Another Armchair Vet question--odd lameness

[PNG_Pony]

Welcome armchair vets! I'm seeking ideas on another lameness


The mare is 20 years old, give or take, Arab/QH pony named Jazzi. She has bad legs/feet in general (her front feet are angled compared to the bones of her leg so that she naturally wears higher on the outside of the hoof wall than on the inside and we have to trim her carefully to keep her sound) . Of all nine horses that I look after here, she’s the one most likely to come in limping. Here’s the video to go with the history: https://www.youtube.com/watch?v=t6VY1pe ... e=youtu.be (sorry that it's a bit blurry...my internet here is slow for uploading large vids)

History:
At the end of July this year, Jazzi came in from the pasture with a very sore abdominal muscle right behind her left elbow. My best guess was that she had been kicked (it later developed a hard lump about the size of a hand, which then eventually reabsorbed). So she was lame on her front left leg. We put her on bute on and off for two months for about a week at a time. After a week to 10 days of bute, she’d appear to be sound and would remain sound for a few days. Then, she’d come in from the pasture sore again, and we’d put her back on bute (we have no options for stall rest here, and alas, our pastures are all hilly). There was never any heat, swelling, or other sign of lameness, other than this one muscle (she didn’t want it touched and didn’t like picking up either front foot).

In October, she finally was sound enough without bute for a few weeks that I okayed some light exercise—walking and leading (this horse only wanted to canter!!) in straight lines. Slowly, over the next three months, we worked her back up to full light riding (she's ridden primarily by beginners, so your basic walk/trot/canter a few days a week. She normally is very fit and loves cantering...she'll canter until the cows come home). However, during this entire time, as she got more and more sound under saddle, she became more and more resistant to picking up her front right foot, so I always thought that something was not fully healed.

See the video for examples of how she struggles to pick up her front right foot. Normally, she only quivers with the front left foot, but a week ago, she actually fell down when she picked that foot up for me (thankfully we were on very soft grass!). I think the video is too fuzzy to see that she often has trouble locking the knee upright of either leg.

Perhaps related to that issue of the front left, a week ago she came in lame again (she hasn’t been visibly lame since the end of September), so she’s back on rest. Sigh. You can see her limping on the video; like I said, this is a recent development.

Side note: This mare on occasion will throw her body weight around if she doesn’t want to do something (somewhat dominant personality and she knows she can get away with it with some beginners), and when she is healthy, she will often test an unknown farrier by popping up in half rears or throwing her weight on the person or backing up. However, it usually only takes one growl from the farrier (and usually only once for all further sessions with that person) and she will stop her shenanigans and be an angel for the entire session. The woman in the video who is getting ready to trim Jazzi’s hooves is quite experienced, and Jazzi respects her a lot. When Jazzi is sound, she normally offers her feet placidly to this woman.So this is not a behavior thing, we don’t think.

Any ideas?

[Hoof'n it]

Look at her right hind.
She doesn't want to bear weight on it, standing, picking up either front feet or trotting. I would start a new search there.
She definitely hates picking up the right front as she has to put more weight on that hind, see how she seriously tenses up to compensate?

As to her left fore... Could the lump have been a cracked/broken rib?

Could be 2 totally unrelated issues

[angela9823]

Can you take photos of her feet? She looks lamantic to me. If so, they can be a little more off on one front foot than the other but she doesn't look too comfortable on either foot.

[Josette]

IMO - something is in her hind end is really bothering her to bare weight. Maybe some hock issues in addition to whatever is going on in the front.

[Dapple Field]

I feel that the left fore is the problem. Her right hind may be a little tired from having to compensate for the left fore. The backing up is her attempt to keep weight off the front left and trying to transfer it to the rear legs. Whether it is an abcess or laminitis, or something else is hard to tell from the video. If you have a pair of hoof testers it would be helpful to see if her Left Front hoof is sore anywhere.

[kande50]

Welcome armchair vets! I'm seeking ideas on another lameness

Any ideas?

First thing would be to get hold of some hoof testers and see if you can locate anything in her hooves. Check the frogs, collateral grooves, and sulci to rule out any deep thrush that could be adding to any other problems she might have.

Then, if the hooves seem sound, the next step would be flexion tests, to see if you can narrow it down to any particular joints in her legs.

[PNG_Pony]

Sorry, I've been out a few days. Thanks for all your thoughts! The update since the OP is that the mare is now sound again when moving (it was only a few days of off-steps, thankfully)--but feet issue remains.

I did flexion tests in the initial injury and it was obviously left elbow/shoulder, but I could retest now. Same with hoof testers.

Early laminitis is definitely a possibility, but as of now, there is no digital pulse, no heat, she stands square with full weight at all times (except picking up feet), is happy to relax a hind leg, she's a hard keeper, she wasn't sensitive (previously; I can retest), and there isn't major coffin bone rotation (but I could be blinded by the fact that we do have at least three who are borderline, so in the grand scheme of things, I haven't been as worried about her).

