The Presto Update

A lot of you (like a lot) have been asking me for a Presto update for a while, and the truth is that he’s been a bit… complicated, and I was waiting until I had some kind of actual resolution before I threw all this word vomit out into the void. Plus I just legit could not handle talking about it while there was still so much uncertainty. In the meantime I’ve been emotionally spiraling pretty freaking hard (did I binge eat like 5 boxes of Little Debbie’s in a week and impulse purchase an OTTB to cope with my variety of emotions? Perhaps. Despair tastes like swiss cake rolls, just FYI.) and if I was rude to anyone who asked about him, I’m sorry, please understand that mentally I’ve been in a very bad dark place about this whole thing for like a month. It’s a lot better now that we know what’s going on and it’s not what I had feared, but y’all know how this stuff goes with horse people. I was replaying the worst case scenario over and over in my mind for weeks.

if there’s an award for most money spent on vet bills in a 5 year period, surely he has to win it

Anyway, this is gonna be a long one so buckle up. When we last left off with our giant intrepid baby hero (ish) he had a very minor suspensory strain that needed a couple months rest. He was sound, the leg was cold and tight, the prognosis was excellent, we did some shockwave to help things along, and everyone was feeling pretty good about things. His final scan appointment was made to check on things one more time before he got the all clear to return to work, and he showed up to that appointment dead-ass lame… ON THE OTHER LEG. The original injury looked fantastic and was clearly not the issue, but now we had to figure out wtf was going on in the other leg. In all this time he has never been lame, so this was a confusing curveball to say the least.

the shockwave was fun anyway

Flexions and hooftesters didn’t show a whole lot. He was a bit reactive to the hooftesters (well, that kind of borderline where you’re like was that a reaction or has he just lost his patience) so the vet was like well his feet seem a bit sore, lets give him a couple weeks, get some films of his feet, get him reshod, pack his feet, etc. We did the films, which looked pristine, talked to the farrier, and we gave him a couple more weeks.

He went back and was still quite lame on that left front. He was no longer reacting to hooftesters, so we did some scans, took some more films of other parts of the leg, and tried some blocking. Again the scans were clear, his xrays looked great (at this point I have xrays of like both front legs in their entirety and they’re beautiful, which is kind of a surprise in and of itself given his size and his history, so there’s that?), and the only thing that really showed up on the blocking is that when he did the coffin bone the lameness definitely improved. It didn’t go away entirely, but it improved. My options were: inject the coffin bone, give him 10 days, and recheck, or – send him straight to MRI for definitive diagnostics. MRI is obviously hella freaking expensive. I asked the vet how optimistic he felt about the coffin injection being the solution and he was 50/50 on it. I asked if he would want to do the coffin injection either way, and he said yes. So I opted to inject the coffin bone and gave him another week.

Presto went back for his next checkup and showed a slight improvement, but not much. Definitely still lame on the LF. At this point it was clear that an MRI was inevitable if we wanted a definitive answer, but the vet needed to try to pinpoint exactly what parts to order the MRI for. This meant we needed to do more blocking. Again he started at the bottom, but this time Presto got LAMER as the blocks went along. It was very weird, and something the vet said he’s only seen happen a time or two before. He took some films of the elbow just to make sure we weren’t missing a cyst or something wild (I told you I now have films of the legs in their entirety), and at that point we had to call off anything else for the day because now his entire leg was blocked and we still had no clue. Another appointment was made for a week later where we’d start over and try the blocks again.

This time he did respond normally to the blocking, and showed some improvement to blocking at the foot and ankle. The vet ordered the MRI for basically everything below the knee on the LF just to be sure, and the appointment was made for a week later. At this juncture we were all thinking that he likely had a soft tissue injury in the foot (probably DDFT or collateral ligament) which is a big deal and potentially career-altering or even career-ending. I’ve had a not-great experience with a collateral ligament injury in the past, and I was replaying that whole thing over and over in my head on repeat. I was already trying to prepare myself for the fact that his eventing career could well and truly be over before it really even began, and I had to make some kind of peace with it. Plus all of this was costing me a stupid amount of money, which is stressful in and of itself. All of that is why I spiraled pretty hard and did NOT like being asked about Presto in general by anyone outside of my inner circle that already knew all the details. I was trying to cope with the loss of a dream that I feared was coming, and everyone asking for Presto updates on social media was just kind of twisting the knife in deeper (not anyone’s fault, totally understand why people were asking, just explaining why I mostly did not respond or may have been testy about it, depending on the day. Sorry for that. This is the downside to being so public.).

