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Mysterious Lameness Advice

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  • Mysterious Lameness Advice

    2005 Selle Francais Mare did training level eventing in 2012.

    Trying to figure out diagnosis and next steps for a high left hind injury.


    July 2012 - Bolted during fitness gallop,came out short behind particularly on left hind when going to the right, gave time off and bute.

    August 2012 - Mesotherapy and methocarbamol, doesn't feel better after two weeks. Inject SI joint and left stifle.


    September 2012 - Competes two events sound, maybe hesitant over back at times but performs very well. One week after last event, comes up very lame on left hind but still walks with overtrack. Block lower left leg to high suspensory with no improvement. No heat or swelling or reaction to palpation anywhere. Radiograph stifle & hocks and ultrasound left stifle. Vet thinks the chip detached from left hock might be causing lameness and recommends 6 weeks stall rest.

    http://www.youtube.com/watch?v=QvDMn...ature=youtu.be


    October 2012 - Improved from original lameness, but still off especially when left hind is on the outside. New lameness vet reblocks lower leg and blocks hock & stifle with no improvement (thinks bone chip not related). 60 days stall rest with hand walk. Really twists left hoof to the outside when pushing off in walk.


    December 2012 - Bone scan clean with nothing of significance found (working to get these off a CD since my laptop doesn't have CD player). No longer twisting left hoof in walk, appears mostly sound but weak.


    January 2013 - Give loading does of Adequan. Start back to work with straight line trot & drugged turn out. She was walking an hour in hot walker before work started. Added a minute of trot a day for 25 rides. Feels consistently sound.

    February 2013 -On full days non drugged turn out in small paddock. Start building up canter work on straight lines, feel like canter transitions are a bit resistant at times but sound. Got myofascial release body work to help muscles coming back to work. Then comes up lame again several weeks after canter work starts. No twisting of the hoof in the walk like original injury but wants to stand consistently with left hind leg turned out. Chiropractor thought muscles were not firing properly on left side. Gave first dose of pentosan.

    Straight line Trot:
    http://www.youtube.com/watch?v=ol3q5...ature=youtu.be

    Trot/Canter:
    https://www.youtube.com/watch?v=Agcng4-ruWA

    Lame Again:
    http://www.youtube.com/watch?v=ITS7d...ature=youtu.be

    Considering turning out in a field for a year and letting her recover. Any other advice?

  • #2
    MRI of hind left leg?

    A whole bunch of stuff was injected..but not the suspensory?

    Hind suspensories are maintained through injections. You get it done...go back to work--the horse eventually gets sore again and then you re inject. or, seems as if everyone is having luck with fasciotomies of those hind high suspensories.

    MRI of back leg.
    Fasciotomy of suspensory.
    Go back to work.

    Turning a horse out with a hind suspensory is all fine and dandy. It will eventually be sound but then as soon as you go back to work it will become lame again. It's the nature of a hind suspensory.
    http://kaboomeventing.com/
    http://kaboomeventing.blogspot.com/
    Horses are amazing athletes and make no mistake -- they are the stars of the show!

    Comment


    • #3
      Did they block the inside of the left hind from the hock down. That can be a difficult spot to get to if the horse is at all cranky about his hind leg.

      Some of these horses can appear sound after a short rest, and then slightly sore again, and again until one day they really show soreness. The trouble is, if it is a suspensory, the longer you dealy, the harder it is to bring them all the way back.
      Some riders change their horse, they change their saddle, they change their teacher; they never change themselves.

      Remember the horse does all the work, we just sit there and look pretty.

      Comment

      • Original Poster

        #4
        First lameness vet blocked high suspensory down. She did the needle all the way thru, does that make sense? Horse is a saint in the not kicking regard.

        Second lameness vet who comes from a top clinic in the area, reblocked suspensory down and the hock & stifle.

        Is it possible it did not block out? I have never had to block a horse that high before.

        No vet has suggested injecting the suspensory. I am trying to avoid excessive injections at this point, unless that is the only thing to make her comfortable.

        Comment


        • #5
          I agree MRI the hind. I'd also run a lymes and epm test. I took my boy to the university after having the vet here check him out for seeming to be off in the backend. We couldn't really figure out what it was. He was good sometimes others not so much. University blocked him no change then neuro came out and took a peek ran the bw and it was a high positive for epm . Just trying to think out of the box. She is very cute though.
          Horses aren't our whole life, but makes our life whole

          Comment


          • #6
            Originally posted by rabicon View Post
            I agree MRI the hind. I'd also run a lymes and epm test. I took my boy to the university after having the vet here check him out for seeming to be off in the backend. We couldn't really figure out what it was. He was good sometimes others not so much. University blocked him no change then neuro came out and took a peek ran the bw and it was a high positive for epm . Just trying to think out of the box. She is very cute though.
            ^ This is exactly the kind of out of the box ideas I think would be helpful in this case. Halfhalt08 (this is Nora by the way) I know neuro is not fun to think about, but it's an interesting suggestion.

