Wobblers - steroid injections

[Womblebomble]

Hi everyone,
I’m hoping for some advice. My 8yr old OTTB has been diagnosed with wobblers. Long story short - since I’ve had him the running joke has always been he could cope with 3 legs, just not 4. I always put this down to being a weak under developed TB as he’s 17.1. We had a lovely summer competing after I spent last winter retraining him, he’s always been quite clumsy, getting too close to fences, etc but it did improve. I went on holiday in October so gave him a holiday in the field (2 weeks) when I came back he became really disunited behind, especially in canter it would literally feel and look like he didn’t know which leg to put down but it was intermittent, some days he’d work lovely other days it would feel like I was back at square 1, tripping more than he used to, not jumping right and one day he was being shod and literally tipped backward and looked like he was about to sit down like a dog. After the farrier visit, alarm bells started ringing, I had the physio out who said he was stiff in his neck, the vet came 2 days later and he badly failed the wobblers test and showed abnormality & arthritis c6-c7 on his neck X-rays. The vet advised I go ahead with steroid injections as I have a 50/50 chance but due to his extreme reactions to the wobblers tests I would have to rehab from the ground as he deemed him not safe to ride. I was told to give him 4 weeks off followed by 8 weeks rehab and by the end of the 8 weeks I will know if the steroids have worked or not. He’s now had the 4 weeks off following the injections and has started rehab yesterday. Has anyone else had experience with this? Success stories or not I’d like to hear them all. He is a big horse and I do have to be careful around him as he doesn’t know where his feet are going but I want to make sure I’ve done all I can before calling it a day hence going down the injection route. Plus any rehab tips would be great! I’ve lunged him yesterday & today I was going to long line him tomorrow and build up to walking over poles over the next few weeks before starting trotting & raised poles but any other advice would be great. Thank you!

 

[poiuytrewq]

I’ve not read properly (phone, just woken up and no glasses!!)
But I’m in a kind of similar situation but not as far on as you.
I just wanted to comment and bump but will read properly when i get in and have functional eyes!

 

[cornbrodolly]

How does the steroid injection actually help? Not wanting to be a downer, but I assume it s a disease that cant really improve. We bought one [passed the vet!] but she ended up being PTS.

 

[Womblebomble]

How does the steroid injection actually help? Not wanting to be a downer, but I assume it s a disease that cant really improve. We bought one [passed the vet!] but she ended up being PTS.

It’s supposed to take the inflammation down in the vertebrae which is affected by arthritis. Apologies I should’ve added that bit! one side is abnormally large and the opposite side has arthritis due to compensation. I felt I was doing him a disservice by not trying everything but now I feel I’m just prolonging the inevitable :/

 

[ihatework]

If his symptoms have been that pronounced for that long I suspect you are delaying the inevitable But if the decision needs to be made you can take comfort from trying. I wouldn’t be dragging out the treatment forever though.

 

[Jambarissa]

I want aware you could treat wobblers. Assuming everything goes well would he just be 'normal' and safe to ride?

I hope it all goes well, another 8 weeks isn't bad to get a good idea of the likely outcome.

 

[ihatework]

I want aware you could treat wobblers. Assuming everything goes well would he just be 'normal' and safe to ride?

I hope it all goes well, another 8 weeks isn't bad to get a good idea of the likely outcome.

‘Wobblers’ is just a generic term for horses showing neurological symptoms. There are a range of pathologies for those symptoms. Some are very much treatable to the point of restoring normal function, some are a bit iffy but can be medically managed to be safe, some are not treatable.

 

[Womblebomble]

If his symptoms have been that pronounced for that long I suspect you are delaying the inevitable But if the decision needs to be made you can take comfort from trying. I wouldn’t be dragging out the treatment forever though.

I know… when the vet said 4 weeks off 8 weeks rehab I thought it was worth a shot. If it was any longer or he’d have to be stabled the entire time I wouldn’t have gone through with it. I think I already know in my head what’s going to happen. I made a decision there and then to inject when in hindsight I should have researched more about the steroid injections.

