The end of something (barely started).

It has been a long time.

I keep starting to write an entry and stopping. I am still in a muzzy state of unrest from the recent diagnosis I received for Deli. Unrest and heartbreak.

A couple of months ago after a long-but-slow conditioning ride, Deli presented with some pretty severe back soreness. This was much worse than the muscle soreness she had after her first LD at Mt. Adams. I thought, at first, it was related to a new pad combination I’d tried (since that was the first long ride with the new pad configuration). Then, when it didn’t resolve as expected, I wondered if she had hurt something while bouncing around in the mud trying to avoid a water crossing.

Long story short of it, we’ve been chasing odd back soreness in her lower lumbar region since then. I finally decided to get a back ultrasound after the normal R&R, chiropractic adjustments, and acupuncture did not make a difference. She would get better, but then I’d do an easy ride and the back soreness would flare up again.

Well, the news from the ultrasound was not good: kissing spines and some serious damage multifidus muscle along her spine – right behind her withers.

What is kissing spines? The more technical phrase is “overriding dorsal spinous processes” – essentially this term describes the touching or “kissing” of spinal processes, which are the long thin bones that protrude upward from each vertebrae in horse’s back. It’s likely she has always had this underlying problem because she has always over-built her lower back muscles. Her conformation (that high-headed saddlebred set) likely predisposes this problem in this area of her back. The damage to the multifidus could be acute or chronic. Regardless, time carrying a rider and the increased workload we have had coming into endurance riding has made an underlying pathology become more obviously painful.

You want to get technical? Here are some ultrasound images.

Normal multifidus muscle fiber pattern with some underlying proliferation of bone on a dorsal spinous process. 13^th thoracic.

Damage to/atrophy of the multifidus muscle as it courses from one spinous process to the next. Notice the total loss of normal fiber pattern compared to the previous image.

Location where dorsal spinous processes are close-riding or touching. Approximately 13^th-15^th dorsal spinous processes.

Her lower back region looked great, so my vet rightly determined that being unable to use her upper back properly and is straining her lower back muscles. So the obvious pain is not where the underlying problem is.

In the short term I am working with Deli to try and get her back to lift (by using her abs) in that upper back region. So far, the therapies and ground exercises I’ve tried have been unsuccessful. Our next step is to try mesotherapy, a pain-dampening technique that stimulates the mesoderm, the middle layer of the skin. Our hope is that pain relief will make her more able to build the muscles needed to relive those spinous processes. We are also going to get a theraband (a lounging therapy tool) and continue with massage, acupuncture, and chiropractic work.

In the long term… any more endurance riding is probably out of the question for her. For this, I am heartbroken. She really showed she has the mind and enjoyment for it and I know this is the sport that I want to be involved in over any other. My plan is to try this rehab work for a couple months and see if it seems probable that we could get her strong enough for long trail rides without her always presenting as back sore. 

Then I will need to get a new saddle. Though the edema I was getting with my Ghost saddle didn’t appear painful to palpation, you could see in the ultrasound that it was not superficial and may have been contributing to the multifidus damage and internal pain. I am considering doing the Reactor panel “rent for rehab” program, but the cost of all of that makes me cringe. 

As of right now, if after a couple months of ground therapy it does not look like Deli will be able to be decently sound and comfortable for trail riding I am going to retire her altogether. It’s rough and my heart aches because she is my heart and the one I want to go off and have adventures with. But this pathology means I can’t rely on her comfort. And if it will take 10 hours of doing hard arena work she hates just to get an hour on the trail... I’m not sure that’s worth it. Especially if that would require me buying her a $4k saddle that would set back my financial situation. It will make her so very unhappy. And she isn’t that horse that has a huge work drive – she would be perfectly happy being a pasture puff. With the money I would spend renting an insanely expensive saddle I could easily lease another horse to compete in endurance with. If I had my own property I could probably own another horse, but given the state of the world that’s not going to happen anytime soon! 

On the other hand, if she has just been annoyed by arena work because of this underlying condition the whole time, she may thrive under these therapies. Not enough to do endurance, I’m sure, but it might be enough to justify not retiring her (in part because this condition is chronic and will progress even if she is a pasture puff, and proper work might help her longevity). 

I don’t have to make any decisions yet, but having a “if, then” plan is necessary for me to not otherwise implode from stress. We still have some things to try, but I am preparing myself for the idea that Deli is going to be retired sometime soon.

Next time: an update on how our rehabilitation is going!
Last time: final thoughts about our Mt. Adams LD