Puzzled by Ginny's Nappiness

Took her to Leahurst Equine Hospital. It's a veterinary teaching hospital and had awesome faclities so at least she is in good hands. Saw 3 vets including an orthopaedic surgeon who evaluated her. Her back won't flex laterally or up and down and she is subtly lame on 3 legs - both hinds and right fore. He said scintigraphy is the only sensible way forward as frankly they would have no clue what to xray/block or scan! He described it as 'complex multi-limb lameness' and said these were challenging cases because often there was so little to see for a long time. So you just have several months of poorer performance before eventually movement is affected is and people notice.

I feel dreadful that she has been in full work for months being ridden through nappy behaviours. We even scoped her for napping saying to the vet we were uncomfortable riding her through it if she had ulcers and got a diagnosis of 'grumpy mare' and permission to carry on getting after her.

Katie is so upset and feels guilty. I have pointed out that she has had weekly lessons since we got Ginny and until last week no-one noticed anything wrong so how was she to know. But I feel guilty too!! I know that's not rational. The thing that is really breaking my heart though is that for a long time I have believed that Ginny is just not a happy pony. I have spent so long trying to work out why - Stressed? Bullied? Lonely (when separated because of being bullied? Trauma? She is so much less stressy than she was and does not bite and kick us anymore but I still never got the feeling she was ever truly relaxed or contented. I guess now I know why.

I asked the surgeon what he thought might be going on and he refused to speculate saying it would just 'ruin my weekend' but he gave me absoutely no reassurance whatsoever and did say the degree of 'boardedness' of her back was concerning in such a young pony. Oh and she also has fluid over her spine and in her coffin joints. So it's all a bit rubbish really. Finngers crossed for a simple fix!!
 
At the risk of sounding like a stuck record, I'd run this past the vet chiropractor who I linked to earlier. She worked at Leahurst as a staffer for many years, so has seen most things. The worst thing she can say is to proceed with the scintiagraphy first. How can the back be 'stuck' if the physio has been happy with her?

I know that insurance is a factor here, but sometimes the best thing for niggly undiagnosed lamenesses is to chuck them out in the field for a year. Leahurst has a reputation for gobbling up all insurance cover, and then some, so are unlikely to recommend that (but maybe they've changed).
 
Rough day. It's difficult when it isn't an obvious lameness - I'm in that position right now. How did he assess subtle lameness on the 3 legs? Gadget or just from the work-up?
 
SEL said:
Rough day. It's difficult when it isn't an obvious lameness - I'm in that position right now. How did he assess subtle lameness on the 3 legs? Gadget or just from the work-up?
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Sorry for late reply. Mad weekend. The lameness was from various exercises. She was sound trotting up in a straight line, slightly lame on flexion tests in hinds, slightly lame on front fore lunging on hard ground. She also couldn't hold canter on the lunge, reluctant to strike off and broke to trot immediately.
 
Tiddlypom said:
How can the back be 'stuck' if the physio has been happy with her?
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Back would not yield laterally or in an up/down plane when they manipulated it. She has physio every 6 months routinely and has been fine. Back has felt ok. But when we first got her the back was tight too and was loosened off by physio. She was due another session just afte rthe vet came - it was actually booked in for 26th July already. But both my vet and physio (who work together often) felt that there was (or at least may be) an underlying pathology that meant she was locking up her back to protect herself from pain and so treating the back was a bit pointless unless we were sure the back was actually the source of the porblem and not a secondary issue caused by her response to pain somewhere else.

So we agreed to investigate the cause and not just treat the presenting symptoms which makes perfect sense to me. My own vet, the physio and the Leahurst vets agreed that diagnostic tests were the logical next step as we simply could have no idea what was going on without them. We would just be guessing. Scinitgraphy was recommended because from the way she was presenting the pain could be coming from pretty much anywhere.
 
She had it on Friday and she needs more investigations today to figure it all out. She was radioactive over the weekend so could not be handled then. Vet did contact me on Friday just to say it had gone well in the sense that it had worked and they had identified several 'hot spots' but I was driving my lorry at the time and there was not much clarity anyway so today is the day I will find out a lot more.
 
Ambers Echo said:
She had it on Friday and she needs more investigations today to figure it all out. She was radioactive over the weekend so could not be handled then. Vet did contact me on Friday just to say it had gone well in the sense that it had worked and they had identified several 'hot spots' but I was driving my lorry at the time and there was not much clarity anyway so today is the day I will find out a lot more.
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Good luck xx
 
Ambers Echo- I had a similar issue with a mare this year. Leahurst is ten minutes from us so it’s our local hospital, and also the practice I use. Who did she see while she was there? PM if you prefer.
I had an issue with a mare that went from reluctance to canter to rearing when asked to trot. Horse is an absolute gem so I knew she was trying to tell me something. Vet came out and said there was no obvious problem to see but I pushed for further investigations and sent it into the hospital.

