Any lameness gurus out there?

confirmedponyaddict

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Where to begin? I actually posted a thread on here months back entitled 'Very worried' or something similar. Turns out I was right to be. My horse had a holiday between xmas and new year of this year, brought her back into work, did a few bits and bobs with her (low level jumping) and she didn't feel great, kept throwing poles out with her front feet and not making a great shape over her fences so got her saddle checked and it was pinching her shoulders so changed saddle. Then thought I would get the chiropractor/physio out to check no lasting damage from the saddle and she noticed that my horse asymmetrical behind. Her right hip appears lower than her left and on walking and trotting up there was a noticeable drop to that side as well. Slight undertracking on her right hind and moving that leg awkwardly. At this point I felt like the worst person in the world because this had obviously been going on a while and I didn't feel it, or see it, but as no one but me rides her I don't really get a chance to watch her. Chiro was pretty sure (and vet backed this up) that the asymmetry was from muscle wastage, not her pelvis being wonky.

Vet came and did a full lameness work up- nerve blocked from the foot up to the stifle, x rayed and ultrasounded her hock and stifle- all clear. Vet said rest her for 6 weeks then think about giving steroid injections in the SI joint as some of her symptoms indicated this. I should mention at this point she is not insured and I can't afford a bone scan so we were diagnosing by process of elimination at this point. 6 weeks of rest in the field achieved nothing so she had the injections on the 10th of May.

I was told to build her up slowly with lots of walk work to start and gradually introduce hills, trotting and then canter. I long reined her to build topline as well. I think she has improved slightly, especially under saddle, feels straight and willing to go forward when I ride her. Seven weeks on, the vet came out today, he thought there was a 20% improvement in the lameness but was hoping to see 50% to show that the steroid injections had worked. His opinion after ruling everything else out is that the lameness must be as a result of a fall in the field and pelvic fracture and that I should box rest her for 2-3 months.

I have a few issues with this 1) she will HATE box rest or being confined and I'm worried about her throwing herself around the stable or getting cast and hurting herself further. 2) if this happened 6 months ago won't the fracture have started to heal anyway? Vet says no not at all if she's been allowed to moved on it but I'm concerned that perhaps the healing process has started but she's healed wonky. 3) if there is SOME improvement in her lameness was I doing the right thing anyway by building her back up and the vet is hoping for too much too soon.

I'm going to ask for a second opinion (not sure who from yet, I'm so sceptical about vets) but I thought I would pick the brains of you lot on here. Can you box rest for an old injury or would it be pointless and distressing for her?

Lastly, background on the horse- she's a 15.2hh ISH of unknown breeding (I suspect a fair amount of ID) 7yrs old, I bought her as a 4 yr old and we did three BE80s last season with some good results. She does prat about in the field so I would not be surprised if she had fallen but I am surprised she wasn't more dramatically lame at the time.

Well done if you got all the way to the end!
 

Equi

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Is she lame or short? I struggle to see how a fractured pelvis will suddenly heal on box rest after months.
 

confirmedponyaddict

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She is definitely lame, worse on a circle but not as bad when ridden. Box rest, no mention of cross tying just that she needs a very small space.
 

millikins

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It the vet saying box rest or cross tying?

This is my daughter's horse. Vet is saying strict box rest, has not suggested cross ties. And Equi, that is my thoughts exactly, if she did fracture something then it was 6 months ago and I do not understand why immobilising an old injury will help now.
 

be positive

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I am not sure I would want to box rest without a proper diagnosis which at the moment you do not have, I appreciate that a bone scan is not a real option so a definitive diagnosis may prove difficult.
My experience with a chronic SI injury that was injected was an initial improvement then it tapered off and took several months of slow steady work to really level out, mine had regular physio as well as doing a lot of inhand work during rehab so I am not sure whether 7 weeks is long enough and the 20% improvement is probably only a guess anyway as it is not easy to really gauge subtle lameness accurately with so many factors to take into account.
 

ycbm

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This is my daughter's horse. Vet is saying strict box rest, has not suggested cross ties. And Equi, that is my thoughts exactly, if she did fracture something then it was 6 months ago and I do not understand why immobilising an old injury will help now.

Human pelvis fractures sometimes never mend. I used to hunt with a guy who broke his (without falling off!) and has been told it will always be unstable. If the same is true of horse pelvis fractures then I can understand the box rest, but not unless the course is cross tied and prevented from lying down and getting up again.
 

TheMule

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I would be seeking an alternatice vet's opinion, this pelvis fracture idea seems to be clutching at straws.
You said all clear on the nerve blocks, what do you mean? Was the horse consistently lame throughout? IE didn't block out anywhere?
 

confirmedponyaddict

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I am not sure I would want to box rest without a proper diagnosis which at the moment you do not have, I appreciate that a bone scan is not a real option so a definitive diagnosis may prove difficult.
My experience with a chronic SI injury that was injected was an initial improvement then it tapered off and took several months of slow steady work to really level out, mine had regular physio as well as doing a lot of inhand work during rehab so I am not sure whether 7 weeks is long enough and the 20% improvement is probably only a guess anyway as it is not easy to really gauge subtle lameness accurately with so many factors to take into account.

I just can't get my head around why she is slightly better...if there is a fracture and I'm working her on it surely she would be showing more sign of discomfort and lameness? I'm at work atm but will see if I can attach some videos this evening.
 

confirmedponyaddict

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I would be seeking an alternatice vet's opinion, this pelvis fracture idea seems to be clutching at straws.
You said all clear on the nerve blocks, what do you mean? Was the horse consistently lame throughout? IE didn't block out anywhere?

Yes she showed no improvement all the way up to the stifle. Vet didn't want to block her SI at the yard but I am wondering whether to find the money and get her down to liphook for an SI nerve block...might tell me more than keeping her in going stir crazy, although she is still out as we speak as I'm still undecided about what to do.
 

TheMule

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You've effectively ruled out every other cause of lameness so I think it's fair to assume you need to investigate the SI and back further.
If you can spend some money on her then ask for the referral.
If not then stick her out in the field for a year and see what you have at the end of it
 
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