Damage to sacrial illiac joint. WWYD?

[2TBs]

My beloved 14 yr old pone has to be retired due to an injury to his sacrial illiac joint. The tendons and ligaments on the right side were damaged at some point. I think he's had it the entire time I've owned him, but I finally found a vet who could diagnose this issue.

Just so people know, the pain can show up as back pain or as hock pain. If you have a horse who can't seem to carry himself, fights putting his weight back and has a history of being NQR, check this area. Evidently, the larger the horse the more common it is. So a big Tb or warmblood is more likely to have damage to this area than a little pony.

Riding him at the walk and trot was always OK, but at the canter it was like being on a motorcycle. He just could not carry himself.

Even when I keep him on a daily dose of horsey naproxen, it does not make him 100% sound. It just eases his discomfort. So if I do ride him (at the walk, just down the lane) he gets his naproxen. Otherwise, no naproxen. He will need this forever, I think.

With green riders who use their hands he gets very upset. He broke part of his lower jaw a few years ago and is missing the lower left bar, left canine and lower left front tooth.

He's started showing some dangerous behavior when ridden. Balking, bucking, backing, rearing. He seems pretty happy for the most part puttering around out in the pasture. The bugs really bother him as does the cold. So I don't know that he'd be a good 24/7 pasture horse.

The vet said there isn't a lot you can do to rehab a horse with this, especially if he's had it as long as we suspect he has had it.

So, as you can imagine, I just don't know what to do with him.

He really likes having a stall and where I live, that will be about $425/month. That gives him the security to lie down to rest his legs and back. He never lies down outside. That would be $51,000 over the next 10 years just for board. Not including general maintenance stuff.

I do not want to make this a money issue. But it kind of is. I have contacted the rescues, hoping maybe they would know of someone looking for a companion horse. They told me to put an ad on Craig's List. Retirement farms are completely full.

I am at a loss. What would you do?

[tpup]

I'm sorry to hear about your pony. :(

What does your vet say about treatment or prognosis? There is no treatment at all? Injections that might work? Would chiro, accupuncture - anything work?

What about Previcox vs. Naproxen? Does he buck/rear etc. at walk/trot or only at canter?

If money is an issue, you probably wouldn't be open to a 2nd opinion, but I might try that.

[grayarabpony]

Was your horse ultrasounded? What did it show specifically?

[Simkie]

I've heard of cases like this where shockwave makes ALL the difference. It might be worth a try?

I'm sorry to bring this up, but if there's nothing that can be done, euthanasia is not an unkind choice. If I had an unsound horse that I couldn't keep, I would put it down. There's just so much uncertainty when placing a horse that can't be ridden. I'd rather euthanize and be sure the horse did not meet a bad end :(

[2TBs]

When my vet palpates (sp?) the area even just a little, bad reaction. No, I did not have an ultrasound done. I have spent thousands on this horse having x-rays, spinal injections, hock injections, acupuncture, Legend, Adequan, Surpass. I can't even begin to tell you all the things he has had done to him.

My vet is a lameness diva. My horse can't be in better hands. I have a BS degree in Animal Science and have worked for vets for years. I trust this one. In addition to my vet, he's been seen at a veterinary college and I have had at least 6 different vets over the years try to figure this out.

Chiropractor concurs with the vet. He's been adjusted in the past.

No, there is really nothing they can do for it. If this was a new injury then yes, I think there are things that can be done. But like I said, I think he's had this all the time that I have owned him, which is getting on 9 years now.

The bad behavior under saddle is as the walk and trot. We have not asked him to canter in over a year now.

Do you think putting him out to pasture is a wise thing? I live in MN and it can get really cold in the winter and buggy in the summer. Like I said, he really uses his stall. He will lay down and take naps during the day when given the chance in his stall. Sleeps down at night.

As I understand it, when the tendons and ligaments that hold the sacrum and pelvis together are damaged, there is not a lot that can be done. It's like velcro, or so I am told. So if a horse has an accident, such as a leg slipping out sideways and those parts get pulled apart, it's pretty darn hard to get it fixed.

My vet has been following a vet in the UK who has done considerable work on this very area. I guess the jury is still out. I see someone mentioned shockwave therapy. One of the vets that initially looked at him is one of the vets that helped develop shock wave therapy.

[dwblover]

If it was my horse, I would give the pasture board a chance. I've had horses who I thought would hate it fall madly in love with being out 24/7. Get him a good quality, heavy-weight turnout for the cold months, and constant movement may help him feel a little better. Really give pasture board some time, and then make a decision about his future.

