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  1. #1
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    Exclamation Hind end weirdness/C spine arthritis 3 YEAR update: post 154

    Blush went to the vet's two weeks ago for a lameness evaluation. She was sore behind and blocked to the hocks. We injected the lower joint with steroid. I was told to give her two days off and then ride as normal, but was cautioned that she would still be a little ouchy until the steroid really kicked in, which would be 10-14 days.

    She has been AWFUL to ride. I honestly feel like I've lost the last six months of work I've done with her. I waited until last Thurs (13 days post injections) to call the vet, and was told she was out until Monday, and could this wait? I said yes. So I will be talking to the vet on Monday and likely taking Blush in to the clinic for re-evaluation next week. But right now I'm worried and I'd love to hear any ideas about what to ask about when I do talk to the vet.

    Blush is definitely still sore on the right hind, which was the worse hind. She's been doing some weird things with that leg that she was not doing prior to the injections: the leg sort of collapses under her. It looks like when you think you're at the end of the staircase, and you step expecting the floor, but there's really one more step. I've seen this happen at the walk and the trot and even when she's just moving her butt over when she's tied up. Also, today she went very lame at the trot for several strides but was fine when I stopped her and walked her off.

    The fleeting lameness today really made me think stifles, but it really did not feel like a stifle lockup and Blush has just *never* had stifle issues.

    Does anyone have any other ideas, or "my horse did that and it turned out to be X"? It is very frustrating to spend so much $$$ and have my horse be WORSE
    Last edited by Simkie; Jun. 7, 2012 at 04:58 PM.



  2. #2
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    I know others have asked before, but I don't remember what your response was: has she been tested for Lyme disease and for other tick-borne illnesses?

    The recurring NQR and difficulty in getting a diagnosis is classic for Lyme.

    Good luck.
    "The formula 'Two and two make five' is not without its attractions." --Dostoevsky



  3. #3
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    You know, I haven't, but I have been thinking it would not be a bad idea to rule out Lyme. We really don't have it here but Blush did come from Boston in November 2003. Can be inactive for that long before causing issues?



  4. #4
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    Bump for the Monday morning crowd.



  5. #5
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    Could it be something with the SI joint? I know my guy would do some funky shifting when that bothered him at first.



  6. #6
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    Interesting! Yes, I suppose it could be SI related--Blush has had soreness in that area in the past, especially when we first started working on the canter. I've given up on cantering Blush the last couple of weeks...she's been SO unbalanced since the injections. I haven't noticed any SI soreness when I groom her, but I'll check it a little more closely. What sort of funky shifting did your guy do?

    I'd have to say Blush was collapsing on the right hind even more than "usual" last night--she did it a few times under saddle, at least once while I was tacking her up and at least once when I was standing there talking to another boarder. It is quite concerning



  7. #7
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    Just to answer your previous question about Lyme disease: yes, a horse can be infected for a long time before showing symptoms. Or, it may be that she has had such minor symptoms up to this point, that you either haven't noticed them or have attributed them to soreness from a workout, etc.
    "The formula 'Two and two make five' is not without its attractions." --Dostoevsky



  8. #8
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    I am following this thread, and am curious whether your horse holds its leads behind.

    Mine has a mystery hind end weirdness too. The main problem is that he does not want to hold his right lead behind around a turn. On course, I can weight my left stirrup and prevent it. In a round pen, it is very apparent. Both hocks and stifles have been xrayed (nothing evident) and injected (just in case), but that did not fix the swapping.



  9. #9
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    Quote Originally Posted by ToTheNines View Post
    I am following this thread, and am curious whether your horse holds its leads behind.

    Mine has a mystery hind end weirdness too. The main problem is that he does not want to hold his right lead behind around a turn. On course, I can weight my left stirrup and prevent it. In a round pen, it is very apparent. Both hocks and stifles have been xrayed (nothing evident) and injected (just in case), but that did not fix the swapping.
    When I first introduced canter work, Blush did some swapping behind. I figured it was a strength thing, did not allow her to canter disunited, and as she got stronger, it did stop. I have asked for a canter a few times since the injections, and there has been no swapping.

