Hind limb lameness where next…?

GinaGeo

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We have a slightly weird lameness going on, and wondered if I could get some thoughts.

Horse is 9, 16.1hh. Fairly low mileage and has had breaks due to rider pregnancy. Just picked up properly this year, but still not in hard work.

The week before the lameness popped up he had an easy XC schooling session. Popped a few lines, but mostly played in the water etc. Didn’t jump anything huge.

The week of he had a jump lesson. Didn’t do loads. But he jumped nicely and happily. And later on in the week he did a bit of hill trotting - he’s done it previously with no ill effects.

Traveled him to a small competition and he was lame behind so he came straight home.

There is no swelling, no heat, no marks. He doesn’t really want me touching anywhere beyond his shoulder which is new for him. But he’s moving away, nothing more. No ears back, no teeth, no feet. Which I think he would do if really sore. E.g. when he has a sore tummy, teeth fly.

The lameness is behind, the RH is swinging under his body and he is trotting on the wonk (haunches to the left). He’s landing heavily on the outside of his foot. It looks high up and like a “swing” lameness, not a weight bearing one.

He isn’t resting the leg and still picks it up as he always has done to have the foot trimmed.

Obviously we’ve had the vet and have so far ruled out the limb.

We have found a small bone chip on his right stifle, but it blocks clear. And we have also found mild arthritis in both hocks but again they block clear.

Both possibly part of the puzzle but not the main issue at the moment.

His suspensories also block clear and so does the rest of the leg.

He’s currently on box rest for four weeks (in a small pen) and on Bute. Three weeks field rest made no difference to it.

There is also a slight RF lameness that appears to worsen as the work ups go on. We have blocked the foot, but no change. So something higher on there as well - but as the main issue is in the hind limb we’d like to get to the bottom of that first, before investigating the fore limb further.

I have been lead by my Vets so far and they have said that they can block his SI next. I think if that does work then the suggestion would be to inject steroids into the various areas causing issues and see how it goes - but that doesn’t feel like a fix to me. Just a masking of issues.

If that doesn’t work - then where do we go next, and how far do we go chasing it.

He isn’t insured, I’m already at least £1.5k into investigations, which isn’t an issue. And if there is a good chance that he can come back into proper work I don’t mind spending money, but there isn’t a bottomless pit - I do need to be sensible.

He’s a very sweet horse . And we’ve had him since a yearling - I am very fond of him.

But I do not need another happy hacker - so I don’t want to throw endless money at him if that’s the best case , which I have explained to the vets. I have two other older horses who have earned a light work / retirement slot and they are here until the end.
I don’t mind not jumping, but would like to be able to do Flatwork.

I’d be happy to turn him away for a year, to see if time helps.

Would a bone scan be of any use, to try and pinpoint areas?

And even if we do find the lameness, I am well aware that our treatment options are limited.

He’s due a review with my vet in a couple of weeks, to see if the rest and Bute has helped at all, so will have a chat with her then.

But other peoples experiences would be helpful - realistically will a horse who is very low mileage and only 9. With several things going on, some of which we haven’t even found yet, come sound and stay sound?

He doesn’t need to be a high level eventer. Just a good allrounder who can enjoy training (I can live without jumping.)

I don’t know if I’m being a pessimist.
 
Hind limb lameness is often complex and ends up with compensatory issues going on. I have always found full body bone scans very conclusive in these situations, on multiple occasions. Good luck!
 
Only N=1 but my friends horse had a similar mystery, bilateral lameness and bone scan lit up on the SI region, cleared up a lot of questions as multiple vets said he looked sound but he was still very unhappy. But it was maybe £3.5k? I think? So it is a lot.

Has he been seen by a good physio/ osteopath? Where he is compensating might show something and it's a cheaper appointment than more steroids.
 
Can you get to Sheffield or Halifax…Hirds vets…an amazing team of vets with lameness issues a speciality. I’m travelling 5 hour return trip once a month but my mare has improved amazingly under their (well Tim’s) care and direction.
 
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I think I’d get a really good physio or second opinion if that’s already happened. If nothing conclusive is found I’d turn away and give the horse a few months even if he looks sound. If still not right in autumn then start investigating again.
 
I have a very odd horse that always enjoys baffling the vets.
3/10ths lame right hind, didnt block to anything, went for a bone scan, hocks lit up, hock arthritis.
If funds allow i would reccomend a bone scan.
 
Thanks everyone.

He hasn’t seen the physio yet - but that is an easy one to tick off.

I’m not a million miles from Hirds. But I don’t think they have bone scanning facilities. And we have already blocked everything that can be blocked except the SI.

My vets have done an excellent systematic job on the work up. It’s just where we go from here and whether we block the SI or if I push for a referral for a bone scan.

But we already know about the hocks and the right stifle.

Reviewing and then chucking him out with a view to imaging later if no improvement is an option. But I think I’d need to see some improvement off the rest to do that. If he’s still the same after 7 weeks off, I’m not sure more rest will make a difference?
 
A treatment from a good bodyworker (I use a qualified vet who is a chiro) before further investigations is a good shout. They may be able to release various tensions built up from the horse protecting himself from pain which then makes the main lameness easier to spot.

An odd RH lameness would make me query hind gut issues. Chiro vet did indeed correctly diagnose likely hind gut issues in my horse backed up by the Equibiome result, and the horse was subsequently much more comfortable once she had been on the oily herbs supplementation.

Good luck.
 
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i had one pull a muscle once - became very difficult to shoe, was unsound behind, couldn't roll properly, struggled getting up and down to roll. We did everything including bone scan and zero hot spots. Decided she had pulled a muscle. Physio and rest. Came back fine and went 3*. We did inject SI as well just to help and it doesn't cost much.
 
Thank you 😊

This horse has been Hind Gutty before and is on oily herbs and has been for years 😊

But this is presenting quite differently. Definitely a musculoskeletal issue.

He is rolling and getting up and down quite happily. Still happy enough to have legs handled.

But is moving appallingly and is loading the foot abnormally - it definitely is not in the foot.

Okay - bodywork high on list to try. Shall have a chat with vet - expect she may want to see him following the box rest before agreeing to any bodywork.
 
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One of mine was similar to this, stepping too far under on right hind. When vet checked him he was totally sound. So i got the physio out, who found he was sore all over. Didnt want to be touched on his left side. She said its as if he had got cast or fallen in the field. Had one session with them and her presto now all good. Totally straight. Hope yours is as simple
 
I’m a big advocate of dr.green but I’m not sure this would be my go to initially here.

I’d probably X-ray the back if not already done, not convinced I’d block the sacro (unless there was clear indication to do so from palpation response).

This could easily be muscular if the big hitting ortho issues are ruled out. I might be inclined to get a very good physio to look and then have the bone scan in the back pocket.

ETA, don’t panic just yet. Sub clinical X-ray changes are not uncommon and quite manageable!
 
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