To Listen

Acajou. photo by Debbie Dysarti

This article won the 2022 GMO Newsletter Award for a first person article for GMOs with 75-174 members. It originally appeared in the St. Louis Area Dressage Society newsletter, Hoofprints, April 2022.

The USDF Group Member Organization (GMO) Newsletter Awards are designed to recognize outstanding efforts by GMOs that produce newsletters. Awards in two categories will be presented for exemplary articles. Nominations are due by August 31st. Only an official representative of a GMO may submit the nomination. For a nomination form follow this link.

By Toni Kanne

One of my favorite books, My Horses, My Teachers by Alois Podhajsky, underscores the importance of what our horses can teach us if we allow ourselves to listen. This year did not evolve as I had planned. After a year off for a soft tissue injury to my horse, challenges of COVID and work, I finally had a plan that I began to execute in December of last year. My horse and I were returning to the clinic and show arenas. At least that was our goal. The Saturday after Valentine’s Day in February, I walked out, as I often do, to bring my 23 year old gelding in from pasture. If you saw him, you’d never know he was 23! He was standing at the gate, alone, in relatively cool weather. Nostrils were flaring and his respiratory rate was increased. As I noted he was not wet or warm under his sheet, I walked him back to the barn. We spent a few minutes hand walking in our indoor arena with the goal of getting his respiratory rate back to a normal pattern. Upon returning to his stall, his typical interest in food was non existent, not even his favorite alfalfa hay flake. Noting it was already 4 pm, I opted to call the emergency number for the equine veterinarian. Concern for colic was on my mind, although something didn’t really fit. After speaking with the on call veterinarian, I was advised to take his temperature, something I probably should have done prior to calling. It was elevated, near 102 F. Reporting this new piece of data to the veterinarian, I worriedly stayed with my horse and observed for any other clinical signs.

After some time had passed, the on call veterinarian had finished with the emergency patient that was being cared for and made the trek to our barn. After clinical exam, neither one of us were all that convinced it was colic, but something just wasn’t right. Only other item of note was a heart murmur. This was a new piece of information, but this is something not atypical in an older horse. It was a diastolic murmur or a murmur that occurs when the heart is at rest. Treatment concluded and I was advised to observe my horse for the next 24 hours and if return to normal, he could go back to previous activity. After 48 hours off, I opted to ride him as I wanted to keep him solidly in work. Show season was quickly approaching!

Riding my gelding was always a pleasure and a treat. He loved to work! However, he could need a little more motivation on some days more than others. As I went thru our walk warmup, he did feel a little bit sluggish but certainly not unusual. It was February and not the heat of the summer. After about 10 minutes, I asked for trot and started on a 20 meter circle. Making it around once, he continued to feel sluggish but maybe something wasn’t right. We trotted a second circle. The thought crossed my mind to tap him with the whip and reinforce my leg aid. But I didn’t. Something didn’t feel right and I didn’t. Instead, I asked for walk and he immediately stopped, breathing hard and reluctantly took a few walk steps. I hopped off and saw the signs of exercise intolerance.

Our veterinarian was contacted once again and knew the foreboding sign of exercise intolerance, arriving the next day to see the patient. Once again, upon clinical exam the heart murmur was noted, but now it was worse. It was a grade 6, both systolic and diastolic in nature. Heart murmurs are not uncommon in a geriatric horse and most commonly involve the aortic valve during diastole or when the heart relaxes. A murmur is a noise that is not normally heard during heart contraction and relaxation, the time when the heart fills with blood. Murmurs are graded usually 1 thru 6, with 6 being the most severe or loudest. It is described as being heard with the stethoscope bell just above the left chest wall, without being in contact with the body. The louder the murmur, the more significant. It is indicative of a “leak” in the heart valve or an incompetence in the valves ability to perform its job. This results in the heart being inefficient in delivering much needed oxygen to the tissues of the body.

The equine heart is about 8 to 10 pounds and pumps 7 to 10 gallons per minute at rest. During exercise, the heart can pump over 65 gallons per minute. It is quite the organ, composed of four chambers with valves controlling flow in and out of these chambers.

With the finding of a grade 6 heart murmur, standard of practice is to advise the rider to stop riding the horse at once. With alterations of blood flow to the body and the heart, problems could arise resulting in heart abnormalities in beating which can cause collapse of the horse.

My horse was referred to the University of Missouri Equine Veterinary Hospital for further diagnostics. He underwent an echocardiogram with a stress test. This is used to review the heart function during exercise and condition of the heart valves. At walk, there were no issues. However, at trot and canter there were numerous pre ventricular contractions of the heart. These are unstable heart contractions in which the heart works hard but is not delivering the correct amount of blood to the body. These types of contractions can lead to heart failure and potential collapse of the horse. All four of the heart valves were noted to have some “leak” or murmur, but two of them were the worst. With this information, I was advised that my beloved gelding could no longer be ridden. It would not be safe for either of us. After consultation with our veterinarian at home, I decided to continue letting him go out to pasture and just enjoy being a horse. He has worked most of his life and deserves the best retirement I can provide him. The biggest thing I notice now is that he is not himself. The sparkle in his eye is gone and I really don’t believe he would want to go for a ride, even if we safely could.

I will continue to monitor him for heart failure signs as that is his next potential nemesis. Signs of failure include pooling of fluid in the chest and along the bottom of the abdomen. He could also have nasal secretions or difficulty breathing. Those would be emergency phone calls. I won’t put him in bubble wrap though. Although the past few months have been heart breaking, literally, I haven’t lost my friend. I only just can’t ride him anymore. I won’t be able to go to a clinic or show with him again or complain about having to braid or being assigned an early ride. I am thankful, however, that I listened. I listened to him that day and I stopped, even though it was the last time I’d ever put my foot in that stirrup.

References: “The Heart of the Horse”, Kovatch, K. And Wachter, M. 2/11/2016.
“A Quick Look at the Amazing Equine Heart”, Oke, S. 2/24/2020.

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