    I spoke with the vet, who was concerned with our lack of improvement, and I have an appointment this coming Saturday. I will bring up pulling a lyme titer. I'm wondering if I should do some EPM bloodwork as well? That would be just my luck



  10. #10
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    My 4-year-old mare started not being able to canter on her RL under saddle at the end of May. She went from being pretty willing and nicely forward to being very tense and rushy under saddle. Initial lameness eval indicated stifles or SI, but vet said it was nonspecific and we'd need to do further diagnostics. The lameness is very visible under saddle, not so much on the longe (she just looked like she was taking short, "stabby" steps behind on longe, but she could canter on both leads). She had no response to hoof testers or flexions; though she resented having hind legs held up, she did jog off sound. Neuro tests were normal. We talked about chiro, and I opted to go that route first, as mare was/is still growing and was rather butt high at the time.

    Chiro vet came out and worked on her, and mare muchly enjoyed that. We were to gradually start back under saddle over the next few days, and then about 5 days out from adjustment, try cantering. She definitely felt better after the chiro work, and she could hold her right lead on a straight line. But then about a week after her adjustment, things started to go downhill again.

    I started doing some more research, and had a few friends mention that her toes looked kind of long. That got me started looking at her feet, and when chiro vet came out two weeks after first appt. for recheck, I asked her to evaluate mare's trim as well. Chiro vet immediately said her toes were too long and there was lots of flaring, and we discussed whether and to what degree that might be affecting her way of going and structures higher up. Chiro evaluated her, and she was out in the same places she had been two weeks earlier w/ the exception of one cervical vertebra.

    I did lots of research online, learned about the hoof structures, anatomy, etc., how they work together, what a "balanced" trim should look like, and then went out in person to evaluate other farriers' work, comparing it to my mare's feet.

    I ended up getting a new trimmer (mare had always been barefoot and sound), and that coupled with some body work has started to make a difference in how mare is traveling. She's not going so short on her LH at the walk, and her whole way of going seems more relaxed and comfortable. My hope is that if we can get feet balanced, her way of going will be more correct, and hopefully, we'll see improvement in that nonspecific hind-end lameness. At any rate, neither regular vet nor chiro vet said that time off would hurt her, and I was pretty reluctant to start joint injections on a 4-year-old w/o at least fixing her trim first.

    So ... something else to consider, if you haven't ruled it out already. If you like, I can keep you posted on how mare progresses, in case it might be helpful for you.
    Last edited by onelanerode; Aug. 11, 2008 at 02:04 PM.
    Full-time bargain hunter.



  11. #11
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    The funky shifting felt almost like a stifle slip, but not quite. Because I wasn't positive, I had someone watch from the ground and they confirmed it wasn't a stifle slip but more of some kind of shifting probably from a lower back/pelvis being uncomfortable.

    One thing that was interesting was how other aspects of his movement changed because of his SI soreness (got my diagnosis confirmed via bone scan, blocks, etc). Several vets thought it was his hocks by the way he moved, and that changed once we got his SI feeling better (rest, injections, chiro). I also remember before the bone scan that it was tough to localize exactly where the pain was coming from b/c of the large area that still felt traumatized (i.e. we first thought it was at the tuber coxae but once the surrounding inflammation went down it was clear it was in a very specific area in the right SI- exactly where the bone scan lit up)



  12. #12
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    Interesting afternoon--I just got back from having the acupuncture/chiro/vet person I use look at Blush.

    She thinks Blush is in a state of "neurological wind-up" which, honestly, makes an awful lot of sense considering how Blush has been lately. She said it looks like the sympathetic nervous system is just in overdrive, and it's causing Blush to be in a a lot of pain from things that would normally not bother her. We did some supportive acupuncture and she advised asking my main vets about gabapentin or amantidine or acetyl l cainitine. She also advised adding lysine, as this sort of pain can be related to a herpes flare that irritates the nervous system.

    Blush was also pretty damn hot on a couple hock points.

    Nothing really pointed at the sacrum.

    I asked about testing for lyme and EPM, and she did not think it would be a BAD idea to rule those things out, but she said that she would be quite surprised if Blush was positive for either.

