Assessing how much pain a horse is in and why

Frans

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Not sure if our pony is suffering more pain than she seems to, if she has a whole load of issues or one thing with knock on effects, or if I’m just looking too hard. I’m hoping you can help with some wise comments before I speak to the vet.

Basically she trips more than the others, tends to put her feet down flat or even slightly toe first sometimes rather than heel to toe, occasionally one of her knees will “give” (collapse forwards), doesn’t look like she is moving freely behind (slightly lopsided and slightly shorter stride with the off hind).
All symptoms have appeared when both ridden and free in the field but you do have to watch her carefully to see them.

In her vetting she did badly in the flexion tests but was sound in the other tests

She has been treated by the osteopath for a stiff shoulder, croup and had a sensitive patch on her spine roughly “mid saddle” . He thought that the knees giving was probably a result of pain in the shoulder. Shemoved much more freely after his visit but is now starting to do the same things again.

Her back is slightly dipped at the point she was sensitive, she has a poor topline and a rather “in foal” shaped belly (shes not but has foaled in the past, by the look of her more than once)– improved by losing weight but it still hangs heavily. I presume it would lift more if we built her muscle up.

Someone has obviously done a lot of groundwork with her in the past and she is extremely respectful when handled, but in a kind of closed-off, self-contained way as if she has partially shut down until she is released. Once the headcollar is on she will do everything a person on the ground asks of her with no fuss. I think this may mask some issues. Eg if mounted when someone is standing at her head she stays perfectly still, if mounted without someone standing there she shoots forward looking panicked. My personal theory is that she has pain in her back when mounted but that her training overrides her desire to move when there is someone standing there. Similarly if someone walks with her she will go anywhere but if ridden out alone she naps and its hard work to keep her going. Incidentally other oddities, eg until recently you always had to approach her from the left if you want to get anywhere near her, made me wonder about vision issues on the right side (or a previous bad experience on that side) which could also explain these behaviours.

Doesn’t like being petted by humans but also doesn’t seem to like being groomed by other horses either – prefers just to stand companionably with them – which also makes me think she may have pain espcially around the withers as she reacted quite agressively when the other ponies tried grooming her. She is definitely the alpha mare so could that equally have been a way to put them in their places?

Most of our fields are on steep slopes so she spends a lot of time going up and down hill without obvious difficulty.

Wondering if the way she walks is partly due to bad back and not lifting her feet properly or if the bad back is due to carrying herself oddly to avoid pain in the limbs. Or if her back and limbs all have separate problems and the only reason that she doesn’t seem really lame or in pain is that she is actually in so much pain everywhere she looks almost normal.

She is 13.2hh, 10 years old, not shod and is used for light hacking by slightly nervous kids who would like to do a little jumping (at home 2ft max) with her this summer. Not sure whether to do more work with her to build up the supporting muscles or do less until we’ve a better idea of what’s going on (she’s had a pretty easy time of it over the past few months). Vets, farriers, osteopaths and instructors I’ve talked to so far haven’t seen anything to overly concern them so if I want to investigate this further I need to be clear on what I’m asking for.

WDYT?!
 
It sounds like she has several issues going on to me. But the one which I suspect the most is a back problem (possibly kissing spines), which can cause knock on problems such as arthritis in the joints due to compensating. If she is landing toe first, then I would also suspect navicular. Therefore, I would discuss these particular concerns to the vet and ask for xrays to be done of the spine, knees and feet. I hope that it proves to be something and nothing, though from what you describe, I think your instincts about your mare are right. She is lucky to have such an observant and caring owner. I hope she does not have anything too serious.
 
I have one who drags his back feet and often trips by putting his toe down first- it is where he used to have a back problem and just got used to moving this way- he is also quite lazy so doesn't worry about half falling over all the time. He also has a tendency to get nappy when hacking alone, but is fine with a person or horse with him- this seems to be due to lack of trust in the rider but complete trust of anyone on foot (doesn't matter who's on top or who's on the floor).
Don't know if this really helps as your mare seems much more drastic, but thought I'd share my experiences :)
 
From what you say I suspect there will be more than one issue, if the horse where mine I would havea work up from the vet.
From what you say yes I think theres every chance the horse has pain.
 
I agree with goldenstar, I'd also consider whether the feet are causing an issue, foot pain often creates back problems and the toe first landing would be classic of a horse with heel pain.

I'd suspect there was the possibility of low grade laminitis or similar going on and try her on a restricted diet (low sugar and starch, restricted grazing) and see if there is any improvement.
 
If the feet r landing toe first I would look to c if the feet r balanced correctly. If they r then I would look at movement and poss get xrays of feet (to check navicular etc) if nothing showed up. Difficult with backs what is cause and effect and often have to treat body and feet simultaneous to get best results. Xx
 
I would ask the vet for a full lameness work up. Sounds as if she could be bilaterally lame which would be hard to put your finger on. Nerve blocks are a relatively cheap way to try to pinpoint which leg it is and where on the leg, if it is legs of course! But its a good starting point.
 
Many Thanks for the replies. Obviously we knew there were possible issues when we took her on, it’s the idea of her suffering much more than I thought that is getting to me.

Diet has been carefully managed so I’m pretty confident that it’s not lami related.

She did have slightly contracted heels when we got her but her this has improved with regular trimming and I think her hooves are pretty well balanced now (though no expert of course!) – we need to stay on top of this as the toes grow quite fast.

The toe first landing is not consistent and may be a case of me looking too hard or may be related to the way the knees/shoulders move but certainly navicular is on my list of possibilities along with spavins, kissing spine and general arthritis.

Feeling a bit more confident about talking to the vet now, Thank-you!
 
Until I read your last post, I, too was thinking 'feet' and, of course, it could be but if the feet are well-balanced, you've eliminated one problem.
I would ask the vet for a bute trial for a few days to see if she is better with pain relief, at least then you would know if there was a pain problem and could start with nerve blocks.
I hope you get it sorted out soon.
 
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