WWYD (vet treatment options) - horse with hock/back issues

[throwawayaccount]

hi all

so after my last post, my mare went to the vets today (where she still is now). assessment confirmed she is unlevel/uncomfortable on her right hind (which was swollen) and through her back aswell. i've just spoke to the vet, who advised they nerveblocked my mare's pelvis and then her right hind which helped alleviate the symptoms, however her front end then looked worse (she is recovering from a suspensory ligament injury on front left which i'd say its almost healed now, so not out of the ordinary for her to look a bit off)

tomorrow she is being x-rayed on her sacroiliac region and hocks and treating both with steroids depending on what is found

shockwave treatment has also been put forward for her back which i'm happy to consider (mare has been having regular physio since I've owned her) although I don't know anything about shockwave for horses.

another option is ethanol treatment for her hocks which i have said no to for the time being as i'm not sure if my insurance will cover /all/ of this. also, i don't know enough about ethanol treatment to make a decision- i've heard a few things but not enough to be educated

tildren was also suggested which would be given intravenously, i've googled this and one dose is about £800 - not sure how helpful this treatment is?

since I bought my mare almost a year ago (she is now nearly 10) she has been near enough constantly lame, moves strangely and seems to have endless issues. vet described her as complicated!!

its all so much to consider, if I want to make any changes to her treatment plan I need to phone back tomorrow- so researching everything tonight (and relying on H&H of course).

I have told the vet I am not bothered if my mare can't have a ridden career now after all of this (I'm massively disillusioned by it all) and that I'd rather she was made comfortable enough to be retired in a field

I've poured so much money into her already and have grown attached, I just want to make sure that I'm doing the right thing?

does anyone have any advice or has anyone been through something similar?

Sorry for the confusing/rambly post, I'm massively stressed!

Xx

 

[angel7]

Forget the steroids and tildren, any arthritic changes get the arthramid gel injections into all affected areas, insurance should pay.
I'd be more worried about the ligament injury longterm.
I'd be questioning why vet did not start at the bottom if the right hind leg and work upwards, blocking the back and sacrum last? Blocking the otherway round seems very odd...

 

[Bernster]

Oh lawks that’s a lot to deal with. Tbh it seems like a rush to decide on other treatment. I assume this treatment could be done at another time? Doesn’t need to be done tomorrow? I’d rather have more time to research, get the full vet report and speak to your insurance before deciding the next steps.

When there are multiple issues, with a difficult rehab, a guarded prognosis, a history of soundness issues, and limited insurance cover - then to me I’m not sure it’s one to go down the rabbit hole on. But it may be too early for that ofc - get more info, do more research until you feel comfortable with the plan.

 

[AmyMay]

Being stone cold about it. I wouldn’t treat and would pts.

 

[throwawayaccount]

angel7 - thank you, they don't know if it's arthritic changes or not yet. i think her ligament will always be a worry but her ridden career was only ever going to be a happy hacker/light schooling anyway (unless there was some sort of miracle)

bernster - thank you, it is a lot to think over and research- they want to do the xrays and steroids/shockwave tomorrow at the bare minimum so to say, if further treatment was decided such as the ethanol etc then that would need to be at a later date,

amymay - thanks for replying, can I ask why you'd choose pts? she has been up until now, and post ligament injury, comfortable enough in the field and doing light hacking. In my previous thread a user who gave some advice said lameness turns to lameness and that really struck a chord with me. shes been passed round a lot and I want to do whats best for her, although I admit I am massively attached to her

 

[Trouper]

does anyone have any advice or has anyone been through something similar?

Yes - twice -and it is exhausting watching the vets go through every test they can think of.
I just wish I had known about Tom Beech (The Osteopathic Vet) earlier in the proceedings. With such a complicated picture I would not be consulting anyone else as he will give you a holistic diagnosis of your horse and, if there is anything that can help, he will find it.
In my case, things were too far gone and I had to pts but I could do it with a clear conscience knowing that I had tried everything.

Edited to add - I have just read Ambers Echo post of a few minutes ago detailing her experience of using Tom Beech with Toby. It just says it all really.

