Advice needed - could this be ESPM?

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Cathy487

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Hi Everyone

I'm looking for advice about strange gait problem that my 6yo dressage horse has.

She has a consistent gait abnormality at walk - abduction of right hind (less visible at trot and canter and on circle). In addition, bilaterally she cannot flex in her loins (hock/stifle?). She has intermittent shortened stride (particular on RH) and occasionally jerk in her action on hind legs - less so since fit. If not worked every day she gets very stiff and when first led out of the box she walks as if she is constipated. In fact some morning we almost thought she had colic. Problem has been there since I brought her, at the vetting I was told it was a growing quirk and would not affect her performance as a dressage horse.....alas, although we have managed to be placed and get points.....at my last competition the judge pulled me up to tell me my horse had a problem in RH.

She is currently 6 yo, warmblood, fit healthy good muscle - fantastic temperament. Does flatwork 4 times per week, jumps, hacks. Very willing no sign of pain. Flexion tests are normal. At the clinic they performed MMEF test (neurological tests=normal), didn't think it was stifle and basically told me changes of finding cause of problem is very slim. They thought it is mechanical in nature, thats shes not in pain and have written her off as a dressage horse. Does this sound like PSSM or am I clutching at straws! Any ideas on possible diet?
 
It doesn't sound typical, I have to say, but given that you seem to have few options left it might be worth trying the diet and seeing how you go.

What does she feel like to ride? Do the problems seem to be isolated to the specific region or does she feel stiff in general? I know you said the neurological assessment was normal but, for the record, I've be involved with two horses diagnosed with x-rays with major damage to their spines (investigated in part due to "odd" movement, in part for behavioural reasons and "loss of performance") who both passed simple neurological tests. :(
 
Yup, thought I was probably being too hopeful. She's actually very nice to ride...we've been very careful to always stretch her through the back. Behaviour wise, an absolute honey - even when in season. She just can't seem to flex her hind quarters and is very stiff at walk - more so when in season. Tends to amble - and sounds bizarre but actually moves better under saddle than when in the paddock. She also used to drag her hind legs at walk until she was shod. If anyone can make sense of these symptoms I'd be extremely grateful.
 
Clutching at straws ;) , have they had a look at her ovaries etc.? I've seen a few mares now with generalised "hind end" issues who were eventually diagnosed with internal inflammatory conditions.

What have they definitively ruled out? It's so tricky as they're so many bits of the horse we can't really investigate properly. I had an event horse with odd, occasional "not right-ness" behind who was never diagnosed with anything specific. One of the ideas at the time was injury to his ribs and/or the soft tissue in that area but at that point there was no way to definitively investigate that. Years later, he was being looked at for something unrelated and indeed, a band of scar tissue was found about 6" in front of his flank . . .

The fact that she's better under saddle is very odd. Did they narrow down the area/cause for a mechanical issue? What have you tried re non-veterinary routes - saddle fitting/chiro/physio/shoeing etc?
 
Sorry if I'm going over ground you have already covered here, but have you sent her to somewhere like the Animal Health Trust for a full work up?

Having had a horse with 'something wrong' that kep just coming and going and we (vet, McTimmony, farrier) could never get to the bottom of, after about eight or nine months of it, my vet referred her to the AHT. We got a conclusion.

Hope things come right and you find out what is going on with your girl.
 
Hi - thanks for the suggestions, I hadn't thought of ovaries.

As far as other checks, tried corrective shoeing. I have an osteopath/vet who treats her from time to time (she sometimes has L16 out and he pops it into place)- he thought it could be sticky stifles, but the vet at the clinic who specialises in tendon splitting said no.

I also had accupunture vet see her. He said she had a swollen liver and that her hind leg movement was a nervous problem.

At the clinic they stated I could go the full works with scintograthy etc but I balked at the price when the vet was already warning me he didn't think he would find anything.

One thing we haven't tried is bute to confirm that she's in no pain. I guess I try that and then a low starch diet and then think about getting a second opinion after that.

Will let you know if it improves and if I can work out my video camera will try to post a clip of how she moves as that will explain much better than words.

She such a honey don't want to write her off......

thanks again.
 
Some horses have problems utilizing Vitamin E and this can cause stiffness in the big quarter muscles.

