Possible causes of lameness walking uphill?

[BBP]

Horse is lame behind when walking up a steep hill, particularly left hind goes short and kind of on the toe rather than landing the foot flat and pushing. Appears sound on the flat but isn’t really straight through with the hind limbs, brings them in and then out and outside the hoofprint left by the front hoof. We (me, osteopath and Vet) *think* it’s extreme tightness in thoracic area, hip and glute/hamstrings but haven’t done any real diagnostics yet. He is very resistant to any kind of hind limb hip extension stretches. Just wondering if there is anything that other people have experienced that I should bare in mind?

 

[whiteflower]

The landing toe first is something I've seen several times with higher suspensory issues. It can be hard to see on the flat if bilateral. The swinging you describe also indicates not wanting to flex the hock and would make me want to investigate higher hind suspensories or possibly spavin. Hock issues can also cause tightness higher up which may fit with what your physio is finding. Hope you find out what's going on , it's difficult with issues that only show in certain circumstances.

 

[conniegirl]

I'd say you need a vet pronto, a lot of neurological conditions cause lameness when going up or down hills

 

[JillA]

I'd say you need a vet pronto, a lot of neurological conditions cause lameness when going up or down hills

She's had a vet - and osteo- see her post.

Maybe thermal imaging could give you a clue as to the location of inflammation and pain?

 

[SEL]

For mine it turned out (we think) to be a suspensory tear right up by the hock on her left hind. First scan they just found thickening and actually the right hind was worse, but when the more senior vet came out to inject her hocks (we thought that might help) she rescanned. Its literally where the chestnut is so I suspect that's why it wasn't particularly obvious.

Saying that vet #2 and Tom Beech both think the problem is more sacrum as she doesn't have 'correct' muscling on her hindquarters. Her regular bodyworker says suspensory and SI problems often go hand in hand because if one hurts then the other starts to struggle too and that leads to damage.

BUT - she does drag that left hind and I can see her wearing the toe differently to the right hind, so I'm still with vet #1 that the suspensory is primary. Hacking routes back to our yard were up a steep-ish incline and I could feel the 'not quite right' for some time - but I won't bore you with all the vet work-ups as I will start to rant!

Also resistant to hind leg stretches, although I'm working on those very gently.

 

[BBP]

Thanks, I think I’ll look to get X-rays and scans done. He did something else utterly bizarre today which was either just him being stupid (he was being pretty wild when it happened) or something a lot more worrying, so I need the peace of mind.

 

[SusieT]

It's likely something has caused the tightness rather than it being primary cause I'd say, I'd get a good lameness vet to examine

 

[whiteflower]

Thanks, I think I’ll look to get X-rays and scans done. He did something else utterly bizarre today which was either just him being stupid (he was being pretty wild when it happened) or something a lot more worrying, so I need the peace of mind.

Bbp out of interest, if your happy to say, what was it he did that has concerned you ?

 

[BBP]

He was being a crazy loon in the arena when I let him loose in there, dropping down to roll, leaping up, running off, dropping to his knees, leaping up, running off, all normal for him, no concerns. Then he dropped to his knees again, went halfway down at the back end to roll, then went to leap up but almost went over backwards with his butt near the ground as if hind end couldn’t push him up or lost all coordination. Now it may just be that he was being so daft that he pushed harder with the front than the back and overbalanced himself, but it looked utterly bizarre. Stood up and looked a bit shocked. Then trotted off and showed some pretty spectacular sound looking trot work. Canter he was double pushing behind, but the arena was super soft and fluffy and he was trying to go a gazillion miles an hour so it’s tricky to tell. Canter in field on firm ground looks good, no double push. He has been on on all neuro tests. But spinal ligaments/muscles are rock hard (this all follows a fall in the field a while ago) so osteo (approved by Vet as she is excellent) is concerned about kissing spine. Plus he is super tight across his butt (he has RER and I just realised he has not had any vitamin e for months as he quit eating his supplements so I'm trying to push that into him now). So we are debating between full diagnostics and trying 2 months intense rehab as if he has KS etc and then review.

 

[whiteflower]

He was being a crazy loon in the arena when I let him loose in there, dropping down to roll, leaping up, running off, dropping to his knees, leaping up, running off, all normal for him, no concerns. Then he dropped to his knees again, went halfway down at the back end to roll, then went to leap up but almost went over backwards with his butt near the ground as if hind end couldn’t push him up or lost all coordination. Now it may just be that he was being so daft that he pushed harder with the front than the back and overbalanced himself, but it looked utterly bizarre. Stood up and looked a bit shocked. Then trotted off and showed some pretty spectacular sound looking trot work. Canter he was double pushing behind, but the arena was super soft and fluffy and he was trying to go a gazillion miles an hour so it’s tricky to tell. Canter in field on firm ground looks good, no double push. He has been on on all neuro tests. But spinal ligaments/muscles are rock hard (this all follows a fall in the field a while ago) so osteo (approved by Vet as she is excellent) is concerned about kissing spine. Plus he is super tight across his butt (he has RER and I just realised he has not had any vitamin e for months as he quit eating his supplements so I'm trying to push that into him now). So we are debating between full diagnostics and trying 2 months intense rehab as if he has KS etc and then review.

