Forelimb lameness

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sitting_pretty

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Hi all,

I appreciate that this is a pretty difficult question to answer without seeing the horse move, but I just wondered whether anyone would have any thoughts on my horse's lameness.

Almost 3 weeks ago my 10yo showjumper felt uneven in a flatwork lessons, then seemed definitely slightly lame the next day in his near fore when trotted up. No heat or swelling anywhere, but about 2/10th lame when trotted up on the concrete. Called the farrier first who took off his shoe and pressure tested his hoof but nothing really showed up. He suggested we poulticed it to see if we could draw out anything like bruising (he's fairly flat footed) or a developing abscess; which we did for almost a week and kept him stabled. However nothing substantial was drawn from the poultice and his level of lameness remained pretty much the same.

So out came the vet... Again trotting up on the concrete he was about 2/10th lame, and maybe about 1/10th lame on the lunge in the school on the left rein, and pretty much sound on the right rein. Vet's suggestion was to see if he would just get better himself with a bit of rest and anti-inflammatory bute as at this point his guess is that there's some injury between his pastern and knee. As keeping him in wasn't making any different and he was getting pretty grumpy being cooped up, he's left us to turn him out and give him 2 bute a day for 2 weeks. Vet has said if he his still lame after the 2 weeks when he comes off the bute we could start some further testing.

One week is now up, and we have another to go but I'm doing the worst thing possible and googling his symptoms and diagnosing him with everything under the sun! So I just wondered whether anyone else has experienced anything similar? It's frustrating to not be able to find any swelling or heat anywhere!

Thanks in advance :)
 
My showjumper went lame acutely in the collecting ring , no hear no swelling , vets came and assessed odd why no swelling not likely tendon injury , pain releifed and box rested for 2 days then reassessed , worked up nerve blocks done pain to the foot , vets suggested heart bar shoes without X-rays and diagnosis that's another story !! Xrayed eventually after still being lame
Nothing on X-rays , took all of his shoes off and came sound , came back into work and put front shoes on however went lame with the shoes , taken them off again and has remained sound , not same as your horse but just thought I would share x
 
sitting_pretty said:
Hi all,
So out came the vet... Again trotting up on the concrete he was about 2/10th lame, and maybe about 1/10th lame on the lunge in the school on the left rein, and pretty much sound on the right rein.

Thanks in advance :)
Click to expand...

Well I am writing from my own experience here as I am not a vet. I am sure to get jumped on by people but sod it, I am on here to help.

If your horse is sound on the right rein then I would say its his off fore. When the affected limb is on the outside of the circle a lame horse would appear to be more lame. A suspensory ligament injury can often cause little or no heat or swelling. Lameness can be mild and sometimes absent. The only thing that would make me question whether it is a suspensory ligament injury is that you say the horse is better in the school than on the concrete as I would expect it to be the other way round but as there is not much between difference between the 1/10th and 2/10ths that you say you saw, so I wonder if maybe your grading was not that accurate (don't mean that nasty - just interpretating lameness is very difficult sometimes).

As your horse is a showjumper I wonder if he has a suspensory branch injury?

Incidentally my vet likes me to have at least five clear days of my horse being bute free before reassessing my horse (if it is on more than half a sachet a day) which is why I often exceed the vets timescale to reassess by giving my horse a few extra days.
 
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Thank you both very much, I am really keen to hear other people's experiences. Back man is coming out this evening to see whether he has any ideas, although will be difficult as he had a bute this morning! However I thought he was very slightly lame this morning at walk going up the to field..sigh...

Interesting about the shoes as well, farrier is back out on Friday anyway so will see if he has any more ideas.

Any more thoughts welcome!
 
In your shoes, I'd get my vet to do a full lameness workup, including nerve blocks to start with and then x-rays and possibly MRIs. The problem with intermittent lameness is that it can be anything from a stone bruise to a ligament or tendon problem.

Nearly a year ago, my boy showed much the same symptoms. I did what you have done - got my farrier out first, who found nothing - and then my vet. Vet spent over an hour (nearly 90 minutes) with us seeing him move, videoing him, nerve blocking him and felt it was isolated to his off fore suspensory - proximal (where the ligament attaches to the bone at the top). X-rays and MRIs confirmed and showed some damage to the carpal bone and thickening/inflammation of the suspensory. He wouldn't settle on total box rest, so he got tuned out for an hour or two in the morning with a quiet companion, came in for the rest of the day, and then had another 30 minute or so jaunt in the afternoon while I skipped him out. Three rounds of shockwave therapy and cold hosing twice a day (sometimes three times) for 15 minutes at a time saw him much improved and (after the initial diagnosis in April) we had my vet's blessing to start walking gently under saddle (in straight lines only and on firm ground/not in the school) in mid August. We brought him back into work very slowly and, barring a slight blip due to a navicular flare up (he was first diagnosed with that nearly three years ago), he is now back in full work and sound as a pound. I have, however, made the sad decision that he won't be hunting or eventing any more - and that we will curtail his jumping considerably. My vet advises me that there is between a 20 and 50 percent chance that he could re-injure the ligament - the MRIs show thickening so there will always be a weakness. Even if I take the conservative estimate - 20% - that's too high a risk for me. He will jump at home, for fun - and not as high as before - no grids, no repetitive strains - and he may go out and do some little competitions but nothing that requires tight turns on dodgy ground and not very often. Now, if he competes, it will be dressage - and low level unaffiliated at that.

