Gnildron
Member
Hi, I'm in the middle of a 'niggle tornado' and would appreciate any feedback and experience from others who recognise themselves in part of what I am going through with my horse (10 YO OTTB).
1. My horse has always been skew. Offloading the right hind, crab walking down hills. After a lot of other investigations (saddle x3, feet - getting angles better, bodywork) a vet finally diagnosed him with a stifle weakness on the right side. The diagnosis was clinical rather than imaging, just based on his movement patterns and blocking in lameness exam. Xrays showed nothing at all, we didn't do ultrasound but vet said it's a possible next step. She injected with HA. I also moved him off the steep hill he was living on onto a flatter paddock to improve his comfort and we took off his hind shoes on vet's suggestion.
2. Fast forward a few months. Horse is at a new yard (the flat one) and barefoot. Seems happy but is losing weight. It's winter, so we up feed. Eventually, I start suspecting ulcers (he's always been girthy) and treat with some ulsanic first, then some esomeprazole. Some improvements happen, but we're not quite there weight-wise. Vet scopes and finds some mild ulcers (stage 1-2) which she doesn't think requires much more than upping his lucerne/alfaalfa and another two weeks of esomeprazol. In the meantime, the hind end dysfunction has never quite gone away, although he has good days and worse days.
3. The last week, I've been noticing a deterioration in the hind end dysfunction. He is very grumpy, there's hardly any go, there's muscle spasms in his lower back that I recognise from when he's not feeling great behind. The saddle fits, and was checked after he lost some weight so that's not a concern. What does dovetail with the deterioration in his going is that I introduced a joint supplememnt that is given rectally that is meant to be both anti-inflammatory and joint-health-promoting, and it's given on a tapering dose. Recommended maintenance dose is weekly, but I was told to give every two weeks—the second week, which he's currently in, has correlated with our back slide. However I can't say I was blown AWAY by the efficacy of the suppositories. I also feel his weight gain has stalled, but it's also because I was waiting for the ezomeprazol and he'll be going on the last course of it from tomorrow.
4. I'm planning to give the next suppository asap and monitor. If he gets happier then it's obviously something in it that is helping him. However, I am also mindful that we never really got to the bottom of his hind end dysfunction, and I feel tempted to get a second vet out for a second opinion/lameness workup. One of the things that confounds diagnosis is that he tends to warm up and move better after a while, which could be interpreted as a vet block 'working'.
Basically, I feel like I'm playing 3D chess. I don't want to make too many moves at once as it makes it difficult to work out what is helping, and what isn't. The scope did not show any major lesions and so I feel that the hind end being only about feeling ulcery doesn't make any sense. What might make sense is that his stifle, or whatever is bothering him behind, is causing stress, which contributes to gut dysfunction. The dysfunction is pretty slight, and can sometimes be confused for a slight front lameness because of how he offloads the right hind. he also struggles a bit with leads in the canter, but that goes up and down, and under saddle he is pretty consistently right, it's mainly on the lunge that he picks up the wrong lead. It can happen on both reins, which is even more confusing.
Any thoughts? Obviously I will try to go through my options methodically. For people with stifle horses; How bad have they been when there have been signficant findings on imaging? I'm thinking things that show up on ultrasound rather than xray. My physio (or my horse's) doesn't think his stifle looks so bad—it's not swollen. There was atrophy, but it's less now after the initial diagnosis. Are there any things I haven't done/considered that I should?
1. My horse has always been skew. Offloading the right hind, crab walking down hills. After a lot of other investigations (saddle x3, feet - getting angles better, bodywork) a vet finally diagnosed him with a stifle weakness on the right side. The diagnosis was clinical rather than imaging, just based on his movement patterns and blocking in lameness exam. Xrays showed nothing at all, we didn't do ultrasound but vet said it's a possible next step. She injected with HA. I also moved him off the steep hill he was living on onto a flatter paddock to improve his comfort and we took off his hind shoes on vet's suggestion.
2. Fast forward a few months. Horse is at a new yard (the flat one) and barefoot. Seems happy but is losing weight. It's winter, so we up feed. Eventually, I start suspecting ulcers (he's always been girthy) and treat with some ulsanic first, then some esomeprazole. Some improvements happen, but we're not quite there weight-wise. Vet scopes and finds some mild ulcers (stage 1-2) which she doesn't think requires much more than upping his lucerne/alfaalfa and another two weeks of esomeprazol. In the meantime, the hind end dysfunction has never quite gone away, although he has good days and worse days.
3. The last week, I've been noticing a deterioration in the hind end dysfunction. He is very grumpy, there's hardly any go, there's muscle spasms in his lower back that I recognise from when he's not feeling great behind. The saddle fits, and was checked after he lost some weight so that's not a concern. What does dovetail with the deterioration in his going is that I introduced a joint supplememnt that is given rectally that is meant to be both anti-inflammatory and joint-health-promoting, and it's given on a tapering dose. Recommended maintenance dose is weekly, but I was told to give every two weeks—the second week, which he's currently in, has correlated with our back slide. However I can't say I was blown AWAY by the efficacy of the suppositories. I also feel his weight gain has stalled, but it's also because I was waiting for the ezomeprazol and he'll be going on the last course of it from tomorrow.
4. I'm planning to give the next suppository asap and monitor. If he gets happier then it's obviously something in it that is helping him. However, I am also mindful that we never really got to the bottom of his hind end dysfunction, and I feel tempted to get a second vet out for a second opinion/lameness workup. One of the things that confounds diagnosis is that he tends to warm up and move better after a while, which could be interpreted as a vet block 'working'.
Basically, I feel like I'm playing 3D chess. I don't want to make too many moves at once as it makes it difficult to work out what is helping, and what isn't. The scope did not show any major lesions and so I feel that the hind end being only about feeling ulcery doesn't make any sense. What might make sense is that his stifle, or whatever is bothering him behind, is causing stress, which contributes to gut dysfunction. The dysfunction is pretty slight, and can sometimes be confused for a slight front lameness because of how he offloads the right hind. he also struggles a bit with leads in the canter, but that goes up and down, and under saddle he is pretty consistently right, it's mainly on the lunge that he picks up the wrong lead. It can happen on both reins, which is even more confusing.
Any thoughts? Obviously I will try to go through my options methodically. For people with stifle horses; How bad have they been when there have been signficant findings on imaging? I'm thinking things that show up on ultrasound rather than xray. My physio (or my horse's) doesn't think his stifle looks so bad—it's not swollen. There was atrophy, but it's less now after the initial diagnosis. Are there any things I haven't done/considered that I should?
