Is it SI pain? Horse is becoming a mystery to the vets

Joined
4 January 2015
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34
Hi everyone,
apologies in advance for this being a long one.

About 5/6 months ago, my boy started bucking uncontrollably in canter, then trot, then walk, to the point he was unrideable. We think a bit of this behaviour was down to the management he was receiving at the yard, and was having very limited turnout which probably exaggerated the behaviour.

He had suspensory and sacroiliac nerve blocks - no real improvement there, or not enough for the vet to say, "yes, that's the problems". Hock x-rays, suspensory x-rays & spine x-rays all showed nothing. Vet referred him to Newmarket Equine Hospital. He was bi-laterally lame when lunged on both soft and hard surfaces, and slightly when trotted in a straight line. He had a bone scan, which showed some slight inflammation on the ligaments on the spine and some mild inflammation in the hocks. But no kissing spine, nothing flagged up in the SI region. They nerve blocked the hocks, which made him sound. They medicated them and sent him on his way, with 6 weeks lunging walk/trot, long and low, help him to strengthen his back.

After 6 weeks, I got back on - no difference, infact was probably even more unrideable. The vet put this down to psychological issues. Flash forward a few weeks, I wanted him scoped for ulcers. Very mild glandular ones were found - but vet didn't think they were severe enough to be causing these symptoms.
We moved him to a professional schooling yard, to see if it is purely psychological. He's now rideable, walk/trot and canter under saddle and hacks out at walk and trot. But he still seems uncomfortable at the canter under saddle (albiet no where near as worse as he was) and they seem to think that the canter would have completely improved by now if it was purely mental.

In the canter undersaddle, occasionally does bunny hop strides, occasionally goes disunited behind, does mini bucks, struggles most on the right rein (and is often more sore on the right side when the physio comes), always has been reluctant to take a contact/work on the bit, finds it hard to put on muscle, struggles being shod behind (e.g. standing on one hind leg for long periods of time etc. he also struggles to travel, loads absolutely fine, but travels appallingly). Palpates sore over lower back and SI region and is very tight in that area. He's sound on the lunge and looks really well in all 3 paces. He's had a new saddle fitted, which hasn't really made a difference.

Everyones at a bit of a loss really, vet came out again, and decided to medicate the hocks again to rule out that its definitely not those - as we know they were causing low-grade pain at one point. If there is no improvement in the next 2 weeks, hes going to inject the SI joint - despite it never flagging up in any tests/scans.

Does it sound like SI problems? What were your horses symptoms? He's turning into a complete mystery He has regular physio, in fact she was the one who mentioned getting the vet out.

Sorry for this being sooooo long. Thanks in advance
 
Joined
4 January 2015
Messages
34
Hi everyone,
apologies in advance for this being a long one.

About 5/6 months ago, my boy started bucking uncontrollably in canter, then trot, then walk, to the point he was unrideable. We think a bit of this behaviour was down to the management he was receiving at the yard, and was having very limited turnout which probably exaggerated the behaviour.

He had suspensory and sacroiliac nerve blocks - no real improvement there, or not enough for the vet to say, "yes, that's the problems". Hock x-rays, suspensory x-rays & spine x-rays all showed nothing. Vet referred him to Newmarket Equine Hospital. He was bi-laterally lame when lunged on both soft and hard surfaces, and slightly when trotted in a straight line. He had a bone scan, which showed some slight inflammation on the ligaments on the spine and some mild inflammation in the hocks. But no kissing spine, nothing flagged up in the SI region. They nerve blocked the hocks, which made him sound. They medicated them and sent him on his way, with 6 weeks lunging walk/trot, long and low, help him to strengthen his back.

After 6 weeks, I got back on - no difference, infact was probably even more unrideable. The vet put this down to psychological issues. Flash forward a few weeks, I wanted him scoped for ulcers. Very mild glandular ones were found - but vet didn't think they were severe enough to be causing these symptoms.
We moved him to a professional schooling yard, to see if it is purely psychological. He's now rideable, walk/trot and canter under saddle and hacks out at walk and trot. But he still seems uncomfortable at the canter under saddle (albiet no where near as worse as he was) and they seem to think that the canter would have completely improved by now if it was purely mental.

In the canter undersaddle, occasionally does bunny hop strides, occasionally goes disunited behind, does mini bucks, struggles most on the right rein (and is often more sore on the right side when the physio comes), always has been reluctant to take a contact/work on the bit, finds it hard to put on muscle, struggles being shod behind (e.g. standing on one hind leg for long periods of time etc. he also struggles to travel, loads absolutely fine, but travels appallingly). Palpates sore over lower back and SI region and is very tight in that area. He's sound on the lunge and looks really well in all 3 paces. He's had a new saddle fitted, which hasn't really made a difference.

Everyones at a bit of a loss really, vet came out again, and decided to medicate the hocks again to rule out that its definitely not those - as we know they were causing low-grade pain at one point. If there is no improvement in the next 2 weeks, hes going to inject the SI joint - despite it never flagging up in any tests/scans.

