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Thought for certain it was SI issue, but...

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  • Thought for certain it was SI issue, but...

    I am curious what others think about this... My daughter has a 17h 9yo Oldenburg pinto that she plans to show in the hunter / equitation ring someday. We purchased him approximately 2 years ago and 3mos into it, he came up with a hind suspensory tear and sesamoid avulsion. After every possible treatment (shockwave, stemcell, tildren, ligament splitting w/prp, bi monthly US) and VERY Conservative and thoughtful rehab for a year and a half, we received a clear bill of health and a ligament that was like new. He has been in regular work now since June and have been jumping him minimally (trainer was busy with finals and daughter busy with new school). Since rehabbing him, his way of going has always been difficult: Very resistant to move forward, head straight up in the air, bunny hopping in the trot, reluctant to pick up canter, definitely better canter on right lead than left, and sometimes cross cantering on left lead. 2 Issues have come up this fall:

    1. Mid October, my daughter came into the barn and her horse was having spasms in his left tricep. Very isolated but that muscle contracted every second like clock work. Our vet quickly adjusted his diet to high fat/no carb and added Vit E
    /selenium. After the 2nd day, the contractions stopped. We brought him back slowly to normal work for he was a little sore on that Left front. After exhausting blood tests(EPM, WN, Lymes,etc), only muscle enzymes came back a bit high. After a little research and suspecting his dam's pedigree with QH and pinto, we should know whether for certain he has PSSM tomorrow(sent off mane samples).

    2. Mid November, the horse was doing the above (bunny hopping etc.) to the extreme. He also looked a bit off with hip dropping/hiking on one side at trot. I thought for certain we had reinjured that suspensory. Vet came out flexed concerned area, sound. US suspensory, and he said it looked about as good as it could look. A few days later, the chiropractor came out and found that he was "devastated" in his poll and croup. The next day, the horse was fabulous: forward, relaxed, sound etc. After speaking to my vet about the findings, we decided to inject the SI joint. After thorough lameness eval again, last Wednesday, we did the US guided injections of SI with great hope.

    Normally, the vet gives 1 week off but she wanted to keep him moving along given his injury and the PSSM concern, 3 days with t/o and then 3 days walking. Yesterday, we worked him like a normal horse/normal hack. He was MUCH worse than usual. Not wanting to canter, not moving forward, trantering at the trot, not keeping the left lead canter and lifting his tail and swishing it a great deal. Today, the same.

    This is such a mystery and very frustrating for everyone. Any thoughts about whether this is SI or PSSM? Anyone else experience something like this?

  • #2
    Sounds shockingly similar to what I am dealing with; my mare had a strained suspensory this spring (no tears or thickening on ultrasound, but blocked to the upper suspensory), and for the last several weeks has been extremely reluctant to trot off- head high, obviousy uncomfortable, etc. I too thought it may be an SI issue, had the chiropractor out last week, nope, nothing there. She was however very tight in her back and her neck; she's more comfortable this week, but still reluctant to trot off- head high, etc. I have a call in to the vet to see what we can figure out. Just wanted to let you know you weren't alone and wish you luck with your guy!


    • #3
      Your symptoms sound nearly EXACTLY like my mare's, although mine is a 5 yo. Is 9 a little late for the onset of PSSM? My mare was finally diagnosed with PSSM after 5 months of 4 different vets trying everything (her symptoms started in April). The diagnosis was via bloodwork pre and post exercise. We immediately adjusted the diet. Getting her to eat it with the recommended supplements was a chore. I've tried different ration balancers, different brands of supplements, less oil, more Vit. E, adding alfalfa pellets, beet pulp, you name it. She is now on ADM Healthy Glow nuggets, and usually eats about 3/4 of her daily ration. We have been trying to find a diet that works since Aug. 1 and have been unsuccessful.
      She has also started to look a little weird....she always had a bit of a young horse look - narrow through the chest, not fully muscled....but particularly in the last few months she has become a little thin, lost A LOT of top line, her croup looks bony, etc. Last week the vet came out to do a muscle biopsy on her to send to the U. of Minn. I think the results come out on Fridays, so I may hear tomorrow about confirmation of the diagnosis, extent of damage, and prognosis.
      I will be interested in hearing if your hair sample confirms your diagnosis. I decided to just bite the bullet with the muscle biopsy instead; I figured with the way my luck has been going recently that she would be the PSSM type that the genetic test can't identify.
      Last edited by Krallen; Dec. 7, 2012, 12:08 AM.


