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Mystery Lameness: What do you guys see? UPDATE: Tentative Diagnosis

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  • RainWeasley
    replied
    Close up of her feet. I can't get the view from behind to load, resolution is too high and it won't let me change it, but she is pretty straight, maybe slightly toed out but very slightly.

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  • RainWeasley
    replied
    Pictures from today! I didn't get a good one of her from the other side. I know her conformation sucks, has lots working against her.
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  • RainWeasley
    replied
    Originally posted by tipzythegreat View Post
    Per the vet's notes, she's more lame on the RH when it is on the outside of the circle. This goes with what beowulf said about potential suspensory injury, as affected suspensory injuries are generally more painful on the outside leg.

    It's tough to bring up neck concerns -- a regular vet can't really do much for it unfortunately...

    Many people do try and push a horse through injuries like this. It's unfortunately a super common mindset. A lot of time soft tissue injuries, SI problems, back problems, etc. feel worse to the rider than an observer. And people think "she'll work out of it"

    Might be worthwhile just to go to a better lameness vet from the start.

    Could you post us a conformation picture of her from the side? Might be helpful to see her hoof angles and overall conformation too!
    Let me see if I have any decent ones, ones I have now will be her at a better weight haha. I'll get some today if I remember too.

    I do know her front feet are too long, the last guy that did her shoes didn't do a great job. The farrier I really like using, one of the best in the area, just let me know she going to be here Friday (was gone last week), she saw her when Twi was at the vet too and agreed that the feet need to be fixed but wasn't going to be able to do it then. So hopefully that will help with some of her toe-first in the front issues. I'm going to ask her who she thinks I should take her to as well, she knows all the vets in the area really well and is really experienced with lameness issues so she will point me to a good place.

    Leave a comment:


  • tipzythegreat
    replied
    Per the vet's notes, she's more lame on the RH when it is on the outside of the circle. This goes with what beowulf said about potential suspensory injury, as affected suspensory injuries are generally more painful on the outside leg.

    It's tough to bring up neck concerns -- a regular vet can't really do much for it unfortunately...

    Many people do try and push a horse through injuries like this. It's unfortunately a super common mindset. A lot of time soft tissue injuries, SI problems, back problems, etc. feel worse to the rider than an observer. And people think "she'll work out of it"

    Might be worthwhile just to go to a better lameness vet from the start.

    Could you post us a conformation picture of her from the side? Might be helpful to see her hoof angles and overall conformation too!

    Leave a comment:


  • RainWeasley
    replied
    I talked to the vet today, sent him the videos. He wants me to try giving her bute for 10 days, see if that makes a difference. He doesn't want her worked but I think hand walking would probably be okay, I really want that weight off.

    I didn't get to see what flexions he actually did since I was jogging her and she was being a bit of a handful. No ultrasounds or xrays or anything.

    I need to make a list of everything I want him to check on her next time I take her back though...maybe:
    1. X-rays on all four feet
    2. Bring up neck concerns
    3. Possibly ultrasound legs?

    Might just start there and if we don't get anywhere, I think there are some good lameness vets not too far that I might be able to take her to.

    I kind of shudder thinking about the barn she was at right before I got her where the BO just wanted the lady to make her work through everything. Oh! I did get the notes from the vet that came to look at her when she was there (with previous owner), though. His results sound pretty much exactly like what she was doing for my vet:

    Lameness exam: lunge to left --> (cant make it out, looks like 6 3/5 RH)
    lunge to right --> 6 1/5 RH (?)
    straight trot - 0
    flex: LH 0, RH 0
    no pain with testers
    stifles mildly catch with manual patellar pressure
    rec Previcox

    If that helps any. I'll share that with the vet too, I hadn't gotten it yet when I went to see him last.

