Horse and rider with extreme issues...

SmallSteps

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No - that's why the big places employ good riders specifically for riding through performance work-ups. Our job was not to push horses hard - it was to give clear feedback to the vets on the differences we could feel and help ensure that we were objective and fair in our assessments. I rode all sorts of horses....

Ages (~10yrs?) ago I worked with a liphook vet who was having trouble because the performance work up riders are so good the horses tend to progress slightly sounder every time they are ridden, so it's hard to tell if your nerve block is helping ?
 

Caol Ila

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Ages (~10yrs?) ago I worked with a liphook vet who was having trouble because the performance work up riders are so good the horses tend to progress slightly sounder every time they are ridden, so it's hard to tell if your nerve block is helping ?

Yeah, I've found I can hide Gypsum's arthritic lameness stuff, from myself mainly, by riding her in a way that compensates. Up to a point anyway :(. A good rider can do a lot.
 

DabDab

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I have a horse who was extremely exercise intolerant (later diagnosed as pssm), and sending for a performance work-up of the type RF describes was honestly one of the worst things I've ever done to him. And didn't diagnose the issue.

I've also known a number of frustrated owners who know that there is something wrong with their horse but nothing is found. And some vets prefer the regular rider to be on board for this reason.

And I have also met different vets over time with a whole range of diagnostic methods - some whom use scintigraphy, some very hands on and intuition based, some who use less or more blocking and I'm generally pretty uncomfortable with any one of these approaches being pushed or advised against in general terms. If you're paying for vet input you should at least trust their diagnostic methods (or those of the vet they refer to), and let them go through their own process.
 

LEC

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At 70-100 quid per block depending on the block, that could rack up very quickly unless you get the right leg and right block early on. Bone scan circa £1000 depending on where you go.

I had nerve blocks done the other day £10 to get feet done.

I have also had bone scans done on two horses and closer to £2500. Though bone scans actually did give us an answer.
 
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tallyho!

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One thing struck me is about getting him to move at all sometimes... could have been my horse a few years ago.

Has the owner checked for PSSM?
 

RachelFerd

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Ages (~10yrs?) ago I worked with a liphook vet who was having trouble because the performance work up riders are so good the horses tend to progress slightly sounder every time they are ridden, so it's hard to tell if your nerve block is helping ?

Fair point - there were some that came in so unschooled we were definitely accidently schooling them up as we went....

I would add, I found it *much* harder to be objective when I rode my own horse through the blocking process when I took him in, as that emotional connection to the problem, along with being so used to riding him and compensating for his issues made it very hard to assess him as we went.

I think it's fair enough comments re. picking a vet whose approach you align with. For me, that 'intuitive' type vet I'd run screaming from!
 

conniegirl

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Wouldn't waste money on scintigraphy (bone scan) - poor performance work up using nerve blocks *under saddle* and ultrasound of hind suspensories is cheaper and more accurate. Scintigraphy usually throws up a load of false positives and is only really of use when you've got something very acute going on which is causing you to not want to nerve block under saddle.
Ive had 2 horses go through bone scans and both were useful.
Both had had full lameness workups (including nerve blocks) under saddle at a major vet hospital and nothing or very little found.

In fact the first one got to the point of scareing the vets rider (his problem was bolting) he was at the vet hospital for 4 days of investigations before the bonescan revealed 3 fractures to his pelvis and 1 to his skull.

The second horse was such a willing lad who had been compensating pretty much since he was backed. nerve blocks of his hocks helped but didn’t resolve the issue. Bone scan revealed some fairly major arthritis of the spine, vet was amazed the horse let anyone on his back, let alone had been showing in HOYS qualifiers and that the horse hadn’t reacted at all to the physical exam of his spine.
 
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ycbm

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Ive had 2 horses go through bone scans and both were useful.
Both had had full lameness workups (including nerve blocks) under saddle at a major vet hospital and nothing or very little found.

In fact the first one got to the point of scaring the vets rider (his problem was bolting) he was at the vet hospital for 4 days of investigations before the bonescan revealed 3 fractures to his pelvis and 1 to his skull.

The second horse was such a willing lad who had been compensating pretty much since he was backed. nerve blocks of his hocks helped but didn’t resolve the issue. Bone scan revealed some fairly major arthritis of the spine, vet was amazed the horse let anyone on his back, let alone had been showing in HOYS qualifiers and that the horse hadn’t reacted at all to the physical exam of his spine.


This is the sort of thing I thought they were useful for, thanks for the examples.
.
 

RachelFerd

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Ive had 2 horses go through bone scans and both were useful.
Both had had full lameness workups (including nerve blocks) under saddle at a major vet hospital and nothing or very little found.

