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My SI/stifly horse back into work - what do you see - what would you do?

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  • My SI/stifly horse back into work - what do you see - what would you do?

    What do you see, what would you do, considering the below diagnostics already done .
    Some may have followed my posts here in the past. I have a horse that for the last 2 years struggled with delayed patellar release and before winter diagnostics revealed SI pain.

    We X-rayed from poll to sacral, hocks & stifles, ultrasounded stifle, did bonescan, did muscle biopsy.
    Result was SI inflammation and Vit E abnormality in muscle not in blood. Clinically delayed patellar release was clearly present, but clean stifle X-rays & stifle ultrasound. Other X-rays were clean too. We have injected hocks & stifles in the past to no avail, prior to winter we re-injected stifle, injected the lumbar back, did the ultrasound-guided SI injection as well as mesotherapy. He had the entire winter off to pasture and approx 2,5 weeks ago I re-started him on the lunge. He's shod allround under sedation, feet are well balanced and the best they have been in years.

    I just don't know anymore.
    I don't even know whether I see a sound horse or a lame horse .
    http://www.youtube.com/watch?v=DkPURlSgja4
    (trotwork as of 1:47, delayed patellar release noticeable again at 2:13)

    What to do from here
    Do I continue to build him up on the lunge for a couple more weeks?
    Do I just get back on and try to strengthen/improve under saddle? If so, should I get a trainer involved or is it way too soon for that?
    Do I stop and take him back to the vet? If so, to do what?
    Or do I just retire him as a walking trailhorse (not what my heart wants, but this has been such a long & frustrating saga)?

    THANKS!

  • #2
    Well he is def still off, but I feel like I see some sound steps. Have you thought of doing the splitting the stifles surgery? Or even just blistering them. Also any chiro/accupucture work on him?

    I would be tempted to keep him in work and see what happens. At this point what can it hurt. He doesn't seem miserable and is swinging in his back fairly well.

    I can see why you are working so hard! He looks like a NICE horse!
    I love cats, I love every single cat....
    So anyway I am a cat lover
    And I love to run.

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    • #3
      I would go see a neurological specialist ASAP. Have you done any cervical xrays? Many, many neurological horses are misdiagnosed as having stifle problems, I owned one and I know of many others. The fact that you have been unsuccessfully treating the hind end is a huge red flag. I have also found that most vets who are not neurological specialists have no idea how to do a proper neuro exam or know how to interpret the results, so even if they tell you they know, they don't.

      Also, have you tried supplementing him with a high dose of vitamin E? Tested for EPM?
      On the Internet, nobody knows you're a dog

      Comment

      • Original Poster

        #4
        Thx, PP, yes clean cervical X-rays. Had neurological exam twice by two vets, clean. Uni of Minnesota didn't see anything neurological either. EPM neg, gets high doses of Vit E, pointless to up even more, as bloodresults showed elevated E levels.
        Not sure of any neuro experts in my area, vet clinic we went to is known to be pretty good, but I can ask around.
        If cervical X-rays are clean, what neurological disease would one be looking for? Shivers/stringhalt has been ruled out too by Uni of Min. If he has wobblers for all those years, wouldn't that have progressed?

        Beethoven, I'm very unsure about stifle surgery, been in touch with someone who recently did the surgery and horse actually went into a full lock after surgery, outcome so far not what surgery was meant to achieve, hence questioning surgery.
        Blistering I think I feel more okay about now, then I in the past. So on my list, it may be the only hope.
        Edited to add, forget. No recent chiro or acupuncture. I feel chiro failed me in the past, totally missed SI issue. But we will put him back on acupuncture.

        Would you put the horse back under saddle at this point, or not add additional weight, considering he's off?
        Trainer is pointless, right?
        Last edited by Lieslot; Mar. 20, 2011, 09:01 PM.

        Comment


        • #5
          He is lame. And to me, he does not look like he knows where the hind end is, especially the right hind. Without actually knowing the vets you work with or seeing the tests done, it's hard for me to believe anyone who says a neruo test is for sure negative, only because i know horses that have been recently euthanized because of severe neurological deficits that were called sound by vets for ages. So call me sceptical unless a true neurological specialist does proper neurological tests. My mare was cleared for full work by the head surgeon at UC Davis before her diagnosis just a few weeks later!

          That said, if he is not tripping or falling down then you may as well ride him, he doesn't look unhappy or in pain. If it's SI /lower back pain you can always try SI injections and Tildren and see if it helps. Is he better on anti-inflammatories?
          On the Internet, nobody knows you're a dog

          Comment

          • Original Poster

            #6
            But here's what I don't get. Could a horse be neurological for 6 years and not progress? Did your horse have Wobblers? How was it finally diagnosed? How long did she have the neuro symptoms and did they ever progress or stay stagnant?

