Sage’s Story
By Jane Suraci

Editor's note: What we feed our horses is paramount to their health and welfare, and sometimes what we DON'T feed is equally as paramount, as in the following story.

As I stood sobbing in her stall, Sage lay on the ground once again, unable to get up. I had asked her to keep trying for too long and I was just then deciding I couldn’t ask for any more. My rule had always been that if my animals could live a fairly normal and pain-free life, I would support them. If not, it was my responsibility to put them out of their misery. It was April 3, 2001. I was trying to prepare for her last trip to the equine center the next day. After just four short months of knowing her, it was time to let Sage go and it was breaking my heart.

When this stunning filly arrived at our farm late November of 2000, she was just 20 months old. We broke all the prepurchase rules and bought her sight unseen. Well, not quite unseen, I had viewed her on video and decided I had to have her. Without requesting a prepurchase exam, I asked the owners to ship her up immediately. Now, I am glad there was no exam. My husband, Carl, and I never would have purchased her knowing what we would come to know. And if we hadn’t bought her, I’m sure she’d be dead now.

While Sage is half paint, half thoroughbred, she looks and acts all thoroughbred. As a yearling she was 16 hands, a gorgeously tall and slender steel gray with sleepy almond shaped dark brown eyes that gave her a babydoll quality. Her black forelock and mane accented the lovely white on her face and her long legs were perfectly clean. How had her owners managed to keep her looking so lovely? There wasn’t a scratch on her and yet she was as hot as a racehorse.

Yearlings, Sage and her playmate Arabian, Charm. Note the front leg stance Sage must take to reach the ground and the way she towers over Charm who is only one month younger. Nov. 2000

Her owner told me she had purchased Sage when she was nine months old, as her “dream horse”. The woman had always wanted a hunter/jumper and Sage’s lineage included several impressive champions. When I asked her why she was selling this dream horse, she explained that while she really wanted to keep her, her futurities clientele had grown and she had no time to work with her. Sage was left stalled for the most part and not often turned out. When she did get out, she wasn’t turned out with other horses. I think much of Sage’s life had been spent living in a bubble. That impression was supported by our initial experiences with her.

From the minute we released her into our 100’ x 200’ paddock with two other yearling fillies, Sage began getting hurt. Her injuries weren’t serious at first; she simply seemed to lack any sense of spatial awareness. She banged her legs on fence posts and knocked her head on panel rails. She constantly had hematomas on her legs or cuts across her body from running into or scraping along fences. Some injuries were utterly baffling but we were spending so much time nursing her back to health, we quit trying to figure them out.

She had no tolerance for pain and frequently attempted to kick or bite us as we dressed her wounds. She would try to skirt away from me, swinging her hindquarters heavily to one side and when that failed, swinging them twice as heavily back the other way attempting to knock me down. Twice I thought she was going to fall over on top of me. I couldn’t tell if it was intentional or if she had lost her balance.

Those aggressive behaviors were minor compared to the really malicious ones. The day after Sage arrived, two friends came to see her. I haltered her and led her around at a walk. When I asked her to trot she resisted. I tried some subtle cues to no avail and decided not to turn this into a battle while we had visitors.

Later that day I returned to work out the deal. I used every training technique I knew to move her forward but as I increased the pressure so did she. The lesson ended with her viciously attacking me, rearing up and sidekicking in a continuous spiral while bending closer and closer to me. This was no warning. She wanted me hurt. I stopped the lesson feeling not just a little intimidated. I needed a buffer between us. If I had a round pen, I might do better to work with her at liberty a safe distance away.

Sage, shortly after arriving at Carmelo Farms, Nov. 2000

The horse setup we had just completed left us unable to afford a round pen so Carl and I spent the next two weeks collecting materials at junk piles and building one ourselves. It worked, eventually. I trotted Sage at liberty and she did well but as soon as I tried to trot her on the leadline she reverted to her attacks. I returned her to liberty and tried again. Over and over we repeated the cycle. It took a week of sweat and tears but she finally gave up exhausted by the game. I trotted off to explore the farm with leadline and “Temper Tantrum” in hand. I was thrilled.

The next day, we found Sage lying down. When she didn’t get up to eat I knew something was wrong. At first approach, I wasn’t sure if she was unable or unwilling to get up. I coaxed her by pushing her rump with my foot in a rhythmic motion and talking with her. She would go back and forth from lying prone to picking her head up and sniffing her legs. It was as though she was paralyzed. She looked exhausted and scared. My guess is she had tried to get to her feet many times prior to our arrival. With slaps to the rump and loud commands, she did manage to get her front legs stretched out but it seemed she could not use her back end to lift herself to her feet. She would remain sitting for a few seconds only to slump back down. It was frightening. Had our round pen battles injured her? Had I pushed her too hard? My guilt and fear escalated to panic.

