Mystery left hind foot lameness – any insights

flying_high

Well-Known Member
Joined
5 February 2016
Messages
933
Visit site
Mystery left hind foot lameness – any insights

Horse which blocked to 3/10 lameness left hind foot (not main foot bones) at vet college in February 2018

Nothing showed up on x-ray, foot , scans or MRI to explain lameness. Conclusion was field injury, soft tissue not bad enough to show on MRI, rest, slow return to work over 3 months.

Same horse 1/10 lame on and off through 2018. We thought was an inherent weakness following on from using the leg post injury, and worked on cross training and strengthening.

December 2018 - Horse lost back muscle, and poor performance. 3 mild impinging spines on x-ray and bone scan. Nothing else on bone scan. Nerve blocking spine dramatic improvement. Injected spine with steroids, and extensive back strengthening rehabilitation. (Horse was 1/10 lame blocking to LH at this point, not investigated, scoped and no sign of historic ulcers returning).

I think LH lameness largely disappeared for next 6 months.

Horse has continued to show variable performance, intermittent napping, back and muscle soreness and is now back to 3/10 lame left hind, blocks to foot below fetlock.

Not sure where to go, horse isn’t insured, and I have spent last two years trying to get horse right. We’ve gold standard done teeth, diet, saddles, grass levels, back, chiro, sports massage, physio, foot balance. I can ride, and lunge and long rein to a reasonable standard, but there is something not right.

Vet suggests repeating all the previous LH diagnostics and seeing if something now shows up. But agrees may all not show anything. Sounds painful with the amount of debt I have and the issues not covered by insurance any more.

I think I have been chasing secondary symptoms – napping, saddle fit, sore back, sore muscles, over last 6 months, without finding the primary source of pain, when has now worsened again to being visible.

On the basis I wasn’t keen on immediate further diagnostics, the vet has prescribed a week of bute, 3 days off bute, week of slow limited hacking, re-assess.

I am a bit stumped, and very overdrawn!
 

piglet2001

Well-Known Member
Joined
21 March 2014
Messages
153
Visit site
I would be inclined to remove shoes and turn away for a year. You have tried everything and without bankrupting yourself options are limited. If it was mine and was still not right after a year off then tough decisions would have to be made.

Out of interest how old is the horse and what do you do with him?

Sorry it’s an awful situation to be in and so disheartening.

Sadly for some horses you just never do find the answer.
 

SEL

Well-Known Member
Joined
25 February 2016
Messages
12,304
Location
Buckinghamshire
Visit site
An acquaintance of mine has recently had a horse with odd body soreness test positive to Lyme. Mine goes lame when her liver enzymes play up. I'm not suggesting yours has either issue, more that "lameness" can be a result of something not leg related and extremely hard to track down. I presume you've ruled out myopathies? PSSM / RER are woefully underdiagnosed.

I also have one who has shown mystery lameness but with muscle soreness put down to PSSM until bloods proved otherwise. She's now had 6 months off and I think we'll got for steroids in the SI once the laminitis risk is reduced - but if that has no effect then I will have to resign myself to the fact that she's unlikely to be ridden again.
 
Joined
20 June 2019
Messages
10
Visit site
Thanks both. I’m assuming that lameness blocking specifically to below fetlock or foot 3 times means it has root in actual lameness?

My understanding being that the various strange conditions that can cause lameness to appear don’t typically result in soundness when lame leg is locally blocked, as actual pain source not in leg.

Hence thinking the issue is probably in my horse’s left hind foot.
 

flying_high

Well-Known Member
Joined
5 February 2016
Messages
933
Visit site
I would be inclined to remove shoes and turn away for a year. You have tried everything and without bankrupting yourself options are limited. If it was mine and was still not right after a year off then tough decisions would have to be made.

Out of interest how old is the horse and what do you do with him?

Sorry it’s an awful situation to be in and so disheartening.

Sadly for some horses you just never do find the answer.
I would be inclined to remove shoes and turn away for a year. You have tried everything and without bankrupting yourself options are limited. If it was mine and was still not right after a year off then tough decisions would have to be made.

Out of interest how old is the horse and what do you do with him?

Sorry it’s an awful situation to be in and so disheartening.

Sadly for some horses you just never do find the answer.
He’s 13. Owned 2 years. We’ve both competed to affiliated medium dressage but not together yet.


He’s not a great age to benefit from a year off. Prefer to keep bigger horses in regular work once hit teens. And I’m a bit cautious that if issue not recovered since February 2018 it might not. It’s not impossible but I’ve not got a straight forward way of doing that now in current set up.
 

flying_high

Well-Known Member
Joined
5 February 2016
Messages
933
Visit site
An acquaintance of mine has recently had a horse with odd body soreness test positive to Lyme. Mine goes lame when her liver enzymes play up. I'm not suggesting yours has either issue, more that "lameness" can be a result of something not leg related and extremely hard to track down. I presume you've ruled out myopathies? PSSM / RER are woefully underdiagnosed.

