Inconsistent lameness (again)

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Marigold4

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Still trying to figure out my 15-year-old mare's lameness. She is consistently a little lame in both fronts, and on and off lame in her left hind. The vet has x-rayed and based on the findings, thinks navicular in her fronts. We are treating (unsuccessfully so far) with Cartophen and Bosmerix. However, the thing that really confuses me is her hind leg lameness. I was unable to show it to the vet as the horse didn't show any hind lameness during the investigation (walk and trot on lunge on hardish surface 10 m circles and trotting up on a hard surface) and her hind flexion tests were fine. In the field, I very often see her resting a hind leg and when trotting she is visibly lame when going from resting to trotting, but then the lameness mostly wears off. Today, she was very lame on her left hind in trot and bunny-hopping in canter but got less lame as she went.

Can I pick your brains as to what sort of lameness wears off with exercise/free movement? I would happily get the vet out again for a third time but not sure I can reliably reproduce what I see in the field. I should probably try and film it.
 
It may be a totally different diagnosis, but when mine was lame on three legs (both fronts and a hind) it turned out to be back related (mild KS). Despite what the vets said, which veered from navicular to a hind suspensory - after many months of treatment, the physio begged me to x-ray the back. Probably it was made worse by months of low/no work while investigations went on. (There was a happy ending, which was that since being back in work he hasn't had a related problem in the last 15 years, and is now still in work at 28). He has lived out for the last 8 years, which I think also helps with general condition.

In answer to your question: arthritis stiffness does tend to wear off with movement, so this is a possibility for her hind leg - probably/possibly hock. Although it's likely that the Cartrophen would have helped that.

If lame on that many limbs I would be looking higher up, possibly I would talk to the vet about getting the back x-rayed. Hope you find a resolution.
 
Abacus said:
It may be a totally different diagnosis, but when mine was lame on three legs (both fronts and a hind) it turned out to be back related (mild KS). Despite what the vets said, which veered from navicular to a hind suspensory - after many months of treatment, the physio begged me to x-ray the back. Probably it was made worse by months of low/no work while investigations went on. (There was a happy ending, which was that since being back in work he hasn't had a related problem in the last 15 years, and is now still in work at 28). He has lived out for the last 8 years, which I think also helps with general condition.

In answer to your question: arthritis stiffness does tend to wear off with movement, so this is a possibility for her hind leg - probably/possibly hock. Although it's likely that the Cartrophen would have helped that.

If lame on that many limbs I would be looking higher up, possibly I would talk to the vet about getting the back x-rayed. Hope you find a resolution.
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Thank you. That's really helpful. I am glad your horse had a happy ending. I'm not convinced by the navicular diagnosis - she's only been ridden for 6 weeks of her life, has always been barefoot, lands heel first and does not have heel pain when using hoof testers. This mare did have a sore back when I first got her several years ago and xrays showed that she had two sets of processes touching. We rehabbed her and she had steroid injections but she was still unhappy ridden, so she has been retired. We xrayed her back again this time and, although the processes were close, they all had spaces between and the white bone remodelling we saw before had gone! My physio sees her regularly and notes that she is tight in her muscles over her shoulder and back. I talked to my vet again this week, but she seems determined that it's navicular and suggests remedial shoeing as next step!
 
Zoeypxo said:
Have you ever x rayed the neck?

Usually a lameness that wears off would be arthrtic changes but ive also had it with a soft tissue injury.
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Thanks for replying. No, we've xrayed her back but not her neck. Would the vet be able to do that at home or would we have to go in to the hospital? Does the 3 legged lameness suggest neck to you? It's difficult when the vet thinks they have found the answer - I suppose I could just ask her to humour me and xray the neck anyway?
 
Does she come sound on bute? If not it will be mechanical (suspensorys, feet etc) and not much you can do. Hind limb bilateral lameness will often cause lameness in front but usually only on 1 leg.
Dr Green will work wonders on horses who are mechanically lame and I often turn away for 5-12 months if able to and find they come back much better for it.
 
Mine rested one hind leg more than the other before showing any signs of lameness. It progressed to slight head nod in trot which wore off with work. It suddenly blew up into a massively swollen hock (suspect he twisted it or something) and Xray showed severe arthritis in one hock. The other was and remains fine. The vet and myself were astounded at his previous "only slightly lame in trot" and even with the huge hock it's only ever been about 2/10 lame in trot and he still tears around like a loon. Fully retired after a couple of years of light walk hacking.
 
LEC said:
Does she come sound on bute? If not it will be mechanical (suspensorys, feet etc) and not much you can do. Hind limb bilateral lameness will often cause lameness in front but usually only on 1 leg.
Dr Green will work wonders on horses who are mechanically lame and I often turn away for 5-12 months if able to and find they come back much better for it.
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We did do a bute trial but not much difference. She lives out most of the time (in for the very worst of the weather) and is unridden, so Dr Green has been a big feature of her life!
 
Landcruiser said:
Mine rested one hind leg more than the other before showing any signs of lameness. It progressed to slight head nod in trot which wore off with work. It suddenly blew up into a massively swollen hock (suspect he twisted it or something) and Xray showed severe arthritis in one hock. The other was and remains fine. The vet and myself were astounded at his previous "only slightly lame in trot" and even with the huge hock it's only ever been about 2/10 lame in trot and he still tears around like a loon. Fully retired after a couple of years of light walk hacking.
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Thanks, Landcruiser. Did yours show any reaction with flexions? Mine was reactive in front, but not in her hinds. If she had hock arthritis, would this show up on flexions? I'm quite willing to do more xrays if it helps find/eliminate things. I'm really scratching my head with this. I don't want to make a major decision to PTS without making sure it's not something that can be fixed.
 
