Behaviour, Pain or Pilot Error?

[On the Hoof]

Firstly the history and some facts. Sorry this is long for some simple questions but hopefully
will give the full picture.

Horse is 15, diagnosed with bilateral hock arthritis - arthritis is mild. At the time she was also slightly lame on right fore but after 6 weeks rehab after hocks medicated the foreleg was fine and no further investigations made. She had a bone scan as part of original diagnostics and there was some take up at insertion point of suspensory in right fore but no X-Rays done on this leg.

As normal work resumes horse shows reluctance to canter on right rein, put down to pilot error ( she had dumped me on right rein canter before hinds investigated so I am nervous of asking her, it's also rein I’m most unbalanced on). Decide to start once a week schooling with more experienced rider (im a novice) to get her working from behind more and sort right rein canter issue. Rider was able to get canter but horse did try and drop her shoulder a few times. Put down to behaviour/habit from remembered pain as this rider is able to push her through reluctance

After hocks re-medicated in April and I am still having problems with RR canter by late April Im thinking this isn’t just me and she may be in pain so I do a bute trial and on day three of two sachets a day I ask for and get canter on the right rein no problem – so its pain right ?.

Few days later as bute worn off, I want to just try canter again before ringing vet, but don't get the chance. It's a windy day, horse is in season cannot get her to relax in school and before I know it she has spun and tanked up school. I come off when she stops!. She is now short behind. Was she in pain that day...I will never know but I think so? Put on box rest for five days and bute. Then field rest for five days no bute. Trotted up after two days on box rest and she is not placing right fore properly but she is not lame. She is rubbing that foreleg with her head. She has an old splint on that leg. She is iced everyday while on box rest. There is no heat or inflammation but I worked on idea that icing would do no harm and may do some good.

After 10 days she appears sound and we start riding in walk, but I have booked vet to come out on an area visit day.. She may have knocked old splint or tweaked something when she tanked, but there is still right rein canter to sort. I'm thinking that she may have arthritis in foreleg or a problem with suspensory. Would explain RR canter issue if hinds ok post medication??

SHE IS NOT covered by insurance for the foreleg as it counts as pre-existing condition as just changed insurers

Is there anything else I should be looking at as well as right foreleg, I think this is the right place to start given the original bone scan but any advice please? Do I ask for X-rays and ultra sound on that leg, there is no lameness so nerve blocks will be wasted?

Do we X-Ray from knee down to foot.... Any idea of costs?? If foreleg is clear where do I go next?

I could be wasting money if steroids are not enough for her hocks and she needs bute as well, at this point I am assuming that the steroids are doing their job on her hocks and that they are not the problem….

(Back checked 6 weeks and one week ago, tack checked 6 weeks ago, teeth done in Feb. Original bone scan showed back and pelvis ok)

 

[milliepops]

I'd be guided by your vet - tbh if she is not placing the RF correctly as you put it, I'd say there is a lameness there.

Just checked some old bills to give you an idea of cost - I've paid about £250 for initial set of x-rays and £200 for repeats in the past, and about £150 for initial ultrasound scan/£100 repeat scans (excluding visit, sedation etc as required). If possible I prefer to take them into the clinic to be done, seems easier that way as they have all the kit in one place.

 

[wkiwi]

Does sound like your horse has quite a complex situation and there are so many possibilities here. The improvement on bute for canter certainly suggests that there is definitely pain (e.g. the hocks plus or minus something in the foreleg or elsewhere). The windy day incident may have been just the horse spooking which then led to lameness because of the sudden spin? (ask people with arthritis and many will tell you it can flare up with a sudden twist or knock even when on drugs)
The forelimb lameness could be a separate thing or related (e.g. one of mine went sore in front due to compensating for a sore stifle). Agree with milliepops that not placing the limb properly would count as lameness. It is really hard to know the cause without the vet finding something, which as you say could cost a lot of money. It's hard, but you probably need to decide how much you can afford for investigating the problems and I think you should be guided by the vet as to which order to do tests in (you can always ask for a second opinion if you want to be sure). They should be able to give you some guidelines on which tests it would be best to do next; the cost of investigation/treatment; and the prognosis for different conditions.