I also have one who has shown mystery lameness but with muscle soreness put down to PSSM until bloods proved otherwise. She's now had 6 months off and I think we'll got for steroids in the SI once the laminitis risk is reduced - but if that has no effect then I will have to resign myself to the fact that she's unlikely to be ridden again.

Thanks both. I’m assuming that lameness blocking specifically to below fetlock or foot 3 times means it has root in actual lameness?

My understanding being that the various strange conditions that can cause lameness to appear don’t typically result in soundness when lame leg is locally blocked, as actual pain source not in leg.

Hence thinking the issue is probably in my horse’s left hind foot.
 

Melody Grey

Well-Known Member
Joined
14 April 2014
Messages
2,099
Visit site
I think I’d be probably all out of trying to find a cause now, you’ve done and spent a lot! I’d suspect it isn’t a simple cause and fix given that lots of different approaches haven’t nailed it. I would try a barefoot rehab and see if you can get it hacking sound for a quieter life (potentially with someone else if that’s not your bag?)
 

ester

Not slacking multitasking
Joined
31 December 2008
Messages
60,198
Location
Cambridge
Visit site
He’s not a great age to benefit from a year off. Prefer to keep bigger horses in regular work once hit teens. And I’m a bit cautious that if issue not recovered since February 2018 it might not. It’s not impossible but I’ve not got a straight forward way of doing that now in current set up.

If he is lame though you can't keep him in regular work anyway. If I could I'd send him somewhere set up for that sort of life and reassess in a years time.
 

be positive

Well-Known Member
Joined
9 July 2011
Messages
19,396
Visit site
He’s 13. Owned 2 years. We’ve both competed to affiliated medium dressage but not together yet.


He’s not a great age to benefit from a year off. Prefer to keep bigger horses in regular work once hit teens. And I’m a bit cautious that if issue not recovered since February 2018 it might not. It’s not impossible but I’ve not got a straight forward way of doing that now in current set up.

I would turn away as he cannot be kept in proper work anyway but appreciate that is not an option for everyone so my middle ground would be to remove hind shoes, assuming he is shod, and do a couple of months rehab with him and see what the feet do with no real interference from a farrier trying to balance them, without doing yet more investigations you may not find the cause but this may give you a sound, or more lame horse, to allow you to move forward one way or another.
 

flying_high

Well-Known Member
Joined
5 February 2016
Messages
933
Visit site
If he is lame though you can't keep him in regular work anyway. If I could I'd send him somewhere set up for that sort of life and reassess in a years time.

He's not constantly lame, but this is third time going lame blocking to same hind foot.

He's currently lame (or was Wednesday and Friday when assessed). Is now having a week on bute, 3 days off bute, 7 days of 30 minutes walk hacking, with minute episodes of trot building. Reassess.

It is possible the lameness will not be visible at this point. When I guess I re up the work slowly and see what happens.

I am pretty sure current lameness will become not visible in a few weeks / months, but vet suspects is an underlying on going pain issue, which is the problem.
 

flying_high

Well-Known Member
Joined
5 February 2016
Messages
933
Visit site
I would turn away as he cannot be kept in proper work anyway but appreciate that is not an option for everyone so my middle ground would be to remove hind shoes, assuming he is shod, and do a couple of months rehab with him and see what the feet do with no real interference from a farrier trying to balance them, without doing yet more investigations you may not find the cause but this may give you a sound, or more lame horse, to allow you to move forward one way or another.


It is an option, to my eye he’s not got particularly interesting hind feet. Balance and x-rays fairly good, not thin soles / sensitive feet, doesn’t lose shoes, but not bothered if did behind. Farrier commented last visit, he is over weighting front feet, to take weight off hind feet.
 

ester

Not slacking multitasking
Joined
31 December 2008
Messages
60,198
Location
Cambridge
Visit site
No I did understand he wasn't constantly lame but after 3 times and limited funds I'd opt for a clear break rather than go round the same cycle again.

I was concerned about F having so long unridden when he was 19 (so although small- a lot older) but it seemed to do him the world of good - about 6 months all in.
 

HashRouge

Well-Known Member
Joined
16 February 2009
Messages
9,254
Location
Manchester
Visit site
To be fair, 13 is really not that old. I certainly wouldn't have any concerns about giving a horse that age six months off. Not saying that is necessarily what you should do, but if the only thing holding you back is his age, I really don't think you should worry about it.
 

flying_high

Well-Known Member
Joined
5 February 2016
Messages
933
Visit site
To be fair, 13 is really not that old. I certainly wouldn't have any concerns about giving a horse that age six months off. Not saying that is necessarily what you should do, but if the only thing holding you back is his age, I really don't think you should worry about it.