[buck22]

I'd give a pasture routine a go if you can, just turn him out and keep an eye on him. You're going into a great time for this transition, spring he can get adjusted to outdoor living before the doldrums of summer hits. If he really hates it, you at least have the months of better weather ahead to make more changes.

I've had my first horse for 12 years now, he's been lame for the last 9 years with pockets of soundness for riding, officially retired 2 years ago. He's cost me untold thousands of dollars to keep going, I don't even want to think about what I've spent on him.:lol: Board anywhere from $275-575 depending, for a horse that was 3 legged lame. It is depressing, lonely, confusing and a rotten empty feeling caring and paying board and meds on a horse you know you'll probably never ride again, and not being able to afford another one to ride. It just stops making sense at a certain point. I think probably the only reason I stayed the course with my horse is because we're both too pig-headed to give up :lol: there were plenty of times though I just wanted to throw in the towel.

Having gone through it - giving everything you've got and then some, the endless nights of crying and sobbing till there are just no more tears left - I would never blame a person for making the hard choice instead. There were times, honestly, it would've been the humane thing to do. Its a crummy tough road. It just so happened that the powers that be smiled on us eventually, and my horse ended up teaching me more in his lameness about horsemanship than he did as a sound riding horse, but thats me, and I got lucky.

I wish you all the luck in the world, you're in a tough spot.

[grayarabpony]

I have a pony who had a SI injury that wouldn't have been diagnosed so quickly if I hadn't insisted something was wrong with her. It's the perfect example of a problem that often can't be picked up with a regular exam. :no: Sorry to hear you were sent barking up the wrong tree for so long.

SI injuries can heal if they're not too severe -- my pony has been sound for 2 years, after 6 months of 24/7 turnout. No injections, no chiro. I don't know the exact nature of her injury since no ultrasound was performed, just a body scan. However, your guy sounds worse, and this has obviously been going on for a long time.

If this was my horse I'd get an ultrasound done to see just what kind of damage he has. Then, depending on what the ultrasound shows, possibly have him injected, because he is so painful, then try to give him as much quiet turnout as possible. Re-assess in 6 months. Shockwave therapy sounds like a good idea too.

[lstevenson]

I would HIGHLY suggest a second opinion from a different vet, one who has experience with SI issues.

I would not be jumping to retire this horse. The gold standard treatment for SI issues is to inject the joint (4 ways) and put the horse into a progressive muscle building program. The SI has very little movement, and the stronger the topline and muscles surrounding the joint are, the more comfortable the horse will be.

I've known horses with severe SI issues (old fractures, lots of scar tissue from ligament injuries, ect) that have had their soundess maintained with a strict muscle building program.

[PiaffeDreams]

I concur about a second opinion and not jumping to retire the poor pony. I bought a horse 7yrs ago that was coming 4. We vetted him thoroughly, and we all saw a few tight/stiff/wonky steps during the exam but chalked it up to him being really hot at the clinic on a super cold windy day... he was "godzilla on a leadrope" for the vet check and routine flexions/x-rays did not reveal anything suspicious. I'd ridden him twice and he felt like a decently balanced un-balanced greenbroke 3yr old.

He'd just been imported 2 weeks earlier and got very banged up on the trip, but we felt positive he was fine. Quickly I realized he was not fine. He managed through our first 2 yrs to score very well at training and 1st level. But, he didn't really engage and was generally tight and crooked. Girthy and a PITA to pick up his hind feet let alone shoe. He bucked to go into canter and would for no apparent reason, just wig out to the right with a rear and bolt.

By 2nd level he pretty much shut down, wouldn't come to me in the stall and reared dangerously under saddle. He was by that time 7yrs old. All the while I was taking him to vets and looking for any possible answers... scoping for ulcers etc. At 8yrs old I finally found a vet who diagnosed it as probable SI and referred us to a specialist for an ultrasound. That gave us all the gory details with severely torn ligaments an obvious old fracture of the left ilial wing and subluxated pelvis. It was certainly an old injury and fairly severe.

It took a year of him not being allowed free turnout, but staying very active on a carefully monitored and progressively intensified exercise schedule to repair the ligament tissues to within normal ranges. Progress was monitored by ultrasound every 8 weeks. We had one setback at about 6 months and by 9 months from diagnosis he was in a full schedule of w/t/c for an hour's ride and cleared to resume regular turnout.

