I am completely at a loss. The beautiful and sweet mare that I purchased in May started showing signs of front end lameness in August (truthfully I noticed intermittent NQR steps earlier but didn't want to believe that it was anything more than uneven grass footing or typical young horse one-sidedness - Yes, I did have her vetted but did not take x-rays as the vet who did the pre-purchase didn't think they were necessary.) A thorough exam by my local vet, with nerve blocks and x-rays up to the elbow, failed to identify the cause. We gave her time off and re-evaluated but she was still lame, although not quite as bad. So, I took her to the Fairfield Equine Clinic. The doc there found her to be lame on three limbs!! The left front (which is what I had been noticing), the right hind, and the right front - in that order of severity. The hind end was unfortunately easy to pin point. X-rays show moderate changes in the lower hock. (She is five years old and had only been worked and shown lightly as a four year old.) Nerve blocks of the left heel produced improvement, but then a block of the entire foot made it worse which the vet said is often indicitive of suspensory pain. Ultrasound of the left suspensory was mostly normal but vet did note a couple of areas that could be normal for this horse or evidence of "chronic avulsion". Basically, the diagnosis was bi-lateral foot pain, left suspensory pain and right hind arthritis. Her foot x-rays (including navicular) were all normal. Vet says the front end lameness could be secondary to the hind end and the suspensory soreness could be seconday to the feet!? I am not sure about that since my vet didn't even notice the hind end lameness. I am just overwhelmed by all this and seriously depressed. An MRI could tell us more about the foot pain, but I don't think I can afford it at this point, after all the money I have spent on vet bills already. I seriously question whether this mare, even if I can get her sound, will hold up to consistent work (I ride dressage and had hoped to hunter pace as well). My only thought at this point is to try corrective shoeing, give her the winter off, and bring her back in the spring after injecting her hock. I know I don't post often here, but I value the collective wisdom and experience of this board - Any thoughts or words of advice? Thank you! - Jen
To me, sounds like this mare might appreciate a no-riding life. Maybe you need a horse to just groom and play with and love on? I know she's young, and it's really unfortunate. But I've never met a horse who minded life without work.
Did you get a PPE when you bought her, including lameness exam?
Tell a Gelding. Ask a Stallion. Discuss it with a Mare... Pray if it's a Pony!
Sorry to hear about your mare. I know how the vet bills add up. My guy was diagnosed with a collateral ligament injury and a small tear in the deep digital flexor tendon with an MRI in May he is still on stall rest but has improved very slowly.
I understand why you would be disappointed but none of that sounds really major to me. I would talk to the vet about whether stall rest or pasture turnout would be best and then give her the winter off. There aren't many things that time can not heal if given a chance. Best of luck to you both.
I, too, am very sorry for what you're going through. I know how frustrating it is to have lameness coming from more than one leg. But I also believe that time is a great healer. Time, plus careful lay-up and rehab. I'm presently bringing my 7-year-old back from a torn DDFT in left front, torn impar ligament in right front. We're on month 14 and he's doing well. I gave him four months of stall rest with handwalking, then turned him out in the field here at home to let nature do her thing. I started trotting him about six weeks ago and so far, knock on wood, things are ok. I didn't like how he felt after a couple of weeks, so I gave him a few more weeks of walking, and now he feels wonderful.
I cannot over-emphasize how important good shoeing is, however. It's most helpful to find a shoer who's had experience with your horse's exact injuries. Lot of subtle stuff involved in corrective shoeing and this isn't the time to mess around with a less-than-experienced farrier.
I've brought many horses back from soft tissue injuries. I also kept my lovely A/O hunter going while he was dealing with arthritic changes (he's now nearly 21 and retired from showing, but one heck of a pleasure horse). In every instance, I took as much time as was necessary (in one instance, I gave that same A/O hunter a full two years off to recover from torn tendons. He came back sound as could be and showed for another eight years).
Bottom line - it CAN be done if you are patient and careful. Good luck!
