Guys, this is long and Im really sorry about that but there are so many facts!!
My horse has always been a little funky with her stifles (I think). She has a history of being stifle lame before I bought her and when I got her, I knew I was taking a gamble but I was young, dumb, and desperate for a horse of my own. She has good days and sore days. I can usually tell what I’m working with when I get on her and depending on how she feels dictates our ride. As long as she is in shape, she has very minimal problems. I was up to schooling first level dressage and she was as sound as she could be back in the summer and fall. I actually thought she might be cured because I didn’t have any issues for the longest time (silly me!)
In the fall, I moved her to a new farm where she went from about 1 acre flat field with one horse to about 30 acres with 10 other horses with a very steep hill making up part of the field. She is also on stall board here and in 12 hours at night. She was extremely sore the first couple of days. I chalked it up to getting used to more turnout, used to the herd, and used to the hill. However, after 3 weeks, she was a lot better but still wasn’t back to her normal, so I made an appointment with the best lameness vet in my area. She’s not obviously lame but vet could see that she was shorter on the right hind but couldn’t tell if it was stifle, hock, or hip. She didn’t really respond positive to any flex tests so I did x-rays of hocks and stifles. Both hocks and left stifles were clean as could be but right stifle showed a tiny bone spur. He said that may or may not be what’s affecting her and suggests a previcox trial. During the previcox treatment, she returned to normal, well better than normal. I reported this to him and he recommended we inject the stifles, do nerve blocks, or bone scan. I said nerve stifle injections. I did not ride her for 3 weeks after this but she did continue to go out. I had to wait 7 weeks to get the injections because of various reasons mostly having to do with the weather. When I did ride her (lightly) she ranged from fine, to slightly off, to really off. So, I never really asked her to do much and basically hacked around. While she was at the clinic for the injections, they x-rayed her feet and fetlocks (for unrelated reasons) and tested for Lyme (negative). The vet suggested looking into other boarding options to get her off the hill and into a pasture board situation.
I am moving her to pasture board farm next month but in the meantime, she has been put into a flatter field at my current barn and has been off the hill for a month now. After the injections, I have tried to put her back into work. However, she is still off. She still feels off and going right, she has a head bob/swing. It’s not like a front end head bob. It’s definitely coming from behind because I can feel her throwing my body to the left and the head wag is obvious. It looks like I’m seesawing the bit but I have no contact on the reins but only going right. When I ask her to come on the bit, she puts her ears back and hollows, sucks back, etc. I have had one lesson with the resident trainer at the barn one week after the injections. I wanted a lesson because I couldn’t tell if she was or wasn’t lame and my normal trainer wasn’t available. This trainer made me make her work and by the end of the lesson, she felt normal but it took A LOT of effort to push her to round, stay on the bit, and stay forward. She is usually a worker and doesn’t need leg but she was moving a lot better by the end of the lesson. This trainer said to continue to make her work and it would get worse or better and help us determine what’s going on but that she didn’t think she was in a lot of pain. A week later, I had a lesson with my normal trainer. We didn’t get very far because she said she did not look good at the trot at all and she said that I needed to get her out of the ring, do lots and lots of hacking for the next couple of weeks and see where she is after that but don’t try to make her work or push her. I did that for a while but, when I tried her again last weekend, she was still the same as before. She is willing to go forward without contact and doesn’t suck back at all. Actually she gets a bit too forward sometimes. She doesn’t pin her ears unless I ask her to round up. But, she doesn’t feel right and the head swing is still there.
So, Im having the vet back out on Monday. I plan to ride her so he can see this head bob. I think its worse when I’m on her, for sure. On the phone, the vet wasn’t very encouraging about her ever getting back to “her” normal. He never saw her go before this and only knows that she has had lameness problems in the past and now all this recent stuff. I keep holding on to the fact that she was so SOUND back in the summer before I moved her. He was saying things about being honest with my goals and expectations of her and maybe trying to find a non-riding home for her but I KNOW she was so good and so sound before so maybe something is out in her back? This vet is also a chiropractor so he should be able to tell. If you are still reading this, do you have anything to suggest I ask him to do or test? Maybe nerve blocks? Sorry this is all a mess. I’m pretty upset about this and this will be the 4th vet visit in 4 months so I’m getting nervous about cash.
Last edited by ActNatural; May. 7, 2013 at 09:31 PM.