Since I paid a stupid amount of money for the MRI we may as well take a little spin through some of the images, yes?

So he went last week for the MRI. Which, cue some panic about the anesthesia and all the risks associated with that, plus the cost, plus the absolute cinderblock of dread that had been sitting in my stomach for weeks at what the images might show us. He got dropped off on Thursday for his MRI on Friday, so I knew I wouldn’t hear anything until Monday. I spent most of the weekend just trying not to think about it to be honest.

On Monday I heard from Megan (poor Megan has had to coordinate all this and take him to all of his 9000 vet appointments plus deal with me and Presto and all of our emotions) that the vet had called her and given her an initial diagnosis, but he had some follow-up questions for the radiologist and was waiting to call me to give me the full rundown until those got answered. So what was the initial diagnosis? A bone bruise to P2… an unusual place for a bone bruise and something the vet had never seen before. NATURALLY. Because Presto. But my initial reaction was immense relief, because at least it wasn’t “tear of xyz soft tissue”, which is what we all had feared.

How to Achieve A Sounder Horse | Horse Journals
just in case you need a reminder of where P2 is

I finally heard from the vet on Tuesday afternoon, and we had a good discussion. The short version of it is that Presto does indeed have a bone bruise on P2, which is very uncommon (I swear to god if one more vet uses the term “medical mystery” in relation to this horse I am going to freaking lose it). Usually bone bruises occur in P3 (not uncommon in jumpers, eventers, or any horses that take a lot of repeated impact to the ground, especially hard surfaces) or P1 (common in racehorses due to the repeated heavy impact on that area of the leg while galloping). P2 doesn’t take impact from the ground the way that those bones do, so it’s most likely that this one is from an impact or repeated impacts with an actual object directly to the area. We’ll circle back to that. He said that the prognosis was very good for full return to work with no lasting effects, and that the treatment recommendation was 90 additional days of rest, one injection of Osphos, and Osteon for the duration.

I had an immediate “ugh no” feeling at the Osphos recommendation, and questioned the vet about it. He said he understood my concerns but that he had never seen any issues using Osphos within his practice on horses age 4 and up. It can absolutely be a great drug and extremely beneficial (it’s intended to be a navicular treatment but is often used for other bone-related things), but there is a lot of debate surrounding how old a horse should be before they can safely receive it or what things it should be used for. There’s an article here if you want to read some of it for yourself or if you haven’t seen it before. But basically some of the concern is that with young horses it can interrupt the body’s ability to lay down proper bone, and cause damage to still-developing bone at the microscopic level. Obviously this can lead to structural weaknesses later down the line.

A very large, very growthy not-quite-5yo

Y’all, I struggled with this one. I struggled a lot. The official recommendation is age 4, some vets prefer age 5, others prefer age 6. Presto is a couple months shy of 5. On one hand, it’s just one injection and most of the issues they’ve seen have come from repeated use in 2 and 3yo racehorses. On the other hand, Presto is a very very large, very much still growing young horse, and the thought of potentially causing damage to the bones that are still developing (which are important ones like spine and neck) is just… I can’t do it. It would probably be fine but my gut says no and I’m opting to go with my gut. Even if the risk is very minimal, I don’t think I can sleep at night thinking about it. I’d have nightmares of bones with holes in them.

I talked to several of my friends that I deeply respect, and got opinions on Osphos usage in this case from several other vets. The vets were split pretty much down the middle on whether or not they would use Osphos for this. A couple said absolutely unhesitatingly yes, a couple said absolutely positively not. I think that alone gave me my answer. It’s just too much risk for me to feel comfortable with, and not enough potential benefit. Would the bone bruise heal faster with Osphos? Probably, yes. But at the end of the day I’d rather give him more time off, even if it ends up being significantly more time, and not take the risk. He’s young, there’s no rush.

After talking it over more, in the end we landed on 30 days of Equioxx, Osteon for the duration, plus Magnawave and Theraplate. He’ll get 90 days rest in a small paddock, at which point we’ll do another lameness exam and see where we’re at. He might be good to go by then, or he might need longer. Bone bruises take a while to heal, so it’s hard to say for sure how long it’ll be. The excellent and extremely relieving news is that it should heal just fine.