Have you tried Vitamin E and Selenium.

There is a chap here in England called Roger Hatch who could help I'm sure. If you want his phone number let me know
 
Liver issues can cause hind end lameness, particularly on the right, as the leg bones move forward and cause pain to an inflammed liver.

Have you had her liver function tested? It's an easy blood test.

If her liver is diseased then you could also get EPSM type muscle spasms, I'm guessing, since she will not be metabolising sugar properly.

The EPSM diet shouldn't do her any harm either, so you might as well try it - high fibre, low sugar, and at least 500 ml of vegetable oil a day and a selenium and vitamin E supplement (BIG vitamin E dose, at least 2,000 iu) You can buy it cheap online in gel capsules and cut them open and squeeze it into her food.
 
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Emily had another colic this week. I'm travelling on business so wasn't able to start the new diet yet. I also checked the video tapes and she's worst now than 12 months ago. plan to start new diet as soon as I get home
 
Reached all time low this week. Emily had another colic - apparently a blocked lower intestine. Was lucky it wasn't a hospital job. Since then she has been really stiff and unlevel - uncooperative - not at all the same horse. Was even showing hopping on left hind this time! She was slightly better today, worked for short time long and low.

She starts new diet today - Dodson and Horrell ERS cubes. Will gradually add Alfalfa and oil as required. My trainer is not convinced by the diet but we'll see. Fingers crossed it make a difference - for the moment she's not even sound and cannot do anything productive.
 
Is it possible the lameness/gait abnormality has an internal cause? Coupled with the colic, it does seem very suspicious. I've heard of a horse recently which went lame as a precursor to being diagnosed with colitis, and I've known quite a few mares unlevel with ovarian cysts or similar. I've also seen a few with ulcers that seemed "not right" in their movement. I know it's not a common idea but pain is pain and we all know from personal experience that guarding a weak spot can produce all sorts of postural/gait changes.

Just a thought . ..
 
having had a horse with EPSM I have to say no. However it does sound like a horse I had with a subchondral bone cyst. Which was a cyst in the joint of the stifle. It caused exactly what you describe. He was treated with steroid injections for a few weeks, He did return to full work as a fun hack and family all rounder but would never have made the grade in dressage as he had to be allowed to work in his own way, which mean't not working from behind
 
My first thought was that this was a stifle problem, but the vet at the clinic who specialises in stifles ops said he thought that it was coming from higher up. How quickly would this condition appear? She was x-rayed two years ago and the only observation was a slight flattening of the troncheal ridge in the right stifle- I was told this would not impact performance at all. She was already showing the gait abnormality not long after that.

The other thing it's definately bi-lateral in nature. I'm observing the intermittent shortened strides on both hind legs.

She hasn't been x-rayed in the sacro-illiac region but I guess that would be a clinic/hospital job?
 
Started a 1 week trial of bute to see if she's in any pain. Initial results - gait abnormality is still there and she's still dragging hind toes in trot. However, she seems slightly more level and comfortable. She's been on bute for 2 days now.
 
Hello, not sure if this helps but sometomes these lovely big warmbloods can be prone to OCD. My 5yo warmblood suffered from this, and the lameness was very subtle in onset and definitely worse on a circle. The problem was in the stifle, and his gait was very wide behind, swinging the leg out rather than stepping through. Was eventually confirmed through nerve blocks and then x ray. Hope you get to bottom of it.
 
Flashann said:
Hello, not sure if this helps but sometomes these lovely big warmbloods can be prone to OCD. My 5yo warmblood suffered from this, and the lameness was very subtle in onset and definitely worse on a circle. The problem was in the stifle, and his gait was very wide behind, swinging the leg out rather than stepping through. Was eventually confirmed through nerve blocks and then x ray. Hope you get to bottom of it.
Click to expand...
 
Hi Flashann, Sorry to hear that. What was the outcome wih your horse? Could he be operated or did it get worst?

I've just finished a week of bute and it made no difference to her hind leg movement although she felt slightly more relaxed. Today she was very unlevel again (apparently was doing acrobats in the field yesterday)

I also looked back to the video of when I went to try her for purchase and it's a different horse. Wondering what options I have now as if she's deteriorating I'm worried to even sell her as a hacking horse.
 
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