Slow developing neuro problems?

[chaps89]

Brief background:
Horse is 17 years old (ish) Diagnosed 7 or 8 years ago with arthritis in both forefeet. Initially tried steroids & remedial shoes, no improvement, normal shoes & controlled by bute & limited work for several years. 18 months ago used cartrophen & egg-bars with pads successfully for 8 months until August/September last year when retired, cartrophen no longer working & no need for egg bars if not in work. Shoes off, became alot sounder. He has recently gone from 1/2 schet to a whole sachet of danilon a day as seems to be feeling the hard ground, so he gets this daily along with mobility supplement.
2 and a half years ago investigated for weight loss, mild colic attacks & 'depression'- scoped for ulcers (he's a cribber) totally clear, various biopsies & fluid samples taken, protein losing enteropathy and something else diagnosed, to remain on low dose steroids for remainder of days.

No idea if any of the above bears any relevance but thought would add in incase.
Horse retired last year as kept slipping on back end, which was panicking him & he was taking off (nb, not true bolts) felt not fair on him, me or other road users. Also napping, bucking and trying to take off alot in ridden work (not unusual, all are his 'party tricks' but usually he would try it on once or twice then be good again but this continued for approx 2 or 3 weeks before felt definitiely not right & I wasn't happy 'riding him through it' so started to investigate) He was also standing with back legs together and tucked under him alot.
This combined with front end problems meant felt not worth persisting with ridden work. Did have physio at the time (with vet permission) who found nothing obvious, some tightness through poll, behind the saddle and in glutes/hamstrings but nothing too disconcerting, so he had 3 or 4 sessions (no change in behaviour) until she was satisfied this was improved. Saddler out & teeth also checked, all ok.
Confirmed with vet who suggested turn away and see how he goes.

He was doing ok and looking much better, until about a month or so ago horse was spooked in the field and fell over on his back end, lame the day after & stiff on and off since.
Think it re-triggered the original problem which clearly hadn't gone away as I'd hoped. Quite often seen in the field with both back legs close together & tucked under him again. Struggling to pick his back end up to pick feet out & at the weekend I bathed him. Had horse 9 years and bathed him in pretty much every weather going without him batting an eyelid. Never seen a reaction like it. As I was rinsing him off he started lashing out with his hind legs, very obviously a pain reaction and he was not happy (missed my face by about an inch when he double barrelled) Bum tucked under like he was almost sitting down (like the reaction if you get the dock wet & it surprises them but I'd not done his tail at this point!) Once sweat scrapered/towelled/rugged fine & not any worse afterwards.
Physio this morning, thinks he is looking well in himself and from a physio point of view she is not concerned but basic neuro tests had odd results. Tail pull where horse is supposed to resists, his back end followed her with little resistance, doing leg stretches he would slam feet back down seemingly unaware of where he was putting them, not weight bearing/always resting a hind leg, and his 'back-up' he was doing un-co-ordinated and scuffing.
Vet is out tomorrow, but googling and no other neuro problem seems to be so slow developing. No heat, swelling or other unusual symptons to count (did ask physio about possibility of bi-lateral hind limb lameness ie, suspensories but she felt unlikely). Please don't slate me for leaving it so long to have vet, was with vet support & having had other professionals look at him that being turned away was tried first as felt no danger to him or anyone around him by doing so. Now we know there is most definitley an underlying problem vet has been called ASAP.

Any ideas?
I'm planning on giving him the summer & PTS anyway as he doesn't seem right & although not lame is uncomfortable in front which will never get better & he does not enjoy winter, so for his sake it feels like the right decision as he owes me nothing & I want him to go whilst he still has a quality of life as currently he is still well & bright & perky in himself.
As a result will not push for anything invasive or extreme so long as he is comfortable but would be interesting to hear others thoughts on the matter.
If of course vet feels he could be a danger to himself/there is a chance he might go down & do real damage/not be able to get up then the decision already made will be bought forward for his sake)

 

[be positive]

I would suspect arthritic changes somewhere along the spine causing slight pressure to the spinal cord, in other words wobblers, or a form of kissing spine. The nuero tests are used as part of the diagnostics for wobblers and his reactions sound classic, although I did have one here that did all these things that the vet said had nothing wrong with it, it moved elsewhere so I have no idea if it deteriorated over time.