I shouted louder and moved to her shoulder, rocking it forcefully to get her up. Suddenly, she sprang to her feet and began bucking and rearing. I opened her stall which led directly into the paddock and she took off on a bucking spree, without a hint of lameness or weakness of gait. I remember thinking, “this is one odd animal” and “something is very wrong here” almost simultaneously. It was hard to believe this goofy, playful, strong willed filly had just presented as this pitifully paralyzed and emotionally whipped creature crumpled on the ground.

Over the next month, Sage’s episodes improved. Then on January 17, Sage had a particularly bad morning. It took me nearly an hour to get her to her feet. I called our local vet, Dr. Rick Regusa, at Bar S Animal Clinic. He consulted with Southwest Equine Medical and Surgical Center in Scottsdale, AZ and came back with a differential. It could be EPM. It could be “the wobbles”. It could be some other spinal cord related disease or injury. None offered much hope but I refused to think about that for now. I just waited for more data trying to ignore my pain and fear.

On January 20, we trailered Sage to Bar S for some relatively simple coordination tests. She failed them all. In one, Dr. Regusa walked behind her pulling her tail to one side then the other. She nearly fell over both times and as he shook his head, I felt my heart drop. He looked at me and shrugged, “I didn’t even pull very hard.”

Sage and her friend, Charm, playing as usual, Nov. 2000

On January 25, Carl’s birthday, we hauled Sage to Southwest Equine Medical and Surgical Center where we consulted with Dr. Bruce Kuesis. He did more coordination tests and x-rayed Sage’s neck. I was surprised to learn that if this was a spinal cord problem, even though it affected the hindquarters, it probably originated in the neck. The news was grim.

The x-rays showed that the canal the spinal cord passed through was smaller than normal. Sage was diagnosed with static stenosis, a true case of the wobbles. Her spinal cord was constantly being impinged. In addition, there was some roughness between two vertebrae, probably due to some previous trauma. My guess is, she had used the rearing up tactic many times before and had probably flipped herself over backwards more than once.

Her case was a critical one. The degree of ataxia (weakness) in her back legs was severe. There were also significant proprioceptive deficits or difficulties with spatial orientation of the limbs. There was even some weakness in the front legs. No wonder she was so clumsy and accident prone! And who could blame her for not wanting to trot around on a line? Her prognosis was guarded.

Then came the questions. How did she get this? Why didn’t it show up when we first got her? Is there a treatment? Can she recover? What are her chances? What would it cost? Is she in pain? Forget about asking if we’ll ever be able to ride her. We were just hoping she’d survive. Dr. Kuesis was calm and precise as he educated us. In addition, I read everything I could get my hands on about her condition.

How did she get this? The wobbles is five times more prevalent in thoroughbreds than other breeds. In one form, as with Sage’s, the growth plates pinch the spinal cord. This is far more likely to occur in rapidly growing yearlings like her. The rapid growth can be genetic. It is exacerbated by high-energy diets. Sage’s previous owner had put her on such a diet, even after the original breeder had warned her against one. Babies are often “power fed” to be transformed into those huge lovely 16 hand yearlings. There’s a market for them. I know. I bought one.

Why didn’t it show up when we first got her? The wobbles commonly manifests as a horse approaches two years old. While starting the groundwork wasn’t the cause, it had likely set the symptoms in motion. The application of pressure to her neck while she reared hadn’t helped. It was a good thing that most of the work had been done at liberty.

Is there a treatment? Can she recover? What are her chances? Dr. Kuesis admitted Sage’s recovery wasn’t likely but added that dietary management could be helpful. He told us he had successfully treated one Arabian. Since dietary management was relatively simple and inexpensive, he suggested we try it but he cautioned us against getting our hopes up.

In one book a veterinary surgeon wrote that no true case of the wobbles could be cured. If a horse appeared to be cured either the diagnosis or the cure “was not genuine”. Another vet who specialized in the care of thoroughbred racehorses told my husband he typically gave a wobbler a ten percent chance of recovery at best. An anatomy book described spinal cord surgery for wobblers that cost over ten thousand dollars and often ends in failure.