In fact the first one got to the point of scaring the vets rider (his problem was bolting) he was at the vet hospital for 4 days of investigations before the bonescan revealed 3 fractures to his pelvis and 1 to his skull.

The second horse was such a willing lad who had been compensating pretty much since he was backed. nerve blocks of his hocks helped but didn’t resolve the issue. Bone scan revealed some fairly major arthritis of the spine, vet was amazed the horse let anyone on his back, let alone had been showing in HOYS qualifiers and that the horse hadn’t reacted at all to the physical exam of his spine.

Horse 1 - does sound like classic situation in which bone scan was really useful.

Again - in the *i'm not a vet* territory here. But where I worked for the 2nd horse, I think vets would have nerve blocked spine, demonstrated that that did help resolve the issue, then would have x-rayed. Probably saving everyone £2k plus on a bone scan. But many roads to Rome and all that and glad you found the answer!

ETA - link to article by one of the vets I was working with - https://www.horseandrideruk.com/expert-advice/articles/too-close-for-comfort/, albeit re. kissing spines not arthritis - "Nuclear scintigraphy (bone scan) has been used to assess the activity of kissing spines. A radioactive substance is injected into your horse’s bloodstream and binds to bone, particularly if the bone is actively remodelling. This shows up as a hot spot. However, hot spots on bone scans don’t necessarily equate to pain and this technique can give false positive and false negative results, so it can’t be reliably used in place of a thorough lameness examination and blocking with local anaesthetic."
 

DabDab

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I would add, I found it *much* harder to be objective when I rode my own horse through the blocking process when I took him in, as that emotional connection to the problem, along with being so used to riding him and compensating for his issues made it very hard to assess him as we went.

I think it's fair enough comments re. picking a vet whose approach you align with. For me, that 'intuitive' type vet I'd run screaming from!

Yeah I find it really hard to be objective with my exercise intolerant one (still do, I have to rely a lot on the eyes of the saddle fitter because my feedback is pretty pants), which is part of the reason I thought a full work-up might work...hey ho, got the answer eventually. I find it much easier to be objective on my others, particularly my older mare, though she is very much more a heart on sleeve type.

I really appreciate the flexibility of approach that my current vets have (and a real diversity of vets available), there are just so many individual factors, particularly when trying to figure out the issues of a complicated case.
 

tallyho!

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Palo1... just to add although too late for my post above... a change of diet would be the thing I'd go to first, and cheapest to see if it makes a difference. Try a PSSM diet - it's a great diet for any horse to be fair which makes me sometimes wonder if diets for horses went wrong somewhere...
 

maya2008

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Physical problems ruled out...

If the horse likes hunting, sell it to be a hunter? I had a pony who basically hated ‘normal’ ridden life - too spooky- but was bored in the field. I put two years of work in to make her rideable, then sold her to be a games pony. She LOVED being a games pony so much and was really good at it. Happy as anything. Keeping her would have been unkind, selling her was the best thing for her.

I currently have a 13hh pony who is supposed to be for my son. She wants to be mine, very obviously so. I am only 5ft4, I don’t squash her, so for now at least she can have her wish. I won’t try to make her be a kids’ pony if she doesn’t want to be.
 

hollyandivy123

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Physical problems ruled out...

If the horse likes hunting, sell it to be a hunter? I had a pony who basically hated ‘normal’ ridden life - too spooky- but was bored in the field. I put two years of work in to make her rideable, then sold her to be a games pony. She LOVED being a games pony so much and was really good at it. Happy as anything. Keeping her would have been unkind, selling her was the best thing for her.

I currently have a 13hh pony who is supposed to be for my son. She wants to be mine, very obviously so. I am only 5ft4, I don’t squash her, so for now at least she can have her wish. I won’t try to make her be a kids’ pony if she doesn’t want to be.
reminds me of a lass when i was a kid............the kid wanted to be a show jumper the pony didn't...........the pony loved games, thrived on it...........the kid still thought of it as a "show jumper" (the pony would jump the first on the course, slow for the second and stop at the third) they eventually sold it and the person who bought through it straight into games and i think they ended up on telly!

the sort of moral of the story is sometimes they prefer to do want they were not bred for...........................

if there is nothing physically wrong with the horse the OP mentioned, it really does sound that the partnership has become blocked, they seem to both expecting a repeat of the same thing.

horse is i do this then i can avoid doing that, rider if the horse does this then it will not do that.......................
 