            We did the SI injections & meso in Nov, no anti-inflammatories at present, other then feed-thru sups.

            Comment


            • #7
              Originally posted by Perfect Pony View Post
              I would go see a neurological specialist ASAP. Have you done any cervical xrays? Many, many neurological horses are misdiagnosed
              I highly doubt it.

              Comment


              • #8
                Originally posted by Lieslot View Post
                But here's what I don't get. Could a horse be neurological for 6 years and not progress? Did your horse have Wobblers? How was it finally diagnosed?
                Yes as a matter of fact. My mare I bought at age 4, and she drug her RH when I bought her. All the vets told me she was "weak". It never got worse, but never got any better either. She ended up having stifle surgery (for an OCD lesion) when she was nearly 8 years old. She became more comfortable under saddle, but when she started using herself more I could still see the RH toe drag. The surgeons all thought it was just an unsuccessful surgery, but finally a resident at Davis called in the neuro specialists and she was diagnosed as 1-2/5. After 4+ YEARS of seeing every vet under the sun. Not a one ever saw it.

                She had very mild arthritis at C6-7 but no spinal compression on a myelogram. The final thought is she has mild neurological deficits due to a vitamin E deficiency as a foal (EDM). She is actually doing much better after some time off out on lush green pasture, and is going back to work to hopefully be used as a low level school horse. But she will most likely always slightly drag the RH, and never be able to travel up and down steep hills.

                Through all this I have learned a big lesson about equine physiology, sometimes they are just NQR for whatever reason and just need to be managed through proper care, supplementation, and work.

                That said, he looks like a very nice horse, and I commend you for caring so much and trying so hard. He looks happy
                On the Internet, nobody knows you're a dog

                Comment


                • #9
                  Originally posted by davistina67 View Post
                  I highly doubt it.
                  You highly doubt many neurological horses are misdiagnosed? I am telling you I lived it, and know of a dozen more. Go spend some time at a University hospital where horses are diagnosed every single day that owners have had misdiagnosed for years.

                  I know of two horses that have been euthanized recently that had to get to the point where they were FALLING DOWN before anyone even noticed they were 3+/5 neurological.

                  Sorry but it's an f'ing travesty.
                  On the Internet, nobody knows you're a dog

                  Comment


                  • #10
                    First of all I am not an expert, but I don't see anything neurological. Did anything show up in the neck vertebrae on the bone scan?

                    I have a horse with sticky stifles, and it's really hard getting him going in the spring after the winter off. I just take it slow; lots of walking. I try to limit his ring work until he is more fit (circles aren't good). Have you tried estrone injections? They worked well for my gelding.

                    Comment


                    • #11
                      btw, I am certainly not diagnosing the horse, I'm not there. I just want people to realize that unless someone who truly knows what they are doing and specializes in neurological diseases examines a horse, I simply don't trust their judgment.

                      But I don't think every horse is neuro, just way more then people realize.

                      I also now think that there are some horses that simply cannot be fixed, you can only make the best with what you have. It sounds to me like the OP has tried everything and done the best for this horse. I was just pointing out that I would make damn sure that a neuro specialist was consulted with on a horse that has had everything under the sun done with it, and has a hind end "mystery lameness".
                      On the Internet, nobody knows you're a dog

                      Comment


                      • #12
                        Originally posted by Perfect Pony View Post
                        You highly doubt many neurological horses are misdiagnosed? I am telling you I lived it, and know of a dozen more. Go spend some time at a University hospital where horses are diagnosed every single day that owners have had misdiagnosed for years.

                        I know of two horses that have been euthanized recently that had to get to the point where they were FALLING DOWN before anyone even noticed they were 3+/5 neurological.

                        Sorry but it's an f'ing travesty.
                        Sources please?

                        Comment

                        • Original Poster

                          #13
                          I guess they can all have missed it. It all started 6 years ago (3 weeks after purchase -they saw me coming uhn-), he has since been seen by a number of vets, even before moving to the US, some dutch vets looked at him too.
                          One vet concluded stagnant shivers resulting in a weak hindend. However Uni of Minnesota negated that and said they see no signs of shivers. So I guess there we could still say, perhaps he does, perhaps he doesn't, but the Uni of Min is considered the final expert on this stuff, so don't know what to conclude from that.

                          The delayed stifle issue is obvious, it can't be missed. The SI pain was clear since it was on the scan. As for wobblers, the cervical x-rays were clean, you'd think they'd see something there. Bonescan in neck region was clean too, it only lit up in one area, the SI. Now I know bonescans are not say all however.

