Sacroilliac issues treated but movement/ridden issues remain

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redmimosa

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My 7 year old gelding has been treated (injections and shockwave) for sacroiliac issue on the off side, he really reacted negatively to palpation vet thought there was some laxity of ligament. Post treatment the area feels really good. Horse has been rehabbed but lunge and ridden issues remain. Short all over (pottery) and changing behind. Holds his front end to outside of circle on lunge, twists his hind in a little (particularly on right rein). Ridden very reluctant to go forward and especially reluctant to canter (particularly on left rein). Vets did initially say the sacroiliac issue was most likely to be secondary but wanted to treat the injury first.

What do people think is the most likely secondary issue? Hocks are very clean and horse no worse after flexions.

I have video if anyone is interested in seeing them.
 
Oh how I feel for you having been in this position myself a year or two ago.

We went through several diagnosis - some real and some red herrings but in the end we went for a bone scan and found several areas of concern. I had tried to rehab him a few times by this point but it wasn't working so now he is turned away unfortunately.

So what could your SI problem be secondary to? Hocks, stifles - anywhere in the legs really plus back plus tendon / ligament damage elsewhere

Are you insured?
 
You need a full lameness work up from an experienced vet. SI can be primary or secondary. What is his conformation like? Croup high? Long in back? How fit is he? What work has he been in?

Could be kissing spine, stifle, hock, PSD, foot imbalance, even ulcers/hind gut PLUS 101 others!

Can also be just incorrect riding that can lead to SI problems if horse conformationally predisposed to such issues.
 
PSSM? Sounds very like my horse was when he was bad.

Otherwise psd would be a possibility. Has your vet suggested anything else?
 
The vets are unsure what is going on and want to do further investigations. He is more or less sound trotting in a straight line so a lameness work up is difficult. Horse was competing successfully as a 5 year old and early in his 6 year old year but he got progressively more backward later last year and ultimately refusing to canter at all. Leading to sacroiliac diagnosis, vets were going to do a bone scan to confirm at the time (October last year) but thought the injury was obvious enough to warrant treating it first. The problem is he is no better, worse in fact. He has always been spooky and quirky to ride though very good natured and easy going on the ground so I am now wondering if it is something that has always been bothering him but has gotten worse.

He is not insured as in Ireland. His conformation is very good, short backed and no muscle wastage. Next step will be a work up and presumably scans etc.
 
The first thing I would do is x ray his back. He sounds like a shoe-in for kissing spines with his history.
 
Yes my money is on kissing spines too. He has no soreness over his back or girthiness etc but does react negatively to sitting trot
 
If it is, please do not have the ligament desmotomy operation. Now that it has been around a bit longer, spine instability is causing issues.

Mine was not girthy or sore in his back, but his stride shortened and he would explode when put under pressure. He didn't have SI issues but they are very common with kissing spines.

Sorry you have problems, I hope you get to the bottom of it.
 
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redmimosa said:
The vets are unsure what is going on and want to do further investigations. He is more or less sound trotting in a straight line so a lameness work up is difficult. Horse was competing successfully as a 5 year old and early in his 6 year old year but he got progressively more backward later last year and ultimately refusing to canter at all. Leading to sacroiliac diagnosis, vets were going to do a bone scan to confirm at the time (October last year) but thought the injury was obvious enough to warrant treating it first. The problem is he is no better, worse in fact. He has always been spooky and quirky to ride though very good natured and easy going on the ground so I am now wondering if it is something that has always been bothering him but has gotten worse.

He is not insured as in Ireland. His conformation is very good, short backed and no muscle wastage. Next step will be a work up and presumably scans etc.
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I am in Northern Ireland but it was Troytown he went for the bonescan. He was diagnosed with kissing spine from xrays by a different vet but the bone scan showed that there was no changes and his back was in good health.
 
Wheels said:
I am in Northern Ireland but it was Troytown he went for the bonescan. He was diagnosed with kissing spine from xrays by a different vet but the bone scan showed that there was no changes and his back was in good health.
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My understanding is that a bone scan cannot show that there are no changes, it can only show that there is no active inflammation in the bone at that point in time. And it will not show nerve pain unless it is also associated with bone remodelling.
 
Wheels said:
At that point in time there were no changes occurring
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No active changes in the bones didn't mean that the horse wasn't in pain from the nerves which are pinched between impinging dorsal processes, though, did it?

The surgeon who did the ligament operation on mine said it works partly because it cuts the nerves as well as the ligament, and stops the pain even if it doesn't stop the physical touching.
 
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ycbm said:
No active changes in the bones didn't mean that the horse wasn't in pain from the nerves which are pinched between impinging dorsal processes, though, did it?
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The vet was satisfied that my horses behaviour was not to do with kissing spines or any associated issues. Based on his vast experience, various xrays, the bonescan, clinical exams and other diagnostics along the way.
 
Wheels said:
The vet was satisfied that my horses behaviour was not to do with kissing spines or any associated issues. Based on his vast experience, various xrays, the bonescan, clinical exams and other diagnostics along the way.
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In not sure any one generalist vet can have vast experience of kissing spines, it's a relatively newly diagnosable condition and not that common. And maybe knowledge has moved on since then? Your vet was never able to give you a more plausible suggestion than my surgeon has and your horse was never completely diagnosed and is retired.
 
Enough.

The OP came on as she is worried about her horse, I posted up to really just offer a bit of support. That is the end of my discussion with you on this subject.
 
We both posted to help Redmimosa. I didn't post to argue with you. I posted to help her understand what might be going on with her horse.


RM I hope you get to the bottom of it.
 
Batgirl said:
I just had my horse at Newmarket - SI issues are often secondary to something. In my case both branches of both suspensories.
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And that would be my first thought if I was asked to make one guess about OP’s horse .
OP I would get the the horse to a diagnostic specialist and ask them to start my ultra sounding the hocks .
 
He sounds very like my horse, quirky, spooky but a nice person, no girthiness. SI injury treated but continued to move like a banana on the lunge, and refuse to move forwards especially in canter. Shuffled behind. I had him tested for muscle myopathy and he came back as having mild chronic RER but we didn’t think that accounted for it. His back x rated clear. He was also grinding his teeth and yawning a bit. I had him scoped for ulcers and he had a couple of small areas of ulceration near the pylorus. He was on omeprazole and sucralfate for 3-4months. After that I had sacroiliac remedicated, got Rob Jackson out, changed my saddle and bridle. I then had a lovely forward, willing horse who happily cantered etc and stopped bending like a banana on the lunge, started to lower his head and stretch over his back and is now on top form. I believe the ulcers, although they looked minor and the horse looked fabulous, caused him a lot of discomfort as that was the main thing that made him anxious and reluctant to go forwards.
 
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