 

[chaps89]

Thanks for the reply. I hadn't thought of wobblers purely because the horses I've known who've had it have either developed it and deteriorated extremely rapidly or it's been severe but stable. Will put it it back in as a possible to bear in mind now!
Would have thought maybe the physio would have had some sort of pain response to the poking/prodding if it was arthritic changes/KS? Also, he has recently (ie, 2 weeks ago) gone from 1/2 to a whole sachet of danilon, improvement seen in front, would have thought if it was arthritis would have seen an improvement behind too maybe?
Arthritis isn't unlikely considering he has it in his front feet tho. Food for thought, thankyou.

Photos for anyone that may be interested.
(please excuse the post bath photo where he's all wet & feathery, saw him standing like it & just really wanted to get the photo! He also looks quite round in that photo, there is not an ounce of fat on him and you can see his ribs when he moves & feel them easily, he just has a bit of a grass belly) Second photo is after a stretch the physio did, he put his leg down like it & didn't move it despite the fact it isn't a normal position.

 

[EstherYoung]

If he's already got arthritis in the front end I'd hazard a guess that this is arthritis in the back end too - it could be in his back or hocks or fetlocks or all of the above.

My old chap has an arthritic back end and the first signs with him were 'losing' a back leg when ridden, and problems backing up. He's never actually been lame as such with his, it's just that he's losing power behind.

Good luck with the vet xxx

 

[Birker2020]

Brief background:
Physio this morning, thinks he is looking well in himself and from a physio point of view she is not concerned but basic neuro tests had odd results. Tail pull where horse is supposed to resists, his back end followed her with little resistance, doing leg stretches he would slam feet back down seemingly unaware of where he was putting them

There are a number of other neuro tests that you can do, but probably best to wait until the vet visits as they can be quite dangerous for the handler unless you know what you are doing.

It may be that you have a horse with arthtitic changes in his neck, which are causing neuro problems due to a slight compression of the spinal cord and associated nerves.

My wobblers horse would quite happily stand with one front foot touching another, something that I have only ever seen since in our dog after she had a funny turn the once.

Even if it is wobblers/cervical myopathy it can take time to develop and I wouldn't worry to much until you have received a diagnosis. One thing I would say, is that if the vet intends x-raying the neck I would recommend you get the horse to a fully equipped hospital with a decent powerful xray machine. My vet xrayed my horse in 2004 with a portable xray machine and said he was fine. few weeks later at Liverpool with proper xray machine he was diagnosed with wobblers and PTS. He was Grade3 touching on Grade 4, and couldn't trot without almost falling over, and if you pulled his tail he woudl be on top of you, very, very sad. Your horse doesn't sound anywhere near as affected as my horse so don't worry too much.

Portable xray machines weren't very good at penetrating the huge muscles of the neck in 2004. They may be better now.

 

[Calcyle]

Photos for anyone that may be interested.
(please excuse the post bath photo where he's all wet & feathery, saw him standing like it & just really wanted to get the photo! He also looks quite round in that photo, there is not an ounce of fat on him and you can see his ribs when he moves & feel them easily, he just has a bit of a grass belly) Second photo is after a stretch the physio did, he put his leg down like it & didn't move it despite the fact it isn't a normal position.

I presume the physio pointed out that leaving the leg in that position is also a classic neurological symptom? Quite a severe one if he just left it.

KS doesn't always elicit a pain response.

My best guess would be an impingement caused/exacerbated by the fall. X-rays definitely the way to go. Please keep us updated, good luck.