                          I know lunging is not good for stifles and I really don't like doing it, but I figured adding my extra weight wasn't helpful either to get him started again, hence I tried to lunge very large.

                          Comment


                          • #14
                            Originally posted by Lieslot View Post

                            Would you put the horse back under saddle at this point, or not add additional weight, considering he's off?
                            Trainer is pointless, right?
                            So, if he were able to stay sound, what is your goal with him?

                            What level has he worked to in the past? Does he have a history of having more lameness symptoms when worked consistently and higher level?

                            If he is forever lame, how does that affect you? Does he then have a forever retirement home with you or ?

                            Comment


                            • #15
                              Originally posted by Lieslot View Post

                              Beethoven, I'm very unsure about stifle surgery, been in touch with someone who recently did the surgery and horse actually went into a full lock after surgery, outcome so far not what surgery was meant to achieve, hence questioning surgery.
                              Blistering I think I feel more okay about now, then I in the past. So on my list, it may be the only hope.
                              Edited to add, forget. No recent chiro or acupuncture. I feel chiro failed me in the past, totally missed SI issue. But we will put him back on acupuncture.

                              Would you put the horse back under saddle at this point, or not add additional weight, considering he's off?
                              Trainer is pointless, right?
                              My vet did a stifle surgery at the barn. He laid the mare down and just "poked" several spots on her stifle ligament and injected at the same time. I then rode her for 30 days straight and what a difference. She went from unsound to totally sound.

                              I have had my own mare's stifles blistered and it helped her a lot. She is the one that ultimately the SI injection made a difference. She is doing much better after that. We also injected the back right in front of the SI because she kind of has kissing spines there. I say kind of because it looks like she broke the top of her one of her lumbar vertebrae off and it healed almost touching the vertebrate in front of it.

                              My mare is also on high dosed of Vit E as she used to walk crooked and once was rated a grade 2 on neuro scale, but that vet said it could be her stifles causing it. I think it ultimately was her stifles, but the Vit E helped her so she stays on it.

                              I think I would stay off his back for now since you are doing such big lunging circles. Can you add in cavalettis? Maybe some backing? Also if there are any hills around maybe some work on there might be good, probably easiest to ride that or maybe hand walk.
                              I love cats, I love every single cat....
                              So anyway I am a cat lover
                              And I love to run.

                              Comment


                              • #16
                                Originally posted by Lieslot View Post
                                I don't even know whether I see a sound horse or a lame horse !
                                What does your vet say?

                                Comment

                                • Original Poster

                                  #17
                                  Vet hasn't seen the horse since I started lunging, but will take him back.

                                  No worries about his longterm future, he can stay here at home.

                                  If he were sound, training level is the most I'd be interested in, but not sound, no TL .
                                  Bought him advertised as a 3rd level horse, but my personal goal for him is & was TL, I'd be more then happy with that. Geezzz even an intro would probably make me ecstatic.

                                  Lameness history, dunno what to say, always had this delayed stifle issue :
                                  I guess you can say he was lame in 2009 too
                                  http://www.youtube.com/watch?v=a_kMGXQOrkE
                                  And in 2008
                                  http://www.youtube.com/watch?v=R5uFz6Qfd9k

                                  Comment


                                  • #18
                                    He is such a beautiful horse!

                                    Another thought, have you tried starting him in the canter? That seems to have helped all the stifly horses that I have had/known. I start my older horse in the stifle as he can have a sticky left stifle and this helps us avoid the issue.
                                    I love cats, I love every single cat....
                                    So anyway I am a cat lover
                                    And I love to run.

                                    Comment

                                    • Original Poster

                                      #19
                                      I used to canter him fairly quickly when under saddle, but since this is just 2 weeks of 20mins of lunging after having had 3 months off, I didn't feel like asking too much just yet.
                                      But worth a try.
                                      I was planning on putting out cavalettis again.
                                      Not sure about hillwork anymore, I seem to think the endless hillwork I did last fall may have caused his sore SI back then.

                                      Comment


                                      • #20
                                        Just my thoughts and I am no where near an expert. He's had off 3 months. If he has weak stifles I wouldn't expect improvement without work.

                                        He appears not to be in pain and looks pretty happy to me.

                                        I saw a nice rolling hill up the side of the property in one of the videos. I'd start walking him up that hill. I really doubt your weight would adversely effect him. Maybe start with one or two trips up the hill a day and gradually increase the number of trips and then start adding some trots up the hill.

                                        Go slow and if he seems sore or unhappy stop. As long as he's safe to ride I don't think you have anything to lose.
                                        "Some people are born on third base and go through life thinking they hit a triple Barry Switzer

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