I did maneuver her head and neck all around, and there's no resistance or pain. No pain upon palpitation down the back or spine either. She does, however, show sensitivity when the muscles and tendons are palpitated on her chest around the the point of her shoulder (specifically the bicep).

I think I've been trying to simplify this down too much. The more I think about it, the more likely it is two issues--the original elbow/shoulder (cracked rib is a possibility (though it wasn't quite that point-specific), or severely pulled muscle, or major bruising,or maybe even moved into bicep bursitis). When you talked about hind end lameness, that definitely rings a bell. She also has TERRIBLE back feet; one has a major crack and the other just came in a few weeks back with a chunk of hoof wall missing. I neglected to mention this before because I forgot; the crack has been going on for over 7 years (before I arrived), and the owners have attempted treatment a couple of times, but it's never succeeded, and she's somehow stayed sound on it (treatment failure for various reasons, mostly people stopping too soon; we've pushed them to keep at it, but there's only so much I can do when it's not my horse).

It poured the entire time I was at the paddocks yesterday (and we have no indoor-facilities), so I missed getting photos. I'll see what I can do. Thanks, ya'll!!

[Koolkat]

Looks like her hindend/LS to me, she "tucks" her hindquarters when she has to weigh them and has an odd way of balancing. She also cocks both hind legs, sometimes even with the front leg lifted. The last time the trimmer raises her right front (~ 1 minute), she is licking/chewing before she does, and as she asks for her leg, she turns to looks at her (WTH) and then gives her the leg, but can't balance. Look at her loin muscle ~ 40 seconds.
I see it when she trots, too. And she's off in front.

[angela9823]

I see that kind of tucking pretty regularly on horses foundering on the frontends but especially more so when they are more off on one front foot but still not comfortable on the other. If the horse moves like this pretty regularly, she's going to be sore over the rear too. She's constantly cramping the hindend to get weight off the fronts. If OP is correct on saying hind feet are horrible too, she's not going to be comfortable getting weight off the frontend and putting it on the hind.

The horse was so off on the front though that it is hard to tell if there is a secondary issue here too. By the way, when horses are just a little off on the fronts, you start seeing it with cigar rolling of the muscles across the shoulders and across the rib cage. This is one reason many people think the issue starts in the shoulder. That kind of contraction of the muscles makes the horses very sore in the muscles and people see the soreness there first - before seeing the hooves hurt - especially if they are equally sore in the front feet.

[PNG_Pony]

Good to know about the the muscles in the shoulder and ribcage for front-end lameness. That's helpful to know!

So last night, Jazzi started off sound when walking and trotting in hand. I hoof-tested all four feet and there was no reaction anywhere.

When I flexion-tested, though, I got a lameness/head-bobbing reaction with her right front knee and her right hind fetlock (and potentially the right hind hock too...but it was hard to tell because of the fetlock). There still could be stuff going on in the left front and left hind, but I couldn't get a clear read on it since the right-side lamenesses were so obvious. After the flexion-test, she was constantly shifting back and forth to weight one hind leg and then the other, so there is discomfort on both sides.

So thank you for pointing me to the hind end; I've talked with several vets about this, and we were all focused up front because that's where the initial problem was.

When I turned her in a tiny circle to the left, she consistently stumbled over her front left (except when I wanted to video it), and at one point, even left it oddly twisted under her body when she should have corrected and put it straight. Turning to the right was no problem.

Here are some photos. I took them after the flexion test, so she wasn't always wanting to stand square with weight evenly on hinds, especially on the right hind. They are a bit long, but I wonder if that's more to do with the fact that the person who regularly trims her (not in the video) ended up *not* trimming her for a few months with the initial lameness because he was afraid to pick up her feet...unknown to me. Gah. But, now that I'm looking for it, I see a bit of flaring in her fronts.

Right hind:

hind right.JPG (48.09 KiB) Viewed 16491 times

Left hind:

hind left.JPG (52.14 KiB) Viewed 16491 times

Right front

front right.JPG (50.2 KiB) Viewed 16491 times

[PNG_Pony]

Left front:

front left.JPG (49.47 KiB) Viewed 16490 times

[angela9823]

When was the last time the horse was trimmed and how often? What I'm seeing is very long/low toes - actually overall the whole hoof is really low but due to weak heels. This horse could easily be ouching around because the heels are moving too much. There doesn't SEEM to be any integrity in the back of the hoof. There should be some life above the coronary band of the heels and instead that area is completely flat. So if you take the heels down low and allow them to go forward, the horse hurts because there is too much heel movement. The toe angle looks too open meaning that either the horse has consistently been trimmed with too long a toe left (or trim left too long consistently) or the horse has been lamanitic. The hoof wall looks really smooth so I'm not thinking a constant founder/ lamanitic horse. Does the horse toe in? It is of course hard to tell much just from a few pictures, but this is just what I'm seeing from angles etc so far. I was always taught that if the hair sticks up as it does around the coronary band, that could also mean the coffin bones are "dropped". It is like the bones have sunk further into the hoof capsule and distorts the coronary band, the ends of the lateral cartilages (making that flat look to the heels area described above).

