Advice needed for vet visit due tomorrow please?

[Ellietotz]

My mare went to the vet Monday just gone for lameness investigation as she showed very very slightly off on the right hind on flexion plus my concerns with what could have caused her ulcers in the past and behaviour towards other horses and general grumpiness at times which I wanted to check.
As it's very stressful getting her there after a bad experience while travelling as a youngster, I wanted to get as much done as I could which they knew.
So they did a walk and trot up on hard ground which she was sound on and assessed her in walk, trot and canter on both reins lunging which she was sound but short on the back in canter as normal and they agreed she did look stiff with little flex in the pastern and hocks on both legs.
Then she was assessed ridden which they noted of her tail swishing which she has always done (I'm friends with her breeder who says she has never moved any differently, she only ever had one owner which was her so she knows how she's moved right from the start. Also to note, she was very spoilt as a baby which her breeder admits and probably should have taught her more manners), she also showed resistance to being asked to canter which she does little bucks either when asked or during which I think could be down to being a mare and hates being told what to do, she doesn't do this out hacking even if I ride her in a circle while out.
The vet said those signs were classic SI pain symptoms and that her conformation is probably the likely cause as she is bum high (13yo now and never caught up), has quite straight back legs and she is 13.3hh but very long at 5ft9 rug length but agreed they will xray hind legs and back as I wanted to be sure that nothing was going on with that too. They didn't x-ray the SI because they said it's too hard to tell if something is going on with it.
Anyway, xrays didn't show anything of concern with her back and legs so they got my consent to inject the SI joint and have also advised to start her on regumate that day for her attitude towards other horses and to see if her behaviour in the school is partly due to being a mare too.
I'm now a bit concerned that the regumate might effect the results? Not that I think it's made any difference at all, she's still a grumpy wotsit when she wants to be. I am assuming that when they come to do the ridden assessment tomorrow, if she doesn't do her stroppy bucks, that they will be able to tell if it's SI injections working or the regumate? I'm worried that it's going to confuse the results though. I'm hoping that it'll be more based on if she is moving properly? Although seeing her galloping around in the field like a loon today it doesn't look like it's made a blind bit of difference.
I have asked for them to bring the ultrasound to check hind suspensories tomorrow as well to check that off.

Bearing in mind process of elimination, xrays, hormone levels and ovaries were fine. When do you decide when it's just them? She is happy out hacking which is all we do anyway. She has always moved odd and that hasn't stopped her wanting to go out, she is forward going. When she had ulcers, she let me know of that and when her saddle caused pain, she showed signs of that too. I wanted to check her out because of the way she moves as I'm paranoid anyway but I'm starting to think it is just her now.
I have completely lost track and this is a long post but I would appreciate any advice or opinions on what has already been done and what I could possibly do next, if anything, to ask the vet tomorrow?

Thank you for spending the time reading this, I appreciate any help!

 

[Pinkvboots]

I know you said they will check suspensories tomorrow but were any nerve blocks done when she was there last week?

 

[Puzzled]

I would definitely be treating for ulcers again before I did any further work. Get a prescription and order online if she’s not insured

 

[Ellietotz]

I know you said they will check suspensories tomorrow but were any nerve blocks done when she was there last week?

No, they didn't do any

 

[Ellietotz]

I would definitely be treating for ulcers again before I did any further work. Get a prescription and order online if she’s not insured

The movement and grumpiness didn't change when the ulcers were healed so it's a separate issue

 

[Shay]

Sometimes it is just a process of elimination. If she moves better and isn't resistant / stiff / short etc does it matter whether it was the regumate or the SI injections? Regumate of course you can continue but if it was the SI injections which helped then it will wear off in 3 - 6 months so you would at least have the answer then when you have to have them re-done.

If it hasn't made a difference then it is on to the next thing to eliminate - hind limb suspensories presumably. I know you say that this is just how she moves and how she is - but reading it cold it really does sound like a horse in low grade pain. And her confirmation does seem a bit unusual which might well be at least part of the cause and why she has "always been like that". I think the past we have just accepted horses in low grade pain - not out of cruelty but more just because we could not tell as effectively or didn't know as much as we do now.

 

[Pinkvboots]

I suppose you have to see how she is in the ridden assessment, it does sound like it's a back or hind end thing, I just thought they might have nerve blocked the back legs because she may be bilaterally lame and doing a nerve block will often then make the opposite limb show up lame, so then they would have had a bit of better idea and something to go with or rule out.