Now, let’s circle back to how exactly we think this happened. If you know Presto at all, you know that his left front foot is his “chaos” foot, in that it’s the one he prefers to use to create all manner of chaos. He likes to put it on things, in things, and whack stuff with it when he’s bored. He’ll stand on fences with his left foot, he’ll put it in buckets and troughs, he’ll whack stall doors or trailer walls with it if he’s bored or feels like he’s being ignored. So it’s very likely that, in the course of resting for his RF suspensory, he found enough trouble with his other foot to where he actually managed to hurt himself for real. This is not hard for me to imagine at all, I have watched him stand there at horse shows and repeatedly whack that exact spot on his foot into his buckets for no other reason than the fact that chaos is his jam. He’s sneaky about it too… if you yell at him he’ll just wait until you leave and resume his mission. Pain does not seem to deter him.

Proof that the LF is and always has been his chaos foot

After talking to a few people about it, I’ve decided to send him up to Michelle’s for his rest time. She has perfectly sized small paddocks there, neighbors right next to him all the time, there’s plenty to look at and to keep him company, and it’s pretty darn hard for him to whack his foot on her fences. Plus she has friends with Magnawave and Theraplate nearby, so it’ll be easy for him to have quick and more frequent access to those therapies. And obviously Michelle knows him really well, so I trust her to look after him. And instead of sending Gemma up to Michelle’s, Gemma can just stay here where she’s already settled in well. Change of plan, but I think it works better and makes sense.

While this whole situation has been stressful enough to take a few years off my life, and expensive enough to legit make me curl up in a ball in the corner (heeeey, anyone want to buy some shirts or a BEMER? Ha. Ha. Hahabutreallytho.) I’m extremely relieved to finally have an answer and have it not be nearly as bad as I had feared. In my head I had resigned myself to Presto only being a dressage horse and while I tried to make peace with that, I’ll admit it was a very hard sell to myself. Please no. Kid wants to run and do jompies, and so do I. With any luck he’ll be back in full swing by summer, assuming we can keep him from committing further chaos-inflicted damage to himself. Fingers crossed.

36 thoughts on “The Presto Update

  1. Oh my goodness, I felt my anxiety ratchet up just reading that. I can’t imagine how awful it felt to go through it. I hope Presto is able to keep most of his feet on the ground most of the time, and heal quickly. Tell him that his fan club is rooting for him!

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  2. Oh what a nightmare. Thank whatever diety you believe in that it’s not something really awful. My experience with collateral ligament tears is also devastating. When you mentioned that, I held my breath. Fingers crossed that Presto can manage to be a good noodle and behave himself for 90 more days. And I completely agree about the Osphos. Definitely not worth the risk. I’m sorry you had to go through all this stress and worry, but at least the final diagnosis is as good as it could be. I’m sure all of us out here in blog land would be happy to buy a new Presto t-shirt if you wanted to design one to help offset your vet bills a little bit. Sending calming thoughts to you…and Presto.

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  3. Not gonna lie – when I read the Gemma acquisition post, and realizing that it came in conjunction with radio silence on Presto for a little while, one of my first thoughts was “um, I hope Presto’s ok…” As someone who likes to keep difficult, in-flux things very very under-hat, even to those closest to me, I totally get your approach. Glad things ended up better than expected and hope our intrepid (anti?)-hero continues to improve 😉

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  4. Young horses will take years off your life. I had one get worse with blocks and the vet went “Hum, I didn’t expect that” – cue a really weird OCD in a fetlock that like, only a very few horses get. I also just got a new OTTB and I have been telling everyone that I have no plans for him and he is a pet, because as soon as you start having aspirations they get hurt. So far so good. I’m so glad Presto is going to be okay and I really sympathize with the experience. I think the “new horse starter package” for owners should probably just be a bottle of wine and xanax.

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    1. ALL horses take years off your life! Jaguar was fine until he was 24 (he’s 28 now and colicked bad enough to stay with the vet twice in the past 14 months). Yes to the wine and xanx!!!

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  5. Oh my that is so hard when you are in the middle of a event like that. I had been wondering why you hadn’t said much about him but figured you would update when you were ready. I had a pony with a bazar lameness that no one could figure out but didn’t have the money to do more in-depth diagnostics so I asked the vet if I could just put he out to pasture for a year. He said it probably wouldn’t hurt and I got lucky that a year later she was sound as could be and never had a issue since. Horses ownership is such a emotional rollercoaster.