It isn’t the only thing holding me back, but it is one, as he’s a fairly high mileage teenage horse and has had impinging spines, I worry that the lack of regular work and back lifting work, might cause increased arthritis and his impinging spine to worsen.

I don’t know a good set up to turn him away for 6-12 months, I’d want to find good full grass livery herd, on well draining land, ideally on a slope and with good care. But I have transport, and could hopefully find something with enough searching.

He’s also not an easy horse to settle in a new environment, and despite me being a person who has previously had fully clipped competing horses wintering out, I am not absolutely certain this horse would be happy to winter out. He’s bit marmite about turnout and weather. He wants to be OUT until he wants to be IN!

I also have a gut feeling turning him away is just pushing the problem further down the line but not fixing it. If we knew he had a specific soft tissue injury, and 12 month rest might help, then absolutely. But we don’t know the issue is soft tissue, vet mentioned various things including “bone cysts in some locations don’t show up”. It’s guess work.

Plus there is a fairly big wait list for my current 7 day part livery space, so I’d need to make a decision on that.
 

ycbm

Einstein would be proud of my Insanity...
Joined
30 January 2015
Messages
56,550
Visit site
Given the history, my money would be on something very subtle going on which doesn't show on the scans which is affected by minute changes in foot balance in the shoeing/trimming cycle.

If he is shod, I would give him one last try by taking off the hind shoes and letting him grow whatever bizarre shaped foot he chooses, to see if he can stabilise the balance for himself. Ditto if he is trimmed, I would stop the trimming.


..
 

flying_high

Well-Known Member
Joined
5 February 2016
Messages
933
Visit site
Given the history, my money would be on something very subtle going on which doesn't show on the scans which is affected by minute changes in foot balance in the shoeing/trimming cycle.

If he is shod, I would give him one last try by taking off the hind shoes and letting him grow whatever bizarre shaped foot he chooses, to see if he can stabilise the balance for himself. Ditto if he is trimmed, I would stop the trimming.
..

Hmmm I wonder if I can plot the highs and lows against shoeing cycle dates.
 

ycbm

Einstein would be proud of my Insanity...
Joined
30 January 2015
Messages
56,550
Visit site
Hmmm I wonder if I can plot the highs and lows against shoeing cycle dates.


I did wonder if you could. And don't forget that growth slows in winter and it might not happen at all when growth is particularly slow.

.
 

flying_high

Well-Known Member
Joined
5 February 2016
Messages
933
Visit site
Hmmm not really conclusive.

There isn't a clear pattern of getting worse just after shod, or worse when due to be shod. It doesn't look like any connected pattern. Though I don't have absolute record of how he went, and remember this significant highs and lows, and the diary events / lessons / competing etc. is documented.
 

MrsNorris

Well-Known Member
Joined
1 January 2006
Messages
1,301
Visit site
Agree with ycbm, my older horse has an old injury to his right hind from years ago, if he’s kept barefoot and left to his own devices, his feet look hideous but he’s sound. When he’s trimmed so that his feet look normal, he goes lame. It’s definitely worth a try..
 

flying_high

Well-Known Member
Joined
5 February 2016
Messages
933
Visit site
Spoken to farrier who thinks new type shoes behind next week and pads. He thinks he wants to land to outside edge of foot. Current shoes stop this but create jar. It isn't that visible within balance x-rays as he's rebalanced and shod frequently, so doesn't go that far out of balance.

Possible new shoes are new design, and he’d bevell outside and have shock absorbing pads. Idea being to get closer to landing horse wants and keep it within correct parameters. Shoes would be w...ider behind and have more heel support. Suggested that the issue showing again now due to harder ground.

And that maybe reason nothing show up on diagnostics, is there isnt anything to see, but that it's a kind of jarring. Something like that ...?

Might be a new avenue to follow up? Landings and balance? Is there a way follow this up further?

Farrier did also say absolutely not to taking his hind shoes off, because he lands to the outside, and would crush the structures of his feet, and quickly wear the outsides of his feet. And he's not anti barefoot per say.

I cant help wondering where the root cause of landing to the outside of his hind feet comes from and if that can be fixed?
 

Regandal

Well-Known Member
Joined
5 August 2011
Messages
3,387
Location
Perthshire
Visit site
I doubt he would crush any structures, just grow flare to balance himself.
I have one here who I have to rasp only on the inside of each front foot as he leans to the outside.
 

ycbm

Einstein would be proud of my Insanity...
Joined
30 January 2015
Messages
56,550
Visit site
Farrier did also say absolutely not to taking his hind shoes off, because he lands to the outside, and would crush the structures of his feet, and quickly wear the outsides of his feet. And he's not anti barefoot per say.

I cant help wondering where the root cause of landing to the outside of his hind feet comes from and if that can be fixed?


All barefoot horses, almost without exception of you watch on slomo, put the outside of the hind foot down first. This action is so normal it could even be classed as desirable.



.
 
Top