Sacroillialc? suspensory? help very unusual lameness!!

[i-love-wellies]

So my 5 year old Connemara Pony was at a show a few weeks ago. He arrived the monday and did a few bronco impressions the rest of the week he was a little sticky but by his class the thursday he couldnt canter properly as he couldnt seem to get his hind legs under him. Got the chiro out and his pelvis was out 3 inhes to the right i think. He fixed him and all seemed to be well but we have now realised that he still cant canter on the left rein only. The left hind still seems to be blocked as he wont pull it under him so he keeps changing behind. Hes sound in walk trot and canter on the lunge and sound when ridden in walk trot and right canter when ridden its just left canter thats the prob. HAd the vet out and he doesnt know where the problem is so put him on high dose but for 5 days to see if that would know a spasm out. However theres no real change on the bute (maybe very slightly but not a good enough change to constider it effective). Theres no sign of heat or swelling anywhere, he remains sounf upon flexion. It seems to be to do with weight bearing but at this point im at a loss with what to do. Going to try get the chiro out again to see if he sees anything. Ideally id get a full body scan but finacially thats not an option and if i get nerve block we are going in blind as to where it is so could be very costly.... im thinking its the sacroilliac as he twisted when he was juping around that day. Has anyone had anything similar? Vet thinks it might be mechanical seein as the bute didnt really help

 

[mjcssjw2]

yes, my horse is very similar, and like you I am flumoxed.

 

[be positive]

If it is the SI it will require more than one visit to fix it is not as simple as putting the pelvis back in place and all will be well, I would get an ACPAT physio involved who will help you get the muscles working properly which will help hold everything where it should be, you need to be working on building up the whole topline not just getting a quick fix done otherwise it will just keep going again.
If it is the suspensory ligaments then obviously it will require a different approach.

A bute trial is not always going to work, just because no improvement is shown does not rule out pain as the cause, SI pain does not always respond to bute.

 

[mjcssjw2]

suspensory issues don't response to bute either, i have the physio tomorrow and was going to ask her to do a second visit in quick succession on the grounds that when my sacroiliac area is causing me problems it always take the chiro more than one treatment to sort it.
To be fair he is going into canter (well tonight anyway) but doesn't want to maintain it.

 

[Primitive Pony]

Sounds very familiar to my horse's SI issues, which were best managed with a combination of chiro and physio. Pole work in hand is also very good for strengthening the pelvis and keeping the joint stable again, once you're sure it's level.

 

[cellie]

Im dealing with sacroilliac , horse is going back to vets on 10th. First lot of treatment really helped he had injections ,he wasnt lame but couldnt work on right rein and swapped his legs or bunny hopped on lunge on right rein.Hes lame now and have suspicion its spavin as well, suspensory was scanned so hopefully thats still ok. Its not easy to treat and his back might become very sore compensating. pole work is recommended to build up top line and muscle . Im supposed to be lunging but not happy pushing him hard when sore so going to ring my vet again .Get good chiro .Steriods into area not ott if you dont have insurance but my claim is already at £2000 as he had shockwave and back xrays for kissing spine.Very difficult to treat and Im not sure if theres not something else going on at same time with my horse.

 

[be positive]

Im dealing with sacroilliac , horse is going back to vets on 10th. First lot of treatment really helped he had injections ,he wasnt lame but couldnt work on right rein and swapped his legs or bunny hopped on lunge on right rein.Hes lame now and have suspicion its spavin as well, suspensory was scanned so hopefully thats still ok. Its not easy to treat and his back might become very sore compensating. pole work is recommended to build up top line and muscle . Im supposed to be lunging but not happy pushing him hard when sore so going to ring my vet again .Get good chiro .Steriods into area not ott if you dont have insurance but my claim is already at £2000 as he had shockwave and back xrays for kissing spine.Very difficult to treat and Im not sure if theres not something else going on at same time with my horse.

Mine has had injections recently into his SI but I am not lunging, circles are still pretty much banned although we do a little, we are doing hacking mainly, lots of polework in hand and under saddle , there seems to be a varied opinion on what to do to build them up properly, I certainly wouldn't want to be doing much lunging with mine and am not really pushing him yet, we are about 7 weeks post injections so still early days, it is probably just the SI with mine so nothing else to worry about or confuse the way he responds to the treatment, my vet only wanted an ACPAT physio involved which I am more than happy with.