Dr. Kuesis wanted to try dietary management. The plan was two-fold:

1. Stop the growth plates from further growth. Sage’s overall feed ration was to be gradually decreased by 20% - 30%. Additionally, her protein intake was cut substantially. She would lose some weight but this would help slow down her growth.

2. Stabilize the spinal cord. The pressure of the growth plates on the spinal cord causes inflammation, which can result in permanent damage. Had Sage suffered permanent damage to her spinal cord? The test necessary to determine that was expensive. Dr. Kuesis recommended against the test explaining that regardless of what it would show, he would recommend the same treatment. Since recovery wasn’t likely it didn’t make sense to spend a lot of money at this point. Treatment for the inflammation was simple. Vitamin E was to be administered orally. Each day, Sage received 10,000 IUs in her food.

Is she in pain? Probably not. That was the first and last piece of good news we were to get that day. We were to follow this regimen for three months then return for x-rays. Because the risk of further damaging the spinal cord was so great, Sage was on “complete bed rest”. Dr. Kuesis shook our hands and asked us to call if there were changes in the interim.

There weren’t. For the next three months Carl and I rode the roller coaster. We often found each other sitting on the ground with Sage’s head in our laps. Usually we couldn’t hold back the tears as we soothed her, encouraged her or just plain loved her. We would have ended things much sooner if it weren’t for the stark contrast she displayed once she was on her feet. She played hard with her friends, galloped around the paddock and performed comic antics that kept us laughing. Sage was truly a trip!

Now here it was, April 3, the day before her three-month check up and she was down and exhausted again. I knew we were at the end of the road. Sage had given it a great fight, but with no improvement, keeping it up seemed inhumane.

As soon as Dr. Kuesis started the coordination tests he remarked on her improvement. In fact, he seemed genuinely surprised over signs I couldn’t even detect. My mouth dropped open as he recommended we x-ray her again and see if his impressions were validated. They were. Sage’s spinal canal was approaching normal size! I shared my amazement as I explained that we had seen her deteriorate at home. Dr. Kuesis suggested we continue the treatment for another three months and advised that we’d probably see improvement shortly. While he was “cautiously optimistic” his expression showed a twinge of hope that was contagious.

Carl, Jane, and their owner Sage, Jan. 2003

Half the trip home I was in shock and the other half I was in tears. From there, we did see improvement. Sage was on her feet most mornings with evidence that she had lay down during the night. There were a few more episodes but there was steady improvement. She still couldn’t be worked but we were grateful for just having her alive and with us. She was the great enigma: a constant comedienne who lightened up the barn when she got her way but a spoiled brat capable of reeking havoc when she didn’t. Slowly that began to change. It was as though she was gradually realizing that we cared for her and that it was in her best interest to cooperate. That became very evident when a setback hit.

One night at the end of July we came home to a horrific sight. It was the first time we had ever left the horses in the care of someone for a full day and it was a welcome relief until we saw the note on the door. The young girl had written, “Sage’s legs are pretty banged up and the water went out so I couldn’t clean her up.” There had been a problem with the well. Carl went to work on that. I ran to the barn. When I saw her legs I remember thinking they looked like they had been through a meat grinder. The best we could figure is that she had gone on a bucking spree in her stall and caught her back legs in her hay feeder. It appeared impossible, but that was Sage.

The gashes opened to large patches of pink flesh. They appeared to be many hours old, too late for sutures. Dr. Regusa was on a call several hours away but instructed me by cell phone as best he could. Carl and I spent most of that night and the next three weeks nursing Sage back to health. She was in a lot of pain but she finally made the connection that we were trying to help her feel better. That’s when she began to soften when we asked her to do things she didn’t want to. I could almost see the wheels turning in her head as she began to trust us. I felt her relax as best as any animal could in that kind of pain. It was a turning point.

But with the good came a new problem. Around the same time as the injury, Sage began a bizarre behavior of resting her neck over the top rail of the fence and pressing down hard on her throat. It wasn’t cribbing but it became an instant habit. Just before she pressed she would grind her teeth on one side. It became so chronic and she pushed with such force that I was sure she would damage her esophagus or trachea. It baffled Dr. Regusa and Dr. Kuesis. Was it a nervous reaction developed from boredom or lack of work? Was it a response to pain? She might be releasing endorphins. Was there something wrong with her teeth or jaw? Had she injured her neck or head along with her legs? We waited and watched. The habit continued as we approached her next three-month checkup.