Reason: made clearer
If it is the stifle bothering her I'd go with injections and if the previcox really helped I'd keep her on it. I have one on previcox daily for knee arthritis and he does well. It's much better than bute and will keep them comfortable. Question is are you wanting to show? I don't know what the rules are with previcox because my old guy on it is semi retired so I don't show him anymore. After you get her comfortable I'd go back to trying to get her stifles stronger and see how she takes to it. How old is she btw?
Horses aren't our whole life, but makes our life whole
I'd want to find out if the spur on the right is what is bothering her and if it is, is it possible to have it surgically removed.
What was the point of the injections? You say she isn't arthritic so I don't understand what effect they would have unless the injection was a blister.
I might be wrong (and I've been wrong plenty of times), but my understanding is that if a horse has weak stifles the best thing to do for them is to pasture them in a hilly field and to hack up and down rolling terrain while avoiding small circles and tight turns until they build muscle and strength behind.
That's what I've just started doing with my horse. He's got some hind end lameness going on and the vet has ruled out a lot of possibilities leaving me with the conclusion that 2 months of stall rest and naturally weak stifles have left my horse weak behind. My prescription is several months of hacking straight lines and up and down hills and keeping work done in the arena to a bare minimum for now.
This is something you deal with on a scale of months, not weeks.
Good luck with your mare. Hope you find out for sure what the problem is and can take steps to fix it.
Sorry if I missed it, but did the vet ever do nerve blocks on that right stifle? The most systematic method, IMO, is to do the lameness exam with flexions, etc., and then nerve block when you get it narrowed down to the supposed limb. Then if the horse is sound from the nerve block, xray or ultrasound that limb. After your horse slipped, how was the stifle diagnosed? Could be the bone spur if your ultrasound looked normal.
"And I saw heaven opened, and behold a white horse..." ~Revelation 19:11
See I was a little confused as well. I've always been told by vets to do hillwork for weak stifles but my confusion is if the stifle is weak or is it arthritis. I looked back and see a bone spur. Somehow missed that. If that's the case I'd block the area and see how she responds. If it's well I'd probably have the spur removed if there is no arthritis there ESP. Injections will probably not help much with just a bone spur but those can lead to arthritic changes also early on. So is the horse athritic in the right side or just the spur?
Horses aren't our whole life, but makes our life whole
Thanks everyone so far! Let me try to answer all the additional questions.
She's 11. We were going to do nerve blocks because the x-rays didn’t really tell him much during the initial exam but, between then and the scheduled appointment for nerve blocks, she had the slip in Jan and he came out the next day so he could see her right after the slip. Because she was so obviously lame then on her right stifle, he felt pretty confident that her stifle was the issue and suggest we inject stifles first, the maybe the tiny bone spur bothered her and the fluid surrounding the joint indicated some arthritis. He felt that it wasn’t a question of hock vs. stifle anymore because of her injury the previous day made her lameness more pronounced. So, we scheduled the injections but weather made that difficult and she didnt get them until late Feb, a month and a half after the slip.
He says that some horses have bone spurs and you never know it until a PPE and hers is so small that he isn’t confident that it bothers her but isn’t confident that it doesn’t but given her positive response to previcox initially (suggesting a bone/joint issue vs. soft tissue) and given her more pronounced stifle lameness, he suggest injections.
I feel as though he may be lumping things together (her past history of stifle funkiness, what he saw in December when he first came out and then what he saw after her slip) but I’m concerned that, prior history aside, her slip messed something else up and that is why she is still lame. Maybe she pulled something or has some sort of soft tissue issue but he did put her through the whole list of flex tests the very next day so if she had done something serious, he would have pick it up, right?
IMO having the slip could have just made a new injury. To say since she was more lame now than then because of the slip it must be stifle really isn't that conclusive again IMO. If you were not sure where it was coming from before it may not be the same issue. That said I would start where we know it is at the moment, meaning the stifle because of the slip. Correct that and then if not better move on to investigate other areas. A good lameness vet or sport horse vet is where I'd go next instead of my normal vet that does everything else. This way you can out your money in one time with the appropriate vet and not have to spend more possibly later. Even if you have a university vet school near you would also be a good place to go. Good luck.
Horses aren't our whole life, but makes our life whole
Diagnosing lameness is a methodical procedure. It starts with hoof testers, and proceeeds to blocks . Blocks should start at the bottom, and proceed up. Radiographs and ultrasounds, come later, unless something absolutely jumps out at the examiner.
Injections are treatment, which shouldn't start before a clear diagnosis, because injections can mask the actual problem.
In this horse's case there is an easy chance for error without methodical exclusion. You need someone practiced in blocks, cause they can be exciting.
Some riders change their horse, they change their saddle, they change their teacher; they never change themselves.