Similar to yours- horse could also not raise back up. Hospital vet noted that horse was rigid through it’s all whole back. Was mildly bilaterally lame, not even 1/10, behind but not enough to block or give any real indication where problem was so bone scan was done. I had 3 things I thought it was when I sent her. Long story relatively short, one of those things was found on bone scan and X-ray and we treated and bought her home for rehab. Problem got worse.
Had vet Chiro out (same one as Tiddlypom is suggesting), who is absolutely incredible and fixed the horses back problem in one pretty intense session- so much so that when we took the horse back to Leahurst a week later, the hospital vet was in complete disbelief that he was looking at the same horse and couldn’t believe the difference in her.
Anyway, we took her back because once we sorted her back, the lameness suddenly became apparent, which is fairly common in these situations. We now had a horse 4/10 lame on right hind. I asked for a scan as I had PSD in my head and sure enough...
Hospital were honest, horse unlikely to do the job and putting down might be something to consider, but we brought her home and she’s having 12 months off and then I’ll review it in spring.

Highly recommend this vet chiro. I’m not normally the type of person who goes mad on recommending people, but I honestly can’t sing her praises enough. She was my vet when she was at Leahurst and is actually coming to see my other two horses tomorrow. Feel free to PM me if you want.
 
Thanks, that sounds like a similar story. I am certainly not ruling out using a Chiro and I have complementary treatments on my insurance policey too which helps. Though I'd pay anyway if necessary. I think this echoes what my physio said about the back - she can loosen it off but if the back pain is secondary to pain somewhere else then it won't help longer term. I once called my physio out because a pony was reluctant to move off the leg which was unlike him. She felt his back said it was very tight/rigid and worked on him. After which it was clear he was lame on his fronts and actually he was in the earliest stages of laminitis! The vet is Dave someone. Irish chap. But I think he is new.
 
It may sound counterintuitive to get the back treated and the tension released before a niggly lameness or loss of performance workup, but as scats points out and I have also come to realise it then it can make spotting the primary physical issue much easier as the horse is no longer locked up rigid protecting itself. The vets, chiro, owner and physio all have to work together to help get to the truth.

Good luck with the results of the scan, I hadn't realised that she'd already been scanned when I posted earlier.
 
She's lame in all 4 legs. Looks like coffin joints. Vet sounded very gloomy. Said they now need to xray possibly MRI scan. It looks like a degenerative joint condition but that seems so unlikely because the has just turned 6. If it's that it's 'very bad news' but I don't really understand the implications and no point going into all that till we know.
 
Is the pony shod AE?

If so, do you want any information about how helpful a barefoot rehab could be? It is likely to conflict totally with what Leahurst will tell you.
 
I'm open to any suggestions ycbm but until I know what's wrong I can't really evaluate different options. So I'm trying to stay optimistic that they find something less serious and simple to fix! Till then I'm trying not to speculate and don't feel I can plan. But I'm all for being well informed.
 
So poor Ginny remains lame and sore everywhere. Coffin joints, suspensory, back.

ycbm how could barefoot rehab help? She has been shod with heart bar shoes by the Leahurst Farrier. There is no clear diagnosis but vet is 'disconcerted' by her lack of progress despite cortico steroids, other drugs, other injections and box/small paddock rest. I am feeling very disheartened and looking for ideas and I'm open to suggestions.
 
Ambers Echo said:
So poor Ginny remains lame and sore everywhere. Coffin joints, suspensory, back.

ycbm how could barefoot rehab help? She has been shod with heart bar shoes by the Leahurst Farrier. There is no clear diagnosis but vet is 'disconcerted' by her lack of progress despite cortico steroids, other drugs, other injections and box/small paddock rest. I am feeling very disheartened and looking for ideas and I'm open to suggestions.
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Because it allows all the normal concussion limiting effects of a horses foot to work, and if you can get them to shape their own feet, they will create ones which are optimum for the issues that they are dealing with.

You're in let chance saloon by the sound of it. You have nothing to lose.

A horse I previously owned was given only a 20% chance of return to work by Leahurst. Within eight weeks, yes you read that right, into a barefoot rehab, he was sound in all three paces and has not looked back since. Of course not all l are that successful.