 

[ester]

Injecting doesn't work for all horses, I'd think the canter issues might still be an issue with the hinds rather than in front.

Does the horse live out? Hack? Physio?

 

[Wishful]

I'd still be inclined to nerve block to localise the issue - X ray plates are more expensive than individual nerve blocks once the vet is out anyway. Given it could well be a multi limb issue nerve blocks of the hinds might allow her to show the lameness in front.

Might be worth booking her into your vet's clinic for a lameness work up - limits additional call out charges - and ask for suggestions on the most efficient use of your budget for work up/ treatment.

 

[On the Hoof]

Injecting doesn't work for all horses, I'd think the canter issues might still be an issue with the hinds rather than in front.

Does the horse live out? Hack? Physio?

Hi thanks - yes I do wonder if its still the hinds. She is out most of the time but will be stabled for between 4-6 hours per day. She is happy hacking on roads. She recently had McTimoney practitioner who adjusted tilt on atlas (?) and pelvis. they felt that the right fetlock needed adjustment but didnt do anything as I wanted x ray of that area first.

 

[Auslander]

Canter issue shouts out hind suspensory to me (I' have an alarming amount of experience in this area, thanks to Alf!) - which would not have been touched by joint injections. I'd be getting them scanned and nerve blocked (you cant successfully block hocks and suspensories on the same day without getting inconclusive results - in case you've already had nerve blocks).

 

[ester]

Kind of why I asked the hacking, as am I right in thinking suspensories show up more on a surface Aus?

 

[chestnut cob]

Kind of why I asked the hacking, as am I right in thinking suspensories show up more on a surface Aus?

I thought this was the case too - always thought it was soft tissue injury which showed up on a soft surface and boney/ arthritic changes on a hard surface.

OP I really feel your pain. My last horse was like this; older horse with a whole host of problems. It does take time to work out what is going on and how best to manage it. To me a horse which will not place its foot down on the ground properly has a lameness issue. Horses are very good at masking leg and feet injuries.
If you aren't insured you will probably find the diagnostics are actually much cheaper than if you are. Once my insurance ran out I used to pay around £150 for hock injections (both hocks) including sedation for my lad.

In my experience if it is arthritic changes you will just have to learn how to manage it best rather than expect dramatic improvement. If your horse has hock problems and possibly bony changes in the foot (might be ringbone or something like that) then TBH you want to be minimising the schooling and no jumping. Maximise hacking as straight lines is the best thing and hocks are best kept in gentle continual work.

Ask your vet for their honest opinion as to what they think might be the issue and give you an idea of the cost of diagnostics then go from there. Your vet probably has a pretty good feeling already about what might be going on.

 

[On the Hoof]

Thanks everyone for your thoughts on this and especially Millipops for checking old vets bills for costs...that was really helpful. Im Glad that I posted this first before speaking to the vet as I would not have thought about hind suspensory and it will be interesting to hear his thoughts on the best order to test giving lack of funds.
I did ride her today and having spent a week slowly building her up in walk and trot she was very ready to canter on both reins so the 10 days off and bringing back into work over anothe seven days have temporarily given her some relief so it will be interesting to see how she is tomorrow..it has however left me more confused as to what is going on.

 

[On the Hoof]

Just a short update on this ..lameness work up shows problem is in hinds. She is less than 1/10th lame on right fore so vet wanted to concentrate on hinds. No more arthritic changes shown on x Rays so nerve blocked right hock below large joint and this showed positive within a few seconds of the trot up. She is normally given steroid in lower hock joint so he has injected higher joint and we reassess in two weeks. I guess if no change then we may be nerve blocking suspensory . Fingers crossed , after a couple of days rest I need to work her and not back off from that so we can see if any change. I'm a bit confused as there were no arthritic changes in large joint ...apologies for any lack of appropriate terminology.....but will see how she fares.