 

[i-love-wellies]

One other point for my pony when hes in the left canter (which is the problem) its almost as theough he feels fine but then suddently someting catches him thats very sore so he changes it happens in straight lines and circles but i notice it in particualr when bringing him back to trot he hops then changes so im almost wondering if it could be a trapped nerve/kissing spines? Its not constant pain i dont think as he does do some left canter corretly. I'm not that keen to go down the nerve block route with my lad just yet as I think we will literally have to nerve block everything. Has anyone been abble to diagnose through ultrasound and then nerve blocked to test of thats the source of pain? Maybe its a bit backward but to me it makes sense as its not as invasive. OR has anyone tried thermography? theres a place here in Ireland that does it i know it wont diagnose the problem but at least it may help narrow down an area. Im hoping the physio can pin point something but I need to work out a plan of action for if he cant, i know its a process of elimination in these cases but wanna be as smart as possible about it as he's not insured. Typically I was planning on starting a policy this month but this obviously cant be covered now

 

[be positive]

If the pelvis was out of alignment that may be the main issue, as you are not insured and there is nothing else obvious enough to start doing diagnostics on then I would start with sorting that out properly, if it is not the primary issue but caused by compensating elsewhere then he will probably not respond to the physio so you can rule that out and start looking elsewhere, it may take a few treatments and a good rehab plan to enable you to move on.
Thermal imaging is not too expensive and can give a good result with where to start scanning or xrays, I wouldn't start with ultrasound as that could prove as expensive as a full body scan if they cannot find anything easily, it takes time, they need to clip the areas and clean up before scanning and many require sedation for it, as a guide mine was scanned over his SI, it cost £110 plus sedation although he may not have needed sedating just for the scan but injections were planned anyway, we had a horses tendons scanned last year that was £180 for both legs so they would add up fairly quickly if you don't start in the right place.

 

[GermanyJo]

How are his stifles? Mine has problems behind which to start with only showed as difficult in canter left, going disunited, I have been convinced for a long time that mine was not ok, but several vets could not see anything and simply told me to continue to work him....he tweaked his psl (front) had to stand in the box for 7 weeks...lost alot of muscle, and came out of box rest lame behind, ...pelvis crooked, but more telling he has problems with his stifles ...R worst, now we are thinking this is what I have been seeing/feeling for months, and is probably why he tweaked his psl, ...the comments about something catching sounds similar to what mine shows, - mine is an issue with the ligaments and the payrolls then displacing, which causes the catching

 

[GermanyJo]

Patella, not payroll, although it seems to be displacing my payroll to the vet !!

 

[mjcssjw2]

I have had the phyiso out this morning and in spite of the vet saying he had no problems with his back - he is very sore.
She is reluctant to do to much treatment if the SI issue is being caused by his hocks or suspensories, I too am not insured.
The physio discussed this morning about taking him to the vets to establish if there is a problem with his hocks before keep treating the SI as the hock flexions may not be a good thing is he has a problem. I have called the vets several times to discuss - but have not had a reply.
How much are the steroid injections into the hocks does anyone know?

 

[loopylucifer]

you need a definitive diagnosis. I have dealt with SI problems and Suspoensories. what you have described is very similar to mine with SI problem but without a vet work up you will have no idea what is a primary problem and what is a secondary compensatory problem.
You need to book your horse in for a lameness work up with your vet, if you are not insured you need to discuss this with them and know what your financial options are, despite popular belief many vets will work within financial constants. mine was only diagnosed by bone scan which whilst was expensive (was insured) this can be quicker and cheaper.

 

[be positive]

As above you need a diagnosis otherwise you can throw things at them in the hope it works but in the long term it may well cost more and give you a false picture along the way, there is certainly no point in having steroids into the hocks if they are not required, doing the correct rehab for hock problems only to find it is still not right and then looking at the suspensory ligaments, if your vet is sensible they should be able to find a good starting point without having to look at every part of the horse.

