Lower Hind Limb Lameness

[sassandbells]

Just wondering if anyone has any thoughts or ideas or suggestions of what to do next with my mare who’s been mildly lame for a few months. She’s not the most cooperative patient so it’s taken a little while for us to get anywhere.

7 year old, Welsh D x ID mare - not wanting to compete but mainly hack & have a bit of fun

Initial consult with vet in May due to poor performance in the school, was still happy out hacking. Struggling to bend on the right rein in trot & canter. Would go disunited in canter on the right rein. Started “randomly” refusing small, simple jumps.

Had saddle fitter who said left flocking had compressed significantly more than right.

Initial vet consult was positive LH on flexion, but lameness was barely there on trot up or lunging. 4/10ths lame under saddle.

Second vet trip, this time 2/10ths lame under saddle, 3/10ths lame on trot up so significantly worse despite a month off. Nerve blocked stifle & hock (vets thought typically presenting with stifle issues) with no improvement.

Third vet trip, 3/10ths lame on trot up, nerve blocked fetlock down, improvement to 1/10th lame in trot, a lot freer movement in walk. Xrayed fetlock, pastern & hoof. My vet saw a couple of changes but these were replicated on the opposite limb so referred to specialist at liphook for review, I’ve heard back today and apparently X-rays are normal with nothing significant showing & angles are all good. My vet did say when trying to put her foot down on the pad to xray she was reluctant to put her foot flat.

Next steps have been suggested as either ultrasound scan of the RH lower limb to see if anything is highlighted (roughly £250) or go to Liphook for an MRI (roughly £1500). I don’t know what to do. There is enough left on insurance to do both but then it depends on what is found as to how much we can do the other end of it. That is also if the insurance will cover it which I need to check..

I feel awful as she is such a sweet mare and I’d love to just get an answer. I guess I’m worried about going for the ultrasound and then not finding anything and her having to go to liphook as she seems to throughly hate the investigations and is requiring a lot of sedation to be even slightly amenable. But I also don’t know want to send her to Liphook if the ultrasound might find something? Vet said to think about it but after a recent break up from a long term partner, huge changes at my job & being in the process of buying a house I just feel really overwhelmed and I don’t know what to do.

If she can never be ridden again I don’t mind as she’s such a lovely character and she appears very happy in the field, but as she’s so young I’m just a bit heartbroken. Any advice or rational thoughts would be appreciated. Thank you.

 

[SEL]

If I had my time again with my now retired Appy I would have gone for the MRI while I still had the insurance. The vets kept telling me it was unnecessary but I think the piecemeal approach they took was unhelpful. She was the same age as yours when we first started investigating and has now spent more of her life retired than in work.

She was a horror for the vets because they kept doing flexion tests on an obviously uncomfortable horse so she started kicking at them. I think an MRI earlier in the process would have been helpful but I ran out of money in the end.

I hope you get to the bottom of whatever is going on - it's so stressful

 

[sassandbells]

If I had my time again with my now retired Appy I would have gone for the MRI while I still had the insurance. The vets kept telling me it was unnecessary but I think the piecemeal approach they took was unhelpful. She was the same age as yours when we first started investigating and has now spent more of her life retired than in work.

She was a horror for the vets because they kept doing flexion tests on an obviously uncomfortable horse so she started kicking at them. I think an MRI earlier in the process would have been helpful but I ran out of money in the end.

I hope you get to the bottom of whatever is going on - it's so stressful

Thank you, I think that’s where my mind is heading. I just want to know now as she deserves to be happy but I don’t want to put her under extra procedures unless they’re likely to get results. I guess I’m also worried in case the MRI doesn’t highlight anything significant.. or on the flip side in case it finds something awful

 

[Birker2020]

Thank you, I think that’s where my mind is heading. I just want to know now as she deserves to be happy but I don’t want to put her under extra procedures unless they’re likely to get results. I guess I’m also worried in case the MRI doesn’t highlight anything significant.. or on the flip side in case it finds something awful

Sometimes it's better to get a diagnosis even though it might not be what you want to hear than to wonder for ever and a day and worry.

At least it will put your mind at rest and you can move forward having made a plan. Wish you the best.

 

[Melody Grey]

There are similarities in what you say with when mine broke down with bilateral hind PSD. Get the suspensories scanned if you haven’t already as it’s quick, easy and inexpensive. I would MRI while you have the opportunity under insurance if that doesn’t bring answers.

Mine had NPA in the hind feet but also a ligament strain in one front foot thought to be compensatory damage from the diagonal hind where the PSD was worse… we found that through MRI…..just making me wonder with the reluctance to place the foot flat whether you might have a similar issue?

 

[Pinkvboots]

Thing is the initial problems as in disunited in canter and not bending could indicate something else like suspensories, si joint back pain so I would ask your vet about that also, I'm guessing they will mri the foot and lower leg which there maybe an issue as well but I would look into other possibilities going by her initial symptoms.

 

[sassandbells]

There are similarities in what you say with when mine broke down with bilateral hind PSD. Get the suspensories scanned if you haven’t already as it’s quick, easy and inexpensive. I would MRI while you have the opportunity under insurance if that doesn’t bring answers.

Thing is the initial problems as in disunited in canter and not bending could indicate something else like suspensories, si joint back pain so I would ask your vet about that also, I'm guessing they will mri the foot and lower leg which there maybe an issue as well but I would look into other possibilities going by her initial symptoms.

Thank you, I had considered suspensories as she’s quite straight through the hock - the vet did a block on the lower part of the hock and said that if it was likely to be a suspensory issue then that should have shown some improvement? Although I guess it doesn’t rule out the lower branches… ? Never had anything to do with PSD before so I don’t really know how it all works!

 

[sbloom]

Straight ess in the hock can be a sign of postural issues, those angles soften as posture improves, and so often lameness is the result of a compensatory movement pattern ie poor posture or similar.

I can't advise directly on what to do, but it may be worth having your hand held with someone like Encompass Equine Solutions. She has online offerings and I'm sure would offer an advice service to help you make decisions in this context. She's never one to turn away from vet treatment when needed but also will look at the underlying cause.