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"SI" and/or back and/or wither injuries???

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    "SI" and/or back and/or wither injuries???

    We have a horse in the barn with what appears to be predominantly an SI injury - most probably happened before we got him so is in the chronic stage and no longer acute unless he does something to flare it up

    Bute has done diddley squat. Vet recommended DMSO covered with plastic. That has had limited to no effect. Chiro recommended a lot of walking in hand and under saddle and backing up once a day in hand for about 10-15 steps. Chiro said ride every second day. Vet said to ride every day. The only consensus so far was no canter work - just walk and trot

    He is completely and totally fine on turnout - bucking, galloping around - having a grand old time, playing with his turnout buddies and instigating a lot of the play so obviously it doesn't appear to be bothering him then

    Limited lungeing is being done with him and he is 100% okay and moving freely and easily from behind

    2-3 days ago the short video clips I saw of him being ridden almost looked like he was tying up. Refusing to move forward. Popping up in front if he was asked to do so. Clearly an unhappy horse, but absolutely fine with no rider. Chiro feels it may be a lactic acid buildup in the muscles so they are starting the baking soda regime with him to see if that will sort it out

    2nd adjustment was better than the first. Less pain and muscle spasm through the SI area but when the chiro was working on the wither area and neck, he'd pin his ears and try and snake around to bite her. On the right side only - on the left he was far better and more accepting. Chiro stated that from a purely "chiro" view, there was noticeable improvement in this session than in the first one 2 weeks ago

    Chiro stated in some cases an injection into the SI area guided by ultrasound has done wonders but she wasn't sure exactly what was being injected into there. maybe cortisone???

    There is no noticeable area of swelling - just pain on palpation and manipulation and adjustment. In the week following the first adjustment there was "0" improvement. In the 2nd week, for about 4-5 days he was absolutely amazing and starting to push from behind, moving out from the shoulder - exactly how he should be going. And then the 2-3 days prior to the latest adjustment he was awful - like he was tying up through him entire body but only under saddle. Not loose. Loose he was moving fine and running and bucking and playing ...

    Owners aren't on any boards at all so I said I'd post this and send them any recommendations that others make that may give them some ideas as to what to try. They have owned this horse for about 8 weeks now and it was supposed to be their new show horse this year. Oh - and he came to them very thin and with a whack of high fat feed and unlimited hay in front of him 24/7 now I doubt has gained even a pound in that time frame. he is a low key, non stressing kind of guy - the chiro mentioned a possible metabolic imbalance that possibly was preventing him from assimilating the calories properly. It could be pain related, but 99% of the time (when he isn't being ridden) he appears to be totally okay and pain free so that theory doesn't make much sense

    The girl that rides him is a beautiful, soft, petite rider in maybe the 115-120 lb range - tops - well used to backing the babies and sitting softly on their backs so she is definitely not sitting heavy on him and setting him off

    Any/all suggestions would be very much appreciated

    True Colours Farm on Facebook

    So far the plan you are following is quite different than what a specialized vet recommended for my horse with an SI injury. I would suggest seeing an actual vet and doing diagnostics to confirm the exact location/extent of the injury (ligament involvement? arthritis present in the joint? etc.) and then following the vets rehabilitation plan.


      Sounds like the adjustments are not holding. It may be time to try the SI injection. Only have it done by a vet that knows what they're doing though. They usually use some type of cortisone in the injection. Poor guy does sound uncomfortable, so probably time to take the next step.


        Most vets who have the experience to do the SI injections, which involve a huge needle and ultrasound, are experienced lameness vets. I would start with a work up (at a clinic if need be) to determine exactly what the issue is.
        I have had SI injections done and they do really help if that is the problem...most recently when my older arthritic horse felt uncomfortable behind I thought it was SI (it was clearly high up) but my lameness vet palpated and watched him lunge with and without a weighted surcingle and said his SI was fine, but his back just in front of the SI was quite sore. We shock waved the area and he has felt super since...MUCH less big deal than SI injections.
        Get a diagnosis and then you can figure out what, if anything, to inject. It's not a cure-all.
        The big man -- my lost prince

        The little brother, now my main man


          How are his feet? This sounds a lot like my horse and it was fixed by a good farrier. Mine had the long toe/low heel and thin soles. Vets pretty much overlooked that for awhile, as he looked pretty sound when not under saddle. One vet told me my problems were behavorial.

          My horse also is keeping weight better now, although he is a tb and a food machine - he gets 8 lb safe choice and 2 lbs amplify and tons of hay and still needs a bit of weight, I will probably switch to something like ultium.


