- This topic has 11 replies, 2 voices, and was last updated 4 years ago by
.
-
Posts
-
-
Our 23 year old Friesian got into the barn in a very small space, tried to turn around, and ended up in a heap for many hours until she was discovered – possibly as long as 10-12 hours on top of wood pallets. Through only what could be described as a miracle, we were able to unload enough hay and got enough space available to get the pallets out from under her where she could finally get on her feet. She was very dehydrated, wobbly, banged up with stiff/swollen legs. Most of the scrapes and cuts were superficial. She had a lot of swelling in one hock. There were some cuts by her stifle joint. Most of the larger issues appeared to be in the back legs that were under her.
After a few days of banamine followed by bute, she started to recover. I’m not sure that she would have passed any flex tests, but she was trotting down the hill to get her feed, etc. Prior to this event we did ride this horse all summer, so she was very sound with no signs of lameness. (Maximum 10 miles, walking only.) Two weeks after this event, we took her to a horse camping outing where she was ridden for about 2 miles and then walked about 2 miles – very slow, only walking. She appeared fine. However, she got cast in her temporary corral that night. My guess is that this was too much, too soon, and she became stiff from the exercise, and then had a hard time getting off of the ground. At this time, she has no swelling anywhere. She was wobbly for a couple of days. When she moves the hind legs, she swings them out, and sets them down carefully, several inches outside the front hoof track. As she improves, she starts to track more closely to the front leg tracks. We returned to the banamine followed by bute regimen that we had followed before, and we were able to get her home, trailering without incident.
My sense is that it is the hocks that may be driving the most pain/lameness. I can’t see any hitching in her stifles.
My goal is to just keep this horse comfortable in her senior years. While I have enjoyed being able to still use her, I had already purchased a 2 year old that will become our new riding horse. I have been pretty amazed at how sound she has been in her 20s because I wasn’t under the impression that Friesians are as long-lived as some other breeds.
I had seen her be somewhat slow rising from rolling, so I know she probably had some arthritis/aging issues prior to the above event.
What would be your recommendation for a drug regimen to keep her comfortable in her old age? I have heard of people using Previcox/Equioxx for this. Do the joint supplements really work (I’m a skeptic.) Do any other joint treatments like injections make sense for a horse this age?
I’m not sure what kind of damage ensues when a 1,500 lb horse sits on its legs in a cramped position for hours. Other than anti-inflammatories, I don’t know what else we could do for her?
Thank you,
Laurie
-
Hello Laurie,
The problem I see with any recommendation at this time is uncertainty as to what the issue is with damage from the recent accident. With a specific diagnosis you can use specific treatments. From a general getting older and stiffer from arthritis, yes NSAID’s can be very helpful for the old getting around if there are no problems with the kidneys or stomach. As to which one it depends but firocoxib has much to recommend it. For more on this see https://horseadvice.com/horse-equine/medications/anti-inflammatories-nsaids-steroids-arthritis-rx/ . You would think after 40 years we would have better answers considering the joint nutraceuticals but clinically we still remain uncertain. Here is a recent paper:Equine Vet J. 2014 Sep;46(5):611-7. doi: 10.1111/evj.12182. Epub 2013 Dec 10.
The effects of three-month oral supplementation with a nutraceutical and exercise on the locomotor pattern of aged horses.
Higler MH1, Brommer H, L’Ami JJ, de Grauw JC, Nielen M, van Weeren PR, Laverty S, Barneveld A, Back W.
Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
Abstract
REASONS FOR PERFORMING STUDY:
Multiple in vitro studies assessing articular tissues have indicated that glucosamine and chondroitin sulphate may possess anti-inflammatory effects, but little is known of their clinical effects in vivo. Many old horses have stiff joints, which is likely to be attributable to inflammation and therapy with these nutraceutical compounds could improve joint function.
OBJECTIVES:
To assess the clinical effects of a mixed supplement on the improvement of stiff gait in aged horses.
STUDY DESIGN:
Randomised, blinded, placebo-controlled study.
METHODS:
A group of 24 geriatric equids (age 29 ± 4 years; mean ± s.d.) received either 3 months oral supplementation with a test compound (containing glucosamine, chondroitin sulfate and methyl sulfonyl methane), or a placebo. Kinematic outcome criteria (primary: stride length; secondary: carpal flexion, fore fetlock extension and tarsal range of motion) were objectively quantified on a treadmill at a walk and trot before and after treatment.
RESULTS:
Stride length did not change significantly in the treated horses at the end of the trial. In the control group, carpal flexion and fore fetlock extension were significantly increased (P<0.05).
CONCLUSIONS:
There were no indications of effect of the supplement on gait characteristics. The observations in the control group may have been due to a habituation or exercise effect. This study does not support the use of a glucosamine/chondroitin sulfate/methyl sulfonyl methane supplement to improve stiff gait in geriatric horses because of the lack of a sizeable effect. The significant changes in gait parameters in the control group may indicate the usefulness of exercise regimens in older horses.Of course there is more on this subject on the page linked to above. A good physical exam followed by some lab to rule out problems with chronic NSAID use seems a good place to start.
DrO -
Thank you. This article supports my skepticism as I have read similar studies. Additionally, consumer reports tested many supplements and found great variability in the composition of supplements, with some products containing very little of the supposed active ingredient.
I have a prescription for firocoxib at the normal dosage for a horse. My question now is if a 1,400+ Friesian should get a higher dosage? At .1mg/kg I come up with 63.5mg vs the 57mg average horse dosage. Significant?