Does it sound like SI problems? What were your horses symptoms? He's turning into a complete mystery He has regular physio, in fact she was the one who mentioned getting the vet out.

Sorry for this being sooooo long. Thanks in advance
Oh I forgot to add, he also had an ultrasound of his suspensories, which came back fine.
 

ycbm

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Joined
30 January 2015
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17,743
About all that's left that that wouldn't have shown up on what you've had done so far is a very deep muscle strain in the hind quarters, or just possibly in the shoulders showing up as transferred in soreness at the back end. I would, myself, turn the horse away for six months and then see what I had got, and is still lame, PTS. I'm sorry if this is not what you need to hear, it's a tough one when the vets can find nothing.

Have the standard neuro tests been done? I can imagine a wobbler giving the symptoms you describe.
 

TPO

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Kinross
Were the ulcers treated and was there a follow up scope to see if they'd improved/healed?

It could be 101 different things but you've ticked all the major checks off the list. Does physio have any ideas as to what she thinks it is/she can feel when treating him? You said he's sore to palpate and tight; are there any changes after the (course of) physio treatments?

Is vet an equine vet? Could it be worth getting a full work up by a specifically competition vet?

Have you tried turning away for any length of time in case it is "just" a strained deep muscle?

What are the surfaces like that he is being lunged on and how much lunge work is he doing? Are any lunging aids (eg Pessoa) being used?

If he's "sound on the lunge and looks really well in all 3 paces" then it would point at being saddle and/or rider related if that described canter behaviour only happens under saddle. The bunny hopping, bucks and disunited would tend to indicate SI but I'm not a vet...

Have you done a bute trial?

Does he trot up sound on hard ground when he's sound on a circle on a surface? Who is saying he's sound; vet, you, yard peeps? I don't mean that to sound bad but I've been on yards where they have been lame horses and heard the owner tell physio that they are "sound" and said physio not do any dynamic observation. Just meaning one person's "sound" isn't always accurate. No offence meant, no idea of the experience of any of the people involved, I just know I can stare at a horse until a perfectly sound horse starts to look off!
 

Leo Walker

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This is where you need Rob Jackson or Tom Beech. They are both osteopathic vets and have saved more than a few that conventional vets have written off. They are my go to for anything not quite right or anything that has vets stumped.
 
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bubsqueaks

Active Member
Joined
16 July 2015
Messages
240
Hi everyone,
apologies in advance for this being a long one.

About 5/6 months ago, my boy started bucking uncontrollably in canter, then trot, then walk, to the point he was unrideable. We think a bit of this behaviour was down to the management he was receiving at the yard, and was having very limited turnout which probably exaggerated the behaviour.

He had suspensory and sacroiliac nerve blocks - no real improvement there, or not enough for the vet to say, "yes, that's the problems". Hock x-rays, suspensory x-rays & spine x-rays all showed nothing. Vet referred him to Newmarket Equine Hospital. He was bi-laterally lame when lunged on both soft and hard surfaces, and slightly when trotted in a straight line. He had a bone scan, which showed some slight inflammation on the ligaments on the spine and some mild inflammation in the hocks. But no kissing spine, nothing flagged up in the SI region. They nerve blocked the hocks, which made him sound. They medicated them and sent him on his way, with 6 weeks lunging walk/trot, long and low, help him to strengthen his back.

After 6 weeks, I got back on - no difference, infact was probably even more unrideable. The vet put this down to psychological issues. Flash forward a few weeks, I wanted him scoped for ulcers. Very mild glandular ones were found - but vet didn't think they were severe enough to be causing these symptoms.
We moved him to a professional schooling yard, to see if it is purely psychological. He's now rideable, walk/trot and canter under saddle and hacks out at walk and trot. But he still seems uncomfortable at the canter under saddle (albiet no where near as worse as he was) and they seem to think that the canter would have completely improved by now if it was purely mental.

In the canter undersaddle, occasionally does bunny hop strides, occasionally goes disunited behind, does mini bucks, struggles most on the right rein (and is often more sore on the right side when the physio comes), always has been reluctant to take a contact/work on the bit, finds it hard to put on muscle, struggles being shod behind (e.g. standing on one hind leg for long periods of time etc. he also struggles to travel, loads absolutely fine, but travels appallingly). Palpates sore over lower back and SI region and is very tight in that area. He's sound on the lunge and looks really well in all 3 paces. He's had a new saddle fitted, which hasn't really made a difference.

Everyones at a bit of a loss really, vet came out again, and decided to medicate the hocks again to rule out that its definitely not those - as we know they were causing low-grade pain at one point. If there is no improvement in the next 2 weeks, hes going to inject the SI joint - despite it never flagging up in any tests/scans.

Does it sound like SI problems? What were your horses symptoms? He's turning into a complete mystery He has regular physio, in fact she was the one who mentioned getting the vet out.

