WWYD: Bi-lateral hind PSD, Kissing Spines and Hock Arthritis

timbobs

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As a few of you will have seen from my previous thread, Ed is going through the wars at the moment. He has quite a few issues going on, and I'm not quite sure what my thoughts are/the best way forward is taking into account the different problems.

He has:
  • Mild arthritis in both hocks
  • 4 kissing spines which have been injected,
  • PSD in both hinds
    • right hind is an old injury and is showing as thickening and jagged along most of the suspensory on the ultrasound
    • left hind has a hole (I haven't got details on size or location but have asked for this and copies of scans)
He isn't seeming very happy in himself- he has been very spooky and unsettled on the ground. I would expect this with the pen rest, but this has been his behaviour for a few months which is why I have kept pushing for more investigations as I didn't feel we'd found the problem. This has got worse with the pen rest, as I would expect as he isn't a fan!

At the moment Ed is on box/pen rest for a month and the vet will come back out. Before pen rest, his current management was living out 24/7 with friends and had a busy lifestyle. He's not generally a horse that enjoys just chilling in the field.

I just wanted people's opinions on what they would do if he was theirs.
 

timbobs

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What treatment has he had ?

He's had steroid injections for the hocks and back, but nothing so far for the PSD.

The vet said he wouldn't recommend shockwave, PRP etc. for the PSD and has just suggested rest at the moment.

I think the thing I'm struggling with is understanding how the different issues affect each other and the prognosis for successful treatment/return to work.
 

ycbm

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I'm sorry, but as an ex racer, with his history, I'd have him PTS. I hope that you don't find that view upsetting, I am harder nosed about it than many people, I don't do long retirements of unsound horses.
 

timbobs

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I'm sorry, but as an ex racer, with his history, I'd have him PTS. I hope that you don't find that view upsetting, I am harder nosed about it than many people, I don't do long retirements of unsound horses.

Not at all. I’m trying to work towards making him comfortable for a summer as I don’t think he’s the sort of horse to enjoy retirement as his management is already that of a retired horse and he isn’t happy in that management when he isn’t working.

I don’t know if I’m just postponing the inevitable or if there is an opportunity for him to come back into work which is why I’m wondering what others would do.

Do I give him a year off in the hope he’ll heal enough to come into work or is this unrealistic with the other issues he has?
 

Pinkvboots

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I wonder why they have not treated the suspensories? In my experience they need some sort of treatment to heal, I don't have much experience with kissing spine, with the arthritis it's always going to need treatment just depends on how long the injections will last, I suppose it's hard to tell if the treatments his had so far have worked because of the suspensories, a month is not long for suspensory damage one of my horses had a hole in his but he had prp and 5 months box rest.
 

Red-1

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In these situations, as long as the horse is not left miserable and in pain, I always think the owner is right.

IMO, if you decide to PTS it is right.
IMO, if you decide to retire, that is right too.
IMO, if you give aggressive treatment to bring back to work, that is also right.

Joys and heartache of horse ownership.
 

timbobs

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I wonder why they have not treated the suspensories? In my experience they need some sort of treatment to heal, I don't have much experience with kissing spine, with the arthritis it's always going to need treatment just depends on how long the injections will last, I suppose it's hard to tell if the treatments his had so far have worked because of the suspensories, a month is not long for suspensory damage one of my horses had a hole in his but he had prp and 5 months box rest.

The right hind suspensory injury is old and healed the way it is so there isn’t much to be done there.

With the hole in the left hind, the vet isn’t convinced in the results achieved through shockwave and PRP with the latest journal articles (my vet is Liphook so I assume they are up to date on latest views, but I can get a second opinion).

Ed isn’t a horse who will box rest really and I’m not sure we’ll manage the month we are aiming for so far and would be looking at turning away rather than box resting.
 

ycbm

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Not at all. I’m trying to work towards making him comfortable for a summer as I don’t think he’s the sort of horse to enjoy retirement as his management is already that of a retired horse and he isn’t happy in that management when he isn’t working.

I don’t know if I’m just postponing the inevitable or if there is an opportunity for him to come back into work which is why I’m wondering what others would do.

Do I give him a year off in the hope he’ll heal enough to come into work or is this unrealistic with the other issues he has?


For me, the combination of all three issues at the same time would suggest that his ridden career is almost certainly over, and that if he comes sound enough to work, it will be a very short time before he is unsound again.

Best wishes with whatever you decide.
 

paddi22

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I agree with ycbm, i've been in the same position with some exracers, and PTS would be my choice. Unless he can potter around a field. But i've pts one with similar arthritis and kissing spine, as the arthritis would have started to act up in bad weather.
 

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I also agree with ycbm, with three things going on - possibly related - the likelihood of him being sound enough to work for any length of time are slim-to-nil. I can usually see my way to managing 2 minor niggles, but anything more than that is unkind to the horse, IMO.
 

Pinkvboots

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The right hind suspensory injury is old and healed the way it is so there isn’t much to be done there.

