Bilateral Lameness - Positive Stories please!

[Deano645]

Hi

In 2021 we bought a 10 year old connie gelding for my then 11 year old daughter to event. He had done up to BE100 very successfully with his previous owners, passed 5* vetting. They had the most brilliant, successful year together in 2021 eventing in unaff 80's. This year they started some 90's and all was going well until he started stopping at fences, just the odd one here and there. We initially put it down to her not being strong enough in the leg as she is very slight and only 5 stone - but a very gutsy, kind rider.

Recently the stopping has become more frequent, so we decided to get him checked at the vets this week before we sent them off to a bit off a boot camp together. What shocked me was that he has bilateral hind lameness, 3/10 one side and 1/10 the other. Positive on flexion. Back is all good (he regularly has physio and chiro neither of whom picked any lameness up). He is booked in for a bone scan on his hind end in two weeks and I am terrified that he has PSD or something as serious. He is the most sweet, genuine boy who always tries his best and has looked after her so well. On the flat he is going amazingly well and they won PC dressage regional champs last weekend. He is tracking up ok, but on the lunge at the vets canter was slightly laboured. From what I have read PSD can be lurking a long time before lameness / performance issues become apparent, and Connie's coming from Ireland are often worked very hard in their younger years. He came to England as a 4 year old, his previous owners had him for 5 years and brought him on slowly and carefully.

Can anyone off any positive stories of it not being something so serious? It would break my heart if their partnership were to prematurely end, and with the prices of good ponies being as they are now, I just couldn't afford another good eventer for her and that is her passion and she works so hard at it. The internet is full of the negative stories and not the positive ones. We are very careful with what we do with him, and have withdrawn from 3 ODE's this year due to hard ground so as to save his precious legs. Having to wait so long for the bone scan is horrible.

TIA

 

[HelenBack]

My Connie has hind limb lameness but his is caused by arthritic hocks. He's had steroid and gel injections and they really helped him. It could be anything so try not to worry too much. And if it is PSD then they can operate and I think this has a pretty good success rate. I'm confused though as to why you're going straight for a bone scan. Did they not suggest nerve blocks and x-rays first?

My Connie's first symptoms were stopping at fences too by the way, and having more fences down/ generally losing his ping. He's honest to a fault so when he started stopping the little voice that I wanted to ignore told me something was wrong.

 

[Deano645]

My Connie has hind limb lameness but his is caused by arthritic hocks. He's had steroid and gel injections and they really helped him. It could be anything so try not to worry too much. And if it is PSD then they can operate and I think this has a pretty good success rate. I'm confused though as to why you're going straight for a bone scan. Did they not suggest nerve blocks and x-rays first?

My Connie's first symptoms were stopping at fences too by the way, and having more fences down/ generally losing his ping. He's honest to a fault so when he started stopping the little voice that I wanted to ignore told me something was wrong.

The vet said she could do nerve blocks when we were there yesterday but suggested we go for the bone scan first as he is insured and then the nerve blocks at a later date if needs be, do you think I should query this? She suggested the bone scan would offer more clarity to the problem than nerve blocks might. They are an equine vets, I have a good friend who is an equine vet, I may bend her ear! Thanks for your reply.

 

[SEL]

If I had my time again I'd have pushed for the bone scan under insurance. I must have spent £1000s (or insurance company did) with vets moving from one area to another to another.

If it's hocks then I'd go straight to arthramid gel these days

Good luck

 

[Deano645]

If I had my time again I'd have pushed for the bone scan under insurance. I must have spent £1000s (or insurance company did) with vets moving from one area to another to another.

If it's hocks then I'd go straight to arthramid gel these days

Good luck

Thank you, yes this is what the vet said about nerve blocks. We used arthramid on another of our older ponies with success.

 

[piglet2001]

I would be asking for a second opinion as it sounds like your vet is just spending money for the sake of it as he is insured. Bone scans are really only ever used first when you have a loss of performance with no clinical signs such as lameness for the vet to go on. I would start with an excellent specialist sports vet and see which way they direct you. As your horse is lame I would expect this to include a few nerve blocks initially followed by potentially some focussed x rays/scans.

 

[ycbm]

I am confused by you mentioning a bone scan in conjunction with PSD as it's my understanding that PSD is a soft tissue injury and will not show up on a bone scan. I would be asking for PSD ultrasound scans and hock (and possibly stifle) x rays before a bone scan.
.