    Leave a comment:


  • beowulf
    replied
    the right hind has a very strange circumduction, that would make me think up high - pelvis or hip.. but i don't think that is all you are dealing with here. she does look footsore all around to me, and her back looks uncomfortable as well. her front pasterns are quite soft, she is landing heel first especially on the left one, shorter striding to me.

    sometimes horses with stifle injuries can move that way -- but normally, it's accompanied by other stifle symptoms.. and stifles usually flex, quite aggressively.

    where in the hind foot was she blocked? as another poster said, sometimes that is a sign that what you "blocked" was compensating for something. clear as mud, right?

    when you say the vet flexed, what flexions did he do?

    given all you've provided, and the video, my first thought would have been some sort of bilateral suspensory issue. i've seen it get worse after blocking the hoof / pastern, and the rest of the symptoms fit.

    has this mare ever had an ultrasound of her legs, and, what did the tissue look like? while watching the video, i saw a horse that was overall uncomfortable, not just specific to one spot (though the RH was most obvious).. whenever i see a horse with overall body malaise, odd circumduction of hind legs, and clear preference to not move out, it makes me think EPSA/DSLD. not saying that's what she has, but i would keep it in the back of your head, especially given her history of being worse without work.

    she did have a moment where it looked like she was not very coordinated and almost fell, so i agree with the poster that mentioned suspecting the neck.

    i'm with others that she needs to lose a lot of weight, stat. whatever she is dealing with, will likely be exacerbated by all the extra weight she needs to carry.

    Leave a comment:


  • tipzythegreat
    replied
    I would personally get her on a diet and a walking program to start -- only walking. This would be free and wouldn't hurt anything! Sounds like that was kind of your plan anyway

    Detective wise... I'd get x-rays from the vet to look at hoof angles and then get with a good farrier. I'd certainly be interested in the laminitis or navicular diagnosis, as others have suggested.

    I don't personally think it is her stifle. I didn't watch the videos the ENTIRE time, but I didn't see her leg giving out or that typical wringing of the leg you see with stifle issues.

    Likely there's several things going on. SI pain and back pain is generally secondary to another issue. Not always, but I'd think she's having a primary source of pain (or two) contributing to the back problems.

    I don't think the chiro is going to do anything until you determine and address the underlying issue. It wouldn't hurt to do, but likely the adjustment won't stick.

    Good luck and keep us updated!

    Leave a comment:


  • x-halt-salute
    replied
    Originally posted by RainWeasley View Post

    I really really though right stifle when I took her, but nope, she looked great doing flexions (granted, I didn't see them as I had to be the one to jog her, she is a bit of a brat with some people and the tech was struggling with her, but both the vet and my friend who was with me said she actually looked much better *eyeroll* ). I'm still not toootally convinced though, especially with her dam's history of stifle issues (though hers was locking patella). The neck is a really good point too. I did send the video to the vet today, so he will look at it when he gets a sec and I'll see what he says just from watching that. If he wants to go ahead and see her soon, I'll bring up some of the concerns, especially neck, and I'm considering just insisting that he at least check the stifles.

    If he doesn't want to check yet, I think I will keep doing what I was planning on, long handwalks, lots of stretching, some other things an equine PT friend of mine suggested, possibly get the chiro to come look, then reevaluate in a few weeks.

    I do hate it for her. She is a super tough little pony, which makes it so much harder to tell what's going on. The good thing is her general demeanor has changed a ton since I got her back, and more after the SI injection, so maaaaaaybe it is helping at least a bit.
    Sounds like whatever happens she's in good hands and will be well cared for.

    I'm not sure how much stifle PT stuff your plan would involve if you do decide to go ahead with reconditioning and getting the vet out in a few weeks to re-evaluate. In case it's useful, this article describes an approach to stifle PT that is similar to what I've had success with in the past with low-grade stifle weakness that isn't yet causing upward fixation of the patella. There's a fair bit you can do to address the potential of a stifle weakness issue, even if you want to restrict exercise a bit until you have a more solid diagnosis.

    Leave a comment:


  • RainWeasley
    replied
    Originally posted by x-halt-salute View Post

    This is exactly what I was going to say. IME when blocking paradoxically increases the lameness, it can be because it makes something sore feel better that was causing bilateral or opposite leg lameness, and really allowing the asymmetry to show up.

    She wasn't positive to stifle flexion? I also see RH as the most obvious problem, and would be suspicious about the stifle had you not already done a thorough flexion exam. To my eye, the first video shows trouble swinging that leg through on the left lead canter, which makes me think SI (I agree -- wait a couple weeks before calling that one a total miss) and/or stifle.