 

[throwawayaccount]

thanks trouper, had a google and he is relatively local to me so I will bare him in mind for sure

i've rang vets and requested for xrays to be discussed with me first so depending on the severity (if severe) to reassess a treatment plan

 

[sbloom]

I would suggest Tom as a possibility too, and ultimately it probably will be serious in hand rehab work that, on top of whatever vet procedures you decide on, will get you to the best place. Most vets aren't hot on that, and neither, in my experience, are some bodyworkers. (Though to be fair sometimes it's a matter of them not feeling the customer would take on a full postural programme, so always worth opening up the discussion and showing willing)

 

[LEC]

TBH with a horse like that you are never going to get it right. I probably wouldn't bother but as you have insurance then I suppose you might as well use the options you have. An Asymmetrical horse with forelimb and hindlimb lameness is near impossible to get right. There will always be another problem occurring due to compensation when you think you have got one bit right. Though, I am sure Tom Beech is very good, I am just not convinced he is the messiah with horses who are intrinsically broken but probably does a very good job with those who are just off and its asymmetrical and not reached the serious issues developing.

 

[Andrew657]

I would agree with Bernster - there are obviously several issues.

Before starting treating I would be trying to work out both the appropriate treatment and the necessary rehab; and whether the rehab required for one would be the opposite of that required for another). (eg taking a human example when I got kicked and the tibia spine broke - I was told that for the bone the leg needed to be kept in one position but for the ligament movement was better)

If you're proposing to retire - I would be asking about the prognosis of the treatment - in these circumstances.

I would also be considering whether insurance time limits would kick in before treatment was completed.

You have my sympathy - multiple issues are going to be a long and difficult journey

 

[SEL]

Arthramid gel injections for the hocks, steroid into the SI and then see how she goes IMO

 

[pansymouse]

I've just bought myself a LED infrared machine which my physio rates highly and use on my mare who starting to show initial signs of arthritis (aged 28). I also use it on myself and it is already improving my chronic skin condition.

 

[throwawayaccount]

thank you everyone for all their helpful and thoughtful replies so far, which have not only given me perspective, but are helping me to deal with a hard situation.

my mare was discharged today from the vets albeit not officially (vet wasn't there, so only spoke to vet nurse). when i asked what the diagnosis was she said mild bone spavin, but to discuss with vet tomorrow and receive discharge papers etc.

i'm a bit gutted to say the least, my mare has been made comfortable enough for now (i hope). she's due back in a few weeks for her ligament scan so i can go from there

i think as long as the insurance is willing to pay out for this new claim, i'm willing to drain it and throw absolutely everything i can at her to help. if its not covered then i will do what i can afford so long as she isn't declining. if the insurance won't pay i'm not in a position to shell out thousands - i'm not rich and have other expenses in my life (saving to move out, car etc) and i could also be buying a sound horse for what i'm shelling out on the upkeep.

on the other hand i feel as though i have an obligation to my mare, she is first and foremost my friend and i owe it to her to do the best for her. she has been passed around a lot and god knows whats gone on down the line, so i want to do my best

 

[sport horse]

Her back is probably compromised by her front and hind leg lameness. Personally I would not spend too much money on veterinary treatment - OK if insurance are paying, but I would give her a summer out 24/7 at grass and see if there is any improvement. If not, by the approach of winter you may have to make a very hard decision.

 

[LadyGascoyne]

I’d take off shoes and turn away for six months and then hand walk and see how it goes.

 

[Tiddlypom]

In my previous thread a user who gave some advice said lameness turns to lameness and that really struck a chord with me. shes been passed round a lot and I want to do whats best for her

That was me, I think. I think I suggested a chiro vet next (could be an osteo vet, but definitely a qualified vet), and that's what I'd still suggest.

There's a lot going on with your horse. Let the chiro/osteo vet do what they can, then see what's left to deal with. It was the conventional vet working in conjunction with my chiro vet, plus good foot care, that turned my mare round.

I wouldn't just turn such a wonky horse out to pasture and hope for the best. If the wonkinesses aren't addressed, they will stay there and niggle away.

ETA When the chiro vet first saw my mare at the loan home, she was locked solid in her spine from poll to tail. She was entered in a BE90 the next week... She was pulled from the event and came back home.