Kali was never hopping lame - and what lameness there was was inconsistent - but I'm glad I listened to my gut and to the good people I have around me and got my vet to do a thorough investigation. There is only so much a farrier or a physio/back person can tell you wrt lameness.

Best of luck sorting out your boy - and do feel free to PM me if you have any further questions, etc.

P
 
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PolarSkye said:
In your shoes, I'd get my vet to do a full lameness workup, including nerve blocks to start with and then x-rays and possibly MRIs. The problem with intermittent lameness is that it can be anything from a stone bruise to a ligament or tendon problem.

Nearly a year ago, my boy showed much the same symptoms. I did what you have done - got my farrier out first, who found nothing - and then my vet. Vet spent over an hour (nearly 90 minutes) with us seeing him move, videoing him, nerve blocking him and felt it was isolated to his off fore suspensory - proximal (where the ligament attaches to the bone at the top). X-rays and MRIs confirmed and showed some damage to the carpal bone and thickening/inflammation of the suspensory. He wouldn't settle on total box rest, so he got tuned out for an hour or two in the morning with a quiet companion, came in for the rest of the day, and then had another 30 minute or so jaunt in the afternoon while I skipped him out. Three rounds of shockwave therapy and cold hosing twice a day (sometimes three times) for 15 minutes at a time saw him much improved and (after the initial diagnosis in April) we had my vet's blessing to start walking gently under saddle (in straight lines only and on firm ground/not in the school) in mid August. We brought him back into work very slowly and, barring a slight blip due to a navicular flare up (he was first diagnosed with that nearly three years ago), he is now back in full work and sound as a pound. I have, however, made the sad decision that he won't be hunting or eventing any more - and that we will curtail his jumping considerably. My vet advises me that there is between a 20 and 50 percent chance that he could re-injure the ligament - the MRIs show thickening so there will always be a weakness. Even if I take the conservative estimate - 20% - that's too high a risk for me. He will jump at home, for fun - and not as high as before - no grids, no repetitive strains - and he may go out and do some little competitions but nothing that requires tight turns on dodgy ground and not very often. Now, if he competes, it will be dressage - and low level unaffiliated at that.

Kali was never hopping lame - and what lameness there was was inconsistent - but I'm glad I listened to my gut and to the good people I have around me and got my vet to do a thorough investigation. There is only so much a farrier or a physio/back person can tell you wrt lameness.

Best of luck sorting out your boy - and do feel free to PM me if you have any further questions, etc.

P
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Largely similar experience with new horse (yes I am that lucky) as no heat or swelling and barely lame. After a 7-10 days rest with no obvious improvement on Danilon I insisted on going straight to full work up. Full work up at equine hospital and vet there suspected suspensory almost immediately particularly due to intermittent nature of lameness (he was sound on a lunge on hard and soft surface and his showed up under saddle only). Was prepared for MRI but achieved a diagnosis through scanning (very slightly cheaper) of slight inflammation of both suspensories so on 12 weeks box rest with gradual walking introduced in second 6 weeks. However, unlike PS I have an 80% prognosis of return to full work (eventing) and vet said that is the highest he would give for any tendon/ligament injury, so slightly more optimistic prediction than PS but I remain cautious. Fingers crossed for you
 
Hi all, once again many thanks for your feedback - it's been enlightening!

It seems however that I have been seriously lucky! Back man is also an all round awesome horseman, and after seeing him trot up (sound but he had had bute in the morning), he began by looking at his foot. To my amazement he straightaway said I know what it is! He said he could feel a pulse suggesting bruising in the frog, and with that grabbed a hoof pick. After picking away you could clearly see that the bruise had burst and there was a hole on his frog much like the hole an abscess would have caused, and smelling the same too. He reckoned it has burst within the past 48 hours, and I'm fairly sure it actually burst during the day as I'm sure he was lame yesterday morning.

Anyway, he's still sound the morning 24 hours after his last bute, so hopefully he will remain so over the next few days and we can get back to normal. Phew!

I certainly won't be taking my horse's soundness for granted though, and thanks to you guys now know a little more of what to look out for in future :)

Good luck to anyone else with a horse suffering a mysterious lameness!
 
Glad you have it sorted SP. That is a huge weight of your mind, emotionally as well as financially.

Good luck x
 
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