 

[nutjob]

I am confused by you mentioning a bone scan in conjunction with PSD as it's my understanding that PSD is a soft tissue injury and will not show up on a bone scan. I would be asking for PSD ultrasound scans and hock (and possibly stifle) x rays before a bone scan.

This is what I would do with a bilateral hind leg lameness. Ultrasound scans have picked up hind suspensory issues in 2 of my horses, it's pretty straight forward and inexpensive. I'm not insured so I don't usually start with something expensive unless I really need it but I would have thought that a bone scan would miss quite a lot of things. Also even if insured spending £1000's on investigations means less to spend on treatment.

 

[Tiddlypom]

Your vet is ahead of themselves.

Bone scans are no longer regarded as a wonder diagnostic tool, though they still have their place. They are now used in conjunction with other findings.

PSD is diagnosed by ultrasound scans, which are cheap enough. My vets would defo have nerved blocked the hind leg and also x rayed the hocks for signs of arthritis. Been there, done that.

By all means get a bone scan done too, as the insurance are paying, but the vet needs to do some more diagnostics to build up a full picture for when the results are in.

I'd be changing vets

 

[scats]

I’d skip the bone scan and go straight in to scan for PSD and X-ray hocks.
I have bone scanned horses but that was when we had a general loss of performance and vets were struggling to pinpoint where the issue was coming from.

As for positive stories, unfortunately mine didn’t have a great outcome, but I know plenty of horses out there still competing with hock arthritis. I think Michen on this forum has her horse injected and he’s a cracking event horse.

 

[sbloom]

Most "injuries" grumble for a long time before finally giving way. Gillian Higgins of Horses Inside Out, at the saddle fitter training I attended said, and I quote "the vast majority of injuries are caused by repetitive strain". We're finally adding to the classical masters understanding of biomechanics, looking at posture and the thoracic sling, the dysfunction of which is, ultimately, underneath a lot of these seemingly unrelated issues.

This company offers some amazing in hand rehab work, once you're at that stage. Bear in mind vets don't always look at injuries through this lens so posture may not get mentioned, and you're simply given strengthening/fittening rehab, rather than addressing what caused the issue in the first place - https://www.facebook.com/wildmagicllc

 

[Goldenstar]

I am confused by you mentioning a bone scan in conjunction with PSD as it's my understanding that PSD is a soft tissue injury and will not show up on a bone scan. I would be asking for PSD ultrasound scans and hock (and possibly stifle) x rays before a bone scan.
.

Psd causes damage to the bone where the ligaments attach the quickest check for PSD is to X-ray the area it’s better at showing up minor problems that are rumbling on .
In a situation like this I can see the sense in a full bone scan of the horse as it gives the owner a all over appreciation of the horses bone health.
The cost can easily be justified if it finds the horse has a bad back a sore neck and the start of stuff in his front feet and this sort of thing is not unusual.
It may be that the vet feels a bone scan will give an all over look at the hind leg . The answer is to ask why they think a bone scan is a good idea you are paying them and it’s your right to fully understand the plan .
What did they block to find the bilateral lameness ?
Hock arthritis is easily managed and you will very unlucky not to get the pony back on form .
I would in a good pony like this put in steroid and do Tilden and little later but in arthrimid ( or a similar drug ) .
You need to keep the pony as slim as possible .

If you are dealing with PSD then that’s not good it’s a difficult thing and as many have, I also my own sad disaster story with this and my personal experience of it with friends is the success rate for treatment seems far less than the vets tell you .
If PSD is found do not proceed with expensive and time consuming treatment and rehab with out xraying to check the bone health in the back .
It’s not relevant that good practitioners have found no issues with the back experience has also taught me that you need a back X-ray horses who don’t show anything in the way of discomfort can have profound changes in back .

It could well be the vet fears the horse has more than one thing one wrong . It been hard season for horses out and about this summer .

Good pony with a issue , take time collect information try to get the best possible all over view of the ponies soundness then plan what to do .
You need to understand the vets thinking and have a talk about the plan going forward you probably need to be prepared to overrun the insurance and to be spending and be managing him going forward .