Marigold4 said:
Thanks for replying. No, we've xrayed her back but not her neck. Would the vet be able to do that at home or would we have to go in to the hospital? Does the 3 legged lameness suggest neck to you? It's difficult when the vet thinks they have found the answer - I suppose I could just ask her to humour me and xray the neck anyway?
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Ive had them done at the yard before yes.
One horse in particular had neck arthritis at the base of his neck and had very odd presenting lameness. He would often look bilaterally lame behind, then a couple of times he was hopping lame infront for a few strides or when turning then it would dissapear for months.
 
Zoeypxo said:
Ive had them done at the yard before yes.
One horse in particular had neck arthritis at the base of his neck and had very odd presenting lameness. He would often look bilaterally lame behind, then a couple of times he was hopping lame infront for a few strides or when turning then it would dissapear for months.
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Thanks. That's useful to know. The case you describe hear, sounds a lot like my horse - I will investigate.
 
Zoeypxo said:
Ive had them done at the yard before yes.
One horse in particular had neck arthritis at the base of his neck and had very odd presenting lameness. He would often look bilaterally lame behind, then a couple of times he was hopping lame infront for a few strides or when turning then it would dissapear for months.
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Neck xray booked for Tuesday. At the very least, it will be good to at least rule out a neck problem in our search for an answer, but having googled neck issues, she does show some of the symptoms of a neck issue.
 
Marigold4 said:
Thanks, Landcruiser. Did yours show any reaction with flexions? Mine was reactive in front, but not in her hinds. If she had hock arthritis, would this show up on flexions? I'm quite willing to do more xrays if it helps find/eliminate things. I'm really scratching my head with this. I don't want to make a major decision to PTS without making sure it's not something that can be fixed.
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Blunt honesty here - what are your expectations?

A 15yo lawn mower who has kissing spine and is lame on at least 3 legs.

It’s really unlikely to be a single fixable thing. You could spend quite a large amount of money on imaging, likely inconclusive, because my money is on a multiple issue.

Are you going to put a retired horse through an extended box rest period or operate?

Have you considered saving your money and just experimenting with different painkillers to see what helps and gives her a better quality of life for however long is appropriate to keep her going?
 
ihatework said:
Blunt honesty here - what are your expectations?

A 15yo lawn mower who has kissing spine and is lame on at least 3 legs.

It’s really unlikely to be a single fixable thing. You could spend quite a large amount of money on imaging, likely inconclusive, because my money is on a multiple issue.

Are you going to put a retired horse through an extended box rest period or operate?

Have you considered saving your money and just experimenting with different painkillers to see what helps and gives her a better quality of life for however long is appropriate to keep her going?
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Point taken. But ... according to recent xrays, she doesn't have kissing spine - no processes touching and no white spots showing bone remodelling, and she has only fairly recently become lame. I'm definitely not going to spend huge amounts on this but xrays are not terribly expensive. I feel I owe it to her to go a little further with investigations. Definitely won't be MRI scanning or CAT scanning, no box rest or operations. Nothing wildly expensive or that can't be done at home. I'm just thinking that if it IS something like arthritis in the neck or hock, injections might sort this for a reasonable length of time and wouldn't break the bank. If we can't find a solution soon, I will admit defeat and go down the painkiller route. I haven't dosed her up yet because that would disguise her symptoms and I would like to get to the bottom of it, if I can. I won't leave her in pain though for very much longer and will use bute if we can't do anything else for her.
 
UPDATE: well, the vet came and x-rayed today. She's still 2/10s lame in her right front and a 1/10th lameness on left front and one leg behind. Her previous xrays showed navicular which could explain the front end lameness but nothing today to explain hind lameness. We xrayed neck, hocks and stifles and all looked very clean. Although expensive, I'm glad I have ruled a few things out and feel she can't be in too bad a way with xrays like that. No swelling or heat anywhere and no other abnormalities. So now we put her on danilon and increase the dose until she is comfortable. No more investigations. She is 15 and a retired broodmare, so as long as the danilon works and she is happy in the field, we will keep her going.
 
Bit of a long shot, but check closely for thrush. Not always smelly and weeping, sometimes it can show as damp patches around the frog, and shredding frog tissue. It is very painful, enough to make a horse tip weight forward and unweight the heels...which would start the navicular changes. Hope it one more thing you can rule out.
 
Thanks for replying, HMC. I had a good look around for thrush and asked vet and trimmer, posted some photos on another thread. Think her frogs are fine. She has thin sole (TB) though.
 
You saying bunny hopping in canter leads me to think maybe she is neurological, my wobblers horse did this.

However, if you ruled out neck with xrays then I'm none the wiser I'm afraid.
 
Birker2020 said:
You saying bunny hopping in canter leads me to think maybe she is neurological, my wobblers horse did this.

However, if you ruled out neck with xrays then I'm none the wiser I'm afraid.
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Yes, I've sometimes thought wobblers. She doesn't show any other neurological deficits though, and, as you say, neck xrays were clear. She's on pain medication now and we'll see how that goes.
 
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