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  6. Is it good ironic or bad ironic that I was literally at the vet getting bad news about Simon that comes with a rec to get a Bemer blanket for him?
    I hope P minds his manners at Michelle’s and can get back to work this summer!

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  7. Geez louise Presto! Way to give your poor mom a heart attack. So glad that it’s something that will heal though.
    Also, how can I get more info on the BEMERSs? I’ve been eyeing them for a while. Are you a rep for them?

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  8. I’m glad it’s looking positive and that he’ll be okay! I wanted to ask about him, but since you hadn’t mentioned anything about him for a while, I figured there was probably a reason you hadn’t given us an update yet. Thank you tho for sharing what’s been going on ❤ I'm glad that while not all is a-okay, it's still positive ❤

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  9. Oh my god Presto, stahp. It’s things like this that make me wonder why we bother with horses, I honestly don’t know that there’s a more stressful pet to have.

    Also, you should probably get a course of ulcer treatment from the vet. Not for a horse, for yourself. I know I’d need one at this point if I were in your boots, criminy.

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  10. I feel so incredibly bad for you, that you’ve had to go through this. I can definitely empathize with how hard this entire process must have been (as I’m sure nearly every horse own can). Sending all the good vibes and juju for a speedy and complication free recovery.

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  11. FFS, Presto. I have also been wondering about him, but figured something was going on that you just weren’t ready to share yet. What a freaking roller coaster. So glad it wasn’t one of the worst case scenarios playing on repeat in your brain!

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  12. Oh, goodness gracious, Presto . . . All things considered, I can only imagine the grief you’ve been dealing with lately. It’s pretty clear that Presto has a fan club almost as big as he is. Hang in there ❤ You know what's up, you've got a plan, and you'll both heal with time.

    Also, your hesitation with Osphos made me think that Equibone might be an option if y'all decide to adjust the treatment plan. I haven't used it personally, but several in my local community recommend it for bone related problems, even at young ages and especially at the very beginning of healing. Idk if it would work for what he's got, but it came to mind.

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  13. I am sorry that you had to go thru all this. He is definitely going to teach everyone a lot. Glad he will be okay but you might want to start wrapping him in bubble wrap.

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  14. There’s nothing quite like the gut-consuming fear of not knowing what is wrong with our horse, and facing that it may be career ending. So glad that it is relatively good news and can be resolved in time.

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  15. Tbh I don’t often feel compelled enough to do this for most creators I follow, but if you started a Patreon (even if it didn’t come with anything extra) I would definitely throw some money at that. Seeing a new post on this blog still gives me the little anticipatory boost it did the many years ago when I first started reading it.

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    1. Several people have said this over the years but I have NO idea what kind of content I could offer on Patreon that would be worthwhile to people. Open to suggestions!

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      1. I think you have a strong enough following of supporters that you wouldn’t need to offer separate secret content, ppl would just subscribe to support you. We all know having horses is spensive and you give a ton of your time to share your experience. I know that’s enough for me.

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        1. Agree with these thoughts on Patreon. Some people subscribe just to support a brand, not because they need it to access content. Might be worth doing!

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        2. I have a blog that I follow, and she has a “buy me a coffee”, people financially support $3-5 a month (or more, if you so desire). It is really helping her through some difficult financial times.

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  16. Sending a really big hug. These nightmares of guessing and not knowing are so awful. Glad there is a plan now. Presto is so fortunate to be in the best hands, all the way around.

    Some day you’ll be crossing the XC finish line on Presto and it will be so worth everything! 🙂

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  17. Nothing like horses to give you a heart attack. Last lameness eval I was crying in the car on the way to the appointment at the barn, which turned out to be for an abscess (YES we love a Dx of abscess). Glad you can take a breath now!

    And Presto, give your mom a break! FFS!

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  18. Effing horses. This is so frustrating and I’m so sorry! I mean, yes, bone bruise is the preferred diagnosis, but still, it’s annoying when you were SOCLOSE to getting back to work. I hope he heals quickly!

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  19. FYI little debbi snack cakes are being turned into ice cream flavors in case you need to eat your feelings in the summer.

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  20. I’m so happy to hear that you figured him out and that he has a great prognosis. I can definitely commiserate with having a homebred that likes to stop your heart. Thank you for sharing with us, I always enjoy reading about whatever horse adventures you are inclined to share.

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  21. Of course Presto would do something to injure himself in a weird spot! Best of luck to Presto’s team on keeping him quiet – I can’t imagine trying to prevent him from not using his front legs as whacking sticks.

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