Twitching shoulder/nerve problem

daydreamer

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hi,

I wondered if anyone had any experiences/ideas/opinions they might be able to share with me. (Before I start ... the horse was seen by an experienced equine vet this Monday). Sorry in advance for such a long post.

My 24 yo TB Barney has been not quite right for a couple of months, just a bit dull and not himself. He had a bit of unlevelness in his left fore which seemed to resolve after a few days off and we put down to foot bruising due to hard ground. I had the physio come to check him about about 3 or 4 weeks ago and she said he had sore/tight back muscles, his pelvis was slightly out, tight intercostals and lats. She gave me lots of exercises to do - front and back leg pulls, pelvis tilts, belly lifts, carrot stretches to the elbow. I was doing the exercises every day and seeing some improvement i those. I did a bit of hacking out - seemed ok, if a little dull still. I rode in the school a couple of times - some initial stiffness then some really nice work. I was long reining and doing pole work in hand too - some lovely trot work on the long reins in the field.

Occasionally i had seen some twitching in the left shoulder this summer after doing stretches or bodywork. Then about a week and a half ago the twitching got more frequent during one of the stretching sessions. After that I stopped doing the stretches/riding and got the vet out.

The twitching mainly appears when Barney is tied outside his stable whilst I am mucking out. If he is eating I don't see it so much. It doesn't seem as bad in the mornings (the yard usually turn hi out for me so I only have weekends to go on). Each twitching session will only be for a couple of minutes on and off. He likes me to rub his shoulder and will move towards me when it is bothering him so I can. The weird thing is he bends his neck towards the twitching shoulder (which the vet agreed is odd - if something is pinching in theory he should relieve it by bending away). I have put a short video below ....

Short video here

The vet did carrot stretches to elbow both ways - fine. No obvious pain in the leg/shoulder on palpitation. 1/10 lame on front left and 1.5-2/10 lame on front right (although to be fair this was first thing in the morning on concrete - I'm not sure how many 24yo ex eventers would be 0/10!?). The vet said he doesn't seem to be protecting his neck. He said neck x-rays on a horse of his age are likely to show changes anyway so may not be diagnostic.

He is currently on 2 weeks off, 2 bute a day for 7 days and then 1 a day for 7 days. Shoulder twitching has continued to appear and is maybe more frequent (or I could just be being paranoid).

Any ideas/experiences welcome. Obviously I will talk to the vet again too but I'm just not feeling optimistic about it and wondered if anyone on here had any advice.

Thanks.
 

hopscotch bandit

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be positive

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Horses will not stretch to relieve discomfort in the way we would because it hurts to do so so they will be more likely go into it to relieve whatever the issue is, they do not have the ability to be logical so often do the opposite to what we would.
That looks like a muscle spasm, possibly aggravated by the physio, who really should come back to see how he responded to the treatment given, I would not be too despondent at this stage but I would get the physio back for the follow up check and see what they think.
 

daydreamer

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Horses will not stretch to relieve discomfort in the way we would because it hurts to do so so they will be more likely go into it to relieve whatever the issue is, they do not have the ability to be logical so often do the opposite to what we would.
That looks like a muscle spasm, possibly aggravated by the physio, who really should come back to see how he responded to the treatment given, I would not be too despondent at this stage but I would get the physio back for the follow up check and see what they think.
Thanks. I see what you mean about the stretching in to pain/pressure it's just the vet said it was odd!

I was very despondent last night but there didn't seem to be quite as much twitching tonight. I had worked myself up in to a state that it was bony changes on the vertebrae and things were just going to get worse rapidly (obviously this still *might* be the case but i have been scouring the internet today and have read at least some positive stories).

I did send a video to the physio and she said it looked like something was pinching in the thoracic/wither region but didn't offer to come back and follow up. If it doesn't get worse I guess I will finish the 2 weeks on bute and then ask the vet if i should get physio/chiro/other/no-one out to look at it.
 

be positive

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Any decent physio should expect to do a follow up as routine to check they have responded to any treatment in the way they wanted, most want to come back within 2-3 weeks, to not do so is unusual and to not want to knowing he has developed a problem seems rather unprofessional and not something any physio I have used would do, he is now under the vet but the two should work together in the interests of the horse, this does seem to be something that a physio would have a better idea of than most vets.
The bute should help the muscles relax, the spasms should reduce but I would want to have the right exercises to do aimed at the area, the ones you are/ were doing may not be appropriate so it could return once the bute is stopped.
 

SadKen

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Sent a PM but just for anyone following the thread later:

My mare had this, seasonally feb-jun/July for 4 years out of 6 I owned her. Never fully resolved but we are confident it was nerve damage, it is overstimulation of the panniculus reflex which means the nerve is firing when it shouldn't.

As per the above threads we thought initially it was saddle, but later developments show it was likely to be low grade lami altering stance which triggered the sacrum area which was bio mechanically linked to the shoulder. Chiropractor work helped, Angela Holland worked on my mare and did a great job.

My mare had cushings at 13 (and likely before). Cushings has been linked to spasms and nerve conduction problems so at your boy's age it is likely worth testing. Might explain his being a bit dull, and potentially if there is a hint of lami that might be your cause. There should be the option for a free test. There is lots of info on the equine cushings page on Facebook. I've seen similar things posted there before too.

Mag ox can soothe spasms if the horse needs supplementation and it's cheap enough to warrant a go, and I'd treat as laminitic in all cases now after my experience at least in terms of feed.

Hope it's resolved, it is horrible to watch.
 

daydreamer

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Thankyou so much for taking the time to write such a lengthy reply and pm.

He had a Cushings test when the vet came and it came back borderline. The vet said he wouldn't treat yet but would test every 6 months. I might ask for a TRH test just in case he has cushings but it isn't showing up on the normal test which I know can happen.

I haven't seen any evidence of laminitis but I can certainly keep more of an eye out. I have noticed this year he has struggled to cope with changes in the grass - a few days after it has rained he sometimes gets what seems to be feacal water syndrome for a few days. He is on magnesium oxide anyway but I might give him a wee bit more (very hard to overdose apparently, they just excrete excess).

I will definitely go down the chiropractic route I think with vet agreement.

The good news is much much less twitchy tonight (only saw about 4 short episodes), no head turning and he seemed much less bothered by it. Fingers crossed the not riding and/or bute is helping the symptoms and at some point we'll be able to find the cause.
 
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