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Help me prep for lameness exam!

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  • Help me prep for lameness exam!

    I'm calling Monday for a lameness exam and want to make sure when it happens I ask all the right questions.

    History: Horse started looking off in the spring - just slightly off behind to the left on a circle, trouble holding the canter (would swap out behind). Had vet out, she flex tested, said she looked fine and took $200 dollars from me.

    I went on the assumption her stifles were weak. I focused on walking and trotting hills on the trails, trot poles, etc. By Nov./Dec. she was looking stronger. Holding the canter better, looking sound trotting to the left, and becoming happier under saddle. Then, rather suddenly a week ago she lost her mojo. Can't canter without swapping, looking slightly off behind to the left again at trot, as confirmed by my trainer (so it's not all in my head). I want to rule out any lameness before I settle down with the idea that this is stifle weakness brought on by winter (no hills/trails for the past three weeks; none in sight for the next 6-8 due to snow and ice).

    So, trying a different vet this time. I want to be prepared to ask the right questions in terms of diagnostics for hocks, stifles, SI (my primary concerns). I'm not sure how one differentiates between weak stifle ligaments and bad stifle joints, or how (if at all possible) to diagnose SI problems.

    I live in the boonies and have found that I need to be as informed as possible to make the best out of a vet visit -- definitely don't want a repeat performance of the first lameness exam. Thanks in advance!

  • #2
    Do some internet research on Lyme's Disease, EPM, and google "neurologic symptoms in horses."

    How long did you own horse before it started appearing unsound?

    Just like with human doctors, in this day and age, you have to be the one to guide the conversation. The vet can offer advice, but you have to do a LOT of research on the possible options beforehand.

    A horse that is on and off unsound behind, likely has a systemic issue/disease, NOT an injury type of issue.

    That's at least my experience. If you post more information on age, level of training, your location, and maybe a video, I am sure COTH can provide (likely wayyyyyy too many) opinions.
    "Friend" me !

    http://www.facebook.com/isabeau.solace

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    • #3
      I agree w/ earlier poster on things to google. You may also want to either have someone video you riding the horse, or have the vet watch her under saddle. This is particularly important if the horse doesn't appear unsound on a lunge or trotting in hand.

      Have the vet do neuro tests. Ask whether nerve blocks should be done to isolate problem - there is an order in which they are done to work up the leg to the stifle.
      We don't get less brave; we get a bigger sense of self-preservation........

      Comment


      • #4
        I would have the vet start as they would any lameness exam, but I would be suspicious of a hind suspensory problem. Many of these start of low level, quiet down, and then restart.
        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

          #5
          Thanks. I will google and ask for neuro tests. The horse has been tested for Lyme (negative) and subsequently vaccinated. The lameness is apparent on the lunge. She is 8 and I owned her a year before the lameness showed up. Isabeau, I agree that my gut feeling is that this is not an injury (or not a recent one, anyway).

          Merry, I will also put suspensory on my list. I have never noticed swelling or heat, and my gut feeling is that it is higher up, hocks or higher, but I could easily be wrong.
          Last edited by geog272; Jan. 13, 2013, 12:37 PM.

          Comment


          • #6
            You mighr want to read this, scroll down to hind end. http://www.vetmed.ucdavis.edu/ceh/do...re-bkm-sec.pdf
            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


            • #7
              Originally posted by Isabeau Z Solace View Post
              Just like with human doctors, in this day and age, you have to be the one to guide the conversation. The vet can offer advice, but you have to do a LOT of research on the possible options beforehand.
              I realize the purpose of this thread is not to argue this point, but I have to say that if you don't trust your lameness vet to do more than offer advice and expect you to have researched on the internet about possible causes, I'd find a new vet.

              I know that every area is not as "vet rich" as some might be, but maybe you can ask for recommendations if you need help finding a good vet.

              In my opinion - the BEST thing you can do to prepare for your lameness eval is to have the symptoms written out and described as best as possible (when they started, how they present, what you notice) - have video available if possible (or even better, send it in advance), and let your vet evaluate the horse before you give theories as to the source of lameness and/or the cause.

              Of course it doesn't mean you shouldn't read about possible sources of lameness - but I would let your vet get an impression about possible causes FIRST, rather than confuse the issue with what you think it might be before they even look at the horse.

              Comment

              • Original Poster

                #8
                Originally posted by S1969 View Post
                I realize the purpose of this thread is not to argue this point, but I have to say that if you don't trust your lameness vet to do more than offer advice and expect you to have researched on the internet about possible causes, I'd find a new vet.
                I don't plan to accost the vet with pre-conceived diagnoses, but I feel like it's a good idea to be as prepared as possible. Around here, I think the vast majority of horse owners do not want to spend much time or money on diagnostics or treatments, and have lower expectations for their horse's performance than, say, the average COTHER. As a result, I feel like it's possible a vet may not even mention a potential diagnostic, for example. I am switching vets from the one who gave an "all clear" in the spring while horse was still lame to my eyes. The clinic I will be calling is our nearest major clinic (the only upgrade from that clinic that I could make I think would involve shipping out of state).

                FWIW, I feel the same way as a human medical consumer -- if I don't ask the doctor what about this or that, I don't get as much out of the visit. For good or for bad, I think most often you have to be your own best advocate...

                Comment


                • #9
                  Originally posted by geog272 View Post
                  I don't plan to accost the vet with pre-conceived diagnoses, but I feel like it's a good idea to be as prepared as possible. Around here, I think the vast majority of horse owners do not want to spend much time or money on diagnostics or treatments, and have lower expectations for their horse's performance than, say, the average COTHER. As a result, I feel like it's possible a vet may not even mention a potential diagnostic, for example. I am switching vets from the one who gave an "all clear" in the spring while horse was still lame to my eyes. The clinic I will be calling is our nearest major clinic (the only upgrade from that clinic that I could make I think would involve shipping out of state).