    That said, I see IPEsq's point about neuro symptoms, and think a standard neuro exam would be money well spent at the next stage of the diagnostic process -- it's a cost effective way to gather information when you're at a decision point of pursuing tricky hind end stuff or looking for neck/neuro problems that could be showing up in the hind end.

    She's a cute pony. I hope you can get her feeling better.
    I really really though right stifle when I took her, but nope, she looked great doing flexions (granted, I didn't see them as I had to be the one to jog her, she is a bit of a brat with some people and the tech was struggling with her, but both the vet and my friend who was with me said she actually looked much better *eyeroll* ). I'm still not toootally convinced though, especially with her dam's history of stifle issues (though hers was locking patella). The neck is a really good point too. I did send the video to the vet today, so he will look at it when he gets a sec and I'll see what he says just from watching that. If he wants to go ahead and see her soon, I'll bring up some of the concerns, especially neck, and I'm considering just insisting that he at least check the stifles.

    If he doesn't want to check yet, I think I will keep doing what I was planning on, long handwalks, lots of stretching, some other things an equine PT friend of mine suggested, possibly get the chiro to come look, then reevaluate in a few weeks.

    I do hate it for her. She is a super tough little pony, which makes it so much harder to tell what's going on. The good thing is her general demeanor has changed a ton since I got her back, and more after the SI injection, so maaaaaaybe it is helping at least a bit.

    Leave a comment:


  • x-halt-salute
    replied
    Originally posted by IPEsq View Post
    Right hind is the most off. Wish I could see her move with the hind blocks. Quite possibly she was foot sore and she looked worse because it became less bilateral after the block.
    This is exactly what I was going to say. IME when blocking paradoxically increases the lameness, it can be because it makes something sore feel better that was causing bilateral or opposite leg lameness, and really allowing the asymmetry to show up.

    She wasn't positive to stifle flexion? I also see RH as the most obvious problem, and would be suspicious about the stifle had you not already done a thorough flexion exam. To my eye, the first video shows trouble swinging that leg through on the left lead canter, which makes me think SI (I agree -- wait a couple weeks before calling that one a total miss) and/or stifle.

    That said, I see IPEsq's point about neuro symptoms, and think a standard neuro exam would be money well spent at the next stage of the diagnostic process -- it's a cost effective way to gather information when you're at a decision point of pursuing tricky hind end stuff or looking for neck/neuro problems that could be showing up in the hind end.

    She's a cute pony. I hope you can get her feeling better.

    Leave a comment:


  • IPEsq
    replied
    Right hind is the most off. Wish I could see her move with the hind blocks. Quite possibly she was foot sore and she looked worse because it became less bilateral after the block. However given the history, I would look at the neck. Behavior change, explosiveness (bolting, rearing), lameness that doesn’t block or flex, and her general way of going behind (the RH lameness is more of an exaggerated circumduction of the whole limb), plus generally unremarkable palpation and no response to the SI and back injections....leads me to want to investigate the neck.

    She looks a lot like how my client’s horse was moving shortly before retirement last year (RH lameness we could not improve, looking foot sore all around, same bad behaviors which came on out of the blue). His neck was a mess. And he had been fine (teenage horse) until suddenly he wasn’t. Unfortunately found out he was just put down last week

    Otherwise, I’d start by blocking one foot at a time. Check foot angles. Put her on a diet. Perhaps try something like Robaxin for the overall stiffness. Give the SI injections up to a month before you draw your final conclusion about them. (At least more than 2 weeks).

    Leave a comment:


  • RainWeasley
    replied
    Originally posted by downen View Post
    When viewing the video, my gut screamed, "Right HIP." Forgive me for skimming, I'm in a bit of a hurry this morning, but have you done chiropractic on her? I'm wondering if her hip isn't out?

    I hope you get it figured out. Pretty mare!
    No worries. I definitely think it is something in the right area, but I've had some swear they think it's left which always makes you doubt yourself a bit. I haven't done chiro yet, trying to decide if I should try it or not.

