KS and now back to PSSM!

[Feral]

Hi,

So in May I was convinced my mare had PSSM, lots of symptoms - was lame both front feet one minute and then stiff across back end the next, reluctant to move under saddle. Tested for PSSM 1 which came back negative. I did try the diet for 4 weeks (I have now been told this was not really long enough)

Anyway, through June and July she has been ok especially in walk but trot still looked 'off' - she was xrayed and vet found slight KS - nothing major but vet seemed to think this was the issue. She went in for the KS injection 3 weeks ago and was put on a very bare paddock a few days before and stayed in their for two weeks after as I was worried about the steroids triggering laminitis.
Two days after the injection she was noticeably looser on her front end, moving from the shoulder and I was feeling positive that their was a change!
We followed a rehab plan with long reining over poles for two weeks until Physio could get to me. She was doing great! Bits of trot on the long reins and was looking the best ever.

5 days ago I had to move her into a bigger paddock, grass was still worn down alot and more weeds so not alot for her to eat (I really struggle to maintain her weight)

Physio came out on Tuesday this week and I was expecting to get the go ahead to ride her!
I brought her in from field on the morning to dry off (she had been out unrugged overnight and the day before in torrential rain) - she was lying down in stable just before physio got there and when I got her up and led her out of her stable she could barely move. Very mechanical, stiff, presenting as a laminitic! - basically back to the way she was in May - all on front end but fine on her back end!
We took her into indoor arena and she did walk alot of the stiffness off but still very mechanical in the way she was moving.

Physio was there for 2.5 hours and found no major problem areas and was not convinced she was presenting as a horse with KS issues. She mentioned PSSM herself (This was before I mentioned I had had her tested for pssm1) and said she was presenting strongly as a horse with PSSM.

Long story short, she is now rugged up and I am slowly starting the PSSM diet again
My vet is not having any of the PSSM and ruled it out immediately when I mentioned it a few months ago and wants to go for a bone scan as the next step - Physio does not think a bone scan will show anything.

Does anyone else agree that this is mostly looking like PSSM now?

Really thought we were getting somewhere two weeks ago.

 

[ycbm]

I think you haven't ruled out laminitis yet. A very bare paddock improved her. A less bare paddock made her worse again. Stiff in front and less behind would not fit classic PSSM assumptions, but it does lami. I would also have expected to see some change in 4 weeks on very high vitamin E. Has she been tested for Cushings?
.

 

[Feral]

I think you haven't ruled out laminitis yet. A very bare paddock improved her. A less bare paddock made her worse again. Stiff in front and less behind would not fit classic PSSM assumptions, but it does lami. I would also have expected to see some change in 4 weeks on very high vitamin E. Has she been tested for Cushings?
.

Yes, she has been tested for Cushings and EMS which both came back well within normal levels.
She has no heat or pulses and can turn tight circles fine.

Farrier is due today so I will also get him to check her again to see if he thinks there is anything showing (he has pinch tested her previously with no reaction)
She has also had feet xrays which showed negative palmar angles which I am working with farrier to correct - however, the lameness is up and down with some days more back end stiffness and others both fronts or one front.

5 minutes after physio left I turned her out in field, he friend was not out and she trotted and cantered around perfectly sound with the biggest show off trot ever.

This mare has just got me baffled.

 

[ycbm]

Are you insured? A bone scan would be a good idea if you are, but meanwhile you can just get her on masses of vitamin E, and i would try alcar as well, and if that works you'll have your answer.
.

 

[Feral]

Are you insured? A bone scan would be a good idea if you are, but meanwhile you can just get her on masses of vitamin E, and i would try alcar as well, and if that works you'll have your answer.
.

No, not insured.... stupid I know!
Ive only owned her since last year, purchased as a just backed 4 year old so did not think to insure her until she was in ridden work

 

[ycbm]

I wouldn't pay to scan her before testing 10,000iu a day of natural vitamin E and a range of amino acids and oil.
.

 

[ihatework]

I think if you got a positive reaction to the KS injection this is telling.

But if the KS scanned mild then my money is on it being a result of the horses posture.

Horses adapt to pain in a variety of ways and what you are describing could be a muscle disorder but could also be laminitis or orthopaedic.

Given your horse carries weight I’d manage grazing as a laminitic. But in parallel I’d try the PSSM diet and keep her back warm.