Mystery Lameness - Ideas?

Artemis
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Mystery Lameness - Ideas?

Postby Artemis » Sun Dec 13, 2015 12:46 am

My horse has a mystery lameness. Has been seen by the vet and farrier - neither can pinpoint a cause.

It started at the end of summer. We do 3 or 4 days of trail riding (1 - 1.5 hours per ride) and the horse began acting a little owie on the front end. Sometimes he would stumble - but it was always very periodic - like once towards the beginning of a ride and once 15 or 20 minutes into it.

He would go down hills more slowly than usual. Then, out of the blue while under saddle, he would suddenly raise his wither area - almost as if he suddenly felt a "zing" of pain - it was almost as if he'd stepped on a red hot poker. The head would go down and withers rise up 2 or 3 times - and then it would be over.

The problem seems like it's coming from the chest/shoulder area. His walk is solid, the trot has some head bobbing. He takes shorter strides with the front than normal. Seems more willing to canter than trot. Looks very disjointed when transitioning down from canter to trot - as if he does not like taking extra weight onto the front.

I kept giving him time off but that didn't seem to make a difference. I stopped trail riding and only did walk in the arena - and it still seems like whatever "it" is is still there.

There is no heat or swelling. The vet said 3 times how excellent the feet are - barefoot - no contracted heels.

Any ideas on what in the world this could be? Horse is 23 and not a prime candidate for an MRI - but I'll do what I can to help him be comfortable.

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Re: Mystery Lameness - Ideas?

Postby DJR » Sun Dec 13, 2015 1:36 am

What have radiographs shown (and what has been radiographed)?
formerly known as "Deanna" on UDBB -- and prior to that, as "DJD".

Artemis
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Re: Mystery Lameness - Ideas?

Postby Artemis » Sun Dec 13, 2015 2:47 am

We didn't do radiographs. Vet first suspected neurological problems - but after having the horse walk, trot, canter and move in various patterns she felt he knows where is feet and legs are.

You bring up a good point - what would be my next step here? Call in a different vet for a second opinion and get Xrays done?

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Fatcat
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Re: Mystery Lameness - Ideas?

Postby Fatcat » Sun Dec 13, 2015 4:36 am

I would find a really good lameness vet and start nerve blocking from the ground up, then what ever he blocks sound on, X-ray.

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Re: Mystery Lameness - Ideas?

Postby Srhorselady » Sun Dec 13, 2015 4:50 am

Definitely get radiographs! I am currently dealing with a similar acting lameness, but due to past history (navicular and nerving) I knew I wanted the digital X-rays pronto. With horses nothing is definite and no diagnosis is easy. We've had seven good years since the nerving with no sign of issues, but now his navicular bones are very bad on the X-rays. He also showed a hint of possible feeling on the lateral side of one heel. My farrier was there for the appt and we are trying backwards shoes to see if they relieve any of the symptoms. If not we will start blocking upwards since we can't be sure this is due to the navicular. We discussed an MRI, but since it probably wouldn't change what we can do probably won't go there. I suspect/fear I am facing his retirement, but I've had 10 great years with him. He was given to me with a full medical history when he was training prix st George and they couldn't keep him sound. My main goal at this time is to keep him pain free and, if possible, allow him to be a trail horse. He loves going out in the desert much more than being a dressage horse. However, sound or pasture ornament he has a home with me. Good luck with your guy!

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Re: Mystery Lameness - Ideas?

Postby Abby Kogler » Sun Dec 13, 2015 5:45 am

Necks can cause so many issues and are often overlooked. Are his knees ok? usually if you have a nav/hoof problem you will get some reaction from hoof testers and it is not a come and go thing as described. The come and go ness/suddeness and the slowing when going down hill make me think neck. Those are hard to test...you can xray but not usually in the field IME, and myelograms are expensive.

How is his spine behind the wither? Saddle ok? does he do it in other tack or bareback?

Will you post updates?

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Re: Mystery Lameness - Ideas?

Postby Hoof'n it » Mon Dec 14, 2015 12:38 am

Generally with joint issues, they cause the same level of (un)soundness everytime you do the same activity. Ie, if the horse is sore and reacts (lame) at something, everytime you transition from canter to trot, every time you walk down a hill, every time you go from walk to trot... Etc. the horse will give you the same reaction, of ouch And become lame.

If it's muscular, the reaction may not be the same every single time.

So from what you say, I'm leaning towards a muscular issue.

That doesn't mean my thought lines on how to deal with it would be much different.

What is he like to ride bareback?
When you trot him up in hand is he still lame?
Ishe lame lunging? If so, is he worse one side to the other?

The horse is 23, could it just be an onset of arthritis? The next question would be, how much money do I was to spend to diagnose this? This will tell you how extensive the testing will become - if it is definitely a mystery and not a run of the mill type of lameness.

I would give him a week of bute. See if that helps. Then once you take the horse off bute, does the issue start back up again?
I can't tell you the amount of times I have a vet come out to look at a lame horse to diagnose, and one of the first questions they ask, is 'does bute help'? So that is now one of my pre-vet rituals for mystery lamenesses.

If it does come back unsound, or if it doesn't help, I would be finding the best lameness vet around, and getting them to do a full work up on the horse. Your bute test will help out a lot as to them finding out where to look.
You could go to the extend of blocking and x-raying, or you could just go with the flow, and have them look over the horse, check for any sore spots muscular wise poll, neck, wither, spine, etc, do flexions and see if they pick up anything. If they find something in the flexions then you would X-ray.