It is possible that she has injured only one foot/limb and the other problems are compensatory Did the vet suggest injecting the hock? I would consider treating the hock and giving her some time off to let the other problems heal. Then you could re-evaluate.
The hock arthritis could be from an injury. I know someone with a couple of horses having joint problelms who has injected the joint and then been able to maintain with a good quality joint supplement with HLA, specifically Acti-Flex 4000. http://www.coxvetlab.com/products/acti-flex4000.htm The horse with the most joint problems gets almost a double dose of this supplement on a daily basis and has not needed any additional joint injections. He needs more than the typical dose anyway because he is a daft cross weighing in at 1600 lbs.
Honestly, I wouldn't panic over any of that. It is what it is, you can only go from here. It sounds like you went to a very very detailed vet who found every little thing wrong, which is good, but doesn't necessarily condemn your horse to a life of retirement. I had a very interesting conversation with my vet recently, where she told me about some limitations that they are finding in using xrays to diagnose arthritis. I don't know all of the details, so I won't go into more of the specifics, but her point was that if you xray a random sample of horses, some will have bad xrays but no hock pain. I am a huge believer in diagnostics, but I think that you need to find out as much as you can about what's going on, then step back and look at the whole horse, and treat that. A lot of what you mentioned could be shoeing related, and could be compensatory. I think your plan of fixing the shoeing, injecting the hock, and winter off is ideal, and on the plus side, at least this is a good time of the year for it.
My parents sent a horse to me last spring that they were going to retire because they couldn't keep him sound. I just decided to proceed as if he was sound, and he would either get better or get worse, and we could find and fix the root cause. Well, he's been dead sound ever since, he's even jumping little courses (he was just doing dressage), and trail riding, and hasn't taken a lame step. Can't claim any magic fix, and it could be related to a million different things, but the point is, horses can have problems and get past them. This particular horse had problems with his hocks, stifles, hooves, back, etc. . . but he's doing great and having a useful productive life, with none of those causing him issues. Don't panic yet after one visit, give her some time to heal, and fix what you can, and then see where you're at.
Get with the vet, the one at the clinic who did find something wrong, and see what they recommend.
It may be she needs stall rest and hand walking for a bit if she is foot sore. And does farrier have any opinion about the footsoreness? There may be something you can do to make her more comfortable, like pads or a bar shoe. Sometimes bruised soles can really make them sore and there is no way to grow them out when they are active on harder ground or turned out. Look into that.
Far as the NQR, just turn her out when you get the footsore thing worked out. Leave her there as a pasture puff. Look at her again in about 6 months.
I have known some pretty good show horses that have been off up to 2 years with NQR issues that defy diagnosis or "mild" suspensories that just don't seem to heal. After initial stall confinement, they went out and stayed there, big pasture in a group. Re evaluated every 6 months. About half of them returned to previous levels, the others were able to work at a reduced level.
This one is only 5. You got time. And I bet she had a few issues before you bought her and this is not new. Pretty common with the vague NQRs that they get them going well enough to sell them and do not give them the 6 months to 2 years off that will allow them to properly heal.
When opportunity knocks it's wearing overalls and looks like work.
Thanks everyone for your words of support - Its very much appreciated!! I have been trying not to be too pessimistic. She is young and has good basic conformation and I keep telling myself that time should heal whatever ails her. The fact that she didn't really improve after two months off threw me for a loop, however. Its very hard to deal with all this when I have only had her for six months. Plus, the whole diagnostic picture is so clouded. My vet really didn't think it was soft tissue, and she also did not see any hind end lameness. And although the clinic vet did detect some suspensory pain, it was not severe and the ulatrasound didn't really pick up much. But, could be lower down in the hoof where the ultrasound can't see. I know I should probably have the MRI done, but at the same time, given the expense and given that she is not severely lame, I kind of feel like whatever they find, the result may be the same as I would do anyway at his point - give her the winter off. The only question is - is it stall rest or just pasture? The clinic vet did say that the front end could be compensatory, i.e. she travels around on her forehand to take the load off her hock making her foot sore (she was barefoot when this all started, but I put shoes on six weeks ago - didn't seem to make a difference) and then the sore feet could alter her way of going making her suspensory sore? I don't know if it is worth injecting her hocks now, even if she is going to get the winter off?