 

[poiuytrewq]

I've not posted about this, but its my new horse sadly. He is showing neuro signs and most recently my farrier was unable to complete shoeing him. I'm not actually sure what we are going to do about that but he currently had 3 new and one old shoe on. Being right before Christmas we didn't really push it too hard as I didn't want my farrier injured especially for christmas.

I'm feeling the same, I'm about to start investigations with mine. I imagine we will find arthritic changes in my chaps neck and we will inject it because as you say I feel the need to try. However, then another bit of me is wondering why I'm bothering. It is always going to be there and will worsen over time. If one of my other horses had similar symptoms I'd be putting to sleep without investigations because in my heart I know its just buying (expensive) time.
I have another neurological horse. He has had his neck injected twice, the first time it worked the second not. He is actually far milder and shows less symptoms but I retired him due to tripping constantly in walk. He has no issues at all with the farrier and never shows any sign of ataxia.

Sorry, not what you wanted to hear but you're not alone in this rubbish! How I'd prefer a broken bone or damaged tendon......

 

[ihatework]

I know… when the vet said 4 weeks off 8 weeks rehab I thought it was worth a shot. If it was any longer or he’d have to be stabled the entire time I wouldn’t have gone through with it. I think I already know in my head what’s going to happen. I made a decision there and then to inject when in hindsight I should have researched more about the steroid injections.

I don’t necessarily think it was the wrong decision. But even if you get some response you will need to have the horse monitored frequently and likely need to reinject relatively frequently. At best he will fall into the medically managed category. Whether that’s in his and your interest I don’t know, but I wish you both the best.

 

[Womblebomble]

I've not posted about this, but its my new horse sadly. He is showing neuro signs and most recently my farrier was unable to complete shoeing him. I'm not actually sure what we are going to do about that but he currently had 3 new and one old shoe on. Being right before Christmas we didn't really push it too hard as I didn't want my farrier injured especially for christmas.

I'm feeling the same, I'm about to start investigations with mine. I imagine we will find arthritic changes in my chaps neck and we will inject it because as you say I feel the need to try. However, then another bit of me is wondering why I'm bothering. It is always going to be there and will worsen over time. If one of my other horses had similar symptoms I'd be putting to sleep without investigations because in my heart I know its just buying (expensive) time.
I have another neurological horse. He has had his neck injected twice, the first time it worked the second not. He is actually far milder and shows less symptoms but I retired him due to tripping constantly in walk. He has no issues at all with the farrier and never shows any sign of ataxia.

Sorry, not what you wanted to hear but you're not alone in this rubbish! How I'd prefer a broken bone or damaged tendon......

Oh no I’m so sorry. This is my first ‘wobbler’ so I am very new to all of this. I am on a livery yard as well so I want to take others safety into account. If I had my own land and stables it wouldn’t be so hard to make the decision as it’s when he’s ridden he seems to be worse. A friend of mine had hers injected and it wore off after 6/7 months, my vet said about 2 years but it seems to be very case dependant on how long it lasts. I’ll see the 8 weeks out which takes me to nearly the end of Feb and make my decision. The vet said I’ll know before that whether it’s worked or not, when did you notice improvement in the horse you had injected?

 

[poiuytrewq]

Oh no I’m so sorry. This is my first ‘wobbler’ so I am very new to all of this. I am on a livery yard as well so I want to take others safety into account. If I had my own land and stables it wouldn’t be so hard to make the decision as it’s when he’s ridden he seems to be worse. A friend of mine had hers injected and it wore off after 6/7 months, my vet said about 2 years but it seems to be very case dependant on how long it lasts. I’ll see the 8 weeks out which takes me to nearly the end of Feb and make my decision. The vet said I’ll know before that whether it’s worked or not, when did you notice improvement in the horse you had injected?