Muddywellies

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Sounds like the horse has done a superb job of training his owner, just as mine managed to very cleverly train me. It took a pro to sort it out, and I still have the pro ride mine fairly regularly to help remind her what's what. I'm by no means a novice, but just not as confident as I need to be. In your friend's situation, if I really wanted to make it work, I'd fully investigate any possible lameness issues and if all OK, put on long term schooling livery with a really good trainer.
 

palo1

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Update: I just thought I would update this thread. Horse was re-treated for ulcers without a second scope and no change noted in behaviour or way of going. Physio and vet have worked together to identify any other potential issues over the last few weeks and the horse has now had a ridden workup with both owner and pro rider. Videos of horse in lessons assessed by both too. There is a query about some back soreness/potential kissing spines but any physical issues have been very, very difficult to find either consistently or definitively. The horse is now on a bute trial for two weeks. So far, ironically, his behaviour has been, if anything worse! This may point to some discomfort which will may be related to his back. He has had several specialist saddle checks carried out previously and his tack is not considered to be an issue. No leg/foot related issues have been found at all. It is intensely frustrating but one by one, potential causes of his behavioural issues are being eliminated.
 

palo1

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I really feel for the owner, that sound like pretty demoralising experience but full credit for trying to work out what the problem is.

Yes, it is really soul destroying for the owner :( She bought the horse thinking that at last she 'deserved' something really super; smart and well bred as she has had a variety of odd-balls over the years (all nice but all with known issues which she has worked around). The horse was expensive to buy, pre-purchase vetted by Rossdales and was to be the owner's final glorious fling!! He has been nothing but horribly difficult and unrewarding for the last (nearly) 2 years. He has cost an absolute fortune in non-insurance paid investigations, tack re-working etc etc but she is still doing her best to work with him. The whole thing makes me shudder but I am full of admiration for her to put so much time, money and emotion into a horse that doesn't seem to give much back. :( I don't think I could do it myself and would probably have put him in the field and gone and bought a cheap and cheerful one to enjoy! She could do that in fact yet.
 

Dexter

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Has a test been done for PSSM? Its the first thing I would have done given what you describe. Sadly its likely to be type 2 in this instance, and it doesnt have a great ending usually. But at least you would have answers.
 

palo1

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Has a test been done for PSSM? Its the first thing I would have done given what you describe. Sadly its likely to be type 2 in this instance, and it doesnt have a great ending usually. But at least you would have answers.

He has been tested for PSSM as far as I know and not positive. So, so many avenues have been explored to date -none resulting in any answers sadly.
 

palo1

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I assume his eyes and teeth have been tested?

Yes, everything has been gone over with a fine toothcomb :( Poor owner would be delighted if some physical cause was now found, even if it meant retirement (which he would have) or PTS. This horse literally wants for nothing in terms of facilities (well owner doesn't have her own arena but can use a neighbour's 5 mins up the road for rehab work if needed), money or care. No stone will go unturned for him. I am astonished,humbled and in some ways inspired by her despairing determination to do right by the horse, but I would not be able to sustain that effort myself (somewhat sad to say). She is still keen to love and enjoy him. The next step, in veterinary terms will be x-rays of his back and subsequently scans of his legs (in spite of apparent complete soundness even with nerve blocks :( ). Investigations have cost thousands but I think that the current thinking in equestrian terms is always to assume that poor behaviour is pain/discomfort related so those things must be ruled out first. Everyone is agreed that there is 'something wrong' though at least!!
 

maya2008

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What does his canter look like? I have known horses look sound at a trot yet their canter never looked quite right. One started by digging up the school a lot when cantering and seeming just a little more unbalanced than you would expect, and ended up cantering with a really horrible, rolling motion. Vet always said sound because they only saw it in trot. Developed pain related ulcers, behavioural issues etc eventually and needed retiring.
 

itroteverywhere

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He has been tested for PSSM as far as I know and not positive. So, so many avenues have been explored to date -none resulting in any answers sadly.

I haven't read all the responses so sorry if I'm repeating something that has already been said - but there are different types of muscle myopathies, so just because PSSM1 has been ruled out, doesn't mean that the horse won't have potentially a different one. I think this is why a vitamin e trial (not the synthetic one) is so useful.

What is the horse currently being fed?

You also mentioned that the horse is almost worse for the bute trial. That would make me consider hind gut ulcers (which won't come up on a scope).
 

palo1

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I haven't read all the responses so sorry if I'm repeating something that has already been said - but there are different types of muscle myopathies, so just because PSSM1 has been ruled out, doesn't mean that the horse won't have potentially a different one. I think this is why a vitamin e trial (not the synthetic one) is so useful.

What is the horse currently being fed?

You also mentioned that the horse is almost worse for the bute trial. That would make me consider hind gut ulcers (which won't come up on a scope).