With the hole in the left hind, the vet isn’t convinced in the results achieved through shockwave and PRP with the latest journal articles (my vet is Liphook so I assume they are up to date on latest views, but I can get a second opinion).

Ed isn’t a horse who will box rest really and I’m not sure we’ll manage the month we are aiming for so far and would be looking at turning away rather than box resting.

I suppose that does make sense in regards to the suspensories, you could turn away as a last ditch attempt of some sort of recovery, so bloody unfair with these horses sometimes :(
 

timbobs

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I also agree with ycbm, with three things going on - possibly related - the likelihood of him being sound enough to work for any length of time are slim-to-nil. I can usually see my way to managing 2 minor niggles, but anything more than that is unkind to the horse, IMO.

This has been where my head is at, but I feel like I’m being harsh in not pushing for more for him.
 

ycbm

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This has been where my head is at, but I feel like I’m being harsh in not pushing for more for him.


You need to go easier on yourself. I once said to my vet 'you will never hear me say 'do everything you can to keep him alive', because sometimes I don't think it's in their, or my, interests'. And he responded 'I wish more of my clients felt the same'.

You're the human who picks up all the bills and faces all the heartache. Your needs trump his tiny chance of ever staying sound.

If you decide that you can't face any more, he won't know. He won't blame you. He will just be at peace where he can never be in pain again.

If it would help, and you trust your vet to be completely honest, you could ask them to give you the likely estimated percentage chance that he will come sound and stay sound for another two years. If you do that, be sure you do it in a way where he can't mistake that you want the bare truth, not the best news that he might think you want to be told.

Best wishes with a hard decision.
 

Pearlsasinger

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I'm another who agrees with ycbm, I'm afraid. I would ask the vet for a realistic, frank prognosis and put quality of life over quantity. I might have a different view about a horse with similar problems who was enjoying pen-rest but then again, I might not.

Good luck what ever you decide.
 

timbobs

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I really go back and forward on what to do with him.

My original reaction to the diagnosis was PTS, but the vet recommended turning away for 6 months and see where we are then.

My gut feel is that with all the issues combined we aren’t going to get anywhere in terms of him healing turned out so I’m trying a month of pen rest. If there is no sign of improvement i’ll turn him out for a week or so to enjoy being in the field with his friends and call it a day.

I feel like I should give him the month as the vet seemed to think that 6 months off and we may eventually get to a rideable stage. I’m not hopeful for this so maybe a frank discussion with the vet is needed.
 

paddi22

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I've had a few with kissing spine, and the current one (in my forum pic icon) needs regular, targetted dressage work to keep his back strong enough to be comfortable. I can't give him more than two weeks off for fear he would lose muscle. He also has hock arthritis, which need a joint supplement and back on track hock boots when it gets to minus temperatures. I don't mind doing it as he is in work, but he's def a horse I can't see retiring happily. I'd imagine all his issues will start causing discomfort..

its awful, but sometimes no amount of money or time can fix them.
 

timbobs

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I've had a few with kissing spine, and the current one (in my forum pic icon) needs regular, targetted dressage work to keep his back strong enough to be comfortable. I can't give him more than two weeks off for fear he would lose muscle. He also has hock arthritis, which need a joint supplement and back on track hock boots when it gets to minus temperatures. I don't mind doing it as he is in work, but he's def a horse I can't see retiring happily. I'd imagine all his issues will start causing discomfort..

its awful, but sometimes no amount of money or time can fix them.

At the moment he isn’t sound enough to do any work to strengthen the back and he’s losing a lot of muscle doing no work, so I’m not sure how long the injections will last for him to keep him comfortable.

I think the combination of issues is making things very difficult.

Thanks for sharing your experience :)
 

Red-1

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At the moment he isn’t sound enough to do any work to strengthen the back and he’s losing a lot of muscle doing no work, so I’m not sure how long the injections will last for him to keep him comfortable.

I think the combination of issues is making things very difficult.

Thanks for sharing your experience :)

I think this is where the issue is.

My heart horse, Jay Man, had a slight suspensory issue. Sadly, I also had a gut feeling that he thrived on work and would go lame without it. The vet said rest, we did but not box rest, he had PRP, Shockwave, Arc Equine and restricted turn out and walking in hand.

His suspensory did heal well, sadly I was proven correct with the lack of work, he sagged and he became a wobbler.

I took him to the vet hospital fully intending not to bring him home, he was a horse who thrived on work plus I thought a wobbler is a wobbler, no cure. The vet, however, X rayed and said he wondered if steroids would help the wobbling.

I jumped at the prospect of a 'cure' and the drugs did improve him, we got a bit more gentle hacking ad 6 months of proper retirement, before it progressed so a stiff breeze could have blown him over so I PTS.

The vet counted it as a success. Me, I am not so sure. I think my gut feeling to PTS in the first place was more correct.

That is why I say the owner is always correct. I think it comes down to gut feeling. You know the horse. I do actually think they communicate their emotions too. I think Jay Man would have been well to have been PTS when I thought it was right.