It was difficult with him as he wasn't showing consistent symptoms but he was injected and I'd say, from memory maybe 7-10 days later he seemed to stop stumbling and just felt better. Sadly It didn't last long. His xrays were iffy though. They weren't blindingly obvious, we were almost ruling everything else out and that was the last thing. I never see him trip now in the field but he has random unsoundness which i believe is another fairly regular symptom with neurological stuff.

My current one I am still riding but very lightly. I'm 99% certain he is better for it. I wonder if that's why I'm seeing more "eww" moments now as he has had less work over Christmas and with several really stormy periods.
My worry is that he's currently insured and even if we inject now will i be able to afford to keep it up long term, but I guess I'll cross that bridge when the time comes.

 

[Womblebomble]

It was difficult with him as he wasn't showing consistent symptoms but he was injected and I'd say, from memory maybe 7-10 days later he seemed to stop stumbling and just felt better. Sadly It didn't last long. His xrays were iffy though. They weren't blindingly obvious, we were almost ruling everything else out and that was the last thing. I never see him trip now in the field but he has random unsoundness which i believe is another fairly regular symptom with neurological stuff.

My current one I am still riding but very lightly. I'm 99% certain he is better for it. I wonder if that's why I'm seeing more "eww" moments now as he has had less work over Christmas and with several really stormy periods.
My worry is that he's currently insured and even if we inject now will i be able to afford to keep it up long term, but I guess I'll cross that bridge when the time comes.

That’s interesting to know. Mine did seem less trippy initially then yesterday he tripped over thin air and also didn’t look quite sound in front and I wondered if that was related so it sounds like it probably is. It’s such a slippery slope and the question is how far do you go down it. He isn’t insured unfortunately and I’m already £1000 down in X-rays and injections and I may never sit on him again! That’s why I’m going to stick to the 8 week plan and make my decision at the end of it but I already have a feeling it’s not worked for him. Sounds like you are in the same boat as me, I’m glad I went through the diagnostic so I know for sure what I’m dealing with. It just doesn’t make it any easier sadly. Keep me updated on how you get on

 

[[59851]]

I'm sorry to read this, I think what you are doing is fair for both of you. At the end of the 8 weeks you will know, if you don't already what the outcome will be. I feel trying the steroids will also give you closure if you decide to PTS. I had a similar situation many years ago and we ended up PTS as like yours she was a big 17.1 hunter type and safety was a consideration, she struggled with the farrier too, her wobblers was a complication of foaling and her "foal" is now in his late 20's and still going strong!

 

[Womblebomble]

I'm sorry to read this, I think what you are doing is fair for both of you. At the end of the 8 weeks you will know, if you don't already what the outcome will be. I feel trying the steroids will also give you closure if you decide to PTS. I had a similar situation many years ago and we ended up PTS as like yours she was a big 17.1 hunter type and safety was a consideration, she struggled with the farrier too, her wobblers was a complication of foaling and her "foal" is now in his late 20's and still going strong!

Thank you. It’s my first experience of wobblers so I was so unsure of what to do! Since doing a lot of research I’m amazed how easily they can get it and they don’t necessarily need to be born with it to have it. I’m so glad you still have a part of your mare with you

 

[poiuytrewq]

It can be a real black hole money wise, the first had a decent insurance policy which covered most but not all of the vet bills. I paid physio and corrective shoeing etc myself, he was different i think as we started lameness investigations first- hock injections and nerve blocks etc so the costs mounted fast.
This time i have insurance but its only 3k. I'm absolutely convinced its neck so have found a vet with a special interest in neurological horses and will start with the neck first in an effort to keep costs down.
I will get him medicated. I won't do a huge amount more than that I don't think. Medicating will help or it won't. As i understand there is not a lot else that can be done sadly. I won't get sucked down a rabbit hole this time with what ifs. It was pretty soul destroying last time.
Like you I will put a time scale on this, I think you have done what you can already.

