Intermittent lameness - any ideas?

[Caramac71]

Firstly, apologies as I know there are a number of lameness related threads going on a the moment, but I wanted to post this and see if anyone had any ideas.

Daughters loan pony has been lame for 2 months. She has been seen by vet and next step is to take her in for further investigations if no improvement. However, as the vet has already said he thinks it will be incredibly difficult to diagnose, I wanted to get as much understanding as I can of her symptoms so that I can rely back to the vet whatever observations are useful.

So, pony looked slightly lame 2 months ago. Rested for a week, trotted up fine but once ridden she wasnt right. Spoke to the vet who recommended a couple more weeks rest, with daytime turnout as long as she was sensible, then see how she looked. Still unsound when ridden so vet came out. Did everything he could on the yard - trotted up on hard ground, lunged in school, watched her ridden, flex tests, checked for abscess. Basically she was 1 or 2/10 lame on left fore, slightly more obvious on soft surface and particularly when ridden. We were about to go on holiday so she had bute and rest for almost 3 weeks.

Returned from holiday, gradually started riding in walk, introduced trot on straight line and she looked great. I am no expert to say the least, I have no experience of lameness, but I could see when she wasn't right prior to our holiday and she looked fine to me (and felt fine to my daughter who rides her) when we came back.

Roll on a couple of days, and advice from vet, and at the weekend she increased trot work to around the arena. It is now evident that she has the odd stride that is still short - worse on the right rein (when leg is on outside) but noticeable enough on both reins that I can see it.

It is much more intermittent than previously when vet said she was 1 or 2/10 lame.

I need to call the vet in the next few days to discuss how it is going. The plan is that if she's not right, then she'll need to go in for diagnostics. However, when he saw her previously he said it was very frustrating as so mild and she wasnt lame enough to nerve block. Therefore I'm not really hopefully of a quick answer.

We have been assuming that the problem is some kind of soft tissue damage in left fore as there has been some swelling (but no heat) that comes and goes from the tendon sheath. And vet said generally the fact that she looked worse on soft ground could indicate soft tissue rather than bone. However, the swelling is very slight and very random, and vet now thinks we should possibly observe this but not worry to much about it. Sometimes she has slight swelling in both legs, and windgalls up on hinds, sometimes it is just in left fore, sometimes no swelling at all. Not consistent with being stabled as its usually down in the mornings when she's turned out, but sometimes up in the afternoons when she comes in.

Pony has had a few sessions of Bowen over the last year, and I did get the Bowen lady to give her a treatment when she was initially being rested as she loves her Bowen treatments and I thought it wouldnt do any harm, even if it did no good.

I'm wondering now whether to get someone out to check her back/shoulders before proceeding with scans or whatever diagnostics vet recommends to her leg. I just wondered how relevant it was that she is only noticeably unsound under saddle? I guess the weight of a rider will make any discomfort appear worse.

Pony is 15 years old, as a youngster she had ops in both hinds for stifle lock which has left her a bit stiff at times. She has a joint supplement and has managed really well in the 18 months + that we've loaned her. She has never been shod and she has regular trims.

So, before we go back to the vet, can anyone offer any ideas as to what this could be, or what to expect from further tests (as everyone seems to tell me of their ponies with vague symptoms that never showed up on diagnostics and never improved!). Am I wasting my time getting back investigated with these symptoms?

We're now coming into the 3rd month of her not being ridden, and with her being on loan to us we are getting to the stage of really needing to know a likely prognosis as there will then possibly be more decisions to be made. We really love this pony and want to do the right thing by her, as well as my daughter being able to continue what she loves doing.

 

[be positive]

1/10 lame is enough to nerve block, I had one done successfully last year that was less than that and we still managed a diagnosis by lunging on a firm surface where you could just about see it, if it shows best under saddle then that needs to be done when blocking.
Most lameness is in the foot so that would be where I would expect the vet to start, whether they can pin point the actual reason for such a slight lameness is more of an issue but it could be something simple such as a slight inbalance within the foot, xrays are worth doing anyway as at her age it could be a slight arthritic change within the coffin joint and treatable by injections, the swelling could be due to her standing trying to take the weight off the painful foot or a reaction to whatever is going on rather than the cause.

It is unlikely that it stems from the shoulder as most muscular problems would have resolved with what has been done so far but it would not hurt to get a proper physio out to look, although one of mine had shoulder pain that stemmed from his feet, feet sorted and the shoulders no longer get tight.

If she were mine I would ask for a basic work up, nerve blocks to the foot, then if she comes sound or improves xrays to see what is going on with the bones, if nothing shows then reassess where you go with it, if she is insured you can continue testing if not possibly a few months total rest turned away may help.

 

[be positive]

1/10 lame is enough to nerve block, I had one done successfully last year that was less than that and we still managed a diagnosis by lunging on a firm surface where you could just about see it, if it shows best under saddle then that needs to be done when blocking.
Most lameness is in the foot so that would be where I would expect the vet to start, whether they can pin point the actual reason for such a slight lameness is more of an issue but it could be something simple such as a slight inbalance within the foot, xrays are worth doing anyway as at her age it could be a slight arthritic change within the coffin joint and treatable by injections, the swelling could be due to her standing trying to take the weight off the painful foot or a reaction to whatever is going on rather than the cause.

It is unlikely that it stems from the shoulder as most muscular problems would have resolved with what has been done so far but it would not hurt to get a proper physio out to look, although one of mine had shoulder pain that stemmed from his feet, feet sorted and the shoulders no longer get tight.

If she were mine I would ask for a basic work up, nerve blocks to the foot, then if she comes sound or improves xrays to see what is going on with the bones, if nothing shows then reassess where you go with it, if she is insured you can continue testing if not possibly a few months total rest turned away may help.

 

[Caramac71]

Thank you for your reply, that's very helpful and I feel a bit more positive now.