Dr. White is coming out tomorrow to perform a posterior digital neurectomy (PDN) on Rocky. This means he will remove a small piece of nerve from Rocky’s wrists, which will numb the back third of Rocky’s hooves. Just the heels, not the whole foot. This will provide relief from the arthritis and low fluid levels he has in his coffin joints.
The slang for this procedure is “nerving” and it has a really bad rap in the horse world. A Google search for “PDN rehab plan horse” brings up a ton of forum threads on how evil it is to nerve horses, how going barefoot, changing diets, using boots, injecting Adequan, or using Equisoxx, or a handful of other treatments are more humane.
After 2.5 years and at least $15,000 (I stopped counting, here, as I really don’t want to know), the PDN is the only treatment I haven’t tried. We have been through: padded shoes, heel-lift shoes, eggbutt shoes, transition to barefoot, endurance/protective boots, Adequan, direct hyaluronic acid injections into the joint, judicious use of pain meds to see if that brought temporary soundness, hoof support supplements, joint support supplements, diet changes, and other herbal supplements.
I’ve had X-rays done four times and joint fluid aspiration done twice. (In early 2008 he had almost no fluid in the left and only watery, brownish fluid in the right; but the X-rays did not show the coffin joint arthritis until the last set, in February 2009.) I’ve had him treated by animal communicators, energy workers, chiropractors, massage therapists, acupuncturists, and six different veterinarians.
The result or diagnosis in all cases has been arthritis but not navicular syndrome. Rocky has the pain in the coffin joint and the weird unfluidness, but none of the other symptoms of navicular. He doesn’t toe-walk. He hasn’t worked on hard surfaces (or even worked hard at all in the past two years). He doesn’t stand with his feet far in front of him. He doesn’t have collapsed heels.
He has done better barefoot than shod, and the trimmer said Rock’s feet are looking great. The Adequan helps some although it wears off in three weeks, not four. Bute does not seem to have much effect. I am about to run out of the hoof support supplement so I guess I’ll find out if that was worth the $50/month (sigh).
The irony about the anti-PDN virulence is that the surgery is not a permanent solution. The nerve grows back in four or five years, at which point I’ll have to decide whether it was worth doing, and whether to do it again. I’ve been going back and forth about the PDN for more than a year now, exhausting all my other options first, because I don’t like the idea of his not being able to feel his heel. On the other hand, it’s not helping that the main sensation he feels is pain. Given the choice, I’d rather the numbness (and in fact with my extreme form of plantar fasciitis I wish I could have Dr. White slice my nerve too).
But the kind of life I want to have with Rocky is not one that includes strenuous competition like reining, jumping, or cutting. We just want to amble along trails with friends, play our way through the Parelli levels, enjoy our moseys and our coffee breaks, and maybe do some parades and Parelli games and things just to keep us sharp. We’d like to trot and canter again, too, but this time in balance without me wincing for him at every head bob. I do not need to jump, and in fact if I can just get enough miles on horseback to build confidence and skills, I’m sure I can find other people to lend me horses to re-learn how to jump, if I want to. Which I might not, by then.
The recovery program will take about five weeks of increasing exercise, starting with “stall rest and hand walks” which of course in a Parelli world means an outdoor pen large enough to walk around and lie down in and lots of clever games with obstacles. I’ve got a mental list that I need to write down, so when I talk to Dr. White tomorrow I can assign games of the appropriate activity level to each of the five weeks.
I will also consult with Erin about how to help Rocky reshape his body. He’s been favoring his feet for so long, so I imagine he’s got his ribs, back, hips, and other body parts out of balance as well. Like a more extreme version of how I feel when I stand up and walk away after 14 hours at the computer.
The most important — really, the only important — thing about all of this time, expense, and swimming against the tide of horsepersony opinion, is that Rocky will have immediate relief. By tomorrow evening he will be munching his dinner with no pain in his coffin joints.
Cross your hooves that this works.