No they don't need to be born with anything at all. It can be just pure unlucky

 

[BBP]

I won’t profess to know anywhere near enough about wobblers to advise you on how to rehab your horse or the likelihood of a positive outcome, so I’ll just talk more generally based on my own horses. I have two young horses, 4 and 5, both unbacked, both extremely dysfunctional. Both with query neck issues. And the one thing I am learning is that there is groundwork and there is groundwork. You have mentioned lunging and walking and trotting over raised poles and raised poles in the next 8 weeks. That’s the sort of groundwork my vets have always recommended. That work is all probably great in a horse who is functionally well and looking to improve their strength and fitness. But in a fundamentally wonky horse, I would think that could be too much in a short time, adding speed and difficulty to dysfunctional movement.

I have just started with an instructor who focuses on biomechanics, spinal alignment and posture. My guys won’t break out of a slow walk for at least 8 weeks I would say. Everything is about teaching them to lift through their thoracic sling and finding relaxation and length through their necks rather than bracing and jamming back into crooked compensation and tension patterns. Trying to release tension at the poll and decompress and straighten the spine. Work out where the areas of tightness are, where they fall out of balance in all planes of movement. Work on limb control, can they abduct and adduct each limb correctly. If not, why, what is the restriction. Can they find relaxation using balance pads. All that sort of stuff is what we are focussing on before we add speed, before we add poles, etc.

I don’t know if my two youngsters will have a ridden future, but I know changing my approach to this kind of work will give them the best possible chance, and it will be a long slow road now if I want to stand a chance of a positive outcome.

I don’t know your experience levels so I might be teaching you stuff you already know. But if I’m not I would say I think if you are going to do rehab work, find someone to help who specialises in correct biomechanics, spinal alignment and nervous system regulation. Good luck!

 

[ycbm]

I can't see that anyone has mentioned this yet, but I think it's important for you to know about.

From reading what you have written your horse has the fairly common TB C6/7 congenital malformation. Even without arthritis this will often cause the horse to be unstable, as the attachments of the ligaments to the vertebrae are incorrectly placed or even missing. The vertebrae are not symmetrical and parts are often missing.

Before you make any decisions, you could do with reading up on that defect, which they are born with.

It's a tough one, I'm sorry you are among the TB and TBx owners facing it.
.

 

[BBP]

I can't see that anyone has mentioned this yet, but I think it's important for you to know about.

From reading what you have written your horse has the fairly common TB C6/7 congenital malformation. Even without arthritis this will often cause the horse to be unstable, as the attachments of the ligaments to the vertebrae are incorrectly placed or even missing. The vertebrae are not symmetrical and parts are often missing.

Before you make any decisions, you could do with reading up on that defect, which they are born with.

It's a tough one, I'm sorry you are among the TB and TBx owners facing it.
.

ECVM was what popped into my mind too when I read the OPs comments on her horses X-rays. This is a decent article I think, I came across it whilst researching ECVM for my little mare.

THE UN-BALANCED HORSE

Practical considerations for ECVM affected horses In nature, horses use their neck as a natural balancing entity. Ever seen a horse turning flat like a motorcycle but still keeping balance? They can do so by placing their weight into the inside front limb while cantilevering with the head and...

www.thirzahendriks.com

 

[Womblebomble]

I won’t profess to know anywhere near enough about wobblers to advise you on how to rehab your horse or the likelihood of a positive outcome, so I’ll just talk more generally based on my own horses. I have two young horses, 4 and 5, both unbacked, both extremely dysfunctional. Both with query neck issues. And the one thing I am learning is that there is groundwork and there is groundwork. You have mentioned lunging and walking and trotting over raised poles and raised poles in the next 8 weeks. That’s the sort of groundwork my vets have always recommended. That work is all probably great in a horse who is functionally well and looking to improve their strength and fitness. But in a fundamentally wonky horse, I would think that could be too much in a short time, adding speed and difficulty to dysfunctional movement.

