RHGR
Well-Known Member
Hello! Back again with the same pony, same issues. I've put a couple posts up last year about my Welsh in hopes people had shared experiences. First we had ulcers diagnosed and treated which were almost completely gone (smallest amount of slight reddening still at pylorus) when we were okayed to start work again. Started ridden work, got about a week on 20 minute walk sessions and a couple little hacks before it became apparent problem was not solved. Still no obvious lameness, still happy to be tacked up and mounted. Got him referred to a specific consulting vet on physios suggestion as he will actually watch you ride on a lameness workup (big issue with last mare, had two different vets tell me she was fine as they never let me ride her for them, only when she was ridden did she show bad lameness, turned out to be fractured pelvis when we eventually got to the bottom of it). Took tank down, consulting vet saw very slight lameness in the hind end. WOOHOO!! Somewhere to start at least. Rode for him, he thought the reaction we were getting didn't line up with the very mild lameness on the ground. We xray. Xrays show arthritis in the stifles, and arthritis in his spine. Went forward with a bone scan to see what we were really looking at. Here's the notes back from the vet
Clinical examination of the hindlimbs revealed “Tank” to have a typical conformation for the breed. He was
not excessively overweight (See later). A mild bilateral medial femorotibial (MFT) joint effusion was
detected in both hind limbs. No pain was detected on percussion of the hind feet or the use of hoof testers.
Due to the clinical signs, I undertook a nuclear scintigraphy (bone scan) assessment of the neck, back,
pelvis and hindlimbs. This revealed mild increase radiopharmaceutical uptake (IRU) in the articular facet
regions of both caudal thoracic vertebrae. Patchy IRU was present in both stifles and mild MRI in the lower
hock joints. The most significant finding on the bone scan was significant IRU in both hind pedal bones.
Following the nuclear scintigraphy bone scan assessment:-
• Intra-articular anaesthesia of the left lower hock joints was undertaken (which was challenging
due to “Tanks” temperament!) but this did not affect the degree of lameness.
• Radiographic assessment of both stifle joints revealed early osteoarthritis of both medial
femorotibial compartments. The FP and lateral femorotibial compartments were normal.
• Radiographs of both hocks were within normal limits.
• No radiographic evidence of laminitis was detected on the hind feet (See later)
• Trans-rectal ultrasonography of the lumbosacral (LS) disc, the floor of the pelvis, the LS joints and
bladder did not reveal any significant abnormalities.
• Radiographic assessment of the thoracolumbar spine revealed evidence of arthropathy of the
articular facets of the caudal thoracic vertebrae.
• Ultrasound scanning of the thoracolumbar spine confirmed the presence of arthropathy of the
caudal thoracic articular facets. In both sides the facets of T15-T16 and T16-T17 were abnormal
with excessive peri-articular bone formation as was T14-T15 on the left side.
• Significant IRU in the pedal bones can be a sign of Equine Metabolic Syndrome (EMS) and therefore
a blood sample was taken. This revealed strong evidence of EMS (See attached)
I was told his insulin levels were high and he should be put on meds to reduce them. He was on Invokana for the month of January and retested last week. His insulin levels are now at 4. After chasing up about 3 times I've finally seen his original blood tests. His levels were only at 20. Apparently that's within the normal range? I'm slightly confused now as to wether he really has EMS and if it would be bad enough to cause the reactions I'm getting. I know these guys are professionals and I should trust them to know what they're doing, but 20 isn't a high insulin level and now I just feel more confused than anything. Are the problems more likely from his arthritis and the back feet inflammation is almost a red herring? How are his back feet so inflamed if his insulin levels are low and we've had no case of laminitis? Has anyone had experience with spinal arthritis and stifle arthritis? I've only dealt with hock arthritis before.