 

[Ellietotz]

I suppose you have to see how she is in the ridden assessment, it does sound like it's a back or hind end thing, I just thought they might have nerve blocked the back legs because she may be bilaterally lame and doing a nerve block will often then make the opposite limb show up lame, so then they would have had a bit of better idea and something to go with or rule out.

Will just have to see what they say and where they think we should go from here but I will be surprised if they say it is the SI because I don't think it is now and I don't want them to say it just to close the case. :/

 

[Ellietotz]

If they are ultrasounding, would there be any point doing nerve blocks?

 

[Leo Walker]

If they are ultrasounding, would there be any point doing nerve blocks?

Yes. scanning the suspensories looks at those. Nerve blocks show if one leg is worse than the other and then allows it to be pinpointed to which part of which leg. If you block the left foot and she is instantly sound then you know its the left foot. If shes not sound then you block higher up the leg until she is. That's a bit simplistic but basically how it works.

 

[Ellietotz]

Yes. scanning the suspensories looks at those. Nerve blocks show if one leg is worse than the other and then allows it to be pinpointed to which part of which leg. If you block the left foot and she is instantly sound then you know its the left foot. If shes not sound then you block higher up the leg until she is. That's a bit simplistic but basically how it works.

Is that something instant that they can do or is it a full day thing?

 

[be positive]

Has a bute trial ever been done? it will not give an answer but can help to a degree and is easy enough to do, it is a minor risk with the ulcers but a few days may give more idea if she improves.

Nerve blocks are fairly complex if the horse is not lame, they need to be done from the foot up to be of any real value so a fair few to do if nothing changes, all require a clean clipped area so are best done in a hospital environment.

 

[Ellietotz]

Has a bute trial ever been done? it will not give an answer but can help to a degree and is easy enough to do, it is a minor risk with the ulcers but a few days may give more idea if she improves.

Nerve blocks are fairly complex if the horse is not lame, they need to be done from the foot up to be of any real value so a fair few to do if nothing changes, all require a clean clipped area so are best done in a hospital environment.

No haven't done a Bute trial. I would be worried about it flaring up the ulcers again though. I guess all I can do is wait and see what they suggest.

 

[Pinkvboots]

If they are ultrasounding, would there be any point doing nerve blocks?

Yes nerve blocking will pin point an area in the leg worth investigating, otherwise your going in blind but because she is not showing lame as such a nerve block won't work but it will show up if she is lame on both hind legs, as quite often it's not noticeable until you block one leg.

 

[Ellietotz]

Well... she has been reassessed.
The look on my vet's face said it all, along the lines of "sh*t this has racked up a huge bill and I have to tell her it's all between the horse's ears".
He agreed the SI injections did nothing, he genuinely didn't see the need for ultrasound as he really doesn't think there is anything wrong with her hind legs. He said the positive flexion was likely just dodgy ground as we did it on the only track we had at my yard as she was sound when tested on flat ground. He watched me hack her out and school her while out on a 20m circle and at home plus asked me to pop her over a couple of jumps. He said she moves lovely when she's not having a strop. He wants to reassess her in a couple of weeks now to see if the Regumate has made any difference. Then he wants to inject the part in her spine that isn't touching but is quite close as the next step just in case it's kissing spine but he isn't entirely convinced it would be that but he honestly thinks it is just behavioural now. So that's £1900 later and probably not going to be a successful insurance claim...

 

[SEL]

I think it would be really "off" for your vet not to support the insurance claim. The insurer will exclude SI anyway on renewal and there was obviously enough there in the first vetting for them to inject. Careful writing up of notes required. If you need to try crying over the phone and pleading poverty.

I'm never convinced that these are behaviour issues, but then it's taken me 2 years to find a vet to agree mine is bilaterally lame behind. And I had to video her at her worst.

 

[Caramac71]

I've read many of your posts and your mare sounds quite similar to ours. I'll try to keep the story short ...

Bought as a very green 5 year old. 1 year later, still struggling with canter and progressively getting worse, eventually kicking out in canter, then refusing to canter, then refusing to go forward at all. Tested for everything, presented as SI issues and vet was convinced thats what we'd find but bone scan showed no uptake in SI and arthritis in facet joints T18-T15 (back Xray was perfect but facet joints were obscured by the gut on Xray so never showed up). Vet gave poor prognosis. Had Tildren and shockwave, and long physio guided rehab. We tried various bodyworkers and rehab for the best part of 2 years and then turned away for about 9 months as at that time was intermittently lame (shifting sides) on hind legs.