 

[Trouper]

Seriously - please just read Tom Beech's latest FB post on the inter-connectedness of everything. Multiple "problems" do not necessarily mean multiple causes. He may not be able to solve her problems but for a few hundred pounds and a very knowledgeable second opinion, I think it would help you understand what is going on.

 

[throwawayaccount]

sport horse - I agree with you, and echo'ing LEC, that asymmetrical with front and hind lameness is relatively impossible to get right. I will chase the vets shortly because I need to know if its bone spavin in /both/ hocks or not. I am slightly irritated I had to press to find out what the diagnosis was, even if it was meant to be seemingly obvious- I don't know nor do I have the veterinary knowledge to make that conclusion myself our fields change on the weekend and the new one is lovely but has rich grass, so I'll introduce her to it carefully and see what the plan is from the vet. I'm not interested in riding now if I don't have to, because I could just take the pressure off with inhand walks as others here have suggested which I think is a really good idea

ladygascoyne - thanks for replying, she has fronts on at the moment but struggles to be barefoot, so I'll just wait for now- she had her new set popped on last week. she's TB x french trotter and doesn't have the best feet. she has to be sedated to have her shoes on (we've got it down from a full tube of domo to half after a year of struggling, so massive improvement)

tiddlypom - yes it was you! thank you for saying that. its one of the reasons I really value this forum, because when you are stuck in a difficult situation its addressed with honesty and not sugarcoated, but in an informative way. people irl keep telling me (probably meaning well) that it'll be alright but I am the type that sits googling everything! and in the year i've had her (well almost, end of this month marks our 1 year) its been nothing but problems.

we have clicked really well on the ground and I feel as though I understand her better now. she really is a sweet mare, she stands there for hours just wanting cuddles and scratches, licking your hand etc! and mooching treats in hindsight I was naïve to think this would be the only problem as she's always walked strangely. (lesson learned, don't buy unseen- although she was sold at over 3 grand with no health issues). so after tackling her ligament and throwing everything at that (PRP etc and draining my insurance claims near enough), there are now 2 new issues. I really will bare in mind a chiro / osteo vet, I have looked into Tom Beech at the advice of Trouper/sbloom/Ambers Echo, but haven't contacted him yet. I do agree her wonkiness needs to be kept on top of. and that is massively worrying about your mare, i'm glad she was pulled away! how can people think or not feel that its okay to ride a horse that feels uncomfortable? its scary

trouper - thank you for that, i'm going to read it now! and that is very true... i think my head is just filled with everything and its hard to think clearly but i'm trying my best. I really do like the sound of him and he isn't too far from me.

I just feel so sorry for my mare it explains why she started to play up at the mounting block again, I thought it was just playing up - but trying for 40 minutes isn't a normal response and I'm now mad at myself for getting frustrated. horses always have something to say, we just need to listen and try to decipher their unspoken language!!

here are some photos that may help you guys:

1. this is how she was stood on wednesday morning, it never used to be this bad with her right leg.


2. how she stands generally, wed morning


3. yesterday evening once she was home from the vets. this makes me want to cry tbh looking at it now. trying to attribute it to everything that was done with her yesterday


4. view from the back yesterday evening. sorry about the blood- the vet nurse said I am not allowed to wash it off until today; my mare did have a bandage on, but it kept slipping(?) and she wasn't happy so it was taken off.



sorry for the long reply, and thankyou again to everyone who has helped, i'll keep this thread updated xx

 

[dorsetladette]

Being stone cold about it. I wouldn’t treat and would pts.

I don't think I'd be treating so many problems in a horse that is also having to be sedated to shoe (to me this implies she is not the easiest to handle generally). It sounds like this poor girl has had a rough time of it previous to coming to you OP. Personally, I would give her the summer turned away (possibly on some form of pain relief) and PTS in the autumn before the weather changes.