    So, I don't really know much more about why she's so damn sore in her hocks, but this nervous system wind up thing does explain why she's suddenly so upset about the saddle pad, and why I'm getting a tail in the face all the time and why Blush has been so sour lately.

    Sigh. Poor horse.

    onelaneroad--Blush's feet are the one thing I think we definitely have right. I recently (as in this last time we did her) have a new farrier and we fixed some things I'd been concerned about up front. She's been quite comfortable on her feet in front, and the feet behind look excellent as well, so I think I can pretty safely rule that out.

    pharmgirl--that's interesting! I think we're okay in the SI, but I'll absolutely keep that in mind.



  13. #13
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    Quote Originally Posted by Simkie View Post

    She thinks Blush is in a state of "neurological wind-up" which, honestly, makes an awful lot of sense considering how Blush has been lately. She said it looks like the sympathetic nervous system is just in overdrive, and it's causing Blush to be in a a lot of pain from things that would normally not bother her. We did some supportive acupuncture and she advised asking my main vets about gabapentin or amantidine or acetyl l cainitine. She also advised adding lysine, as this sort of pain can be related to a herpes flare that irritates the nervous system.
    Wow. I wonder if this ties into her eating problems she's had, too.

    I didn't know they used Gaba or Amantidine in horses! Did she explain why? We have an old rescue dog with very bad (great dane that had lived in a walk in closet for 8 or 9 YEARS! before we got him). He came to us on Amantidine (which I understood as a Parkinson's drug that also was a build-up antagonist) and Gaba (pain/inflammation reliever specifically helpful for neuro/back). He improved, but not to the point that we were happy with. We switched to Pred. (quality vs quantity, this critter has already outlived the normal Dane lifespan). WOW. He is on a tiny low dose now, and he feels like a puppy again. He's not 100% sound (still paces), but he runs and runs, jumps off the deck, and is really enjoying his life. It also helped with his appetite and some nerve damage he had (which was making him have a pooping problem!).

    Lysine is incredibly effective in Herpes cats, esp. ones with ocular problems.

    Let me know if you use those drugs and how they work!



  14. #14
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    I would definitely recommend a lyme test.
    One of my horses had some hind end issues. In fact, he was taken out of training due to hind end soreness last year.

    This year, it was almost like he would fall down at the hind end if pushed gently sideways.
    I honestly thought it was conformational, but since he just came back positive for lyme, well, there you go.
    As I have mentioned in the lyme threads, all mine have presented so differently, that I don't think this disease has a consistent symtom.
    Good luck in getting some answers.



  15. #15
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    I am definitely going to ask for a lyme titer and an EPM titer when I am at the vets on Saturday. Even if they're not likely, they do really need to be ruled out at this point.

    FP, gabapentin down regulates ... damn, I forget...some neuronal pathway, effectively calming down the nervous system and stopping the pain. Blush was equisitely painful along her back. She is so painful that she cannot tolerate the saddle pad, much less the saddle pad and the saddle and the girth. Now, we've been treating some back soreness for quite some time (probably related to the hocks) but she has NEVER been like this.

    Amantadine is an anti-viral. It was recommended because this sort of nervous system sensitivity is often caused by a herpes flare. Control the herpes, control the flare.

    I was going to wait until Saturday to discuss these options with the vet at Countryside, but I think I'll be calling her tomorrow. Now I know what it is I'm seeing in this horse, it's really, really obvious that she is in a LOT of pain. I think I'm going to give the gabapentin a go and see how she does.

    Oh, did want to add: shes eating GREAT. Cleaning up her hay and finishing her grain. I guess she only like to have one (cluster of related) problems at once



  16. #16
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    Quote Originally Posted by Simkie View Post
    Amantadine is an anti-viral. It was recommended because this sort of nervous system sensitivity is often caused by a herpes flare. Control the herpes, control the flare.
    You never get a break with Blush, do you?

    Sounds like in Blush's case, this med. may be a good choice.

