Back Pain? Poor Attitude? Or Something Else?

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By Katherine Simard

Katherine is Rocky Mountain Dressage Society President, a USDF Instructor Certification Junior Faculty, a USDF Certified Instructor through Fourth Level, USDF “L” Graduate with Distinction, and a USDF Bronze and Silver medalist.

Editor’s Note: This article won first place for a GMO Newsletter Award for first-person experience for GMOs with 500 or more members category. It appeared in the May 2017 issue of the Rocky Mountain Dressage Society newsletter, The Centaur.

Last year I realized that as each month passed my mare Springfield, aka Millie, was becoming increasingly grumpy with me and her equine friends. She had always been sweet and had a very confident yet carefree attitude. She had her red mare moments. But last year the chestnut mare stereotype moments seemed to be the norm and the sweet, pretty, willing to try girl was gone. By fall, I could hear her squealing at everything and anything in her range as I rode and taught during the day. She was also becoming very reactive under saddle and Millie is a mare who does not spook at much if anything! Her heat cycles had gone from barely noticeable to very obvious.

The beginning of November found me standing in the lobby of Littleton Equine Medical Center asking who could help and where should I start. Dr. Jessica Dunbar overheard me and came out to offer her suggestions. Following her suggestion, I booked an appointment with Dr. Jackie Christakos for November 18. On the day of the appointment Millie was in a very strong transitional heat and upon examination quite sore behind. This of course lead us to further examine her back and SI area. Millie wanted no part of the examination process once we went beyond her shoulders. Even though she was reactive to back palpation, I did not believe it was just her back bothering her. We decided to free lunge her a bit to see if she relaxed, which she did. Dr. Christakos was still not sure we would get a true indication of her back pain because she was still very wary of the exam process. I went and started scratching her favorite places and she noticeably relaxed. Dr. Christakos was still pretty convinced it was something in her back. I was less convinced as I know this horse very well and the symptoms seemed cyclical to me. We decided to treat her with muscle relaxants and bute and re-evaluate in a couple of weeks. Dr. Christakos mentioned a blood test to see if the ovaries were a factor as I kept saying I had a feeling it was something reproductive and not her back. I agreed to have the blood drawn for an anti-Mullerian hormone test. This blood test is sent to UC Davis and is the same test human women have done if there is a suspicion of ovarian cancer. The cost was $150.

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Unhappy Millie

As time passed with Millie on the bute and muscle relaxant not much seemed to change. In some ways, Millie was worse and she seemed out of sorts on the medications. November 30, I received a call from Dr. Christakos with the blood results. The high end of normal for a mare is 3.8. Millie’s anti-Mullerian results came back a 6.2!!! There was a reproductive issue. The lab said we could wait and retest in two months. I decided not to wait as I had been feeling this was the issue all along! We decided not to go further with the bute and muscle relaxant combination but to go ahead and give her the bute for a few more days. Millie was off all medications by December 5th, she seemed more herself mentally but still unwilling under saddle. Cantering seemed to be the biggest issue and canter is her favorite gait! I noticed she no longer wanted to lift her back when being ridden and could be very reactive when being groomed around her flanks.

As LEMC’s reproductive specialist, Dr. Rebecca Dietz was called in on my and Dr. Christakos’ request. December 12 Dr. Dietz palpated and did an ultrasound examination on Millie. Millie was more cooperative during the examination, but we did give her a mild tranquilizer to do a thorough exam. While there was nothing Dr. Dietz could say was 100 percent abnormal, many of her findings were not necessarily normal for it being the middle of December. The ovaries were quite large with many follicles inside. The ovaries seemed to have thickened walls or fluid build-up in the linings. Combined with the change in attitude and the results of the blood test, Dr. Dietz recommended an ovariectomy for Millie. I decided to wait until after the holidays to schedule Millie’s surgery. I had been keeping a journal since Millie’s appointment with Dr. Christakos and continued to do so through the surgery. My entries are filled with Millie’s good and bad days fluctuating like a rollercoaster. Good days were usually centered around her being more social and interactive, but not wanting to canter under saddle. Bad days included nervous pooping in the crossties and being generally unrideable under saddle. Definitely not my mare! I didn’t think surgery could come fast enough for either one of us!

January 11, I brought Millie to the clinic for surgery. January 12, she had the surgery done by Drs. Peter Rakestraw and Dustin Devine. It was done standing in the stocks. Two incisions were made on each side of her flanks. One for the laparoscopic device and a larger one to remove the ovary through. One thing to note is that because this surgery is not performed under general anesthesia, my surgical insurance policy did not cover it! Total cost when all was said and done was $2000.

I saw the removed ovaries at the clinic post-surgery. They were huge and quite firm. When I picked her up Millie was the talk of the clinic. “Did you hear what they found inside?” Apparently, there were several quarter sized cysts/follicles in each and she was getting ready to release another large follicle. Remember it is the beginning of January! Poor girl had to be uncomfortable. Tissue was sent to histology at CSU.

Millie’s recovery was rough for the first twenty-four hours back at the barn. She seemed interested in eating the hay she was gradually being fed. However, she was not drinking and there was no manure passing. At about 1:00 a.m. the following morning she finally passed some “raisins”. But still wasn’t drinking. By morning there was more manure in her stall but she still was not drinking and had begun shivering. She was wearing a blanket and the stall door to her run was closed. She appeared bright and alert. Was it pain or colic? I called Dr. David Lori and he recommended changing her pain medication. Millie had been sent home with bute. He suggested switching to banamine and begin soaking her hay. That did the trick!

Within another 12 hours Millie was eating, drinking, pooping and peeing! All music to a horse person’s ears! Note for internal surgeries…ask for banamine to control pain. Not bute. Millie was also sent home with SMZs and we went through all of the usual ways to get it in her. Surprisingly, even though she was getting both banamine and SMZs via an oral syringe, she never once argued with me about getting either one. Was she just a really good patient or was my sweet cooperative mare returning?

Happy Millie

Over the next two weeks, Millie steadily improved. Happy to have the window of her stall opened. Happy to get her run back. Happy to go on walks. No squealing!

January 23 Dr. Rakestraw called with the histology results. Granulosa tissues in both ovaries. In lay terms, equine ovarian cancer that causes reproductive dysfunction and the mares with it tend to be aggressive. He said in his experience it was the first time he had the results be abnormal in both ovaries. He was glad I had chosen surgery and glad they had removed both ovaries.

As I write this near the end of February, Millie is still recovering. I hope to ride her for the first time at the end of this week. Her behavior has improved immensely! Everyone who works with and around her has seen the change. She is more at peace with herself and her sweet expression is back when she sees me in the barn. I wonder how long “female issues” had been causing her pain. I wonder how many mares are misdiagnosed with back pain. As one vet said, if I did not know her so well I could have ended up paying for back injections which may have treated symptoms but not the cause. Wondering if your mare has an issue with her ovaries? For $150 you can have your vet draw blood for a test that will help you at least be on the right path to help your mare be her best. It may be that easy.

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