I would go by your gut feeling. Whatever you decide is right, IMO.
 

ihatework

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There is no way I would have any aspiration of riding the horse again given the number of diagnosis.

If you want to save him then I’d try retirement on Bute. But if he is noticeably lame or unhappy on that lifestyle I would PTS
 

Northern

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Sorry you are in this situation :( Poor Ed and poor you!

I think you need to take into account your wants/needs in this decision as well. Are you happy "wasting" 6 months to see if he may come sound to ride? Knowing that his issues will require expensive ongoing maintenance throughout the rest of his life? Do you want to keep riding/get another horse? Can you afford to keep him as a field ornament if you do? I don't think its selfish to think of yourself and your enjoyment as well. If he already is miserable you can't be happy watching him either... I would discuss frankly with your vet, and depending on the result of that conversation turn him out with friends for a while as you said and say goodbye. He won't know any different.

I had a similar situation with my beloved mare last year. Arthritis (probably more widespread than we originally though) and post several severe injuries I decided it would be cruel to box her through the 6 months recovery over winter for a "maybe" field sound horse. Big hugs for whatever you decide to do.
 

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The (very) old fashioned way to deal with this sort of dilemma was to turn them away for a year and see what happened. I can't help thinking that this was a nicer process than being poked, prodded, injected, extensively confined, etc. very expensively by vets facilitated by insurance. It very often worked too.
 

timbobs

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The (very) old fashioned way to deal with this sort of dilemma was to turn them away for a year and see what happened. I can't help thinking that this was a nicer process than being poked, prodded, injected, extensively confined, etc. very expensively by vets facilitated by insurance. It very often worked too.

Yes I agree, I’m not going to be doing extensive box rest or any more invasive treatments to try and sort him out.

I’m just trying to get my head around if he will be comfortable/happy enough to have a bit of a retirement really.
 

timbobs

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Sorry you are in this situation :( Poor Ed and poor you!

I think you need to take into account your wants/needs in this decision as well. Are you happy "wasting" 6 months to see if he may come sound to ride? Knowing that his issues will require expensive ongoing maintenance throughout the rest of his life? Do you want to keep riding/get another horse? Can you afford to keep him as a field ornament if you do? I don't think its selfish to think of yourself and your enjoyment as well. If he already is miserable you can't be happy watching him either... I would discuss frankly with your vet, and depending on the result of that conversation turn him out with friends for a while as you said and say goodbye. He won't know any different.

I had a similar situation with my beloved mare last year. Arthritis (probably more widespread than we originally though) and post several severe injuries I decided it would be cruel to box her through the 6 months recovery over winter for a "maybe" field sound horse. Big hugs for whatever you decide to do.

I won’t be getting another horse for a while, even if I decide PTS. I need a break from the emotional and financial stress of horse ownership for a while. The Horsebox has been sold, the dressage saddle sold today and I’ve alresdy got rid of a lot of stuff.

Sorry to hear about your mare - horses are definitely heartbreakers.
 

Northern

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I won’t be getting another horse for a while, even if I decide PTS. I need a break from the emotional and financial stress of horse ownership for a while. The Horsebox has been sold, the dressage saddle sold today and I’ve alresdy got rid of a lot of stuff.

Sorry to hear about your mare - horses are definitely heartbreakers.

I'm sorry to hear, I did like following your instagram. I completely understand though. I would have been more wary had I not already had another mare when I had K PTS. Now I'm back to two! I'd had such a bad run (and I gather you have too!) that I thought it surely must end at some point!
 

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I imagine he's probably got ulcers secondary to that lot which won't be helping. My mare has a similar load of problems, although SI instead of KS and with pssm in the mix to further complicate rehab.

My vets have taken the pragmatic view that as she can't box rest let's kick off with field turnout and gentle rehab and see how her suspensories stand up to it. I am having to manage her stomach through this - she's bright and breezy on a few tummy supplements and grumpy without them.

It's heart breaking when they get these problems despite everything we do to keep them well. I had a bad day last week seeing posts of friends out and about with horses that I know get a fraction of the attention mine gets - but never seem to have an issue.
 

timbobs

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I imagine he's probably got ulcers secondary to that lot which won't be helping. My mare has a similar load of problems, although SI instead of KS and with pssm in the mix to further complicate rehab.

My vets have taken the pragmatic view that as she can't box rest let's kick off with field turnout and gentle rehab and see how her suspensories stand up to it. I am having to manage her stomach through this - she's bright and breezy on a few tummy supplements and grumpy without them.

It's heart breaking when they get these problems despite everything we do to keep them well. I had a bad day last week seeing posts of friends out and about with horses that I know get a fraction of the attention mine gets - but never seem to have an issue.

He’s had ulcers previously so I did re-scope him and thankfully he’s clear of ulcers which is one plus point!

I’m sorry to hear about your mare - I know what you mean about seeing everyone else out when you’re doing everything possible to keep your horse happy and healthy.
 
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