Yes, the horse has been on a Vit e trial (natural variety at 10,000 per day); no result :(. Hind gut ulcers could really be a problem in my view though I would hope and imagine that all of the veterinary involvement to date would have considered this and/or discarded that? The horse is on a very ulcer-friendly regime but I agree that being worse on bute might suggest that there is stomach discomfort somewhere...ETA - I remember that the horse has had 2 treatments of sulcralfate (which I understand is the recommendation for hind gut ulcers) with no resolution.
 

palo1

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Final (I think!) update which may be interesting for anyone else in this situation. Horse has now been discharged for veterinary issues - performance work up at equine specialist vet has been done with any suspect areas of potential pain focussed on. The horse has been declared fine with no physical/pain issues that can be realistically found/identified. That is good news! His attitude hasn't improved but the owner is happy now to work on training and doing the things that the horse seems happiest with. It has been a hugely expensive and emotionally draining experience for the poor owner who now recognises that she would really struggle to sell him; his veterinary records would put anyone off even though nothing has been found. After nearly 2 years of very frustrating ownership and worry I do think the owner is now reconciled to making the best of things with this horse. He is a very, very lucky horse. I really hope that training and the development of a partnership will make a positive difference to both horse and owner. It is nice that the horse has a wonderful, caring home for life and entirely admirable that his owner is prepared to try to work with what the horse enjoys perhaps at the cost of what she enjoys - I so hope that ownership of this very tricky chap brings unexpected rewards. :)
 

BunnyDog

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Forgive the late addition and post.

I would suggest, from my own job here, that the horse might well benefit from an evaluation by a neurologist.

There's a disease that we're seeing here in quite a lot of horses, many from your side of the Atlantic, called Equine Degenerative Myeloencephalopathy. Aka EDM, not to be confused with EPM. (Equine Protazoal Myeloencephalitis).

No way to simply test whether or not a horse has it while alive. You can only definitively confirm in it post mortem samples of the brain and spinal cord.

Lots of symptoms, bigger red flags are changes in behavior and inability to process normal things, like ask it to go forward undersaddle and it can't.

I work as the admin for a boarded Equine Neurologist here. Essentially this goes back to how much vitamin E/ fresh pasture the horse's have as a foals. A lacking of Vitamin E leaves the brain itself susceptible to this. BUT I am not a vet. But a ton of horses that came from places in UK/IRE/Europe without lots of pasture are being seen and put down because of this.

Em
 

Dexter

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I haven't read all the responses so sorry if I'm repeating something that has already been said - but there are different types of muscle myopathies, so just because PSSM1 has been ruled out, doesn't mean that the horse won't have potentially a different one. I think this is why a vitamin e trial (not the synthetic one) is so useful.

Vitamin e is not the treatment for type 2 PSSM, so absolutely wont rule it out
 

palo1

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Forgive the late addition and post.

I would suggest, from my own job here, that the horse might well benefit from an evaluation by a neurologist.

There's a disease that we're seeing here in quite a lot of horses, many from your side of the Atlantic, called Equine Degenerative Myeloencephalopathy. Aka EDM, not to be confused with EPM. (Equine Protazoal Myeloencephalitis).

No way to simply test whether or not a horse has it while alive. You can only definitively confirm in it post mortem samples of the brain and spinal cord.

Lots of symptoms, bigger red flags are changes in behavior and inability to process normal things, like ask it to go forward undersaddle and it can't.

I work as the admin for a boarded Equine Neurologist here. Essentially this goes back to how much vitamin E/ fresh pasture the horse's have as a foals. A lacking of Vitamin E leaves the brain itself susceptible to this. BUT I am not a vet. But a ton of horses that came from places in UK/IRE/Europe without lots of pasture are being seen and put down because of this.

Em

Thank you for this. How interesting and concerning as well as sad. I am not sure I will pass this on at the moment tbh as it may freak out the owner who is emotionally exhausted at this point BUT I will hold this in my head!

As for PSSM tests, this has been discussed at some length with the vets but it seems that really there are not enough symptoms or behavioural issues to warrant any further expense or worry. Clearly those tests aren't especially expensive or difficult but I fear the owner has totally lost heart for veterinary investigations now. Horse has improved slightly in some ways also - with the help of a good and sympathetic coach. He will now hack out without continually napping and is better both on his own (very short hacks) and in company. He does seem to 'enjoy' jumping; ears are forward and gears engaged for that even in an arena that he is hugely familiar with and generally uninspired by (so no adrenaline effect). The owner has put in a great deal of patient and sympathetic training and will continue that but of course should a veterinary issue arise or become evident she will deal with that. Horse hasn't bitten anyone spontaneously or casually for ages now either!! I REALLY hope that there will be a positive and happy future for the partnership - it really is a wonderful home and life for a horse and the owner absolutely deserves a lovely horse which this one looks like even though at present he is not quite the full deal! :)
 
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