Sacroiliac or PSD causing issues, which came 1st?

[samleigh]

My mare has been lame/not right since earlier this year, began Vet investigations, diagnosed PSD with Sore Sacroiliac area. We opted to Operate (N & F) after no improvement with SWT.
Its now 12 weeks after OP, 9 weeks Box rest and Pen & then normal turn out, we could detect no lameness at walk at this point, all positive, began in hand walking & she is very sore along her spine and over her sacroiliac again, its like her backend does not belong to her body, her RH especially rotates/twists at the fetlock outwards, constantly slipping behind, struggling to turn, holding herself stiffly in walk, now refusing to do Carrot stretches to the left (I don't push her, she just stares at the carrot, absolutely fine to the right)
The vet has put her on Danilon for the rest of this week, to see if the symptoms improve & said don't panic yet!
She's been injected twice now with steroids to her Sacroiliac, June & August, had 2 x SWT to her Sacroiliac area too, had regular Mctimoney, who detected soreness still on last appointment along spine and over Sacroiliac, it has worsened since last appointment mid Oct, I only have to run my finger down her spine and press lightly on her rump and she dips away from the slightest of pressure, next appointment is next week, Vet agreeing, one of her previous symptoms was not holding any improvements with Mctimoney.
I always hoped that the PSD was the issue and once treated the SI strain would improve too, but she's gone down hill rather suddenly and her lameness is the worse she's ever been, I'm wondering now if the SI was the problem all along ?

She's also had stifles & Hocks exrayed, no problems.

I'm out of Insurance money & back to where I was in June of this year..lame horse on pain relief!
I'm speaking to the vet again on Friday to discuss.

Any questions you think I should be asking the vet? Any supplements you've found to help (currently on Riaflex MSM), Management changes I should consider.
She has 10hrs TO per day, stabled at night.
I've read so many threads, articles, my head is spinning.

Many thanks

 

[lori ann]

I feel for you it is a minefield I to have read so many articles but one of the best places I have found for information is the psd facebook page it is well worth joining it is a closed group.

From all my research and more than one vets opinion SI comes first as not working through the back properly overloads the suspensories. Your horse will not come right until the SI is addressed and with time and a rehab programme should do. It is all very slow and unfortunately the op does not fix everything.
Many owners on the FB page have SI issues they will be able to help. Our problem was head tilting and evading the bit due to a calcifying wolf tooth long story !
We did not have the op but are on a slow rehab programme at the moment under saddle in trot work.
I feed turmeric but cannot say if it definitely works or not.
One thing I have found works though is the Arc Equine unit would be worth giving them a ring to discuss how it could help your mare.
Do not loose heart and join the group. x

 

[be positive]

I have no experience with PSD but have gone through a long rehab with my horse who suffered an injury to his off hind which was treated but the vets missed the fact his SI had also been damaged in the same accident so it went untreated for over 12 months before my new vet picked up the SI issue and it was medicated.
My guess with yours is that the box rest has made the SI worse even with it being medicated being in 24/7 for 9 weeks would be in my view, and from what helped my horse, almost the worst thing that could be done and probably means the injections at the time were a waste of money, I am not a vet but it seems counter productive to have done both the op and injections at the same time.
My horse responded well initially to his injections June 2014, a couple of days on box rest, then out 24/7 with daily exercise/ physio exercises and in hand work but he did not come totally right so I eventually gave him a complete break apart from once a week short hack about 6 months after the injections, he is now, almost 18 months on, finally sound, it has been a long haul and I had thought he would never be right, the prognosis was poor, I think the most benefit has been from him being out as much as possible he is still out at night and will stay out until I have no choice but to keep him in if the weather gets bad.

I would not lose heart yet it can take so long for this area to fully heal and I think you are still in the early stages due to the box rest, if turning out more is an option I would do so, overnight is ideal so you can spend time doing her exercises without having to reduce her turnout time, I was lucky I was doing most during the summer as I was spending up to 3 hours each day on all his "therapy"

 

[cellie]

After similar symptoms and reaction to sacroiliac I had X Ray's and bone scan and found kissing spine . His back is great after having Ks lig snip unfortunately we have navicular and hind leg issues . X Ray would be my next course of investigation good luck

 

[ycbm]

Had the back been x rayed? Sacroiliac and psd problems are often associated with kissing spine.