 

[throwawayaccount]

I don't think I'd be treating so many problems in a horse that is also having to be sedated to shoe (to me this implies she is not the easiest to handle generally). It sounds like this poor girl has had a rough time of it previous to coming to you OP. Personally, I would give her the summer turned away (possibly on some form of pain relief) and PTS in the autumn before the weather changes.

thanks for replying, the old owner wasn't candid about what she had done with her or where she had got her from- turns out, after some digging it was beeston auctions. i eventually managed to get in touch with her first owners who had no idea she'd been passed round so much. although judging from videos from when she was young she had weird movement then (2-3 i'm guessing from the videos). with the sedation, shes fine to be trimmed without etc and shoeing sparks a nervous reaction- she is getting better each time thankfully, but it was an absolute necessity for her to have the shoes on and to try and correct her feet. from how you've worded your reply, i'm sad to agree, she does have so many problems.

i really do value my mare as my friend first and foremost and i owe it to her to do the best by her, so i'll do what i can

 

[LEC]

Your horse has chronic offloading of all its limbs. I have a horse who looks near identical in how she stands. We have managed to narrow it down to suspensorys but I won't put her through the surgery because we have such asymmetry in the hocks now (like yours turn in) and the hocks are not going to miraculously straighten to put less pressure on the suspensory. We might improve it but there is no guarantee it will then solve the front limb lameness. We have nerve blocked the front twice over a period of 6 months so know its not the front limb/foot actually causing problems its the hind. Mine has completely clean x rays. Mine is now effectively a happy hacker until she looks terrible and then will be PTS. Shame, as a good competition horse. We turned away for months but made no difference. Mine has been quite difficult to shoe in the past but we have made progress in this with patience. My horses all started after a field accident.

 

[throwawayaccount]

Your horse has chronic offloading of all its limbs. I have a horse who looks near identical in how she stands. We have managed to narrow it down to suspensorys but I won't put her through the surgery because we have such asymmetry in the hocks now (like yours turn in) and the hocks are not going to miraculously straighten to put less pressure on the suspensory. We might improve it but there is no guarantee it will then solve the front limb lameness. We have nerve blocked the front twice over a period of 6 months so know its not the front limb/foot actually causing problems its the hind. Mine has completely clean x rays. Mine is now effectively a happy hacker until she looks terrible and then will be PTS. Shame, as a good competition horse. We turned away for months but made no difference. Mine has been quite difficult to shoe in the past but we have made progress in this with patience. My horses all started after a field accident.

sorry about your mare, ours do sound quite similar don't they? thank you for sharing your experience- its really helpful. i'm surprised the xrays were clean- it just goes to show doesn't it x

rang vets, getting a call back after lunch to discuss everything...

 

[SEL]

thanks for replying, the old owner wasn't candid about what she had done with her or where she had got her from- turns out, after some digging it was beeston auctions. i eventually managed to get in touch with her first owners who had no idea she'd been passed round so much. although judging from videos from when she was young she had weird movement then (2-3 i'm guessing from the videos). with the sedation, shes fine to be trimmed without etc and shoeing sparks a nervous reaction- she is getting better each time thankfully, but it was an absolute necessity for her to have the shoes on and to try and correct her feet. from how you've worded your reply, i'm sad to agree, she does have so many problems.

i really do value my mare as my friend first and foremost and i owe it to her to do the best by her, so i'll do what i can

If you changed those photos to an appaloosa colouring you'd have my mare So here's the list of what we know;

Bilateral hock arthritis diagnosed at 6 before she'd done any real work (backed at 5, light hack). Responded well to arthramid much more so than steroids
Clean stifles, clean SI and various other joints in those areas (ultrasound as much as possible under insurance) - but responded favourably to steroid in the SI which indicated to vet she was sore 'somewhere in that region'
Strain on left hind suspensory - which we believe started as a tweak in a deep surface and is now part of a vicious circle of odd movement straining it, which leads to more odd movement
Soft tissue damage right fore - which seems to be healing well. Probably an unrelated injury but not sure.
Type 1 PSSM and extremely symptomatic judging by blood tests and muscle feel. Possibly at the root of her issues.

Came to me as a 4yo with behaviour problems and also needed sedation for hooves to be trimmed. Still struggles with her back legs and we ask the farrier to not bring them forwards if she protests.

