Stifles :-(

[LouiseG]

Just looking for some advice to see if anyone has any helpful suggestions. Background as follows:

Spavin in right hock from a kick as a 4yo. He is now 7. Was intermittently lame and after nerve blocks etc localised to stifles, very low grade lameness in the hock, if anything at all. Bilateral arthroscopy in December revealed cartilage damage in the weight bearing part of both stifles with a lot of inflammation in the joint. The cartilage was debrided, followed by 3 IRAP injections over a period of 6 weeks whilst on box rest. He was given a 60% chance of recovery by the surgeon. Rehab was followed to the letter. Got back on in March, hacked for about 3-4 months, started schooling again gently building up trot and canter, trot nothing ever smaller than a 20m circle, canter still cantering large.

August he started to feel sluggish, had issues turning him off the track etc, starting to feel unlevel through changes of rein and on 20m circles. He then he went very lame, had a couple of days box rest and trotted up sound for the vet, had some danilon, and we have now done 6 weeks of hacking in walk only with some very small trots in the school really just to assess his movement, and he is very lame again in trot under saddle, and actually has been feeling stiff and unlevel in walk even which I’ve never felt before. He feels as bad as he did before the surgery (and even then was only ever 2/10ths lame on a straight line but significantly lame on a circle/flexion). Annoyingly he trots up sound on a straight line for the vet and that appears to be their assessment of choice, but he is significantly lame under saddle. The vet is back on Friday for a serious chat about his future. He’s also been lame in front taking the pressure off his hind end, sliced his fetlock open due to his hind end moving so close together now and basically I feel is deteriorating before my eyes and it’s heartbreaking.

I just wondered if anyone has been through something similar and can suggest the next steps? He’s cost me a fortune to treat, probably around the £7500 mark now and still lame. He gets physio monthly. My feeling is he will never be more than a light hack and the surgery hasn't worked (he was struggling with the most basic of schooling and after taking it so slowly he really should be feeling better than he is). I think I want to retire him since it’s his conformation that has caused this (he is very croup high) so we will always be fighting a losing battle. If he is field sound without danilon or bute, then he’d make a great companion, if I keep riding him I think he will break beyond repair.

Has anyone got anything they could suggest? Steroids I know don’t work too well in stifles and my feeling is they will only help in the very short term and I don’t want to put him through more intervention if it’s unlikely to keep him sound longer term. He has been through a lot already and stifles are just the worst joints to have this happening in as the success rate for this injury is incredibly low

Thanks for reading!

 

[amage]

At the risk of asking a stupid question have you checked his saddle fit? If only lame under saddle then is there a connection there? Also we have successfully treated two with steroids in stifles. While yes not as successful as treating suspensories etc you could get lucky.

 

[LouiseG]

Thanks for your reply. I've had his saddle checked and should have said he is also very lame on the lunge with no tack on

 

[TrasaM]

My friends horse went through a similar process including him trotting up sound but vet kept on advising bute rest then start again. He was taken to newmarket eventually ( August this year) for a full diagnoses. He had developed bony growths on both stifles and because he was compensating for the problem his rear feet had changed shape. He also had 3 areas of kissing spine. Insurance wouldn't pay out for the stifle op as it was deemed a pre existing condition..back problems included, so although he was just 7 years old with 7/5 vet opinion in favour of PTS rather than operate that is what happened She was told, like you, that there was a chance the surgery might work but with the spinal issues as well that it would not be a permanent fix even if it did succeed. Sorry, not a positive answer. I suppose on bute BB might have been ok in the field for a few more years but that wasn't an option really for my friend.