For me blocking is one of my last ditch 'at home' attempts to find the lameness in the lower leg (knee/hock down) and it certainly won't tell you anything if it's higher up, Normally for me it comes just before more extensive diagnostic work.

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Re: Mystery Lameness - Ideas?

Postby Chisamba » Mon Dec 14, 2015 3:33 pm

Many very good soundness vets i know say that radiographs do not significantly improve diagnostics of a mystery lameness. horses often show radiographic changes where there is no pain, and do not show significant radiographic changes where there is significant pain. if you cannot get pain from testers, or flexions, then xrays are not particularly helpful. blocking, on the other hand, can isolate the injured area, but only if the horse is very consistent in its pain response. in your case, with the pain being intermittent, blocking may not show you anything.

I agree with Abby on this one, it sounds more like a neck/back issue than the usual joint or lower extremities. my suggestion would be a good massage therapist or acupuncture/accupressure therapist. palpating the soft tissues and examining saddle fit ( especially the downhill slowness and wither lifting response you are describing) is most likely to show up an anomaly.

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Re: Mystery Lameness - Ideas?

Postby Artemis » Sat Dec 19, 2015 11:03 pm

Thank you , everyone. I appreciate your help.
When I had the vet examine my horse she did a full chiropractic work-up on him. She didn't find any soreness - including the back and wither area. She could see he was off but found no aberrations in the muscle tissue and his Achilles tendons were flexible, in great shape.

--This week it seems the back end is moving better, but the front end still seems off. It's like the front end is still ouchie- does not want to take on much impact. On the longe line- Downward transitions look bad. Front legs still taking short steps. Not really reaching out at the canter.
--Another weird thing is when he wants to graze he will lower his head about to his knees, stop, then make a second try and get the head down to the grass. I saw it happen a few times over the last week. I can't find anything sore in the shoulder, wither area.
--final weird thing, my horse just seems dull. He will walk, trot, canter if asked, but otherwise just stands there in the arena until prompted. There is just some kind of dullness in his eyes. My barn owner noticed it too. Otherwise he is eating, playing with his pasture mate, being turned out daily.

I've been on the fence about retiring him at 23. I'll keep working with him for now - even if it's a 15 min. walk around the arena.
I do have a vet that does acupuncture - so maybe after Xmas I can get that for him.

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Re: Mystery Lameness - Ideas?

Postby Hoof'n it » Mon Dec 21, 2015 12:59 am

So you have had the vet, who acknowledges the horse is lame... Can't find anything.
What does your vet suggest you do next?

Has the horse been on painkillers at all? Any medication?

The horse seems in obvious pain, after your last post about him being dull etc. I would do more than just see how it goes. The vet or a new vet needs to one out and figure out what is going on.

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Re: Mystery Lameness - Ideas?

Postby Reiter » Fri Dec 23, 2016 9:59 pm

Worth checking the shoulder sling. The consistent theme you mention several times is DOWNhill and DOWN transitions. Problems in the shoulder, hard to Dx, but result in horses having difficulty, lameness or reluctance to move downhill or move weight downhill. Could be neuro, muscular or fracture causes, but results in similar clinical signs.

I have a big guy who got shoulder crunched into a fence post as a baby, and it killed a lot of nerves in his right shoulder. On ultrasound as 3rd level, muscular boy, you can 'see' the shadow of the dead spot the size of an 8" round post from the top to bottom of shoulder. As he has developed and aged, now 14, he is having some soundness issues in that area. Shorter strided to compensate and even bucks occasionally at canter if he takes some steps downhill on forehand. While I am sure dressage (and we are decently correct, training under Herbermann and Mikolka trainers) has actually kept him sound longer than he might have been, the neuro disconnect between that area and his brain/limb loop is really showing up, the more I try to develop him. So he is retired to mostly light work and trail riding which he loves. Though muscles are maleable and muscle around that 'dead' area compensated to a a degree, they have met their limits. And no doubt he may develop some arthritis in his neck or surrounding joints over time. He is on Adequan once a month and this is helping him a lot. Off of it he is noticeably lame on that shoulder at the trot.

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Re: Mystery Lameness - Ideas?

Postby angela9823 » Sat Dec 24, 2016 1:24 pm

Since this was a come and go thing, does it coincide with trimming schedule? Have his teeth been checked? That could also have a lot to do with neck and front end pain. If his teeth are causing TMJ issues, he'd have the starting down with his head and stopping til he adjusted his jaw. At 23, he may be having some loose teeth, or abscessing or points.

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Re: Mystery Lameness - Ideas?

Postby Chisamba » Sat Dec 24, 2016 8:48 pm

To me unwillingness to lower head significantly points to neck.

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Re: Mystery Lameness - Ideas?

Postby LeoApp » Tue Dec 27, 2016 2:41 pm

Chisamba wrote:To me unwillingness to lower head significantly points to neck.


Yes totally agree.

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Re: Mystery Lameness - Ideas?

Postby texsuze » Tue Dec 27, 2016 6:49 pm

Adding to the neck-related possibility: When my oldster received one of his vaccinations a few years ago, the injection was given in the neck and, IMHO, too close to the shoulder. For several days my guy couldn't lower his head completely to eat grass, so I had to elevate his hay to make that comfortable for him to reach. Also had to make sure the water level in his water trough remained high enough for him to drink without discomfort/pain. Very distressing for us both.


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