I have just started with an instructor who focuses on biomechanics, spinal alignment and posture. My guys won’t break out of a slow walk for at least 8 weeks I would say. Everything is about teaching them to lift through their thoracic sling and finding relaxation and length through their necks rather than bracing and jamming back into crooked compensation and tension patterns. Trying to release tension at the poll and decompress and straighten the spine. Work out where the areas of tightness are, where they fall out of balance in all planes of movement. Work on limb control, can they abduct and adduct each limb correctly. If not, why, what is the restriction. Can they find relaxation using balance pads. All that sort of stuff is what we are focussing on before we add speed, before we add poles, etc.

I don’t know if my two youngsters will have a ridden future, but I know changing my approach to this kind of work will give them the best possible chance, and it will be a long slow road now if I want to stand a chance of a positive outcome.

I don’t know your experience levels so I might be teaching you stuff you already know. But if I’m not I would say I think if you are going to do rehab work, find someone to help who specialises in correct biomechanics, spinal alignment and nervous system regulation. Good luck!

Thank you that’s really interesting I shall look into it! Still can’t believe in September I had a fit competition horse and now I’m faced with this! I do understand it gets progressively worse and my case does seem to be the general issues TBs face, especially big ones who are covered as foals and causes the joints to calcify. I will definitely look into up specialists, thank you!

 

[Womblebomble]

ECVM was what popped into my mind too when I read the OPs comments on her horses X-rays. This is a decent article I think, I came across it whilst researching ECVM for my little mare.

THE UN-BALANCED HORSE

Practical considerations for ECVM affected horses In nature, horses use their neck as a natural balancing entity. Ever seen a horse turning flat like a motorcycle but still keeping balance? They can do so by placing their weight into the inside front limb while cantilevering with the head and...

www.thirzahendriks.com

Thank you! That article was extremely interesting and covered all the bases I am currently faced with. The chestnut horse that was stood with its gait off is exactly how my boy stands. My vet said CVM falls under the big umbrella that’s wobblers I titled it wobblers as when I’ve mentioned CVM to people they say ‘oh you mean wobblers’! It’s such a minefield what to do and the best course but thank you for adding that article that’s been an interesting read, I hadn’t come across that yet.

 

[Womblebomble]

I can't see that anyone has mentioned this yet, but I think it's important for you to know about.

From reading what you have written your horse has the fairly common TB C6/7 congenital malformation. Even without arthritis this will often cause the horse to be unstable, as the attachments of the ligaments to the vertebrae are incorrectly placed or even missing. The vertebrae are not symmetrical and parts are often missing.

Before you make any decisions, you could do with reading up on that defect, which they are born with.

It's a tough one, I'm sorry you are among the TB and TBx owners facing it.
.

Thank you, It’s all been quite a learning curve for me. Unfortunately I can’t seem to find many success stories with C6-C7, only short term relief then the symptoms are worse and the steroid doesn’t seem to last long, if it works at all. My vet said it should last 2 years but I can’t find any cases where that happens, it seems to be more like 6/8 months and the 2nd injection not working. He has mild missing spine which I’ve always managed, I am slightly concerned this will now rear its head with him losing muscle due to the time off.

 

[Birker2020]

My horse had wobblers after falling on his neck. He was very ataxic and he couldn't raise his head above chest height when it happened. Y.O at the time yanked him with his chifney bringing him in from the field when she lost her temper and he reared and went over backwards banging his neck. Emergency vet thought wobblers but then decided it wasn't after speaking to the yard owner (they were close friends).

He had extravagant movement, wobblers horses often have high front feet movement due to the condition.

Basically Rommy had transient periods of ataxia. In between times he'd be normal. Vet told me to continue riding him and he was jumped competitively BSJA but every now and then he'd do something really weird like put down on top of a jump or jump with his front end but his hind legs would just go through the fence. He developed a funny bunny hop canter and started rubbing his hind fetlocks together. I consulted the farrier and McTimoney but neither could tell he had wobblers, the vet never reached any conclusion at the time. I think they thought I was imagining things.