    Leave a comment:


  • downen
    replied
    When viewing the video, my gut screamed, "Right HIP." Forgive me for skimming, I'm in a bit of a hurry this morning, but have you done chiropractic on her? I'm wondering if her hip isn't out?

    I hope you get it figured out. Pretty mare!

    Leave a comment:


  • RainWeasley
    replied
    Thank you everyone for your input! I will bring up possible laminitis or Cushings to the vet. I don't think laminitis though, she really doesn't show any discomfort walking or standing and had absolutely no reaction whatsoever to hoof testers and isn't laminitis usually painful when you use the hoof testers? I have no idea though, never had a horse with laminitis so it's unknown territory for me.This barn has a very rocky drive though, I could very well see her getting bruised from walking on the rocks. The only discomfort she ever shows is walking on the drive so I let her walk on the grass where I can, and it's only her hind feet, which aren't shod. I can still ask about it.

    I definitely know she is extremely obese. I found out this barn has her on Safe Choice Original, only a pound, but they said they can't give her less because she takes the other horse's feed (she is on pasture board), and it's definitely not a feed for easy keepers. Between that and being in no work for at least 6 months, I'm not surprised she is so chunky. I have a grazing muzzle but the grass is about gone so there isn't much point in using it now. I am waiting for a horse to leave the barn I am going to move her to, should just be a couple of days, and then I can move her there and get her switched over to a ration balancer and take more control of what she is getting as I'm limited on what I can do at this barn. I've only had her back for two weeks, the first week was waiting for an opening to get her to the vet (they had a really busy week) and the second week was waiting for the period of time the vet instructed me after the injections. It's a process, trying to figure out what all is going on with her, what I need to do, where I can keep her, etc.

    Leave a comment:


  • Postandrails
    replied
    It looks like the right hind to me, and seems quite evident in the canter. I agree that she is carrying too much weight, and I'd be very worried about that, but a horse with laminitis in the front feet wouldn't get so much lift in the front end when jumping into the canter. It would be very unlikely to be laminitis in the hind feet and not front feet. There is also a point where her right hind gets left behind during the canter stride. My guess is right hip, hock or stifle. I think I agree with your friend.

    Leave a comment:


  • 4LeafCloverFarm
    replied
    Having two at home that are prone to laminitis, I also think weight could be a factor here. If this were my horse, I'd put her on an immediate diet, off grass pasture, lowest NSC feed available (a senior feed or rational balancer), quality hay weighed and in small hole hay net or feeder. And I've have a vet out to pull bloodwork and do an IR test ASAP. While her excess weight may not have caused the issue, it can still contribute to it. It also possible that when she was tossed out in that field, that she foundered or had a bout of laminitis. Once they'd had laminitis once, they are more prone to having it again.

    So do have your vet back out to pull blood and do an IR test.

    Leave a comment:


  • jonem004
    replied
    Looks mostly sore in front. I’d get hoof X-rays up front. There’s probably also something going on behind, but if you’re dealing with a systemic inflammation issue like laminitis then it might gut just be her compensating .

    Leave a comment:


  • joiedevie99
    replied
    Ditto what has already been said re: extreme obesity and metabolic conditions. Laminitis is certainly a possibility I'd investigate now. I see stifle at one point in the first video, but that wouldn't be my primary concern. I'd have her on a dry lot with small amounts of soaked hay and a vitamin/mineral supplement right now.

    I would go back to the vet, not the chiro.

    Leave a comment:


  • mmeqcenter
    replied
    My first thought was also that the horse is extremely overweight, and the issue could possibly be laminitis or navicular.

    Leave a comment:


  • PaddockWood
    replied
    My gut feeling is could you be having a bit of laminitis with that bruising? And she's terribly overweight so just
    moving is harder. Is she muzzled? Do you have her out on pasture and for how long? Gotta get the weight off her. My next thought is testing for Cushings and Metabolic Syndrome. I know ACTH can be falsely high this time of year so test now out of curiosity and then test again in January.

    I see a horse that doesn't want to move. If she's willing to walk then get her moving at a walk and do that....as long as she's comfortable. Listen to her.

    Thoughts?

    Leave a comment:

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