On October 17, 2001 we returned to the equine clinic, primarily to address the wobbles. Dr. Kuesis couldn’t hide his enthusiasm this time. The progress was marked and we knew Sage was recovering. We didn’t expect she’d ever be normal but we knew she was a miracle just the same. The next thing Dr. Kuesis said blew Carl and me away:

”For liability reasons, there’s not a vet that would tell you that you’d ever ride a horse with the wobbles like this one. But I think you’re going to ride this horse someday.”

I looked at him in amazement. The only thing that computed was that “Temper Tantrum” and I had a lot of work to do together before I’d ever think about getting on her back.

Dr. Kuesis approved resuming her training. Now, what about her neck pressing? Her teeth were examined but showed nothing remarkable. They were floated just in case. Her jaw appeared normal but we agreed to x-ray Sage’s skull and poll area. When I saw Dr. Kuesis looking something up in a book and then making a phone call I got nervous.

“There is a large calcification at the point where the nucchal ligament attaches to the skull.” He went on to explain that this large ligament runs from the skull, down the back all the way to the tail. The calcification was a response to some severe trauma to the poll. The skull had not been fractured but the force of the blow had nearly torn the ligament from the skull. The degree of calcification indicated the trauma had occurred before we purchased Sage. It supported my theory that Sage had probably fallen over backwards before. Dr. Kuesis offered a second possibility. Sage may have hit her head on something above her.

We could not directly connect Sage’s neck pressing to this old injury. After all, she had only recently started this habit. It was possible that this area had been retraumatized when she injured her legs. Dr. Kuesis did not see evidence of a horse in pain but did suggest the possibility of shock wave treatments to break up the calcification. Unfortunately the cost per treatment was high and three treatments would be needed. Hoping that she was not in pain, we chose to wait and see how her recovery from the wobbles continued.

During our first trip to the round pen, Sage was so hot that I established only one rule. Stay on the rail, away from me! She bucked and ran and ran and bucked and then she ran and bucked some more. She was clearly delighted and when she was done she came to the center and looked at me as if to say, “OK, I’m done.” She learned so fast. She was walking, trotting, cantering, stopping and reversing on command within days, though her legs were weak and scattered. She often fell into a cross canter. I would transition her down and try again and she soon learned what the correction meant.

Our walks together on the ranch were not as inspiring. She had no sense of personal space and often bumped into me. She continued exploding in spirals each time she was frightened and most things scared her. How could I blame her? She had nearly no life experiences other than her trips to the vet. She was on sensory overload and needed time to process all the things her ears, eyes and nose were telling her.

I began carrying a five-foot piece of one-inch PVC on our walks. I held it horizontally in front of me so one end nearly touched her shoulder. When she moved closer she would bump it and reorient. If she exploded I bopped her to keep her away from me and then backed her as quickly as she could move to refocus her. I would rub her with the PVC particularly on the legs to help stimulate her neurologically and help her feel where her legs were in space. Things improved slowly. Then my husband asked the sixty-four thousand dollar question. “Can I ride her?”

I had asked myself the same question and wasn’t sure of the answer. Carl was a fairly green rider but he was a natural. He was also built like a jockey and it would certainly be better for Sage to carry a small rider like him. Carl also had no fear of Sage, but I did. On the one hand I felt it was irresponsible of me to allow a green rider to be the first one on this horse’s back when I myself was afraid to do it. On the other hand, Carl’s horse sense was excellent and I was probably much more effective being the one on the ground. I didn’t trust her out on the ranch yet, but I was willing to let him try her in the round pen.

She seemed not to even notice him on her back as she walked the circle with me at her head. She stopped on command as usual. I looked at Carl and without words we shared the awe. Carl’s riding Sage! Sage is carrying a rider! And then we shared the quiet tears of joy. At that moment I knew everything the three of us had suffered had been worth it. It was going to be O.K.

It continues to be O.K. and more. Sage improves steadily and learns quickly. We’ve both ridden her in the round pen. Carl’s been on her back as I’ve ponied her around the ranch. Just recently, he took her out alone for a short ride around the property. She seemed to understand that she had to do well and she did. Carl diverted one explosion with a simple turn of her head and Sage responded with calm. Sage’s legs are still very weak and she has absolutely no collection yet. She’ll need lots of time and exercises to develop her coordination and strength. We are still trying to solve the neck pressing puzzle. But mostly we are cherishing the impish Sage that continues to teach us about miracles. Our future together? Good or bad, we accept that anything is possible.

About the author:
Jane has worked and played with horses for over 35 years. She and her husband, Carl, are currently preparing for a breeding operation at their Arizona home, Carmelo Farms.