 

[i-love-wellies]

My main concernt at this point is to diagnose the problem in the most logical way possble. Although a pain im not to worried if revoer takes a while. Just dont wanna be giving unnecessary injections etc. Personally I dont think its anything lower than the stifle but that still leaves lots of potential areas

 

[be positive]

My main concernt at this point is to diagnose the problem in the most logical way possble. Although a pain im not to worried if revoer takes a while. Just dont wanna be giving unnecessary injections etc. Personally I dont think its anything lower than the stifle but that still leaves lots of potential areas

Your thread has rather gone off track onto someone else's horse.

I think with yours being very recent, most likely something acute you really need to stick with the course of physio treatment and work to build up the muscles unless either they cannot do anything as it requires a vet or he doesn't respond well to the treatment.
It is early days to be thinking of injections, he is very young so it could be simply that he has done too much and requires a rest along with physio to ensure the muscles are not in spasm, you have had the vet who has done his bit by giving bute and admitting he has no idea, it is unlikely to be mechanical as there is no reason to suspect there is a long term injury, mechanical lameness usually follows if something never quite goes back to where it was before, this is still fairly acute so should be more easily resolved.

I wouldn't be panicking yet, give it a bit more time.

 

[mjcssjw2]

to be fair time is what is needed with most things.

 

[be positive]

to be fair time is what is needed with most things.

Not always though if you don't know what you are dealing with, mine had injured his SI but it was missed by the vets doing the diagnostics, he was treated for his other injury and went through rehab but failed to recover fully, the vet just said more time as there is nothing else wrong based on nerve blocks done when assessed, nearly 2 years later we are redoing rehab, physio etc as the SI was injured despite being told otherwise, leaving it has meant the injury is now chronic and possibly never going to come right, if it had been diagnosed earlier he would have been treated appropriately and the prognosis would have been more favourable.

That is why a definitive diagnosis is so important, you then have options based on fact rather than guesswork but the diagnostics do have to be done correctly, mine was done while he was on high doses of bute, vet was aware he was on it but I was unaware they were going to do the assessment so the findings were, in my opinion, rather misleading.

 

[i-love-wellies]

Just to give everyone an update.
After coming of the bute where there was no improvement I continued to ride the pony in walk. About a week after coming of bute while waiting on the backman I decided to chance a canter and there was a huge improvement. He could canter left without changing and felt pretty normal, so the backman came out a few days later saw me ride and thought there was maybe some limited movement in his hocks (although looking back on vidoes of the pony he doesnt use them a whole lot anyway). So hes on a three week exersize programme to see if that gets him working. His pelvis was out slightly so he tweaked him again. I also chaged his saddle to one that is a better fit. However hes still tring to change behind on the left rein when you try to slow him doWn to go back to trot (in both saddles), yesterday Inoticed a tiny bit of puffyness in the left hock but it may always be like that as its very mild. So basically im still not sure what the issue is could still be the hock or sacroilliac if its a joint thing. ThougH seeinG as there was such a rapid improvement Im unsure if its either but maybe more of a muscular thing. Another issue at the moment is that our arena is being rebulit at the moment so im riding in a field that has hard ground so theest thing to dores very little grip for him that added to the fact that hes pretty much just walked on a long rein for the last 6 weeks means hes very unfit to working correctly so im thiking that I may just work him properly for a little while and see if he rides though it or a lamenss finally shows itself. The whole situation is just very frustrating as I dont know whats the best thing to do but as its such a mild problem diagnosis as this point witll be extremly difficult.

 

[chestnut cob]

What does your vet say? I would get a proper chartered equine physio out rather than a 'backman' for a start off. If it's very mild, you could try to work through it and see what happens (ie it resolves or it becomes bad enough to give you something to go on), or you could push for x rays and scans now.

 

[ihatework]

In your situation at the moment, and with the go abead from the vet, I would keep the horse on bute for a little longer and work the horse gently, primarily in straight lines hacking to a contact/over back, just in walk & trot for another month , combined with weekly Physio.

Then reasses. If still seeing difficulty in the canter I would then nerve block the hocks, X-ray them and scan suspensories. Once they are ruled out then I'd focus on the sacroiliac.

 

[i-love-wellies]

Should have said the back guy is a qualified chiro, theres no physios near me unfortunately. I have to ring the today to update him, but I think seeing as theres been an improvement he'll just want me to work him and see what happens, if he gets worse then go for xrays etc as we will hopefully know where to start! If it wasnt for the changing behind coming back to trot id say he was pretty much back to normal already.