 

[chaps89]

Thankyou for all of the replies.
Applecart - sorry to hear about your horse, what an awful thing to happen with the x-rays on top of what was going on with him.
Calcyle- yeah the physio pointed out it was abnormal for him to leave his leg like that for so long, to the extent she actually took a photo herself because of it being unusual.
Vet attended yesterday, whether he didn't push for extensive exams etc because I'd already said I was contemplating pts at the end of summer anyway cause of his arthritis or whether he could see enough from various neuro tests & looking at him I don't know but either way I am happy with what we discussed.
He agrees neuro problem and based on what he could see has suggested cauda equine neuritis (sp?) as a diagnosis. He is happy that with how horse is at the moment that a last summer is feasible on the basis that if he were to deteriorate suddenly we bring the decision forward but as he is he feels symptons (considering it's a neuro problem) are mild we are ok as we are.
I did ask about the possibility of physical but he felt with the way he reacted to some of the tests definitley neuro. Alot of the tests were well within normal ranges but one or two were unsatisfactory.
All I wanted from the visit was to check he wasn't in huge amounts of pain or that it wasn't unsafe to keep him alive which the visit has helped with.
So a hard decision but the right one for the horse and I am lucky I can prepare myself for saying goodbye too.

 

[Birker2020]

Thankyou for all of the replies.
Applecart - sorry to hear about your horse, what an awful thing to happen with the x-rays on top of what was going on with him.
Calcyle- yeah the physio pointed out it was abnormal for him to leave his leg like that for so long, to the extent she actually took a photo herself because of it being unusual.
Vet attended yesterday, whether he didn't push for extensive exams etc because I'd already said I was contemplating pts at the end of summer anyway cause of his arthritis or whether he could see enough from various neuro tests & looking at him I don't know but either way I am happy with what we discussed.
He agrees neuro problem and based on what he could see has suggested cauda equine neuritis (sp?) as a diagnosis. He is happy that with how horse is at the moment that a last summer is feasible on the basis that if he were to deteriorate suddenly we bring the decision forward but as he is he feels symptons (considering it's a neuro problem) are mild we are ok as we are.
I did ask about the possibility of physical but he felt with the way he reacted to some of the tests definitley neuro. Alot of the tests were well within normal ranges but one or two were unsatisfactory.
All I wanted from the visit was to check he wasn't in huge amounts of pain or that it wasn't unsafe to keep him alive which the visit has helped with.
So a hard decision but the right one for the horse and I am lucky I can prepare myself for saying goodbye too.

Yes you are 'lucky' to be able to say goodbye but its still awful for you.

Cauda equine neuritis is a progressive nuero condition and is an immune disorder which causes the body's immune system to over react..

 

[chaps89]

Thankyou for the reply applecart.
At the moment I am fine, and very matter of fact about the matter, spoken to the vet about the practicalities of pts, spoken to the insurance and feel ok about it. I very much suspect at the time will be a different matter tho and am not looking forwards to it (not that anyone does!)

Vet did say it can be caused by the herpes virus & mentioned immune system, which to a certain extent doesn't surprise me as he's had various 'off' results from blood tests over the years but nothing major has ever flagged. I did ask if it was contagious/infectious in any which way & he said the virus would be long gone & not a concern.
I have briefly googled it but not had chance to do a proper research as been doing extra shifts at work.
Interestingly he did suggest that steroids can help, but he is already on these with his stomach problems so I wonder if the reason it has developed slowly is because the steroids have slowed it down? The dose he's on is extremely low tho & I guess I won't know, just one of these things really.

 

[Birker2020]

Vet did say it can be caused by the herpes virus & mentioned immune system, which to a certain extent doesn't surprise me as he's had various 'off' results from blood tests over the years but nothing major has ever flagged. I did ask if it was contagious/infectious in any which way & he said the virus would be long gone & not a concern..[/QUOTE)

Hi Chaps 89,

Equine Herpes Virus (EHV1) can cause ataxia (loss of co-ordination in the hind limbs and sometimes forelimbs also).