            You said that the horse tried to bite the chiro. when she was working on his wither area, correct? How is the saddle fit?


              I've had the symptom you described- ok to move without a rider, but once weight is put on them they don't want to move at all and when asked they kind of bunny hop (that's how I describe it). When two vets heard and/or saw it in person, they both said classic neck issue. One thing I would also notice is that when he was really bad, he would be very tight and spasmy around his withers- sometimes I could palpate his withers and see the spasm go all the way down to the point of his shoulder. If it was this bad, just the weight of putting a saddle on and girthing him up would make him unhappy.

              He did have facet tears in his neck (he whacked his head on a doorway, slid and fell to his knees), which we tried treating, but that didn't really help the symptoms much. Turns out, it wasn't just the neck that was the problem (in fact, not the main problem at all). It really was his left shoulder. We didn't realize it until treating the neck didn't do anything, and his left shoulder dramatically atrophied over a few months. We injected underneath his left shoulder blade and that has helped immensely. It was amazing to see the muscle tone return within a couple of weeks.

              Given how you mention that the withers were a sore spot with adjusting, I would check out the shoulder as well and possibly ultrasound around the neck to see if there's anything going on. A lot of vets around here now seem to think that hind end issues are really issues that stem from the neck.


                Original Poster

                pharmgirl - from what I saw when the chiro was there, his withers almost seem to be the worst spot. His shoulder - not so much. But he also almost moves from his front end - dragging himself from the front rather than pushing from behind which tends to make you really think the problem is coming more from behind

                Before he arrived, he had probably a dozen or so riders on him with a dozen or so different saddles. Absolutely possible that one of those saddles / riders caused a wither issue that was never resolved. It just stayed the same and/or got worse over time so now any saddle is irritating it

                The last rides leading up to the chiro adjustment yesterday were the worst and almost the most telling. He literally looked like he was tying up and if you viewed him from behind, it was like he had just been gelded - he was moving as wide as possible in behind - instead of his hind legs tracking up, he was putting them down left / right with as short a stride as possible

                The barn vet has been consulted on him as well and he is a very good, all round vet whose opinion is very trusted but he is not, nor does he profess to be, a lameness "expert" nor does he have the facility to do a full work up for something like this, nor do I believe he would be able to inject the SI if that was indeed the course of action to take.

                I think what is most puzzling and most frustrating is that progression is being made. There are days or a week in a row where each day he gets better and better, he starts to push from behind, really uses that shoulder on both sides and in both directions and reaches forward and moves long and low and then the next day he comes out, looks like he has tied up and is spasming, moves wide in behind, refuses to move forward at all and pops up in front if you push the point with him. He is as sweet and kind as the day is long and when everything clicks is 100% willing to give 100% and we believe his previous owner "got after him" for not moving when asked and we believe from what we are seeing that it is not behavioral at all but rather physical.

                I guess the tough part is where is "Ground Zero" with him? Where did this all start and where does it need to be addressed? That's the tough part to get a definitive handle on ...

                Thanks so much for the suggestions

                True Colours Farm on Facebook


                  Check the previous postings for SI injections. They have been very helpful for my horses with chronic recurring SI pain.
                  Whatever you do, or dream you can, begin it; Boldness has genius, magic, and power in it ~ Goethe


                    Check for lyme disease if you have it in your area. Not holding adjustments after chiro or bodywork is a classic symptom. It could also account for on and off stiffness/pain.


                      1. Diagnostics. You really need to shoot neck/wither/spine x-rays. If there is an old injury there with arthritic changes, kissing spines, previously broken withers, etc. the last thing you want is a chiropractor working on the horse.

                      2. Do some basic neurological tests to make sure he doesn't have any deficiencies there.

                      3. Run a basic blood panel and a Lyme test.

                      4. If all is still good, a good sporthorse vet should be able to do a lameness exam and decide whether SI is the likely case of the issue. This will likely involve watching the horse with and without rider up.

                      If so, I'd inject the SI (steroids) and start the rehab protocol. The idea is that you stop the spasming/pain and allow the horse to develop the correct muscles to support the area. Generally, this involves avoiding cantering/jumping for 2-3 months. The horse works 6-7 days per week - cavaletti, trot sets, hillwork, long marching walks over varied terrain, and backing. Most importantly though - it means riding very correctly from back to front so the horse really develops those muscles. I've seen well-meaning people make little progress and have to repeat the injection well before they should because they just don't get the horse working well enough to build the back.