    I think the veterinary use of Amantadine for chronic pain may be off label, but here's some stuff CSU wrote about it (although they are talking about small animal use- I wonder if this build up effect is also seen in horses?). I remember trying to find it in Plumb's etc, and there wasn't much written about it. It can be hard to find cheap. Did they mention the cost? I think it was about $50/month for our dog (from Walmart), but that was only one of the meds he was on.

    http://www.cvmbs.colostate.edu/ivapm...amantadine.htm

    "Very briefly, amantadine is an antiviral drug which has been used in managing Parkinson's Disease in humans. In addition, it has been shown to have pretty good NMDA receptor blocking activity, which is why we are using it.
    It is used in conjunction with your primary analgesic to prevent dorsal horn windup. It has no significant analgesic effects of its own, so must be considered a supplement for those animals that opoids and/or NSAIDs are not quite doing the job. The dose most use is 3mg/kg once daily. It is available in 100mg tablets or a syrup.
    R. L. Headley"

    "Will block the NMDA receptors used 3mg/kg sid for chronic windup pain.

    Amantadine-- as an oral NMDA receptor antagonist, it not only reduces central sensitization (always helpful in chronic pain), but also seems to enhance opioid receptor sensitivity and help abolish opioid tolerance. I use it in 7-10 days increments when opioid effectiveness seems to be waning, and subjectively feel it helps quite a bit (I realize this is anecdotal; Duncan Lascelles is the main advocate of this use, and until he publishes something anecdotal is all we have). Dosage is 3 mg/kg SID (it's available as a 10 mg/ml generic liquid as well as 100 mg tablets); excretion is principally renal (dose reductions may be necessary in severe renal failure) and side effects are minimal (occasional agitation or diarrhea).
    Gary T Old"

    Found this too on VIN:
    http://www.veterinarypartner.com/Con...299&A=2781&S=0
    In the small animal world, it was always used with a med like Gapapentin.
    Last edited by FatPalomino; Aug. 12, 2008 at 08:45 AM. Reason: vin link



  17. #17
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    Quote Originally Posted by FatPalomino View Post
    You never get a break with Blush, do you?
    No Apparently not.

    Did they mention the cost? I think it was about $50/month for our dog (from Walmart), but that was only one of the meds he was on.
    Nope, no mention of cost. I'm really hoping that this sort of therapy is well-accepted enough to get my insurance to pay for it. Really, really hoping. Pam also said Blush would only need to be on gabapentin for 4-6 weeks, so it's not a "keep her on it forever" sort of thing.


    "Very briefly, amantadine is an antiviral drug which has been used in managing Parkinson's Disease in humans. In addition, it has been shown to have pretty good NMDA receptor blocking activity, which is why we are using it.
    It is used in conjunction with your primary analgesic to prevent dorsal horn windup. It has no significant analgesic effects of its own, so must be considered a supplement for those animals that opoids and/or NSAIDs are not quite doing the job. The dose most use is 3mg/kg once daily. It is available in 100mg tablets or a syrup.
    Ding ding ding! NMDA receptor! THAT's what Pam said gabapentin affected. From what she said, and this info you posted, it sounds like gabapentin and amantidine work in a similar fashion.

    Also interesting: she said CSU was working with teeny tiny doses of ketamine for these sort of issues in equines.



  18. #18
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    I realize I'm late to the party, but have you ruled out EPSM? What is your mare's breeding? Abnormal hind limb gate can be a symptom.



  19. #19
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    Quote Originally Posted by Druid Acres View Post
    I realize I'm late to the party, but have you ruled out EPSM? What is your mare's breeding? Abnormal hind limb gate can be a symptom.
    Nope, have not ruled it out. The vet/chiro/acupuncture person has even brought it up as something that might also be going on with Blush. Blush is currently on TC Low Starch plus 2 cups cocosoya a day, which v/c/a person was happy with, and says if Blush is a EPSM horse the diet she's on now should manage it fairly effectively.

    Blush is a TB. Here's her pedigree: www.pedigreequery.com/blushing+maiden



  20. #20
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    Quote Originally Posted by Simkie View Post
    Nope, have not ruled it out. The vet/chiro/acupuncture person has even brought it up as something that might also be going on with Blush. Blush is currently on TC Low Starch plus 2 cups cocosoya a day, which v/c/a person was happy with, and says if Blush is a EPSM horse the diet she's on now should manage it fairly effectively.
    That sounds like a good diet for EPSM - Cocosoya is an excellent product, too. How long has she been on two cups of oil?



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