 

[ester]

Has the pony not had any nerve blocks/suspensories scanned?

 

[i-love-wellies]

No the vet wasn't keen to do them yet because the issue is so non speific im waiting to hear back from him today as to whether to just keep working him and see what happens or if we should jsut try xray the hocks. Nerve blocking will be made more difficult as the issue only shows up when ridden in left canter( and now only just at the downward transition to trot) you wont see it on the lunge or in walk and trot. At the moment you could be talking nerve blocking pretty much his whole hind end and just tring to eliminate everything and as he's not insured its not an ideal route to go.

 

[chestnut cob]

Should have said the back guy is a qualified chiro, theres no physios near me unfortunately. I have to ring the today to update him, but I think seeing as theres been an improvement he'll just want me to work him and see what happens, if he gets worse then go for xrays etc as we will hopefully know where to start! If it wasnt for the changing behind coming back to trot id say he was pretty much back to normal already.

In that case, as you've already seen an improvement, I would echo IHW's advice. Talk to your vet about continuing the bute for a while longer and build the horse up slowly. I wouldn't work him in circles in an arena, I would hack him (working properly, in an outline, making sure he is active and pushing from behind) in walk then introduce some trot. Ignore the canter for now. You could also think about long reining in the arena, mostly straight lines with changes of rein and very large figures, in walk and progress to trot. I am sure there are physios in your area, there are physios everywhere. Ask your vet for a recommendation. The physio I use covers quite a large area so I am sure you will find one who will come out to you unless you live up a mountain somewhere and there are no people around for 500 miles.

Also agree the horse needs regular physio while you are trying to change the muscles. I can say from experience of my own issues with my hip that when the physio gave me a new exercise programme to deal with some stiffness and lack of mobility, I needed weekly then fortnightly physio for a 2-3 months.

Either way, if you are going to go down the route of scans etc eventually then you will be, I assume, claiming on your insurance, so you need to have your vet involved now.

 

[i-love-wellies]

Just to clarify the pony isnt on bute at the moment he improved off bute. When he was on the bute he was pretty bad and we saw no imporvement. He improved about a week after coming off bute so I doubt its a pain issue more of a mechanical one. He has no insurance (typically i was about to take out a policy the week this started) so my options realistically are going to be limited to ultrasound and xray if it comes to that. I only have the field to exersize in as the arena wont be finished fora few weeks so depeing on what the vet says i will probaly just work him in walk and trot in the field mostly straigt lines with some trot poles toencourage him to use his hind end..... this will hopefully sort him out or at least make him worse to help pin point the problem. I was thinking does anyone have any experience with swimming horses with these issues? I was wondering if it would help my guy as his issue seems to be related to weight bearing? Theres a an equine pool not to far away from me that does swims for 20 euro

 

[ester]

You could ride after nerve blocks though, you don't have to rely on lunge/trot ups. I don't understand why a quick scan of the suspensories given the symptoms hasn't been done as not a big job and no point paying for chiro to keep coming if you there is something else going on (and if nothing going on at least you can eliminate them).

 

[i-love-wellies]

Im going to discuss this with my vet today, to be honest is rather spend the few quod to have a quick look at his hocks even just to rule that area out scan/xray wise

 

[i-love-wellies]

So spoke to the vet ans he wants me to work the pony as normal and see what he does. On day 5 now and he's no worse with work. He's 100% on the lunge in all gaits and ridden over trot poles etc. Still changes the odd time in the canteronly really when you try to slow him down, though the canter feels fine . Im beging to think its partially to do with the ground in the field as its very hard and slippy even with studs so I think hes worried about loosing his balance a bit. Arena still isnt finished so the field is all i have obviously not working hard due to the ground. No sign of stiffness/heat/swelling anywhere after exersize. I really dont think hes sore to be honest. So will just have to wait and see. If there is a problem there hopefully it will now show up with proper work so we can identify an area to focus diagnosis on the vet didnt wanna start nerve blocks as the problem is now so mild it may not even show up clinically at the refferal hospital.

 

[JustMeThen]

If you look for thermal imaging scans on Facebook, you should be able to get one for about £50 and it should flag up any problem areas, good luck.