      • Original Poster

        I don't think for warmbloods it is uncommon for symptoms to come on later. I purchased him when he was 7 and he could have had this brewing for a while. Does your mare move like my guy? I figured with his dam showing signs of PSSM (not yet tested and don't know if she ever will be???), that most likely it is the inherited gene mutation so he should come up positive for Type 1 if he is indeed. The PSSM issue doesn't scare me so much for I feel hopeful that that can be managed (while certainly frustrating). I just don't know if his way of going has to do with PSSM and give the diet more time to see the benefits or if it is something else. He clearly is uncomfortable and I would really hate to push him and compromise the 1.5 years of rehab on the suspensory.
        Thanks or your input...


        • #5
          If it is PSSM, the diet can take up to four months to work. He needs to be getting a pound of fat a day (easiest done with oil). This is the best link to the diet explanation that Dr. Valentine has come up with: http://www.draftresource.com/EPSM/Dr...SM_DIets2.html

          He might need a muscle biopsy if the genetic test comes back negative.

          That being said - I don't think you've ruled out all the possibilities. It might be cheaper and less frustrating in the end to haul him in to a specialty clinic or vet school for a full lameness work up.

          Good luck, I hope he feels better soon!


          • #6
            RideFour - Your description of your horse's way of going and movement issues completely mirrors mine - right down to thinking it was the SI initially....with the same exact canter problems, not wanting to go forward, trantering, tail swishing, etc - and my mare was always sensitive, forward and really happy to work.
            Please keep us updated if you happen to get a different diagnosis than PSMM, I'd be very interested in how you proceed. Good luck!


            • #7
              Before I had my horse's SI done, I read up a LOT about it. People here consistently said that it would take 2-3 weeks before they saw any change. It took a solid three weeks for mine to show any improvement AT ALL. And then it was fabulous. But that's a damn big needle and there will be bruising and muscle soreness from passing through all that tissue. I did a week off, a week of walk, a week of walk/ trot. Week three he started to feel like a new horse.


              • #8
                You did so many right things for him, yet he seemed to "magically" feel better after the chiro. Why not try that again? Perhaps this time he will hold the adjustment for longer; the SI inj. may help or they may have hindered the good work you chiro did a short time prior.

                Keep in mind that your horse may need adjustments more frequently at first, weekly or even by-weekly, but it should reduce, sometimes very very quickly.

                It sounds like you have a good team, a pretty comprehensive plan, and give your horse the benefit of time. Best wishes.
                Horses should be trained in such a way that they not only love their riders, but look forward to the time they are with them.
                ~ Xenophon, 350 B.C.


                • Original Poster

                  I do think I am in good hands. Of the three vets who have seen him recently, one is an internist who nailed the diet initially and then was thorough with ruling out other muscle disorders/diseases, one is the USET Olympic vet who did this horse's prepurchase vetting, and the other is a surgeon at a specialty clinic who successfully carried us through the suspensory injury. I think at this point I need to get them to conference and come up with a plan/diet/exercise regimen in a holistic sense (looking at it from all angles).

                  I have a call into the chiropractor today to come out to work on him. It has been a full 3wks. since he had such success with the last adjustment. Writing this was a bit cathartic and that jumped out at me...

                  I will let all know what I find out today from U of Minn. I hope to speak with someone there if he is positive. They do offer phone consultations with their vets.


                  • #10
                    I can add a comment about the SI injection... I had the SI injected for my 15 year old QH a few months ago. He was not lame, but he is a fine older guy (used to do the 3'6" juniors and now down to me at 2'6"). I do not recall the exact timeframe, but after the SI, I followed vet's protocol. When the first day came to ride (maybe 9 days after?) he was dead lame. He was so lame in his left hind that I though it was his right front. Anyway, I backed off, let him come back a little slower, and within a week or less he was fine. I have a post somewhere about it, maybe you can search my name. I think the SI injection may make them a little sore somewhere. Or maybe just coincidence!
                    Rest in peace Claudius, we will miss you.


                    • #11
                      I should also add that we did a LOT of chiro (I have an excellent, very experienced DVM chiro) before the injection, and then a month or so out (after the anti-inflammatory effect kicked in and we could start to work to strengthen the area). It's been around 16 months since we started the chiro and almost a year since the injections; while my boy is still not 100% "straight", he is a completely different critter than he was before we started. Jingles that this works out for you in a similar way.


                      • #12
                        Also wanted to ask ... did you pull vitamin E/selenium levels? This is a simple blood test.


                        • #13
                          RideFour - Did you get your results back? Mine from the muscle biopsy came in an email already this morning and confirmed PSSM. :-(