In hand work and light hacking she's fine. Flies around the field playing and will happily rear and buck like she pays her own vet bills. No pain relief. The day that changes will obviously be a day to re-think but while I will never criticise someone who puts down a horse they can't ride it isn't the be all and end all for me. Once the vet has come back to you then take some time to think about options and what you want to do. I think if an insurance claim is running then you might as well spend their money - but ask the vet to be realistic about prognosis and likely workload.

 

[LEC]

sorry about your mare, ours do sound quite similar don't they? thank you for sharing your experience- its really helpful. i'm surprised the xrays were clean- it just goes to show doesn't it x

rang vets, getting a call back after lunch to discuss everything...

I will try and get you some photos - the thing that fascinates me the most is the huge change in her feet. She has always had same farrier and on whole good feet.

 

[sport horse]

You may find that if you remove the shoes and turn your mare away- her feet will improve. I would certainly not be sedating and shoeing in your situation. Yes, she would be footy for a week or two but her feet should harden off quite quickly. I have sport horse mares and when they have finished their ridden careers they come into my breeding operation so removing shoes after a long time is quite normal for us and it really is only a short time that they are footy if they are on grass.

 

[throwawayaccount]

SEL - thanks for sharing your story, your appy sounds like shes really been through it all! i honestly had no idea that horses could get arthritis so young :/ i'm not sure what PSSM is so will have a google- i've never even thought about having her bloods ran!! makes sense thinking about it. you've done so well in your journey already, it isn't easy at all. i've told my vet i'm happy to throw everything at my mare so long as insurance will pay, which i'm hopeful for. if they can't pay, then i will go out of pocket to an extent, but not enough to put myself in significant debt.

LEC - thank you, i'd appreciate that!! do you have befores and afters of her hooves aswell?

sport horse - I think that I will consider that when everythings been exhausted kind of thing, for now i'm going to keep up with shoeing as my vet wants me to. my mare was barefoot for a period for about 2 months but the problem with our yard, is to turnout we have to walk up and down a road, so that contributes to her footiness aswell. if she ended up being a field ornament then they'd come off of course.

spoke to vet today and had a good conversation. i think essentially my mare has mild bone spavin/changes in both hocks which was treated for with steroids, and her sacroliliac/lumbar region was treated with shockwave therapy. she's on bute until 22nd of april. for the next few weeks i'm going to do inhand walking with my mare a few days a week and increase her turnout now our fields have swapped over- just have to be careful of that lush grass, hence careful introduction!! she will also have another physio appt which will help aswell.

i absolutely love this mare so will put her first even if worst came to worst, but have to be realistic. i know its better a day too soon than too late; but hoping we have a chance.

 

[LadyGascoyne]

All of ours have had their shoes off for a holiday, even the ones with tricky feet. If they aren’t in work, and are out 24/7, it really helps to preserve the grass and none of them have ever been footy for more than a few weeks.

 

[throwawayaccount]

All of ours have had their shoes off for a holiday, even the ones with tricky feet. If they aren’t in work, and are out 24/7, it really helps to preserve the grass and none of them have ever been footy for more than a few weeks.

it'd be helpful if they did come off as it's £70 a time for fronts plus the cost of domo gel !! dose is being decreased each time. i'll speak to vet at our next appt and see, she only had her new set done last week x

 

[LEC]

it'd be helpful if they did come off as it's £70 a time for fronts plus the cost of domo gel !! dose is being decreased each time. i'll speak to vet at our next appt and see, she only had her new set done last week x

Likits/similar Licking products are the answer while shoeing. The licking promotes relaxation much more than treats/feed does.
I never tie up - always hold them so they can’t hit pressure and when they don’t need work being done by farrier you walk them round and round and only stop when farrier needs to do something. This keeps the muscles moving and they get bored and tend to be happier about standing still. I often will lunge tricky ones first as well. Warms up the muscles.

 

[Tiddlypom]

You don't mention getting her seen by a chiro or osteo vet. I can't recommend getting a good one in highly enough for such a wonky horse. Otherwise she will continue to move wonkily. Insurance might well pay for it, too, though you'd need to check.

A physio is much more limited in their tool kit. Good though my conventional vets and my physio are, we would not have had the successful result with my own wonky mare that we have had without the vital chiro vet input.

Whereabouts are you? People might be able to suggest someone.