Would still love to see some non weight baring heel shorts as well as sole shots to describe further what I would do. I don't want to advise taking toe back right now if the toe is too short (height wise) because it could make the horse more toe sore. Does your trimmer normally trim across the underside of the toe?

[PNG_Pony]

Thanks so much for taking the time with this to write all that out! I've been trying to do lots of reading and watching videos to improve my skills in hoof-interpreting and care, but it's definitely an area that I know I need to learn more, esp. in diagnosing and treating problems rather than just maintenance (I look forward to being in the US later this year and I can shadow some good trimmers). I often know something is wrong, but it stresses me out to not know what is actually happening and how to fix it (esp. when I'm the only one here with no experts to call!).

The problem is, in our situation (for various reasons that can't be changed), owners take care of their horse's feet, including trimming. The trimmer in the video is quite savvy (for a lay person), but is often in the village and so can't do it regularly; but when she comes by, she tries to give advice and direction to owners. This was the first time she'd trimmed the mare in probably a year. She doesn't trim across the underside of the toe, but does try to bring it as short as possible on this horse. She last trimmed her 3 weeks ago, and was planning on trimming her again this next week before she leaves for the village again.

I'm not sure how Jazzi's regular trimmer has been caring for her, but I would guess that it's very possible he's leaving her toes too long and waiting too long between trims--we recommend every 4 weeks in our climate/typical growth rates of hooves (he left her 3 months this last time, we found out, because he couldn't pick up her feet...I didn't know that he'd just abandoned hoof care as a result!) I'll be doing my best to educate him...but he's a bit of a cowboy-type who doesn't always take instruction.

The horse doesn't toe-in, but her front hooves are angled (I think it's lower on the inside than the outside, but I'll have to check tomorrow...I'm having a brain fart)

The strange thing, is the hair sticks up at the coronary band on all our horses--including foals. It was one of the things that weirded me out when I first came years ago; most of the horses have almost no hair at the coronary band, or it's quite sparse and short and spiky. I don't even notice it anymore, but we have seen that it's improved slightly when we introduced zinc and copper supplementation a few years back.

I'll get some sole and non-weight-bearing heel shots tomorrow morning (which is probably your evening).

[PNG_Pony]

Okay here are some photos of the sole. Alas, it was rather muddy...These are 3 weeks post-trim (the chunks missing were a lot worse before. Sigh). I realized after I got to the barn I was rather confused about the non-weight bearing heel shots...after I've picked up her foot, you want a photo from the back of her leg looking toward the heel, not the underside, right?

Back right

back right..JPG (128.01 KiB) Viewed 16432 times

Back left

back left.JPG (48.16 KiB) Viewed 16432 times

Front left

front left sole.JPG (140.82 KiB) Viewed 16432 times

[PNG_Pony]

front right

[Hoof'n it]

front toenails are long, with very little heel support.

I'm no trimmer or farrier, but the heel on the right front is probably the worst out of the lot.

[kande50]

She probably doesn't need the extra wall, and since it's breaking off in chunks and opening up the hoof to infection it would be better if it was kept shorter. A longer wall is a good thing if they have to go from soft, wet ground to gravel, but if she's only going to be on soft ground then a shorter hoof would be better.

Her frogs and collateral grooves look pretty good, although part of the right front frog has some spots where infection might be able to get in. I'd put hoof testers on that to see if it's tender. But other than that one side of the back of her frog, her frogs look pretty good for a horse on soft ground who isn't getting out to wear the ragged parts more.

I'd put the hoof testers on the sulci too, to check to be sure that she doesn't have deep thrush causing problems in there.

If she's normally ridden on gravel part of the time I'd shorten the toes on the backs but leave some wall at the heel, and leave the fronts alone, but if she's going to be on soft ground for the next few weeks then I'd take the wall right down and give her a short trim all around.

[PNG_Pony]

She's due to be trimmed tomorrow and yes, will be taken back short. Horses' feet grow very fast here, because they are in soft pastures and ridden on grass; there's no natural trimming on rock or gravel (so knowing who trimmed her last time, the wall has probably grown to double or even 70% more in the last 4 weeks). The one heel is because of how her hoof is twisted...it always grows like that, no matter how far it's taken back.

I've put hoof testers on her everywhere; no reaction. No signs of thrush. She gets daily apple-cider-vinegar sprayed on her feet, and that makes a big difference.

Yes, she's on very soft ground. This is PNG. It downpours daily, and we live in mud and swamp most of the time

[kande50]

Yes, she's on very soft ground. This is PNG. It downpours daily, and we live in mud and swamp most of the time

One big advantage to soft ground is that there's no dilemma about how much to take off, as there often is with horses who might, or might not be ridden on abrasive surfaces between trims.

[PNG_Pony]

One big advantage to soft ground is that there's no dilemma about how much to take off, as there often is with horses who might, or might not be ridden on abrasive surfaces between trims.

Hehe, true! I'll take my perks wherever I can get them!!