While it took us another year to resolve the fear he had of engaging and closing his frame without him blowing up into rearing, he showed 3rd level last Nov. and I'm going to show him at 4th level in April. He's schooling piaffe/passage, tempis and pirouettes. The effects of such a long standing injury and the faulty movement are likely with us forever. He has an ever so slightly slower drag to his right hind in flying changes left.... but I fully expect him to make it to FEI.

He got one set of injections in the SI joint at the beginning of rehab and the hocks as they were aggravated by the compensation. He received adequan throughout his rehab, but has not been on that for over 18months although he still gets a daily glucosamine MSM oral supplement that all my working/showing horses get. He has chiro care as needed and sometimes goes for long periods of time not needing it.

Horses can have these injuries long standing and severe and most definitely can be rehabbed and maintained. Some cannot for sure, but I've seen many who can. I've also known of stem cell therapy to work with ligament and tendon injuries.

I just wouldn't take it at face value that nothing can be done without a second opinion and for certain an ultrasound.

[buck22]

PiaffeDreams, thats an amazing and inspiring story!

[fordtraktor]

I have a horse with this problem -- mystery lameness and general grumpiness. I knew that something was off (I've had the horse for 10 years) and we kept after it until we found the SI problem in a bone scan.

I went to Kent Allen at Virginia Equine Imaging, and we injected the SI joint. After a few weeks off we slowly brought him back in a program. He was doing extremely well before developing another issue that has resolved itself after a year on the back 40. He's fine now, with no recurrence of the SI problem.

I am no lameness guru, but think that SI injuries tend to be like hock fusions and ringbone -- very painful for the horse when in an acute stage, but they calm down and the horses often come back fully despite the problem. They can continue to have flare ups, etc. I would inject the SI, then give him a few months off to see if he can reach a nonacute stage, then put him back in work.

It is very important to work with a knowledgeable vet to create a program if you are going to try to continue to ride him. Horses like this need consistency and good management. They are not horses you can ride twice a week and manage successfully. They need short, regular works with lots and lots of slow, steady conditioning. If you can't do it yourself, enlist a someone who can help you keep him in work and who you know will stick with the program.

[2TBs]

Thanks, all for your input. After reading this I also have to add that over the years, he has had some large periods of time off.

I have 1 person who is interested in taking him as a companion for her horse. If she takes him, great. If not, then I will move him with me to the barn where my other horse is and I will let him have some time off and will try to get riding time in on him.

Some other information: When my vet talked about rehab, she suggested cavaletti or hill work, slowly working up to 4 days a week. He also had put custom made shoes on him for more support and traction. To help build the muscles to support the structures.

I'll put him out on pasture and will just have to carve out more time to ride him.

This has given me a lot to think about. Thank you all!

[Dune]

I would HIGHLY suggest a second opinion from a different vet, one who has experience with SI issues.

I would not be jumping to retire this horse. The gold standard treatment for SI issues is to inject the joint (4 ways) and put the horse into a progressive muscle building program. The SI has very little movement, and the stronger the topline and muscles surrounding the joint are, the more comfortable the horse will be.

I've known horses with severe SI issues (old fractures, lots of scar tissue from ligament injuries, ect) that have had their soundess maintained with a strict muscle building program.

Ditto this. :yes:


Some other information: When my vet talked about rehab, she suggested cavaletti or hill work, slowly working up to 4 days a week. He also had put custom made shoes on him for more support and traction. To help build the muscles to support the structures.

I'll put him out on pasture and will just have to carve out more time to ride him.

!

The out to pasture part sounds good, but I would NOT jump to doing hill work or cavaletti just yet. Horses with this type of injury, in my opinion, do very well with massage/chiro work coupled with very carefully thought out flat work. Once you have 60-90 days of that type of work then you can start to think about handwalking over some cavaletti or handwalking up some slight inclines, but you have to be very careful and listen to your horse each day. It's a long process.

[clivers]

One of my horses is in treatment for an SI issue right now! He's getting much better with a strength training program (lungeing in a pessoa and correct ridden work), has had a change in shoeing with wedge pads behind, and acupuncture to treat muscle soreness as it develops.

Our vet thinks he will return to his career as an eventer and should not be limited. I was terrified when I first realized how serious it was (this is the best horse of my career) but the right type of rehab is making a big difference!

Anyway, here's the thread: http://www.chronicleforums.com/Forum/showthread.php?t=187778&highlight=sacro-iliac

[2TBs]

No, I would not jump to the hard work right away. My vet had suggested it when he was in regular work. He's been out of regular work now for about 6 months.