Thanks again - I feel like I am desperately groping around in the dark
Get the book "back to work," or at least read it at your local bookstore and you will see the rehab for most injuries is similar. And whether you had an MRI or not, the rehab would be similar.
My mare was given two months off and it didn't fix her, but I let her have turn out. She was not wild in turnout. An MRI diagnosed a collateral ligament tear and it was advised that I would need 9-12 months rehab. I did two months stall rest with handwalking and worked my way up there (2 months handwalk, 3 months mounted walk, 3 months trot, and then canter.) She is doing fine now.
So, in my experience, having the 2 months stall rest with handwalk was more effective than 2 months stall rest and turnout.
Similar symptoms with one of mine (no hind end problem diagnosed, however).
The MRI finally found the collateral ligament and deep flexor damage in one fore (although she had exhibited caudal heel pain in both fronts, and early on, the suspensory strain in one foreleg).
Relatively mild, fortunately - but definatly there, and more time off + adjustments in her shoeing + injections FINALLY made the difference. She is sound today (without the injections or compensatory shoeing).
But they aren't very forgiving - they take (a lot of) time to heal. In our case, it took over 2 years to get her completely back.
I would turn her out -- although not in a big group with horses that she'll have to run with in order to keep up if one of them starts playing. Movement is essential for healing actually, if the movement is slow and steady. Can you turn her out with a quiet buddy 24/7?
Its just her and her companion llama, but the llama can be surprisingly rambunctious at times, and she will run to keep up with him. She is a Haflinger so not naturally "hot". I do have a small sacrifice paddock that I could put the llama in or her for that matter. My husband complains when I "lock his llama up", but its probably the better course for now
The cloudy diagnosis tells me that the vet really has not found the true root cause yet.
Pull all shoes if she wears any, make sure she gets trimmed correctly and give her time off out to pasture.
What does this horse eat and could she possibly have any unrecognized frog infections that are causing the tenderness? Explore the frog with a hoof pick. If she flinches at any point, she has a frog infection. They can ber VERY painful to a horse!
Last edited by BornToRide; Nov. 3, 2008 at 01:15 PM.
You mention "corrective shoeing." Have you seriously evaluated the quality of her shoe/trim? Posting pictures here or on one of the horse shoeing forums might provide some insight. Asking an inadequate shoer or trimmer to make changes for the sake of "correcting" anything is a recipe for disaster. Finding an excellent shoer/trimmer who can guarantee that she is balanced and level is vital.
Just my 2 cents, but bi-lateral suspensory soundness makes me suspicious of the foundation she is standing upon.
As for the hock injections, if they are causing her pain, then injections would definitely be warranted. You’re already going down the path of lameness related to compensatory changes in her way of going….Again, advice worth what you paid for it.
Thanks again everybody! As for the feet - She came to me very over due for a trim with long toes and toe cracks in the middle of both front feet (worse on the right which is actually the "better" front limb) My farrier picked a bad time to go MIA, but I did find a guy who came highly recommended and had clients in the next town over. He finally actually did something about the toe cracks. Fungus had gotten in there despite my regular use of thrush buster, save-a-hoof etc.. He opened the cracks up to try to get past the fungus and get air in there. He did put shoes up front with side clips. (She had been barefoot) This was all after the lameness had already shown up. He did not think the toe cracks or her feet were related to her issues and neither did either of the vets. Local vet did comment that he did a good job with the shoeing. Clinic vet's shoeing recommendations are "Shoes to support foot pain are indicated. A wide web steel shoe that is fit full through the heels and is set back at the toe .."