            Sorry that I'm just not familiar with MRI's but what does that show? Soft tissue? If it was a suspensory, a bone scan wouldn't pick that up correct? Interesting.

            Comment


            • #7
              my horse is rehabbing a suspensory branch injury that was indeed diagnosed via bonescan, confirmed via ultrasound. My super duper fancy lameness vet often diagnoses suspensories via bonescan (although when he saw him in the round pen, he said...looks like suspensory...but the imaging confirmed).
              The big man -- my lost prince

              The little brother, now my main man

              Comment


              • #8
                Can you get a MRI that high up?

                My first suspensory (both branches) was diagnosed by u/s. the second horse's suspensory and collateral ligament was diagnosed by high field MRI. And then later found on u/s.

                So asterix are you going though layup and rehab at this moment? We started stall rest on Feb 6th.....

                Comment


                • #9
                  Originally posted by Ransom's Rider View Post
                  Sorry that I'm just not familiar with MRI's but what does that show? Soft tissue? If it was a suspensory, a bone scan wouldn't pick that up correct? Interesting.
                  There is a brief "soft tissue" phase in a bone scan where soft tissue will light up. If they weren't looking for soft tissue problems, or didn't look at the right time, they would not have seen a suspensory problem.

                  MRIs are excellent to visualize soft tissue.

                  A bone scan should have picked up any spinal issues causing neuro problems, but it would not pick up something like EPM, since that's more of a parasite problem.

                  Comment


                  • #10
                    NRB, thankfully my vet did not insist on total stall rest. My guy is very big and mostly mellow, and had already done a long stall rest a few years ago, so we decided to go for small paddock turnout from the get go. We did do PRP and shockwave. I was walking under tack from the beginning.
                    He wasn't sound until 3 months out but we just got home from our 5 month checkup. He feels great and is sound; still on moderate turnout (for us; it's a nice size flat paddock and he's in at night -- normal is 70 hilly acres with 20 horses 24/7). We are trotting gradually building up to 10 minutes; one last ultrasound in a few weeks and we will be cantering.
                    The big man -- my lost prince

                    The little brother, now my main man

                    Comment


                    • #11
                      Not a vet, but if she were mine, my next direction would be the SI joint, and having her checked by a neuro specialist, in that order. It looks up high to me, and not unlike one I had with an SI tear. But there are moments in the trot canter video where I could make the case she "loses" that limb for half a beat in the downward transition. If those show nothing, then I'd def consider a year of dr green.

                      She is lovely. What a heartbreaker. Sorry.
                      Phoenix Farm ~ Breeding-Training-Sales
                      Eventing, Dressage, Young Horses
                      www.phoenixsporthorses.com
                      Check out my new blog: http://califcountrymom.blogspot.com

                      Comment

                      • Original Poster

                        #12
                        Thanks for all the really good input! The neuro stuff is interesting, would be easy to pull blood work during spring shots.

                        However, I have always felt like it was her SI. She seemed to do better with SI injection and I am worried I masked something in surrounding tissue since bone scan was clean of the SI. She was NQR and then awful lame a week after her last event.

                        Is there a way to ultrasound it? Not sure how to diagnose an SI tear and what the best protocol would be? I hate stall rest because they become so miserable.

                        I agree with the downward transitions, PhoenixFarm. I know how to hold her to mask that a bit, but I kind of just let her cruise in that video so I would see reality. She would prefer to collect a lot in the canter as opposed to canter trot. She also preferred left lead canter and did a couple clean flying changes from the right to left when going right.

                        Comment


                        • #13
                          Originally posted by PhoenixFarm View Post
                          Not a vet, but if she were mine, my next direction would be the SI joint, and having her checked by a neuro specialist, in that order. It looks up high to me, and not unlike one I had with an SI tear. But there are moments in the trot canter video where I could make the case she "loses" that limb for half a beat in the downward transition. If those show nothing, then I'd def consider a year of dr green.

                          She is lovely. What a heartbreaker. Sorry.
                          I was just able to see the videos. Yesterday they didn't load for me.
                          Holy cows she is beautiful.

                          I agree with Phoenix concerning the SI.
                          http://kaboomeventing.com/
                          http://kaboomeventing.blogspot.com/
                          Horses are amazing athletes and make no mistake -- they are the stars of the show!

                          Comment

                          • Original Poster

                            #14
                            Originally posted by purplnurpl View Post
                            I was just able to see the videos. Yesterday they didn't load for me.
                            Holy cows she is beautiful.

