Unknown lameness help

[Hunterjumperxx]

Hi everyone, wondering if anyone might have some insight.. this is a case that I have been working with several veterinary professionals on, and has been improving..

I have a 9 year old WB that went acutely off on the LF back in Sept (no heat or swelling, we assume that she mildly pulled her knee) not the primary concern but it started this whole mess, as after giving her a month off she came out quite lame in the right hind and hasn't been quite the same since ... This RH offness is something that has presented itself briefly on the lunge line over the past year but had never carried through undersaddle

The horse has always been on a strict regieme, ridden 4-5 days a week at 20-30 minutes, lunged twice a week for 20 - 30 minutes depending on season, jumps .8 - .9 courses once a week, horseshown with 1-2 classes a day with 5-6 shows during the season. Started as a 4 year old.

After the acute injury I had slowly brought her back to work and honestly didn't really notice the RH much undersaddle-but very visible and more so in corners, lameness of about a 2 out of 5.

The list of diag/treatments performed as follows (in order)
- X Ray's - mild arthritis, stifles clean, c spine fine
-pro stride - hocks - no help
- ultrasound of RH pastern - nothing (minimal tissue inflammation, vet not concerned)
-legend - fetlock, then pasterns (separate visits) blocks performed first, seemed to help at time - no help
- vet suspect SI involvement , acupuncture series for it (3 Tx over 2 week spans) this seemed to improve a little , at this time trainer noted she looked visibly improved U/S but felt same.
- ultrasound R stifle - clean
- stifle block seem to help, elect SI and R stifle injections
- minimal improvement at 2 weeks, trainer noting that she swings R hip out, continue riding for a month and reassess, at this time also did a trial of 5 days of Bute with no change
- at a month trainer noted that she felt much improved gait wise but still noting that she swings her right hip out and that she feels "creaky"
-recheck vet agreed on improvement with lameness of 1 working out to .5 out of 5, retook R stifle rads to rule out bone cyst. Also assessed spine and did some adjustments (chiro) but did not think anything of issue. - at this time recommend adding selenium, pessoa lunging 2x week and starting to jump a little and reassess in a month.

I have worked with two different vets and also consulted with another at a teaching hospital on this, her current vet has been great and feels that the issue has been mainly been SI and now the remainder is weakness , she is also consulting another vet to see if it would be worth taking to teaching hospital in the event of little improvement this time.

I have been riding this entire time, not having changed much about my routine , other than really focusing on balance and long low as of late. Have tried to minimize any lunging the entire time and currently our regieme is an easy free lunge for 10-15 minutes twice a week after having a day or two off before riding, lots of sore no more and back stretches. Our horses are inside from 3 pm until 8:30 am and she just has a 30x30 paddock.

Has anyone dealt with something this difficult , my vet says she very rarely has a horse that does not come around like this with her treatment plan. Especially since we have no actual diagnosis?

I am looking into moving her to a facility where she can get more movement and hill work - I have read some on sacroiliac or hip issues in horses-they all say to give time off, however since she has been progressing my vets both think work is better for her.

And has anyone had an issue with a horse swinging their hip? It's more so at the canter .

 

[Red-1]

I have had experience of lameness that is unidentified, but usually this sort of thing acts best if rested initially, then brought back to work using straight lines.

Even a little niggle seems worse, IMO, if school work is continued. The horse may seem better as it copes with it, but any inflammation is best sorted by free movement, initially in a large field and then on straight line work.

I hope your stable move goes well to better facilities.

 

[Nudibranch]

Where it the mild arthritis? If it is hind legs, especially hocks, this often goes hand in hand with SI problems. Have you ruled out suspensory issues? You say the blocks seemed to help but it's not clear. Is she a big horse?

I had a big WB with SI issues, which was related to hock and neck issues also. The outcome wasn't good however. Anything SI can be very frustrating to deal with I'm afraid as lameness can be on and off, hard to pinpoint, and hard to treat.

I would cut the schooling out as Red suggests and re evaluate with hacking only (which can be much better in terms of building strength, especially if you have hills). School work is extremely tough on joints and ligaments. I'm afraid I would also be changing the routine, with no lunging as again this can be overly demanding on legs, and a lot more turnout on a decent sized field. Standing in for long periods is also really not good for joints.

 

[twiggy2]

If the horse is lame I would stop working it, run it away to live out in large, ideally hilly fields with a settled herd for 6-12 months, bring back into work very slowly.hacking only, no lunging or schooling, see what happens. You have nothing to lose.
The horse has continued to be worked for 9 months with no improvement under vet guidance to be honest I would change vet.

 

[ycbm]

I would put the horse through a scintigraph or turn it away as Twiggy suggests. I would not be riding it after all that treatment has failed to bring it sound.
.

 

[PinkvSantaboots]

I would do what twiggy says I wouldn't be riding the horse at all if it's lame, turn her away for a while with complete field rest as you have pretty much exhausted everything else.