A little more information on where I am coming from: the husband had a hissy fit because this horse was standing around and costing us $$$$ to keep. I have another horse that I work with and just not enough time for 2. Especially when the 2nd one needs a lot of good consistent work and has these health issues.

[DirtLuck]

My horse just got ha injections tonight for this issue. She's very severely injured and has been this way for over two years, just finally being diagnosed CORRECTLY two months ago. She's making great improvements. She also has many problems down through her hind legs that are starting to improve as well.
She is currently on full turnout in order to keep her moving, and keep her happy. (stall rest for quite some time caused major depression and loss of appetite.)
I was instructed to long line drive her (w/o cart of course) in a larger pen. I like to take her around the fields. (footing is flat and even) We just walk because of lameness issues, but was instructed to trop her in a few weeks. Long lining gets the whole body working and engages the hind end. My mare is doing very well and I'm starting to think there is hope.

[Penthilisea]

First point: every horse is different, I am not a vet, I have no seen your horse.

My TB was diagnosed via nuclear bone scan with a fracture of the ilium.

Looking back I can see this issue came and went for at least 4 years.

I was given the option of 3 months strict stall rest, then 3 months handwalking, then 3 months walking under saddle, OR pasture rest for 6+ months. Based on his age (16) and my finances (0) I decided pasture rest was the right choice EVEN though he is a high maintence accident prone finicky TB who only liked to pee in shavings and hated bugs and rain.

It has been a full year and he is 100% sound w/t/c. He is out on 8 rolling acres, with two safe buddies and a big run in shed. I blanketed him with a waterproof turnout in the winter, and he gets a fly sheet in the summer. I literally have done nothing else but let him be a horse. Some MSM and a vitamin, and his hocks AND stifles look great too! (Always were sticky or stiff when in heavy work).

I would definetly give pasture rest a shot, if you have the finances to let him just do nothing for 6-12 months, and then see what you've got.

Best wishes.

[purplnurpl]

Mine has ligament damage to his right SI as well. It's a cm higher and as fat as my thumb. And he buckles when I palpate deep. Also his right hock is worse off than his left.
He also has some banged up neck vertebrae on the right side (#6-8)
and if he heals from his current condition will have a front leg with ligament scaring
and he already has decreased flexion of his left pastern due to a bad accident when he was a 3 year old. (which is also when he damaged his SI we think)
If his current injury heals he'll easily make an Advanced Eventer.
Basically he gets 8-9s when going left and 6-7s when going right in the dressage.
I can deal with that. ; )

I'm with others. Get a 2nd opinion before making a final decision.
SIs can be rehabbed. I've rehabbed my horse's SI twice. Usually just takes a few months of careful controlled life on the horse's part.

[Tiligsmom]

He's cost me untold thousands of dollars to keep going, I don't even want to think about what I've spent on him.:lol: Board anywhere from $275-575 depending, for a horse that was 3 legged lame. It is depressing, lonely, confusing and a rotten empty feeling caring and paying board and meds on a horse you know you'll probably never ride again, and not being able to afford another one to ride. It just stops making sense at a certain point. I think probably the only reason I stayed the course with my horse is because we're both too pig-headed to give up :lol: there were plenty of times though I just wanted to throw in the towel.

Having gone through it - giving everything you've got and then some, the endless nights of crying and sobbing till there are just no more tears left - I would never blame a person for making the hard choice instead. There were times, honestly, it would've been the humane thing to do. Its a crummy tough road. It just so happened that the powers that be smiled on us eventually, and my horse ended up teaching me more in his lameness about horsemanship than he did as a sound riding horse, but thats me, and I got lucky.

Buck....I could have written this! It's such a personal and crappy situation, that, unless someone else has walked in your shoes, your decision cannot be judged. I ended up retiring mine.... still paying board.... but couldn't live with the thought of euthanizing simply because he isn't useful to me. However... believe me... there are days I wish I didn't have this economic burden.

On the other hand, I wouldn't judge someone harshly for making the decision to euthanize in this case either.

[buck22]

aww [snif] thanks :) I forgot I'd written this post :)

here's the moneypit I speak of:
http://i25.photobucket.com/albums/c54/buck1173/the%20love%20of%20my%20life/bigtrot.jpg
http://i25.photobucket.com/albums/c54/buck1173/the%20love%20of%20my%20life/bucky1.jpg

"a face only a mudda could love" :D
http://i25.photobucket.com/albums/c54/buck1173/the%20love%20of%20my%20life/bucky2.jpg