What you describe I have seen similar with mine with hock/PSD issues. Mine had more issues going down (bum in air, didn't want to flex hocks) but on occasion it would be like something 'caught' and he didn't want to flex getting up and the legs stayed out straight under him even when the front end was getting up. He also had mild kissing spines, lined to the hind end issues. All the issues mine had were pretty 'minor' in the vets description and they said 'most' horses would show much reaction due to the low grade of things.....however mine is mega sensitive and couldnt cope with things being even slightly 'not right'. After stabbing in the dark for a while we bone scanned and then x-rayed and scanned from there to get diagnosis but if your suspecting PSD/spavin it's definately worth x-raying back as they definately go hand in hand. I hope you find an answer as it's so hard when you are trying to help them but are hitting dead ends. Keep us updated

Just to add re diagnostics I think it depends. If he's sound and you want to try rehabbing for what you suspect that's one way forwards, the issue I have is for my own mind I feel I need to know what I'm dealing with some I can make informed decisions but others would say if the outcome is likely to be the same why bother.....it also depends on insurance/finances. I just found it helpfully for me to know exactly what I was dealing with so I could manage my expectations

 

[BBP]

I’m in the position where I like to know exactly what is going on to know if I’m on the right track, even if treatment is effectively the same. I always try to do the best by him and in previous years he has had back xrays, bone scans, CTs for various things. Unfortunately right now is such a bad time, I’m moving house and horses right as my partner is deploying abroad (and leaving me a dog!), my dad is about to have major surgery and I’m having to pay privately for my own health tests for something potentially quite serious as NHS let me down. All in the next 4-6 weeks! So finances and time and my brains capacity to cope are all very limited. I don’t compete or have any expectations for him to work at a certain level, I just want him to be happy and pain free, so if that means a year of rehab type stuff instead of thousands on diagnostics I may have to go that route for the first time. I don’t know...

 

[whiteflower]

At the end of the day you can change your mind and go for diagnostics at any time. I totally understand the wanting to know as I'm the same but with everything you currently have going on it sounds like it's another thing both financially and time wise to add. If he is sound other than occasionally uphill there is no harm in rehabbing him how you would for the conditions you suspect whilst other parts of your life are needing to take some priority. If you reassess in a couple of months time and decide you are still not happy there is no reason you can't go down the diagnostics route then. You can monitor him and always adapt the plan if his level of lameness increases or anything else comes to light.
For me in hindsight, I had a lot of vet intervention early on for the conditions my horse had and had I known what I know now I would have done things differently. I would have still done diagnostics at some point but I wouldn't have gone straight into invasive treatments when actually the biggest improvement for mine was completely retraining him from scratch and learning myself how to train him to carry himself differently with a lot of good support. Where as we were having to inject etc we haven't had to have any vet intervention for years.
It doesn't sound like it's an urgent rush. The rehab/strengthening work you do in the mean time may give you more information about what's going on

 

[ROMANY 1959]

Can you video it next time you let horse have a play in school, it may help the vet see what happens

 

[alibali]

Time and gentle field exercise can be great healers in themselves.

As a single parent of an 8 year old, working more than 30 hours a week in a high pressure job, having elderly and infirm parents and a menagerie of assorted animals to look after along with a chronic health condition of my own to manage I can totally relate to not only struggling to find the physical time but also the head space to deal with things!

So in your position providing 1) the horse is field sound and 2) the condition is not likely to deteriorate due to lack of treatment then I would turn the horse away for a period of time until the other issues in your life have mainly resolved.

In doing so I would accept the fact I would have lost this time as potential recuperation time and the issue may well drag on much longer than necessary however I would also be hopeful nature may have healed the issue in the interim and if not I would know I was then in a position to give sufficient time, energy and metal space to diagnosing and rehabilitation and these processes would likely be quicker and more successful as a result.

Obviously if your horse is suffering or might deteriorate then you need to press on with investigation and treatment immediately. It would be worth having a chat with your vet though as to whether they think anything other than time would be lost by turning away until your life is more manageable.

 

[SEL]

After having Tom Beech and vet#2 out at the beginning of Feb I've just decided to rehab in my own way. Suspensory scans aren't expensive (insurance?), but given rest is usually the answer then turnout while you manage your life and health seems sensible.

BBP couldn't be more different than my Appy, but they both seem to have the gene for running up vet bills!

 

[BBP]

After having Tom Beech and vet#2 out at the beginning of Feb I've just decided to rehab in my own way. Suspensory scans aren't expensive (insurance?), but given rest is usually the answer then turnout while you manage your life and health seems sensible.

BBP couldn't be more different than my Appy, but they both seem to have the gene for running up vet bills!

Yes he does have rather a talent for spending my money!

Turning away would be the easiest thing right now. But he has been in and out of work a lot (fractured splint this time last year) and always seems better in work. The osteo thinks that lack of work may contribute to increased tightening of the affected areas, so I think I will have to do some work with him without knocking myself out, and accept that because it won’t be intensive it will take longer. She advised lots of inhand rehab type exercises to stretch and strengthen. She said he could still do ridden work but with a view to flexibility and releasing certain areas, lots of forwards walking and canter if he tolerates it (this aspect depends on if we think there may also be a suspensory issue not just a muscle tightness issue).

 

[BBP]

Can you video it next time you let horse have a play in school, it may help the vet see what happens

Annoyingly I was just getting my phone out to video but was too slow and he didn’t do it again!

 

[SEL]

Did you ever try him on dantrolene? Just wondering if that would loosen the muscles off so you can see if it's a lameness issue. (I think that's the right drug for RER)

 

[BBP]

Did you ever try him on dantrolene? Just wondering if that would loosen the muscles off so you can see if it's a lameness issue. (I think that's the right drug for RER)

Yes that’s the right one. No I haven’t tried it yet. I’ll keep that one in mind.