Boo's owners, Laura and Tara, first asked me to take a look at Boo after I had successfully treated Tara's other pony Paddy for a misaligned pelvis. We also worked very closely with Kathryn from Culverden Vets, in Tunbridge Wells, who had known Boo since Laura and Tara brought her home.
When I first palpated Boo, I had to try and contain my facial expressions as I attempted to figure out exactly what I was feeling! Before commencing treatments, I had to explain to Laura and Tara that I had never felt anything like this before and was unsure whether I would be able to make any difference to her. At the peak of her curvature, the spinous processes of the thoracic vertebrae were up to 2.5 inches from the midline of the back (yes, they really did feel like they were halfway down her shoulder!!). Boo was highly sensitive to palpation over her right rib cage (she would repeatedly try to bite Laura if I touched her there) and the ribcage felt flattened with no muscle development at all. Here are a couple of photos of Boo, from the first time I met her, back in November 2013...
Boo also had an interesting way of moving - perhaps she was part crab? Her right fore would swing right out and then place almost across the left, so that as she moved forwards she would propel both herself and her handler on a short journey to the left of the world. Her hind end would tend to follow the left fore, so she really did look like a bit of a crab, veering off to the left all the time. This gait pattern was exaggerated on a downhill slope and reduced slightly in trot. I will try and upload some videos in a future post.
So, as a team, we decided to treat conservatively and just treat what we could 'see'. At her first treatment, I treated 13 vertebrae for curvature to the right, from T5 to T18, with the peak of the curve between T6 and T12. Boo's pelvis was also misaligned with a left caudal tilt, however we could not treat this at the first treatment as Boo did not yet trust me and wouldn't even allow me to pick her back feet up, never mind stand behind her whilst one leg was held up!
In all honesty, when I returned to carry out Boo's follow up treatment 2 weeks later, I didn't expect to see any improvement. I was astounded by what I found. Although the misaligned vertebrae were the same in number, the extremity of the curvature was reduced - I had to palpate numerous times to be sure I wasn't imagining it! Although in improving this area, we had caused a knock on effect in the neck - with 2 vertebrae now misaligned and some muscle spasm and swelling around these vertebrae.
To cut a long story (a little bit) shorter, Boo continued to improve over the coming months. By her 3rd treatment, the curvature only reached as far as T14, by the new year we were able to adjust her pelvis (in fact, she trusted me so much that I got complacent one day and put hands on both sides of her - big mistake! Swift kick to my shins backed up with a swift bite to Laura's arm!! Boo always had character and let us know exactly what she thought of what we were doing to her!) and by April I was only adjusting T5 to T9 and intermittently her pelvis. Laura and Tara worked really hard with her ground work and exercises I gave them to try and improve her muscle tone and balance. The improvements were striking but I just couldn't seem to straighten out those last few vertebrae. As time went on, the abnormalities in her rib cage also threw up new questions and I can remember saying to Laura that the rib cage just felt 'a mess' in places.
Below is a photo of Boo at her treatment in May. You can see that she has grown A LOT and really started to change shape from 'foal' to 'pony'. Again, I've chopped her head off as its really the ribcage and shoulder I'm interested in here - can't really blame her for pulling grumpy faces, can I?!
So, on Tuesday 3rd June, I had a desperate message from Laura. Boo had gone down in the field on the Monday and could not get up. The fire service had been called to rescue her but even once up she was having difficulty standing. She was presenting with ataxia, a severe toe drag on the right hind, she couldn't get her head down to graze. I visited her, with Kathryn on the 9th June. I couldn't find anything majorly different to her usual presentation and did not want to adjust her pelvis as she was so very wobbly on her back legs. Again, I treated what I safely could and Kathryn gave her another dose of steroids but unfortunately on Wednesday 11th June Boo went down again in the field and was put to sleep. I was utterly devastated - she had come so far and it seemed so unfair.
Boo was taken to Bell Equine Hospital for post mortem. Currently the vets are unsure what to call what they found in her withers (apparently scoliosis doesn't cover it!) but the curvature of her spine, which they think is congenital, had also caused displacement of her ribs. At this stage, I don't know much more but hope to get the opportunity to see her X-rays and perhaps even her spine if they manage to preserve it. When the time comes, I will share more details of what we find out about Boo, although I'm not sure any of us will see someone quite like her again.
Boo was a super special pony who has made a big impact on my practice and a big impact on me too. I will miss her greatly and am honoured to have been part of her journey x