Sorry for this being sooooo long. Thanks in advance
Our pony had glandular ulcers grade 2 - apparently they are the worst type to treat & cause the most pain reaction - ours was showing none of the classic ulcer signs of girthiness etc but he did show signs of disunited behind, struggling with contact, struggling with right rein, & finally ended in explosive bronking!
He is currently turned away following 4 scopes & one years treatment not curing ulcers.
Looking back at videos, photos, there were also quite obvious signs of him being in pain from his facial expression which is used as a diagnostic tool & is a very telling sign the horse is in pain somewhere as though they are grimacing.
I am now very very suspicious about if our saddle had quite an impact on his pain too.
All the symptoms you describe can also be for hind gut ulcers/issues.
I am very surprised your vet has dismissed the ulcers - did he grade them?
 

bubsqueaks

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16 July 2015
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240
Just found this from The Osteopathic Vet - so very very true

The Tipping Point: Performance Issues In Horses
Some performance issues can be related to a single incident. If this is dealt with promptly the horse can return to being happy, healthy and in active work.
However, a lot of cases that are presented to me are actually an accumulation of many "incidents" or issues that have gone unnoticed. In a lot of these cases I will find a horse to be close to it's "TIPPING POINT".
By this I mean that it has so many layers of issues that it has tried to deal with that when you add them all up it brings the horse close to a threshold. Any further issue that is created sends the horse over this threshold and then strong reactions are seen.
The closer the horse is to its threshold the more sensitive the horse will be.
You may notice that your horse is more anxious; it may colic or ulcer easily; it may head shake; it may regularly throw tendon problems for example. Basically it will feel as though your horse will "over-react" either physically or emotionally to everything.
Some of the layering issues could be resulting from injuries, riding style, saddle, tack, dentistry, genetics, hoof care/farriery, diet etc.
In these cases it is so important to make sure THE WHOLE HORSE is evaluated and considered.
When the horse is presented to me it is key to not only listen to what the owner considers to be the horse's main problem BUT look at THE WHOLE picture to see what problems have been layering up to get to this point.
With this in mind these cases will usually need to be treated and managed from multiple angles via multiple modalities. Again, it is why a WHOLE HORSE approach is important.
By removing as many compounding issues as possible you bring the horse away from it's "threshold" meaning that it can deal with situations without easily passing over its threshold. It allows the horse more of a buffer to stay happy and healthy.
 

hopscotch bandit

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Just out of interest has his neck been ruled out? I assume the bone scan was for the whole body and not just the back and hocks?
 
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pastit

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5 August 2016
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Agree you need a specialist. If the vet's coming back out, I would ask him to check for a bean, just to rule that out. They are more common in geldings that you would suppose and one horse that I had showed none of the classic symptoms.
 

hopscotch bandit

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The bunny hop in canter, the difficulty whilst travelling and the difficulty balancing on one hind leg with farrier could all indicate problems with the neck. I wondered if the horse was sore in the neck as a result of pulling back whilst tied up, or maybe a fall in the field onto the neck? That's what I'd be investigating. That's why I wondered if the bone scan had ruled this out?
 
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Were the ulcers treated and was there a follow up scope to see if they'd improved/healed?

It could be 101 different things but you've ticked all the major checks off the list. Does physio have any ideas as to what she thinks it is/she can feel when treating him? You said he's sore to palpate and tight; are there any changes after the (course of) physio treatments?

Is vet an equine vet? Could it be worth getting a full work up by a specifically competition vet?

Have you tried turning away for any length of time in case it is "just" a strained deep muscle?

What are the surfaces like that he is being lunged on and how much lunge work is he doing? Are any lunging aids (eg Pessoa) being used?

If he's "sound on the lunge and looks really well in all 3 paces" then it would point at being saddle and/or rider related if that described canter behaviour only happens under saddle. The bunny hopping, bucks and disunited would tend to indicate SI but I'm not a vet...

Have you done a bute trial?

Does he trot up sound on hard ground when he's sound on a circle on a surface? Who is saying he's sound; vet, you, yard peeps? I don't mean that to sound bad but I've been on yards where they have been lame horses and heard the owner tell physio that they are "sound" and said physio not do any dynamic observation. Just meaning one person's "sound" isn't always accurate. No offence meant, no idea of the experience of any of the people involved, I just know I can stare at a horse until a perfectly sound horse starts to look off!
Does the horse ever stand with a slightly toe in stance on either fore leg ?
Interesting! Got a horse with very similar issues apart from hocks and they have a toe in stance but not pigeon toed either
 

Northern

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28 February 2013
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Following as my mare is presenting with very similar symptoms (albeit milder, no bucking just not comfortable under saddle and almost lame to the left). Bunny hopping and disuniting had all but disappeared. I believe she may have stacked it in the paddock because her symptoms came on pretty much overnight. I treated her for ulcers, had a chiropractor see her and she had 4 weeks off on hay only over our summer. Much improved thereafter but there is still a niggle somewhere. Vet yesterday reckons stifles or hocks, so she will be having a full workup in a few weeks. Mooching around out of work until then!

Did you actually treat the ulcers? Maybe it is worth trying that again, given he has issues on the right rein at the canter which seems typical. I know how frustrating it is, and I dread what we might find with my horse, she's only 6 :(
 
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OP, the symptoms described match those of one that I had with stifle problems. If the stifles have not been investigated, it would be worth exploring.
 
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