Check out this blog, it's a rehab yard run by a friend of mine, but you can do it at home too. If you are close enough to me I will gladly help you.

Rockleyfarm.blogspot.com
 
Just brief update... Ginny has made absolutely no progress despite all the treatment. She has no diagnosos but the belief is that there is a problem in her coffin joints and the pain everywhere else is secondary to that. There was no obvious pathology so vets seemed fairly confident it would resolve fairly quickly. But that has not happened. If anything she is moving more stiffly and my own vet has reviewed twice in last 2 weeks and she's lamer. Now showing reaction to flexions and lame trotted in straight lines. Back to Leahurst on 6th for more nerve blocks so we can get a true picture of degree of lameness in each limb not masked by the lameness in all the others. Not really sure where we go from here if it turns out that she is still as she was or worse. Will be posting questions on barefoot thread too but this thread has the fuller picture in case anyone has any ideas.
 
Ambers Echo said:
Just brief update... Ginny has made absolutely no progress despite all the treatment. She has no diagnosos but the belief is that there is a problem in her coffin joints and the pain everywhere else is secondary to that. There was no obvious pathology so vets seemed fairly confident it would resolve fairly quickly. But that has not happened. If anything she is moving more stiffly and my own vet has reviewed twice in last 2 weeks and she's lamer. Now showing reaction to flexions and lame trotted in straight lines. Back to Leahurst on 6th for more nerve blocks so we can get a true picture of degree of lameness in each limb not masked by the lameness in all the others. Not really sure where we go from here if it turns out that she is still as she was or worse. Will be posting questions on barefoot thread too but this thread has the fuller picture in case anyone has any ideas.
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Can’t remember but did she have mri? Could this possibly be low grade lami, and actually just coinciding with the rain/grass flush rather than it being the original problem?
 
Sorry Michen - I somehow missed your reply. I don't know now what caused the lameness my vet saw but I do know that lami has been on everyone's radar (both vets, farrier and me) from the beginning because of the steroids. And so far no-one has seen any evidence of Lami. But thanks for the question - all ideas are welcome and sometimes when you are holding a hammer, everything looks like a nail!

Ginny had her review at Leahurst today. My own vet has seen her twice in the meantime and felt she was still bilaterally lame in front both times. The fronts were the limbs that were really, really lame when she was blocked, despite seeming pretty ok when unblocked. The Leahurst vet was expecting the steroid injections into the coffin joints to work pretty much immediately so on-going lameness would suggest more serious pathology that is keeping the inflammation going. So it all started a little depressing because my vet had been chatting to the Leahurst vet and they were both feeling gloomy about her lack of progress .... But today she was sound in front! Hurray!!

She was still lame behind but 2/4 limbs recovered so far is half way there!! Hinds could be hocks or could be suspensories. We are hoping for hocks. So she had her hocks medicated today and she will be reviewed again in 2 and 4 weeks by my own vet..... So having steeled myself for a pretty dire prognosis I am so, so happy. I think I got a bit over excited as the vet was at pains to explain that if it turns out to be suspensories we may still be in trouble. But I have been so worried about her being in pain that I could not identify, that her being sound in front was all I cared about. We have a way to go obviously, but for now I am very relieved and happy.
 
Thanks Michen! I did raise the issue of barefoot with the Leahurst orthapaedic (sp?) guy and he was not in favour at all. He said she had significant foot balance problems which were contributing to whatever else has been going on. He wants her remedial shod for 2-3 more shoeings and for my farrier to use xrays when shoeing to ensure all the angles stay as they are. I don't know nearly enough about barefoot option to argue with an expert and their treatment is working so I will stick with it for now.

It did make me wonder about the more general question of how to evaluate competing information because i am sure there are people that would say the exact opposite - ie that barefoot could solve foot balance issues. But that a question fot asnother day andanother thread..... For know I have a plan and am happy with it!
 
And today she is..... SOUND. All 4 limbs. Woop woop.

So we have a plan: 3 months walking rehab. Just 10 minutes a day to start with. Out 24/7 the rest of the time. After that, start slowly bringing her back into work. Fingers crossed she stays sound now! 2 more cycles of shoes then we can re-think that too.

She needs to recover mentally too. She has struggled to settle since coming back from Leahurst but is a little better every week.
 
Thanks, it feels very positive. Having said that, the vet still said he was only 50:50 on her coming back to 'athletic performance'. But we shall see. For now, we have a plan and it all seems to be going in the right direction. And if she is destined for a life of relative leisure then so be it....
 
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