                        Original Poster

                        The vet is coming back out tomorrow to run bloodwork and check a few other things as well. The young lady that rides him is working so Im heading over to help hold and assist as well

                        Interesting on the Lyme angle - thank you. I'll mention that

                        We have some video footage to show the vet from the last time he was ridden so he can get an idea of what he is like under tack with a rider's weight

                        Thank you - some really good suggestions being put forward!

                        True Colours Farm on Facebook


                          ^ What Rockfordbuckeye said and Joiedevie99 said. If you can get a diagnosis of this, then you can decide on the right treatment. Just wanted to add that an SI injection will not do any good if your problem is a ligament injury (in the SI area) and not related to bony/arthritic changes. And a chiro won't help with that either. The treatment for a ligament injury involved long term stall rest followed by a very specific riding rehab plan. For my horse, with an old SI ligament tear--the stall rest was for 6 months. After the first 2 months, I was doing rehab riding that was very specific for her injury. No SI injections were done--and that would have actually been detrimental to the healing. So make sure you know what you are dealing with before you inject.


                            Tue Colours - According to the chiro I use, Dr. Usha K., wither pain is often associated with foot pain in the front feet. May want to look into the feet as well.
                            Proud Member of the "Tidy Rabbit Tinfoil Hat Wearers" clique and the "I'm in my 30's and Hope to be a Good Rider Someday" clique



                              I hope you don't mind I am bumping this thread. I have a horse that has such similar symptoms that I am curious what happened to this horse. Mine has had the SI injections, got better and then 5 weeks later he is dead lame. Just wondering if they did the injection or not and if it worked if they did.

                              We are going back to the clinic Tuesday so I am trying to go fully armed and prepared for the worst!



                                Original Poster

                                NO problem at all!

                                We gave him about 4 months off and he did nothing but mosey around the field and then had the vet out to palpate and check his back and all seemed to be fine. We started him back to work slowly, he held up just fine and at about the 2-3 month mark after starting back we put him up for sale and he was sold. He passed the PPE, Ive been in touch with his new owner off and on over the last 12-15 months and he has stayed okay and is doing well in the ring

                                We felt that giving him time off was key and that seemed to put everything right in his case

                                Good luck on Tuesday!

                                True Colours Farm on Facebook


                                  I'm happy to hear that! Thanks for answering! My fingers are crossed but my hopes aren't too high


                                    Original Poster

                                    Good luck tomorrow!

                                    True Colours Farm on Facebook


                                      Originally posted by riopony View Post

                                      I hope you don't mind I am bumping this thread. I have a horse that has such similar symptoms that I am curious what happened to this horse. Mine has had the SI injections, got better and then 5 weeks later he is dead lame. Just wondering if they did the injection or not and if it worked if they did.

                                      We are going back to the clinic Tuesday so I am trying to go fully armed and prepared for the worst!

                                      Just wanted to chime in as I just got a diagnosis this week.

                                      I had a similar experience with the SI injections - was tremendously helpful for several months, then horse went quite lame. Not the same symptoms as the OP's horse but definitely coming from somewhere higher up.

                                      I sent him for a full body bone scan and they determined (along with his thorough history of workups, blocking, and treatments) that he has almost certainly injured a ligament in the SI. The injection makes them feel good at first as it helps the inflammation but of course the injury is still there and they get sore again fast.

                                      Mine was nearly ready to drop when they ran a pen across the SI region. I'd had him injected again in December as we thought he had gotten sore again due to being laid up for a month with a bad hind foot abscess, but he didn't come back sound this time. After blocking and xraying a couple other things, we decided to go for the bone scan instead of just throwing money at guessing what was wrong. It ended up being a good choice as we wouldn't have found the SI ligament injury otherwise (vets said that area can't be imaged well so it's a process of elimination).

                                      Rx for mine now is min 3 months stall rest with handwalking, building up duration, and adding in handwalking over poles as we get further in. He will be re-evaluated in 3 months to see if we can start more strengthening before getting back on. It's a slow process but I was told they can come back from it IF you take the rehab slowly and carefully. No rushing or they'll reinjure themselves.

                                      Best of luck with yours. It's a hard diagnosis to hear but better than what it could have been. I was scared to find out he was going to have to retire at age 9 as we've been dealing with this for quite a long time without being able to get a diagnosis.

                                      p.s. slp2 I PMed you with some questions if you see this
                                      I've spent most of my life riding horses. The rest I've just wasted.