Sacroiliac - what is worst case scenario?

[BeckyD]

McTimoney and Equine Touch lady out today thinks it's still SI, but that he's also in pain in some very strange places. If this is still SI, I want to be prepared for what the worst case scenarios are likely to be? Soundish in walk, variable lameness in trot from barely noticeable to very lame (differs step by step). Appears in pain even when standing in stable as adopts contorted body posture every so often as relief.

Still on box rest currently, 3 months since 2nd corticosteroid injection. Back at vets on Monday so should be waiting till then but I'm a worrier

 

[Nailed]

Probably field orniment it the worst..

Lou x

 

[CBAnglo]

It is hard to answer this as each horse copes differently with their SI injury, and also there are varying degrees.

I think for the most part, most horses continue in light work - 2x light hacking (W/T/C on good ground), 1 schooling and 1 lunge session a week. Some go on to jump and hunt on a maintenance of steroid injections as and when, but for the majority, most are retired or semi-retired in light work.

As you know I have 2. My acute one I have just started riding again in walk, for 25 mins, to show that he is still lame and wont be able to return to full work. Vet set his prognosis is poor and very likely he will be retired. He is very stiff and very reluctant to be tacked up, although seems to have become every so slightly more level with work, although is nothing like he was before the injury. The other one who is a chronic case is off and on work every couple of months. Currently off work, but when in "full work" was schooling 1 hr 3 times a week, hacking once and lunging once i.e. 5 times a week. He was fairly fit then, but became disunited in canter and had to have 3 months off after tweaking leg in field. He also has an old tendon injury (SI may have been secondary) so he no longer jumps, otherwise he could have done some small jumps (about 2'6") where he wouldnt have to properly bascule over the jump.

To be honest, I wanted to retired both of them - but my vet wont let me retire chronic (as he just gets more stiff without work) and acute is still undergoing treatment so I still have to keep riding him. It is a nightmare and a lot of hard work for very little reward, and all you are trying to do is find a level of work, whatever that may be, that your horse can tolerate. I dont think they will truly be comfortable or happy in their work as there will always be a certain level of pain when being asked to use that leg properly, but because maintaining whatever topline you can is essential for SI injuries, it is a necessary evil.

 

[neddynesbitt]

Hi Ronaldo,

Sorry I can't be much help re scenario but am very interested in any other replies you get.

All I know with my lad so far is that he had very similar symptoms to yours right at the very start of his lameness. He had the physio in between the vet coming out and him going into the vets for lameness investigation. By the time he got to the vets he was sound...arghh!!

He then went lame again and yes even in the stable he looked really uncomfortable. He had his back legs tucked right under himself, sometimes to the point it looked like he was going to sit down.

The vet and physio are really pleased with him now and he is much improved and better for being out in all honesty. I have started feeding him his hay on the floor as they both said that the constant tugging on a haynet was no good for him.

As far as prognosis, I have to turn him away for 6 months (not a year as originally thought) and they are confident that he will come right as a hack and maybe more (not what I want to hear about our competition horse!!) They have warned me that SI can reoccur even by just rolling in the field. He is always going to have a weakness there now but I have got to remove his back shoes as that will help him. My lads prognosis could well be worse than yours as he also has navicular.

Good luck, please keep us posted

 

[hussar]

My old TB ex-racer had long-standing sacroiliac damage from his racing days which wasn’t diagnosed till I’d had him 3 years, by which time he was 13. He had three months’ field rest and then spent a week at a therapy yard having electromagnetic treatment. He was sent home with a list of daily exercises that I had to do for 6 months.

The exercises involved weeks of handwalking over poles, both in standard grid formation and with alternate ends raised, figures of eight over poles, reinbacks over poles – every day he and I stepped over poles about 400 times. No kidding. I then progressed to lungeing over poles at varying distances, again with raised ends so he was stepping high.

During the whole period I was also lifting each hind leg and rotating it 10 times in both directions – he was 16.3 and it was absolutely knackering!

At the end of the 6 months he was deemed rideable but I more or less retired him shortly afterwards as I could never be sure he wasn’t in pain – and at his age with a hard-working early life behind him it wasn’t a very hard decision.

 

[BeckyD]

Thanks CBAnglo. I'm just utterly confused by Ronnie. He was almost hopping lame on it Saturday/Sunday but I had to ride him through it, he had Monday off, but by Tuesday was feeling so much better, and by last night felt a million dollars, really powering along, trying to canter and feeling *happy* - which I just didn't expect. Chiro/ET lady out today watched him ridden and thought he was a little stiff behind, nothing major, until I trotted him for second time and then he was taking lame steps with left, right both, none; he was all over the place. She thinks all these problems are SI related and quite severe by turns. Initially she thought it was a lesion in supraspinous ligament, but he's getting better with work, not worse so she thinks it can't be that after all.

I think I'm just fretting about where we go from here. He's back at Cambridge next week, they're going to scan his back and SI area.

Do yours respond to manipulation/pressing of the tuber sacrales? When Ron first did this, he dropped to the floor if you pressed on them, whereas now, no obvious reaction.

ETS I can't type. A "legion" in his ligament would indeed be a problem ahahahahah

 

[BeckyD]

Hi Neddynesbitt - we do seem to be going through similar things, unfortunately

Ronnie's now gone intermittently sound too, and we're back at vets on Monday

Your boys' position sounds like Ronnie's - Ron hitches his bum up onto the Haybar, then leans back onto it (back feet barely on the ground, but sort of pattering quickly) with front legs stretched out in front of him. And whilst doing so, he tears the front of his rug to shreds.

So many of us have horses with this problem - and yet until I "met" CBAnglo I'd never even heard of it. From what she has said and I do now agree with her, we think Ronnie's always had a problem there, exacerbated by his falls in October.

Good luck with your boy and I do think there is some comfort in knowing others going through the same.

 

[CBAnglo]

[ QUOTE ]
Do yours respond to manipulation/pressing of the tuber sacrales? When Ron first did this, he dropped to the floor if you pressed on them, whereas now, no obvious reaction.

[/ QUOTE ]

Exactly the same as both of mine. When they first do the injury or tweak it, they will have this reaction. Otherwise all you have is a reluctance/inability to work correctly.

You will find that he works better if you work him every other day, instead of everyday, and some days he will be able to work better than others. Which is why it is so hard to have a one rule for all SI injuries - you have to see what your horse can cope with, and adapt your management routine to that.