                            I agree with Phoenix concerning the SI.
                            Thanks purp! Here she is at the AECs, gave her several days off and went out on a hack and then came out very lame (first video). If you are bored, here it is:
                            http://www.youtube.com/watch?v=EZQI3ib3YfA

                            How would I get the SI diagnosed? Any idea if stall rest or 24/7 pasture would be best?
                            Last edited by Halfhalt08; Mar. 12, 2013, 01:51 PM. Reason: grammar

                            Comment


                            • #15
                              Originally posted by Halfhalt08 View Post
                              How would I get the SI diagnosed? Any idea if stall rest or 24/7 pasture would be best?

                              It depends on the injury and how quiet she is in turn out. There are some vets who can ultrasound the SI but it is iffy. I think they go in rectally. I had one vet practice on one of mine. I think they said sometimes they can see it and other times not. I think you do need to try and pin down a diagnosis. The one year green RX isn't a bad idea if she is quiet in turnout. But you have to stick with it and basically not look at them for the year and then bring them very slowly back to work (like walking for 2 months).

                              Good luck. She is very pretty.
                              ** Tact is the ability to tell someone to go to hell in such a way that they look forward to the trip. ~Winston Churchill? **

                              Comment


                              • #16
                                Run Lyme titre ASAP - it can definitely present this way. Good luck.

                                Comment


                                • #17
                                  My retired advanced horse had mysterious hind end lameness after injuring his hock in a pasture injury. He was rehabbing from the hock, and started showing soreness, again in his hind end. I was completely sure it was up high, but was told by several vets that he had a massive hole in his suspensory, and that was the reason for the lameness. He even blocked out to the suspensory according to several vets. I was still convinced it was up high, so we had stifle rads done, and had them read by the chiro/sport medicine vet that we'd started using for another horse.

                                  The diagnosis: He tore the ligament attachment off the inside of his stifle. We re ultrasounded the suspensory, and there was NOTHING there of interest. definitely no "hole" as had been mentioned before.

                                  This was a horse that several people thought looked sound most of the time, but I could tell, 100%, that he was not right high behind. He presented very much like yours does in the videos.

                                  Consider looking more closely at the stifle, and attaching ligaments.

                                  Johanna
                                  "Animals can sometimes take us to a place that we cannot reach ourself"

                                  ** Support the classic Three Day Event! Ride a Long Format **

                                  Comment


                                  • #18
                                    I 2nd, 4th whatever, the suggestion for an MRI or CT scan on the right hind.

                                    Good luck, she's very nice!
                                    Unrepentant carb eater

                                    Comment


                                    • #19
                                      Originally posted by asterix View Post
                                      NRB, thankfully my vet did not insist on total stall rest. My guy is very big and mostly mellow, and had already done a long stall rest a few years ago, so we decided to go for small paddock turnout from the get go. We did do PRP and shockwave. I was walking under tack from the beginning.
                                      He wasn't sound until 3 months out but we just got home from our 5 month checkup. He feels great and is sound; still on moderate turnout (for us; it's a nice size flat paddock and he's in at night -- normal is 70 hilly acres with 20 horses 24/7). We are trotting gradually building up to 10 minutes; one last ultrasound in a few weeks and we will be cantering.
                                      WOOT that is awesome. My guy is also big (17hh) and mostly mellow but we don't have a small turnout. And where I board it is very hilly/mountainous land. I wish I had access to small flattish turnout to use. He is doing soo well in his stall rest and handwalking that I hate to move him and upset him. We did our 3rd SW today, checkup u/s will be in 2 weeks. I'd prefer a small turnout and keep him moving (gently) from the get go. Main injury was collateral ligament and suspensory ligament (in fetlock area)

                                      sorry for the thread hi-jack

                                      she is a lovely mare OP

                                      Comment


                                      • #20
                                        I will add to the SI camp because you said she bolted and that's when it started. My unscientific data point of one, is my gelding who ran off with me one spring and tore the attachments of his SI - he wasn't nearly fit enough to be going that fast, but I couldn't stop him.

                                        It presented as "huh, he's lame behind, but where" and they finally decided he tore the attachments to his SI. He was 17 at the time and had had other SI issues all his life but competed at Prelim just fine.

                                        I did laser therapy, hot and cold packs and Dr. Green. He was turned out for about 5 months and came back sound enough to foxhunt - he wasn't in pain, but he couldn't sit at the canter for dressage. But he had other injuries to that area and age going against him.

                                        Someone else suggested stifle attachments, so it could be that as well, but the fact that it happened after she bolted points to an injury of that type somewhere.

                                        She's beautiful - I hope you can figure it out.

                                        Comment

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