Nerve blocks made him worse - ideas?

Bedlam

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I'll say at the start that my horse has been referred to AHT for a bone scan and to be assessed by Sue Dyson, but just thought I would ask on here to see if the font of knowledge can shed any light or give us any ideas.......

He's an eventer that has successfully competed up to 2* but didn't have the speed or ability to go much further so we bought him fully fit and competing for my reasonably competent daughter to have a crack at JRNs (or whatever they are now...). His dressage has never been his strong point, but we bought him for safety xc. First few times out very successful - low 30s dressage and lots of clears. Things slowly have been going downhill dressage and jumping wise culminating in a 48.5 dressage, 20 SJ faults and and daughter retiring xc because he wasn't taking her and was knocking every fence.

We have had ACPAT physio - slight stiffness in left shoulder - nothing significant. EDT - slightly sore on bars of mouth so changed bit, but no real issues with teeth (seen every 6 months anyway). Saddler - needed to change dressage saddle as a little too narrow, but nothing huge - saddle now custom fit.

He tends to stand with his hind feet up on his stable banks and also on the raised bit of gravel by the gate in his field. He has started to be difficult to load - never an issue before. He began bucking in canter whether long and low or up and collected. I've had 2 different pro riders school him and he bucks with both (dressage and event rider).

So - vet called. No lameness to write home about on the flat or when lunged on soft or hard. Definite objection to canter ridden. X-rays all basically clean hind fetlock, hind hock, slight, miniscule abnormality on near stifle, not enough to cause huge problems, right stifle clean. All dorsal processes well spaced. No heat or swelling anywhere.

Now the puzzling bit - nerve blocked both hind suspensories. Horse wouldn't canter and displayed new reluctance to trot - bucking and kicking out when asked and pushed forwards. Nerve blocked SI - absolute refusal to move forwards in walk - hunching and bucking and kicking when forced. So the nerve blocks made him progressively worse...??

Waiting for referral, and trust my equine vet, just wondered if anyone had any similar experience....? He's an honest genuine boy with no behavioural issues or vices up to now - a real sweetie.
 

flintfootfilly

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Sorry to hear about your horse. I don't have any suggestions, really, but just wanted to say that if anyone can get to the bottom of what's going on, it will be Sue Dyson. She was very thorough with 2 horses I've taken to her, and was able to find exactly what was going on with each of them.

I have a feeling that standing with certain feet on raised ground may be indicative of something, but I can't remember what. If I find the reference to this, I'll add another post..... or someone else may know maybe.

The only thing I know about nerve blocks is that they can help to uncover when a horse is lame in more than one leg/area. So for example one of my horses was just reluctant to go forward. Nerve blocking one leg revealed that she was lame on the equivalent leg on the other side, so actually we were looking at her being lame in at least two legs. So I'm guessing that your horse's response to the nerve blocks will mean something to SD straight away.

SD started with a bone scan on both horses I took to her. And although it's expensive, it was well worthwhile, as it gives a good picture of any likely problem areas.

Hope she's able to help you and your horse.

Sarah
 

amage

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Sounds like my lady earlier on this summer and she had aggravated both hind suspensories. Steroid injections and box rest have doen wonders and my girl is now back in work.
 

H's mum

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I'm a bit confused by your questions... nerve blocking is done to pin point exactly where the pain is... so if your horse reacted badly with the suspensories then surely this indicates where the problem lies and your vet should've explained this fully to you?
Kate x
 

Bedlam

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I'm a bit confused by your questions... nerve blocking is done to pin point exactly where the pain is... so if your horse reacted badly with the suspensories then surely this indicates where the problem lies and your vet should've explained this fully to you?
Kate x

Nerve blocks are anaesthetics so mask pain rather than worsen it. That would mean that if the pain was coming from the suspensories the horse would cease to exhibit pain response if this area is blocked. This is the exact opposite of what you have written...?

My puzzlement (and that of my vet) is exactly what may be causing the pain as we have managed to worsen it by numbing all the suspect areas from the bottom up.

I suspect that we won't get an answer until after the bone scan and our visit to Sue Dyson - I was just wondering if anyone on here had experienced a similar response to progressively higher nerve blocks and what the outcome was.
 

H's mum

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Nerve blocks are anaesthetics so mask pain rather than worsen it. That would mean that if the pain was coming from the suspensories the horse would cease to exhibit pain response if this area is blocked. This is the exact opposite of what you have written...?

My puzzlement (and that of my vet) is exactly what may be causing the pain as we have managed to worsen it by numbing all the suspect areas from the bottom up.

I suspect that we won't get an answer until after the bone scan and our visit to Sue Dyson - I was just wondering if anyone on here had experienced a similar response to progressively higher nerve blocks and what the outcome was.
AHh right - now I understand - thank you :)
Kate x
 

popularfurball

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My inclination would be that he is offloading lower spine or pelvis but adopting the stance with raised back end - he is transferring his weight more on to his fronts (fronts already bear most of the weight anyway).

That would be supported by the worsening of the nerve blocks (I think!). Injecting bilateral anaesthetic to hind legs would alter the standing position as it would release postural tension (tension adopted by positions taken to relieve pain). He would be less able to control/balance the movements of the back end - for example if he is short striding to avoid swinging through from behind (requiring flexion of the spine to achieve tracking through), he requires control - anaesthetic alters feedback, so I suspect he suddenly loaded the areas he hadnte previously loaded.

As a comparison (to explain my logic!) if your shoulder hurt, you would hold your forearm up to stop it swinging as it would hurt your shoulder more. If you then numbed the forearm, the muscles would not react in the same way - so suddenly the shoulder is loaded.
 

TarrSteps

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^^ I'd suspect something like this, proprioceptive effect and/or a "negative" effect on whatever coping mechanisms he's developed.

I have seen nerve blocks initiate a sort of "layered" effect, where blocking one souce of pain shows up another more noticably. The most obvious is the one mentioned above, where the "lamer" leg is blocked and it turns out the horse is actually bilaterally lame. This is very common. I've also suspected it in more subtle ways, where, say, a lower limb pain is blocked so the horse now "prioritises" another source of pain, say in the SI. A crude example might be if you have a bad back, you might forget all about it when someone shoots you in the leg but if that more acute pain is dealt with, you'll go back to feeling your back again.

Vets usually laugh at me at this point ;) but I'd say most physios etc would agree now chronic pain is almost never limited to one area, but any injury or weakness is going to have a knock of effect and/or possibly cause compensatory damage. And horses are so stoic (especially relative to us) partly because they are constitutionally compelled to keep moving, even to run away from pain, and to hide signs of weakness if at all possible or risk being lunch.

There is also, I suppose, the very slim chance he is somehow reacting to the block itself, perhaps to the feeling or the anaesthetic itself. I have seen horses occasionaly go a bit "funny" on a blocked limb so I guess it's not impossible an individual could have a more extreme reaction.
 

popularfurball

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As I a physio I totally agree with the knock ons - I had problems with my knees and back for years - no amount of Physio fixe it because it's related to me havIng flat feet. It's important to look at joints either side of the problem area and along the chain.
 
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