Then one day I went for a hack and he felt very drunk, very unsteady. Had to get off and lead him back. Emergency vet out again. He went on to develop two more periods of ataxia over several days/weeks. I'd stopped riding him by this point.

He was actually missdiagnosed with EHV for quite a time, he was a carrier but wasn't actually suffering from it. 33% of the horse population are carriers. It can cause ataxia. Eventually I insisted on referral to hospital.

They gave Rommy Finadyne prior to travelling to Liverpool for comprehensive imaging. There was only a 17mm gap in the spinal column, and there should have been 52mm.

Sadly he was too badly affected to be saved and too dangerous to keep as a pet as he was Grade 3 to 4. So he was pts there and then after a frank discussion with the consultant.

Sadly the original vets portable xray machine gave a false picture and I was told he didn'thave anything wrong with his neck, but the stronger imaging at Liverpool told a different story.

Horses can be very ataxic for other reasons, and this can be temporary too. I can remember doing a tail sway test in front of the physio with Bailey and she was like a drunken sailor and I burst into tears remembering what had happened to Rommy but she went on to recover fully. Also Lari was severely ataxic following a pull back accident when he acutely inflamed his S.I joint but again he went back to normal 'i.e unridden but no longert ataxic following 4 months rehab. I think both Bailey and Lari both had periods of hind limb weakness which manifested as ataxia but wasn't anything to do with compression of nerves in the neck like Rommy.

 

[ycbm]

Thank you! That article was extremely interesting and covered all the bases I am currently faced with. The chestnut horse that was stood with its gait off is exactly how my boy stands. My vet said CVM falls under the big umbrella that’s wobblers I titled it wobblers as when I’ve mentioned CVM to people they say ‘oh you mean wobblers’! It’s such a minefield what to do and the best course but thank you for adding that article that’s been an interesting read, I hadn’t come across that yet.

It doesn't sound to me as if your vet knows enough about CVM, or that he's confusing you by trying to simplify his explanation. CVM is not wobblers, though it can cause wobblers. Wobblers is caused by compression of the spinal cord stopping the nerve signals transmitting.

CVM is malformation of the C6/7 vertebrae, an important area for attachment of the soft tissue that holds the front legs onto the skeleton. C6/7 are asymmetric at birth. It causes the horse problems throughout its body because there are no joints holding the front legs onto the skeleton, only soft tissue. And everything is out of balance, from the day they are born.

So you're never going to cure the instability caused by CVM. In your horse it sounds as if that instability has now created arthritis, which is now restricting the spinal cord, causing wobblers on top of the problem he was born with.

I'm sorry to agree with your earlier post, and even more so that you are in this situation, but there's probably only one way this is likely to head.
.

 

[Birker2020]

Wobbler Syndrome in Horses | Animal & Food Sciences

afs.ca.uky.edu

This is one of the more factual information about wobbler syndrome. Apologies its an American article but they seem way more advanced in their knowledge than UK, or that at least was my take on it.

It says cvm is more common in male horses, those with long necks and WB 's and TB's seem more genetically likely to suffer from this. That was my boy to a 'T'.

The article further suggests that the horse may have periods of slight improvement. My horse was definitely in this category, where he'd have months were he would appear fine interspersed with periods when he would start to be 'clumsy'. This was when I researched wobblers an brought in the McTiminey chiro and the vets for xrays, both said they couldn't see anything wrong with him which I still find incredible to this day.

As YCBM said above about steroids it says in this article ;

Steroids are frequently used clinically for spinal cord and head trauma, but experiments have shown no benefit for wobbler’s syndrome because steroid therapy is targeted at treating the acute inflammation in the spinal cord that results from the compression but does not correct the underlying problem.

I agree with YCBM. I'm sorry but I too forsee this only ending one way too. So sorry x