But he was probably referring to the EHV as the cause or outcome from the Cauda equine neuritis that he diagnosed your horse as having.

At the end of the day providing your horse isn't too ataxic and therefore of danger to himself and others by possibly falling on top of people then there is no reason why he can't go the summer with a view to an immediate PTS should his symptoms deteriorate quickly. I am sure he isn't in pain, maybe a couple of sachets of bute a day if you are worried, but you would need to discuss this with your vet. Sometimes the words better a day to soon than a day to late are bandied about and cause people to panic. You know your horse better than anyone.

When my horse Rommy was ataxic I wasn't worried so much that he was in pain, more than he would have been stressed as being a horse he would have naturally needed his senses about him, being a flight animal means that horses can react quickly, and I worred more that he would have been stressed to have felt in a permanent stupor, but to be fair his attacks, although severe when they came were small in number. We were wrongly diagnosed with a diagnosis of EHV when it was wobblers, so my horse probably ended up with more episodes of ataxia than the average horse would have been expected to go through. He couldn't go to a hospital because of the risk of EHV being passed on. When the vets finally decided that the ??? titre levels ??? were too low to be EHV and therefore he was not at risk of passing the EHV virus on, he was (on my assistance) eventually referred to a hospital, xrayed and PTS with wobblers as he was too badly affected to be expected to live a life as a field ornament even.

I was interested to see the photo of your horse with his back lfoot stretched out, sole up. My horse has been standing like that quite recently, but does move after a few seconds. I am a bit wary of another horse suffering neuro conditions so will do the tail sway test every couple of weeks or so but he has always been okay.

when I was Liverpool and the consultant carried out his neuro examination on Rommy, although extremely distressing, it was very interesting to see his foot placement, and the fact he would happily stand with one foot on top of the other, or try to walk off with the 'wrong' leg.

 

[chaps89]

It's interesting seeing your responses, thankyou
I am also glad you don't seem opposed to him having a last summer (well, summer being somewhat debatable considering it is throwing it down outside right now) I am very much of the 'better a day too early than a day too late' school having seen far too many horses over the years that look 'old'/in pain/can't hold their weight/get up any more etc etc that owners seem to keep going for their benefit not the horses and that is why my decision will be what's best for him not me but certainly whilst he is comfortable and also at the stage he is & not a danger he will keep going.
What worries me most is I am not sure I will know when the time is right, people often say 'they just 'knew''. Say he doesn't deteriorate much but winter is approaching I won't want to put him through another winter (he hates living out in winter, (wimpy native!), plus if he suddenly deteriorates I'd feel awful for not letting him go whilst the weather was nice & he was happier rather than trying to get him through another year) I may just have to make the decision on 'when' anyway.
If he suddenly deteriorates or appears to lose interest in life, drops weight, he gets lamer with his arthritis etc then the decision becomes 'easier' to a certain extent.
All if's and buts I know, I can only see how he does as time goes on.
As the vet said, it's one thing knowing it will be done in the near-ish future, picking the day is somewhat harder. I think this is what I will struggle with most but it will be for his sake.

When my horse Rommy was ataxic I wasn't worried so much that he was in pain, more than he would have been stressed as being a horse he would have naturally needed his senses about him, being a flight animal means that horses can react quickly

Absolutely, one of the things I asked my vet was if there was a risk of him falling over/going down, being unable to get up or being a danger to anyone around him because should that be the case I would do the deed sooner rather than later for the safety of him and others around him. Vet felt although at a higher risk of this than any normal horse, it is so mild & he still canters round the field freely etc I am not to be concerned about this at this time and just to monitor him.
Fellow livery has been very understanding and seperated her youngster who is very playful (her other horse was already seperated due to other reasons so it's now just that she has her 2 seperate from mine & the yard owners) as I just wanted to limit the risk of injuries/accidents.
I know I can't wrap him up in cotton wool and nor would I want to keep him on his own entirely as don't feel that is fair on him, & had livery not been so understanding I would have re-thought about what to do as do not want to inconvenience other people for my horse but YO & fellow livery have been very understanding (youngster very keen to play- mine top dog & not keen to play means there is a fair few scuffles, so although mine doesn't have to move out of the way he will often chase the younger horse away, hence why I asked about him moving)