Decided to give it a another try early part of last year, and got the Osteopathic Vet (Tom Beech) out to give his opinion. After 2 very thorough treatments, he felt that her pelvis was being dragged down by hind gut and/or enlarged right ovary.
Since her first treatment with him, and the dietary changes / supplements he's recommended, we have a totally different horse. She is no longer stressy and spooky (she is still worried hacking out in open spaces but that is down to never having the consistency or continuity to keep trying and it's something we are working on again). She still sometimes looks a bit "stuck" and unhappy in canter but then she opens up a bit and relaxes and looks totally fine. She was ALWAYS tail swishing in canter previously, right from when we first had her.

She is a dominant mare, and a bit of a character, she's opinionated and not always on our side. But 100% all the pain-type symptoms she displayed (that many people told us were behavioural and just her being a mare) have totally gone when she is no longer in discomfort.

Happy to give you more information about her and everything we've been through but I didn't want to bore you with all the details. However, what I would say is to trust your horse and if you think she is in pain then dont be fobbed off that it's "behavioural". From my (limited) experience there is a reason for the behaviour.

 

[Leo Walker]

I've read many of your posts and your mare sounds quite similar to ours. I'll try to keep the story short ...

Bought as a very green 5 year old. 1 year later, still struggling with canter and progressively getting worse, eventually kicking out in canter, then refusing to canter, then refusing to go forward at all. Tested for everything, presented as SI issues and vet was convinced thats what we'd find but bone scan showed no uptake in SI and arthritis in facet joints T18-T15 (back Xray was perfect but facet joints were obscured by the gut on Xray so never showed up). Vet gave poor prognosis. Had Tildren and shockwave, and long physio guided rehab. We tried various bodyworkers and rehab for the best part of 2 years and then turned away for about 9 months as at that time was intermittently lame (shifting sides) on hind legs.

Decided to give it a another try early part of last year, and got the Osteopathic Vet (Tom Beech) out to give his opinion. After 2 very thorough treatments, he felt that her pelvis was being dragged down by hind gut and/or enlarged right ovary.
Since her first treatment with him, and the dietary changes / supplements he's recommended, we have a totally different horse. She is no longer stressy and spooky (she is still worried hacking out in open spaces but that is down to never having the consistency or continuity to keep trying and it's something we are working on again). She still sometimes looks a bit "stuck" and unhappy in canter but then she opens up a bit and relaxes and looks totally fine. She was ALWAYS tail swishing in canter previously, right from when we first had her.

She is a dominant mare, and a bit of a character, she's opinionated and not always on our side. But 100% all the pain-type symptoms she displayed (that many people told us were behavioural and just her being a mare) have totally gone when she is no longer in discomfort.

Happy to give you more information about her and everything we've been through but I didn't want to bore you with all the details. However, what I would say is to trust your horse and if you think she is in pain then dont be fobbed off that it's "behavioural". From my (limited) experience there is a reason for the behaviour.

And that is why Tom Beech or similar are always going to be my go to for any sort of not quite rightness. Dont get my wrong I'm not dissing vets and happily use them, but in cases like this where you know there is something but its not obvious then I'm going to use Tom first.

 

[Caramac71]

And that is why Tom Beech or similar are always going to be my go to for any sort of not quite rightness. Dont get my wrong I'm not dissing vets and happily use them, but in cases like this where you know there is something but its not obvious then I'm going to use Tom first.

Totally agree. Vets are under pressure from insurance companies to come up with a diagnosis, which in our case they did but it would seem that the osteoarthritis was a result of, and not the cause of, her symptoms.

 

[scats]

Just to add in- I had to force our vet hospital to scan our mares suspensories. They didn’t think it could possibly be that and I was barking up the wrong tree and going to waste my money.
I insisted that I wanted it, so they did it. I think to shut me up. Turns out I was right, as I had suspected.

Vets do not always get it right, it’s worth keeping that in mind!

 

[Pearlsasinger]

This attitude of 'I don't know what the problem is, so it must be behavioural' really annoys me. It won't be! And yes, your vet needs to write the report for the insurance company to encourage them to pay the bill. I must say that if the mare were mine, I would consider getting a 2nd opinion.

 

[Fransurrey]

My mare also moves odd behind. She struggles with her gut, too. Vet even commented on it when she had a work up. She walks like she has a full nappy on. No tail swishing, but she does struggle with canter and often refuses to on a hack.

Did your vet give a reason for the Regumate, given that her ovaries and hormone levels were fine?

 

[Nudibranch]

If it's behavioural, then you need to ask why she behaves like that. Most likely answer is low grade pain. What else? There's always a reason.