He's currently coming in at night's with a haycube of soaked hay. He gets a little speedibeet and light chaff for his balancer and gut balancer. Gets low sugar Timothy haylage if everything is frozen and I can't soak (gets a little in a hay all each night so it's not a shock to his system if he has to go on haylage for a couple days). Is there anything else I should be doing? Have had minimal support from vets. My own vet seems to not even know what's going on as she's asked 3 times this year about how riding him is going, despite the fact his discharge from the hospital said 3 months rest and fixing EMS before he goes back down to consulting vet for reassessment before starting any rehab. Have told her each time that he's not doing any work u til reassement in March. Consulting vet was fab but I got minimal chance for discussion with him before discharge as it was Christmas and he had emergencies he was dealing with. Doing bits of research but everything contradicts (made worse by his diagnosed conditions being contradictory in nature too!) and in the winter it makes things much harder too. Feel like I'm so ready to give up, the only saving grace is that my pony is actually the cutest pony on the planet so his face at least still makes me smile every day
Clinical examination of the hindlimbs revealed “Tank” to have a typical conformation for the breed. He was
not excessively overweight (See later). A mild bilateral medial femorotibial (MFT) joint effusion was
detected in both hind limbs. No pain was detected on percussion of the hind feet or the use of hoof testers.
Due to the clinical signs, I undertook a nuclear scintigraphy (bone scan) assessment of the neck, back,
pelvis and hindlimbs. This revealed mild increase radiopharmaceutical uptake (IRU) in the articular facet
regions of both caudal thoracic vertebrae. Patchy IRU was present in both stifles and mild MRI in the lower
hock joints. The most significant finding on the bone scan was significant IRU in both hind pedal bones.
Following the nuclear scintigraphy bone scan assessment:-
• Intra-articular anaesthesia of the left lower hock joints was undertaken (which was challenging
due to “Tanks” temperament!) but this did not affect the degree of lameness.
• Radiographic assessment of both stifle joints revealed early osteoarthritis of both medial
femorotibial compartments. The FP and lateral femorotibial compartments were normal.
• Radiographs of both hocks were within normal limits.
• No radiographic evidence of laminitis was detected on the hind feet (See later)
• Trans-rectal ultrasonography of the lumbosacral (LS) disc, the floor of the pelvis, the LS joints and
bladder did not reveal any significant abnormalities.
• Radiographic assessment of the thoracolumbar spine revealed evidence of arthropathy of the
articular facets of the caudal thoracic vertebrae.
• Ultrasound scanning of the thoracolumbar spine confirmed the presence of arthropathy of the
caudal thoracic articular facets. In both sides the facets of T15-T16 and T16-T17 were abnormal
with excessive peri-articular bone formation as was T14-T15 on the left side.
• Significant IRU in the pedal bones can be a sign of Equine Metabolic Syndrome (EMS) and therefore
a blood sample was taken. This revealed strong evidence of EMS (See attached)
I was told his insulin levels were high and he should be put on meds to reduce them. He was on Invokana for the month of January and retested last week. His insulin levels are now at 4. After chasing up about 3 times I've finally seen his original blood tests. His levels were only at 20. Apparently that's within the normal range? I'm slightly confused now as to wether he really has EMS and if it would be bad enough to cause the reactions I'm getting. I know these guys are professionals and I should trust them to know what they're doing, but 20 isn't a high insulin level and now I just feel more confused than anything. Are the problems more likely from his arthritis and the back feet inflammation is almost a red herring? How are his back feet so inflamed if his insulin levels are low and we've had no case of laminitis? Has anyone had experience with spinal arthritis and stifle arthritis? I've only dealt with hock arthritis before.
He's currently coming in at night's with a haycube of soaked hay. He gets a little speedibeet and light chaff for his balancer and gut balancer. Gets low sugar Timothy haylage if everything is frozen and I can't soak (gets a little in a hay all each night so it's not a shock to his system if he has to go on haylage for a couple days). Is there anything else I should be doing? Have had minimal support from vets. My own vet seems to not even know what's going on as she's asked 3 times this year about how riding him is going, despite the fact his discharge from the hospital said 3 months rest and fixing EMS before he goes back down to consulting vet for reassessment before starting any rehab. Have told her each time that he's not doing any work u til reassement in March. Consulting vet was fab but I got minimal chance for discussion with him before discharge as it was Christmas and he had emergencies he was dealing with. Doing bits of research but everything contradicts (made worse by his diagnosed conditions being contradictory in nature too!) and in the winter it makes things much harder too. Feel like I'm so ready to give up, the only saving grace is that my pony is actually the cutest pony on the planet so his face at least still makes me smile every day