 

[ycbm]

Psd causes damage to the bone where the ligaments attach the quickest check for PSD is to X-ray the area it’s better at showing up minor problems that are rumbling on .

Thanks GS, love this forum for learning things.
.

 

[sbloom]

GS I've clicked like as a great post, but I'm very wary of Tildren, heard way too much negative from human orthopods etc.

 

[Goldenstar]

No drug that does as profound a thing as Tildren can be without the possibility side effects however it’s been in use in horses much longer than it has in humans and horses are not human .
In a horse like this that’s worked hard nothing gives you the same chance to treat the whole horse to try to reduce the effect of bony changes .
I have used it often and apart from seeing the excessive drinking three times I have never had issue .
I do however think it’s best used early on when horses are suffering the wear and tear of life and everything about this ponies story suggests he’s let them know early and that gives them a really great chance to get on top things and manage him ongoing to keep him sound .

 

[Deano645]

Psd causes damage to the bone where the ligaments attach the quickest check for PSD is to X-ray the area it’s better at showing up minor problems that are rumbling on .
In a situation like this I can see the sense in a full bone scan of the horse as it gives the owner a all over appreciation of the horses bone health.
The cost can easily be justified if it finds the horse has a bad back a sore neck and the start of stuff in his front feet and this sort of thing is not unusual.
It may be that the vet feels a bone scan will give an all over look at the hind leg . The answer is to ask why they think a bone scan is a good idea you are paying them and it’s your right to fully understand the plan .
What did they block to find the bilateral lameness ?
Hock arthritis is easily managed and you will very unlucky not to get the pony back on form .
I would in a good pony like this put in steroid and do Tilden and little later but in arthrimid ( or a similar drug ) .
You need to keep the pony as slim as possible .

If you are dealing with PSD then that’s not good it’s a difficult thing and as many have, I also my own sad disaster story with this and my personal experience of it with friends is the success rate for treatment seems far less than the vets tell you .
If PSD is found do not proceed with expensive and time consuming treatment and rehab with out xraying to check the bone health in the back .
It’s not relevant that good practitioners have found no issues with the back experience has also taught me that you need a back X-ray horses who don’t show anything in the way of discomfort can have profound changes in back .

It could well be the vet fears the horse has more than one thing one wrong . It been hard season for horses out and about this summer .

Good pony with a issue , take time collect information try to get the best possible all over view of the ponies soundness then plan what to do .
You need to understand the vets thinking and have a talk about the plan going forward you probably need to be prepared to overrun the insurance and to be spending and be managing him going forward .

GS thank you for your reply, this a very useful and informative. I am going to email the vets and ask them why they are going down this route, ie the bone scan first, so I can understand more their plan, I was a little overwhelmed when we were there on Thursday. A friend is a very good equine vet, her practice is just out of our area, but we are going to speak this weekend and look for a second opinion. They didn't do any blocks on Thursday, trot up, lunge on surface and then lunge on hard ground, he was positive on flexion.

 

[Goldenstar]

GS thank you for your reply, this a very useful and informative. I am going to email the vets and ask them why they are going down this route, ie the bone scan first, so I can understand more their plan, I was a little overwhelmed when we were there on Thursday. A friend is a very good equine vet, her practice is just out of our area, but we are going to speak this weekend and look for a second opinion. They didn't do any blocks on Thursday, trot up, lunge on surface and then lunge on hard ground, he was positive on flexion.

It’s great that you have a friend that’s a vet , I do as well .
Speak to her for sure and let her help you negotiate the process .
A positive reaction to a flexion test is just the start and I would want to understand the vets thinking fully .
Some targeted blocking might be more useful than a bone scan they can certainly block the hock joints and they can block the nerve to the attachments of the suspensories but that’s a difficult block to do and it’s sometimes inconclusive .
You are insured so you need to be clear how all things work and they come together to spend money in the best possible way and to help you take decisions .Your friend will help you get all this clear in your mind then it is not such a blur when you are with the treating vet .
Google and look at hocks and see where the issues occur and a have read up this will help you understand better when you see the treating vet again .
Ask questions and then ask again if you need to if they are not for forthcoming they are not doing a good job .
Some vets are very we do this that and the other don’t be afraid to say explain to me the why .
It’s good for a vet to know you going to take an active part in the decision making .
that you require to understand why your going do the things that are chosen .
It keeps them on their toes .