Suspensory Misery........NOW Sacro Iliac Probs??

[louisewarner]

Some of you seasoned old suspensory injury owners may be able to help me out with some possibilities her......for that matter anyone else is welcome too...

My boy is 9 months post suspensory ligament strain (both hinds tho left worse than right) and we have done the box rest, walking and trotting. He was allowed turn out a month ago, has behaved impeccably in the field as so pleased to get head down and eat the green stuff at last....have increased level of exercise to include cantering now and has been doing brill until a week ago. The last scan a month ago showed total healing of hinds and vet said you virtually couldnt tell from scan that he had ever had a prob........

A week ago, just got a little shuffly and a little nappy, canter again felt hard work and resistant,,,,,vet out, watched him ridden agreed with view fromm ground, not lame just unwilling and stiff (he is not a moody boy so I beleive him when he says no, I cant do it)......vet nerve blocked both hind suspensories.....NO difference, still resistant, and very stiff..booked in now for inpatient invetigations this week and vet thinks it may be more Sacro iliac issues........I have to say the feelings I felt were the same as 9 months ago pre diagnosis........any thoughts?? Vet did look grim and admitted she was concerned......is there any hope whatsoever if it transpires to Sacroiliac strain or worse....I know this area is so difficult to diagnose and treat. Am so dissapointed as feel now we have been through all the hard work of rehab and now its something else, tho vet has said it could have been the initial prob in the pelvis that caused compensatory strain on the suspensories, which were obviously the presenting problem 9 months ago. In other words he may have had this SI/pelvis prob predating the susps......any help, as ever, really welcome. Thanks.......

 

[Jemayni]

Omg that is so awful for you, hope you are ok? I cannot really offer any words of wisdom other than your vet is right, in there must have been something to cause a bilateral high susp problem in the first place.

And to draw a comparison with my own own horse who has been lame for 6 months right fore; it was only when he came sound on the right this week, when a left fore lameness became really prominent; the vet says it could have been this causing the off fore lameness (due to him compensating) or vice versa, its shocking the knock on effect these things have.

Good luck, and try not to get yourself to down about it, just think of it as the next next chapter in this god fore saken (hmm sp, that defo don't look right.) challenge horses ask us to endure!

 

[Oldred]

I'm in the same boat but have given in and retired the horse - for the moment! Similar to you I had my mare diagnosed with proximal suspensory desmitis in both hinds. Symptoms were: unwilling to move forward when ridden at walk, certainly not trot or canter (bucking if pressed), quarters bent to right, abrupt transitions down, unlevel behind. Shockwave did not work, nor rest and limited exercise. Although there was apparently signs on the ultrasound of 'disturbance' in the sus ligs she didn't show much, if any, improvement when they were nerve blocked, as far as I could see but the vet disagreed. HOWEVER, when she was blocked in the sacroiliac joint she was instantly 100% sound and straight.

The vet said the reason was.....the suspensory ligaments have caused her to have pain in her sacroiliac and unless the ligaments were operated on, the sacroiliac would never improve. (He didn't think she was a candidate for the op though - he just had a hunch).

I tried a sclerosing agent injection into the sacroiliac joint but it did not have the same effect as the nerve block. I chickened out of a steroid injection into the sacroiliac as I felt it too high a risk as she is a native/cob/pony laminitis risk.

This doesn't help you I know, but I find it interesting what you are saying about your horse and thought you might like to know about mine. And, I recently had a chat, and saw in action, a vet who is a chiropractor. He is coming to see my mare in two weeks as he is very interested in her case. I will let you know what happens.

PS: Have you ever thought your horse may have had a stifle problem in the past?

 

[louisewarner]

Thanks Oldred
That is interesting and I would be interested to know about the chiropracter/vet........If it came to it in my case I may well consider the Steroid injection as I wouldnt consider my boy a huge risk.......tho' sure there is always a risk to a degree.....did your vet give an estimate of the potential benefits of the steroid injection? would it be a lasting effect or would it need doing often (to me, often, is more than once every 4 months??)
Regarding the stifles, we had them X rayed at the initial work up 9 months ago and they were in exc condition.....suprisingly there were no arthritic changes in either hocks or stifles....of course we didnt investigate the SI area......at that time......can you get a good X ray view of the SI joint? I think my vet has said its hard to get a really good look thru X ray alone as the structure is so deep and obscured by muscle and ligs etc.....We are booked in for an overnight stay at vet this week and a complete work up and whatever investigations they like..........one thing for sure I cannot bear to do the box rest again as when he did go out he was sedalined and was an angel and really quiet and just grateful to be out!. Only did the sed for two days and he has been brill even in this cold weather and a full clip...........I will let you know how we go at vet, and please keep me up to date with your girl.....and all the best to you both.......keep in touch.

 

[Oldred]

The vet was vague about how much and for how long a steroid injection would work. Certainly the implication was it was 'likely to work' and 'work for some months' and initially said there was very little risk of laminitis. When it came to the crunch though he was more cautious in his estimate of the risk to her.

Yup, I was told also that the SI area is impossible to x-ray which was why I was so interested in the vet/chiro I saw work recently. He was able to (seemingly) feel whether the SI was functioning correctly as a joint. I'll know more about this when he visits me. It looked convincing. Interestingly he said that the sacroliliac has no voluntary muscles controlling it and one side can show inflammation and soreness but the cause is the other side not working/moving correctly. (I may have misunderstood - hopefully I'll get better info soon).

The x rays of my mare's stifles showed nothing amiss apart from a small dimple which is apparently a bone cyst that has never come to anything and yet I've always wondered about her stifles from when she was a yearling. According to this chiro, there is a connection between stifles and SI (in as much as taking the horse's whole mechanics of movement in to consideration).

Good luck at the vets - your boy sounds sweet. What a relief for you I imagine when he was turned out.

 

[4whitesocks]

Had an 11yo with a sacroiliac strain - not caused by the same thing though - came to the fore when he was being a plonker loading & went up and came down badly, even before this though he had become really reticent to canter (or even trot) wasn't lame just very very unwilling...he had 6 weeks box rest then another 8 weeks off work (turned out) and came sound....

 

[Oldred]

That's pretty heartening 4whitesocks, I've read that sacroiliac strain can be nasty. Glad you were one of the lucky ones - I had got the impression that it was virtually it if they strained that area - never came right. I am sure there is something more going on in my mares SI area but what? She had scintigraphy as well as ultrasound and it showed nothing wrong yet a nerve block to that area had a 100% 'cure' repsonse.