But, you can see how absolutely wonderful this felt by the GREAT BIG grin on my face!!!

More gratuitous pics of our little hack below:

EPSM and the Digestive System

I made the mistake, at the beginning of Summer, to cut down Lutine's oil and protein ration in her food because she looked as though she was getting rather too sleek (a touch fat). We have a lot of protein rich birdsfoot trefoil in our field and I was just worried that by her getting too big she would stress her joints more. Anyway, withing a couple of weeks she'd lost a noticeable amount of muscling over her hind end and she'd been walking stiffly behind again. I've started her on Whole Horse chinese herbs http://www.wholehorse.com/ for the uveitis but then asked for Gloria Garland, the herbalist, to come up with a formula for helping Lutine's stiffness problems. Gloria sent to me a few samples to try on Lutine with applied kinesiology (muscle testing) and the combination that came out the strongest was the 'Easy Mover' (for joint stiffness) combined with the Tendon Support formula and a digestive herb called Shen Zu. Shen Zu is a herbs used to help the digestion deal with carbohydrates and sugars. I mentioned to Gloria about how this all fits in with the EPSM and so Gloria sent to me another sample for a combined digestive health formula and I will test that too when it arrives.

In the meantime I read an article she'd written about Chinese herbs and digestive health . She wrote:

"The earth element, the stomach and digestion, is the source for all the qi of the body. Also referred to as “central qi,” it creates all the cells, tissues and all energetic and physiological functions of the body.

Keeping the earth element strong
A horse with a weak earth element can manifest in several ways: ulcers, poor physical development, chronic colic or diarrhea, declining condition in old age or poor muscle development, muscle tone or wasting.

When the central qi is strong, the body functions more effectively on all levels, stress is better managed, illness and disease are better handled and recovery from injury is faster.

The hay, grain, vitamins, supplements and water we provide are the raw materials for the central qi factory. They become transformed into the building blocks of the body. A strong digestive function can help our horses’ live longer, healthier lives.

Enhancing the earth element with herbs
In addition to a balanced diet, mineral and de-worming program designed to fit your particular horse’s needs, some of the following Chinese herbs are helpful for digestive health:

Shen qu (Massa Fermentata) This enzyme and vitamin B-rich herb enhances the digestion over all by facilitating the digestion of starches and carbohydrates found in high amounts in hay and grain rations.
Mai ya (Fructus Hordei Germinatus) This herb protects the stomach and promotes the digestion of starches, especially wheat and rice based products. (caution - avoid use in large doses with lactating mares).
Gu ya (Fructus Setariae Germinatus) Also digestive enzyme-rich, it is very good for horses prone to chronic, gas colic as well as for weak or older individuals."

I found what was said about the weak 'Earth Element' very interesting because it described all the associated issues Lutine has, especially the extraordinary amount of time it seems to take her to recover from pretty minor issues (like the mud fever she had over winter). Also, the fact that this is associate with 'central qi' and that weakness in that can result in fatigue and metabolic issues.

The full article can be found here: http://www.wholehorse.com/articles/digestive_health.htm

In the meantime, she's gone back on to her usual high oil, protein rich diet and if she starts looking too gross we will increase her exercise this time. I won't make the same mistake twice - but this was another experience that really underlines her EPSM status.

Lutine's siblings show jumping

Went to a show yesterday and two of the horses jumping there were by the same stallion as Lutine. He's a well known National Stud stallion so that's not really a big surprise but what I found interesting was that both horses were very similar to Lutine - chestnut with socks, a white blaze and slightly flaxen manes. And they were a bit chunkier than the other horses there - which is interesting from the EPSM perspective as this condition effects heavier muscled horses more, apparently.

aka The Ginger Plonker

We do adore Lutine - but she is a bit of a goofball. We've nicknamed her, affectionately, The Ginger Plonker because she gets up to the daftest things.....


'Honestly, I was there minding my own business and my fly mask just did this all by itself'

Hurrah! Massage photos at last