                  FWIW, I feel the same way as a human medical consumer -- if I don't ask the doctor what about this or that, I don't get as much out of the visit. For good or for bad, I think most often you have to be your own best advocate...
                  Being a smart consumer is always a good thing. And asking questions is even better.

                  I just know from past experience - once a lameness eval, once a PPE - that what I saw (and what other people saw on a video for the horse I bought) were not what he saw at all. So unless you diagnose lameness very frequently, it can be hard to narrow down what you're even looking at.

                  Comment


                  • #10
                    I think you are wise to study up! I always have a list in my head of things I want to ask about prior to any vet (or doctor visit.)

                    You may find my long thread regarding my horse's neuro issues an interesting read: http://www.chronofhorse.com/forum/sh...pdate-post-154

                    In addition to what's already been mentioned, the selenium/vit e levels could be worth investigating. Simple blood test to evaluate.

                    Also take a very good hard look at the feet. Out of whack angles there can definitely cause all sorts of issues.

                    Comment


                    • #11
                      I tend to have a list written down since it's all too easy to forget what you wanted to ask. Write it down a few days before and then think about it and add to it as you think of more. Then bring out your list during the vet check. It also wouldn't hurt to have another person listening and watching during the exam.
                      The Evil Chem Prof

                      Comment

                      • Original Poster

                        #12
                        Originally posted by Simkie View Post
                        You may find my long thread regarding my horse's neuro issues an interesting read: http://www.chronofhorse.com/forum/sh...pdate-post-154
                        Eeek... scary....

                        Comment


                        • #13
                          Your horse was vaccinated for lyme?

                          Don't rule out back soreness either. In addition to flexion of the legs... ask the vet to palpitate the back. My stifle horse had lots of back issues. Chicken and egg, they often go together (as do back and hock issues).
                          ~Veronica
                          "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                          http://photobucket.com/albums/y192/vxf111/

                          Comment

                          • Original Poster

                            #14
                            Originally posted by vxf111 View Post
                            Your horse was vaccinated for lyme?

                            Don't rule out back soreness either. In addition to flexion of the legs... ask the vet to palpitate the back. My stifle horse had lots of back issues. Chicken and egg, they often go together (as do back and hock issues).
                            She was tested for lyme in the spring and then vaccinated over the spring/summer, so she should be good there. The chiro was out about two months ago and gave her an A+ on her back, but that was before this new round of lameness cropped up, so I will mention her back to the vet, thanks.

                            Comment


                            • #15
                              Where are you located? There's no equine vaccine? She must have been given the dog vaccine? I had not really heard of that being done?!
                              ~Veronica
                              "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                              http://photobucket.com/albums/y192/vxf111/

                              Comment

                              • Original Poster

                                #16
                                Originally posted by vxf111 View Post
                                Where are you located? There's no equine vaccine? She must have been given the dog vaccine? I had not really heard of that being done?!
                                I'm in Northern New England. Almost everyone vaccinates for Lyme here. The vets have been doing it on horses for a few years. It is a series of three spread out over a couple of months. I'm not sure if it's the exact same thing as the dog vaccine, but I think it is.

                                Comment


                                • #17
                                  Originally posted by geog272 View Post
                                  I'm not sure if it's the exact same thing as the dog vaccine, but I think it is.
                                  Yes, it is. Different vets have different opinions about its effectiveness.

                                  Comment


                                  • #18
                                    Originally posted by S1969 View Post
                                    Yes, it is. Different vets have different opinions about its effectiveness.
                                    Interesting that you're in New England. We have pretty prevailent lyme here in the Mid-Atlantic and it's pretty unheard of to use the dog vaccine in horses. I asked New Bolton about this years ago (well, like 5-6 years ago at this point!) and they said the efficacy was nil and no one was doing this at all anymore and it was something vets had tried at one point and then realized it didn't work and stopped. So interesting to hear it has a revival in New England. I would not rule out lyme, based simply on the vaccination, since it's not necessarily known to be effective.
                                    Last edited by vxf111; Jan. 14, 2013, 10:53 AM.
                                    ~Veronica
                                    "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                                    http://photobucket.com/albums/y192/vxf111/

                                    Comment


                                    • #19
                                      Lyme vaccination has become common here (Virginia). It is the dog version.

                                      Id recommend having a friend or SO there to take notes. Its easy to forget what the doc said when you are emotional from not so good news, out of breath from jogging after a flex test, or have a bunch of options thrown at you all at once. Notes will help later. Having just gone through my first lameness exam, thats what Id suggest. I had to text my friend later that night and ask what the doc called the bony thing in her stifle joint he saw on the rads. Since she wasnt in an emotional state, she remembered most of that happened.

                                      Comment


                                      • #20
                                        Originally posted by geog272 View Post
                                        She was tested for lyme in the spring and then vaccinated over the spring/summer, so she should be good there. The chiro was out about two months ago and gave her an A+ on her back, but that was before this new round of lameness cropped up, so I will mention her back to the vet, thanks.
                                        Don't discount the back just because the chiro and accupuncturist said it was not an issue. BTDT.

                                        Also, don't rule out lyme just because you tested in the spring. Also BTDT. I am not sure about the efficacy of the vaccine. Like vxf111, my experience is that it hasn't been taken seriously by vets in the (Mid-Atlantic) area.

                                        Comment

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