Stifle/Hind-end Issues

T

ThreeWBs

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Firstly, sorry for the essay!

5yo 16.2 WB is having some issues with his off hind during work.

Background:
- Turned out 24/7 in summer and out for at least 12hrs a day in winter - usually Dec - March.
- Bought as a 1yo and passed basic 2-star vetting.
- As he grew, he had locking stifles/patella in both hinds, notably more in his OH. Never caused a problem as he unlocked himself and then only had reoccurring locking during grow spurts, continuing till he was around 3.5/4yo.
- Backed slowly at 4yo and has mainly hacked due to overall physical weakness. Happy in W,T, C in straight lines. Noticed on the lunge he is coming up short in trot on the OH.
- Vet said he's very weak in the OH stifle and it compensating through the left of his back making him look bilaterally lame through the front. Prescribed lots of hacking, hill work and pole. Physio agreed.
- Given winter off to grow and mature.

Now:
- Brought back into work in Feb 2019 as a 5yo.
- He has huge movement, but is still very unbalanced and babyish.
- When ridden in circles at trot, it almost feels like he's stepped in a hole for a stride and then is fine again.
- Has new saddle which is being professionally fitted. Saddler noticed he tilts his pelvis to the right (when looking from behind).
- Still suffering with stifle weakness and not coming through fully with OH in circles in trot. Canter is ok, but perhaps fractionally short. His standard walk is really overtracking.
- Still a little sore over his back and sometimes on his loins and pelvis when palpating (comes and goes)
- He's still growing and notably filling out.

He's happy in himself and does all sorts of acrobatic moves in the field. Never sore or tetchy to tack or ride.

Physio is back out at the weekend, but I'm at the stage where I'd like to get him nerve blocked and x-rayed.

Does anyone have any suggestions what I can do to help him?

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Have the stifles ever been X rayed? I had one with locking stifles and I had him done twice, once before he did any real work and again before I started to ask more of him than basic wtc on big circles. He grew out of it around seven, but before that he sometimes felt like he 'fell off' one leg, usually the right one, when he started to tire.

I would want x-rays, and of they are clear give him to e with a gentle hacking workload, or turned away.

I hope that helps.

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I've just watched your video. It's difficult to judge from one short video, but are your vet and physio confident that the issue is just the stifle, and there's no involvement of the sacroiliac?

The definition's a bit too blurred to see clearly, but from the shine on his coat, the muscles around the tubera sacrale look as if they might be rigid, and the tubera sacrale pushing up a bit at some points of the stride as well.

As I say, it's very difficult when you don't see the horse on person, but if he was mine I suspect I might be asking for an investigation of the whole back end. A scintigraph might be easiest if you can afford it.

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I think you are doing the right thing investigating further at this stage, whilst young horses take time to grow and strengthen and a conservative approach to start with isn’t wrong, he does look lame here and I’d want to be sure there’s nothing going on that needs proper intervention.
So for now you are doing the right thing by going the vet route - just use a good performance orthopaedic vet and I’d drop him off at the hospital rather than try to do a half job at home
 
ycbm said:
I've just watched your video. It's difficult to judge from one short video, but are your vet and physio confident that the issue is just the stifle, and there's no involvement of the sacroiliac?

The definition's a bit too blurred to see clearly, but from the shine on his coat, the muscles around the tubera sacrale look as if they might be rigid, and the tubera sacrale pushing up a bit at some points of the stride as well.

As I say, it's very difficult when you don't see the horse on person, but if he was mine I suspect I might be asking for an investigation of the whole back end. A g might be easiest if you can afford it.

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Stifles have not been x-rayed. I asked my vet on his last visit and he said there wasn't any need.

Yes you're right, it does look solid. I will point it out to the physio and the vet. Perhaps the locking stifle issues he had growing up has made him compensate and put too much strain on the SI area. I hope it's fixable :(
 
I'm looking higher up than you have marked. On photo one, spot the tuber sacrale, highest point of his bum, which are directly on a line with the tree. Look at the mound of muscle below that. In your video, it looks, to me, to be absolutely rigid, as if he is trying not to let his SI joint, or possibly his pelvis, move.

I could be completely wrong, but I'd be very interested to see it in the flesh. I'm completely bemused that your vet rules out further investigation of a unilateral weak stifle. I'm not sure he's helping you and I would consider changing vets.



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ycbm said:
I'm looking higher up than you have marked. On photo one, spot the tuber sacrale, highest point of his bum, which are directly on a line with the tree. Look at the mound of muscle below that. In your video, it looks, to me, to be absolutely rigid, as if he is trying not to let his SI joint, or possibly his pelvis, move.

I could be completely wrong, but I'd be very interested to see it in the flesh. I'm completely bemused that your vet rules out further investigation of a unilateral weak stifle. I'm not sure he's helping you and I would consider changing vets.



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Click to expand...
I can see that too. There's a whole bunch of rigid muscles holding him in a shape that he's 'comfortable' which is completely wrong. I'd not noticed his bicep femoris being so prominent and hard until I watched the video in slowmo.

I'm going to work with everyone I can to get him right and I'll certainly obtain x-rays after his physio this weekend.
 
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