I was interested to see the photo of your horse with his back lfoot stretched out, sole up. My horse has been standing like that quite recently, but does move after a few seconds

I sincerely hope there is nothing amiss with your horse, hopefully your awareness will only help should there be something wrong. Mine will stand like that quite happily for some time until I ask him to move, if yours only does it for seconds hopefully there is nothing to worry about.
I am casually browsing ads to see what is about/how much money I will need to save for another and I have seen a few stood with their back legs tucked under them, a photo is only a moment in time but if I were seriously looking I would potentially discount that horse straight away, it has made me very wary!

 

[Birker2020]

It's interesting seeing your responses, thankyou

I sincerely hope there is nothing amiss with your horse, hopefully your awareness will only help should there be something wrong. Mine will stand like that quite happily for some time until I ask him to move, if yours only does it for seconds hopefully there is nothing to worry about.

I am casually browsing ads to see what is about/how much money I will need to save for another and I have seen a few stood with their back legs tucked under them, a photo is only a moment in time but if I were seriously looking I would potentially discount that horse straight away, it has made me very wary!

No I did the tail sway test last night - he was fine, albeit a little annoyed as I pull his tail to the side at least once a week to test!

I would suggest that you ask your vet (when the time comes) if there is anyway your horse can be pts under 'humane grounds'. This is what happened with my horse, as the consultant said his neuro state was quite far advanced. I don't think you will be as 'lucky' as me in that respect though, as by the sound of it your horse isn't so far advanced in terms of deficit as my horse was. It might be worth a try, if it means you can get some money for 'death of horse' on your insurance policy. I'm not suggesting anything illegal or 'naughty' but the vet might be able to swing it for your under the BVA guildelines.

 

[chaps89]

Bless him, they are good at putting up with our neurosis at times aren't they!
I used to work for a well known equine insurance company so sadly know all about the BEVA criteria, unless he deteriorates rapidly he won't fall into this category & vet has already mentioned it & said unless something happens to make it worse/he has an accident in the meantime etc he won't be able to confirm it met the criteria in order for me to claim. He isn't insured for a huge value but the money back would have been handy just to cover the pts/disposal costs but that's just having horses, that it will happen at some point or another and need to be paid so I can't grumble too much.

 

[Birker2020]

I used to work for a well known equine insurance company so sadly know all about the BEVA criteria, unless he deteriorates rapidly he won't fall into this category & vet has already mentioned it & said unless something happens to make it worse/he has an accident in the meantime etc he won't be able to confirm it met the criteria in order for me to claim.

That's a shame. I know its horrid to think about our friends in terms of money but practicality often means we have no choice. Like you say, its just one of those things with horses sad though it is. At least you are making the right choice with him, the sign of a good owner.

And then you go to the other extreme.....I knew of someone once (friend of a friend of a friend type of scenario) whose horse was basically a car crash at a very young age, but rather than keep her/try to mend her/put her to sleep - they tried to flog her to the highest bidder. Poor animal got passed from pillar to post before ending up being classed as 'dangerous/unrideable' when in actual fact she was as honest as the day was long, but was screaming at people that she was in pain and there was no one prepared to stop for a minute and hear her cries. Very sad.

 

[fatpiggy]

My insurance didn't cover anything other than sudden death so I got not a penny when I had her PTS last autumn. It was necessary, she wasn't well enough to go into another winter and I had several months to save up the funds. The vets agreed completely with me. Money should NEVER be a factor when making that decision.