 

[Ellietotz]

The Regumate was to see if it stopped her being aggressive towards other horses.
The vet said he was going to submit the claim in a way it should be accepted and he didn't want to continue racking up more costs until he knows the insurance company will pay out.
She doesn't refuse to canter, in fact, when we are in the school, all she wants to do is jog and canter around until she chills out and starts working on the bit. When changing rein in the school, she thinks you're turning to a jump and she does a really collected canter. She is forward going, she's never resistant IF she gets to choose. Only until I actually ask her to do something is when she shows these "SI symptoms". It was same when one of the vets rode her, she was jogging along but the moment she was asked to actually trot, she had her strop and then continued to trot normally. For example, we are in the school and she goes into a trot on her own accord, I make her walk and then I ask for her to trot and she does a mini buck with her ears back or we get to the corner and she chooses to start cantering so I go with it and she is fine but the moment I cluck her on, she does her buck again. She will canter and trot around and jump all day but if I actually ask her too, that's when she plays up. The moment we go out of the school, the neck stretches out and she thinks we are done. The tail swishing only happens when she's ask to do something, not when she's chosen to do it herself. When he watched us hack up the road, she is fine walking along away from home. When he asked us to trot and canter in a line away from home, we got the tail swishing and mini bucks again. Trot and canter heading home, no swishing and ears forward. She has absolutely no resistance to want to canter when SHE chooses to. She's never had any manners and always thinks she's in charge, has done from the day she was born, got away with everything. She will be reassessed in a couple of weeks to see if the Regumate has helped. This attitude to work and be told what to do runs in the family though, her mum and her mum's mum were the same towards other horses and generally moody, all home bred and spoiled too. You can touch her all over and she will pull faces if you prod her shoulder, neck, under her head, bum, legs etc, there can't be something wrong with her entire body surely. She grew up knowing that when she was done with attention, that was that. When she wants her bum scratching though that's another story, she demands it. I don't give in but there are some things that are just ingrained I think. Another example of her lack of manners and respect is when she's asked to move out the way, she will threaten you with a warning tail swish like she will kick if you tell her to move again, obviously I am not stupid enough to get close to her to be hurt and she certainly doesn't get away with that kind of behaviour, I will always continue to remind her that I am in charge. I don't think the vets have done a bad job. They don't want to rack up a huge bill before knowing it is covered and then they will go from there.

 

[Ellietotz]

If it's behavioural, then you need to ask why she behaves like that. Most likely answer is low grade pain. What else? There's always a reason.

My latest response might answer that question. Upbringing I would have thought.

 

[Ellietotz]

My mare also moves odd behind. She struggles with her gut, too. Vet even commented on it when she had a work up. She walks like she has a full nappy on. No tail swishing, but she does struggle with canter and often refuses to on a hack.

Did your vet give a reason for the Regumate, given that her ovaries and hormone levels were fine?

Answered your regumate question in my recent reply.

What do you do to manage your mare's gut?

 

[Pearlsasinger]

She might well be sensitive all over her body, if the problem is her skin. I had a mare who appeared to have behaviour problems but eventually we found out that she was reacting to her feed. Her nerve endings must have been inflamed, as she too was sensitive to touch all over her body. This might explain why your mare struggles when you give an aid but doesn't actually have a physical problem with the movements.

 

[Ellietotz]

She might well be sensitive all over her body, if the problem is her skin. I had a mare who appeared to have behaviour problems but eventually we found out that she was reacting to her feed. Her nerve endings must have been inflamed, as she too was sensitive to touch all over her body. This might explain why your mare struggles when you give an aid but doesn't actually have a physical problem with the movements.

She gets grass chaff and grass nuts, not very much of it either :/

 

[Pearlsasinger]

She gets grass chaff and grass nuts, not very much of it either :/

The amount doesn't really matter. On the face of it, there isn't much in there that she might be reacting to but there is one poster on here whose horse is allergic to grass - and the grassnuts might contain something that she reacts to. I bought a sack of grassnuts from the local farmstores rather than the tack shop, only to find that they were a mix of grass and alfalfa. They could (almost certainly will) also have some sort of binder. It might be worth stopping feeding the grassnuts, or swapping them for something like Agrobs Haycobs for about a month to see if that makes a difference.

 

[Fransurrey]

Answered your regumate question in my recent reply.

What do you do to manage your mare's gut?

Restrict grazing mostly, but as she gets older, it becomes more difficult. She now has anti-histamines as we think she is intolerant/allergic to certain grasses. 😖