-
-
Well, we take each day at a time. Every day that she is waiting at the gate for her feed is a good day. We had two incidents where she got stuck on my neighbor’s lawn. The first time I commandeered a UPS driver that was in the right place at the right time. We were able to get her to her feet by just pulling on her halter. (I think she needed a little moral support.) About a week later, she got stuck in the same place and my husband was able to help her up. She is no longer allowed to go to my neighbor’s lawn unsupervised. (She can’t resist the cushy grass, lays down, and gets stuck.)
So far on our property, she has not been on the ground unable to get up. Now that doesn’t mean that she isn’t struggling to rise, we just aren’t seeing it. I know she has some issues because her hocks are torn up. She is on 3 acres, and there aren’t many soft places to lay down. I purposely haven’t put out some thick straw because I’m not convinced that it will help her if she can’t get any traction to rise. In reading other posts with horses with hock sores, some people said that thicker bedding can actually create a tougher surface to rise from. For example, I don’t know if the grass is problematic because it is more slippery, and she might not be able to get traction with her stiff legs.
My vet wanted bloodwork before we moved from bute to firocoxib. They ran the blood in their office and everything was normal except that her ALT was slightly elevated. They suggested sending it out to get some refinement with some of the other liver-related blood components, but I elected to not do that. – Basically because I didn’t think it would change our behavior. Generally, my understanding is that the firocoxib would be easier on her system than bute, so we were going there anyway. And if she can’t get off the ground, then there aren’t too many options beyond that. She also wanted 5 days to let the bute leave her system before we started the firocoxib, but I only waited 24 hours. I had only been giving her 1.5 grams of bute per day for several days prior to the change – fairly low dose for a 1,400 lb horse. I didn’t think we could afford to have her without meds. That was 10 days ago. So far so good.
She is bright, hungry and still dominant over the other horses. I even saw her loping up to greet me after work.
I’m not sure how to evaluate her lameness. She does not limp. She does look like she is out of alignment when she walks. It is like the hind end tracks to the right behind her front legs. So the right hind will step about 4 inches to the right of the right front hoof print. Now I will tell you that I have never studied how she walks, and maybe she has been doing this for years.
My vet said that she seemed stiffer than what he remembered. – which without extensive analysis is about where we are at in terms of veterinary analysis – old, stiff horse.
I read one post on the internet where they said that when their horse was due for another hock injection that she would start scraping up her hocks. I still keep wondering if hock injections might help her.
My procrastination in taking this farther is that I don’t want to impact any healing that might be taking place by trailering her and trotting her up and down for a vet. I’m guessing that we are looking at x-rays at a minimum for her hocks, maybe her stifles and hips? I’m not sure how far to take this for a horse with advanced age. She will be 24 in April. (Not that old for an Arab, but pretty old for a Friesian from what I can tell.)
As far as helping her hock sores, I have ordered some hock shields (which I’m dubious if they will stay on, be tolerated, etc.) So far the most successful technique for hock protection from what I have read is a strip of duct tape. 😉 While I wait for the shield arrival, I’m going to try duct tape.
So….that’s where we are at.
Best,
Laurie
-
Hello Laurie,
I have read this last post several times and have little to add. Concerning the lameness evaluation if the tracking problem is regular and every step this may indicate a muscoskeletal problem considering hip or pelvis while if the tracking is irregular and varying step to step this suggests neurological. I think your views on the NSAID use and liver enzymes are reasonable. What is the nature of the hock wounds, I assume she has decubital sores, how serious are they?
DrO -
One hock is starting to heal pretty good. The bald spot is about the size of a nickle and is not an open wound. The other hock has a raw spot that will get a scab, but then be scraped off if she has a tough time getting up. It looks like a skinned knee. It is on the leg that appears to be the weaker of the two.
I think my current setup so far is providing some protection. Don’t laugh. I have a feminine maxi-pad that is dangled from a strip of duct tape. The maxi-pad is positioned over the wound. I then put on her hock shields over that only at night. Pictures to
follow. -
-
This would be an unusual location for decubital sores so I am guessing these came from the original accident or am I missing something? I think your bandages look fine though I would expect some irritation from the tape in time. I find feminine napkins great, easy to acquire and economical bandage material and they are in my first aid box when we travel.
DrO -
She rolled on our lawn over the weekend, and I was able to observe her attempt to get off the ground. What I observed was consistent with what others have reported on the internet. She ends up rotating around on her hocks, ended up sitting like a dog, and then with great effort pushed herself off of the ground. Scroll down through these pictures to the bottom, and you can see the hocks being used as the horse attempts to get off of the ground: https://www.hockshield.com/photos/
What people reported with the duct tape is that it lasts about 3 days. As it gets dusty and dried out, it eventually just falls off. If it is still sticking, I can just got off the soiled maxipad, and re-tape a new one to the existing duct tape. My hope is that I can get a good calloused area going, and then the duct tape can go. I’m also going to check out some medical tape, but I don’t know if it will stay stuck.
Initially, I found the sore and I was surprised that I missed it after the barn event. ….But then I found the other hock scuffed up when it wasn’t before. I think she ended up in a weakened/injured state after the initial injury and kept scraping up her hocks trying to rise.
I don’t know if it is my imagination, but she seems to have more bounce in her step and a little more agility when moving. So it is possible that she had back pain, stressed ligaments, crunched joints that are slowly on the mend. She is also on firocoxib daily. She is on 3 acres that is hilly. So she does get quite a bit of up and downhill exercise that should help strengthen her legs. I haven’t seen her actually favor a leg in some time.
-
Positive update for this mare. The move to firocoxib was uneventful except that she has discovered that we have been spiking her banana and have to find another vehicle to deliver the medication.
I purchased hock boots to protect her hocks. That, coupled with the fact that I think she has generally improved, has completely heeled her hocks. You can’t even tell where the wounds were.
She has a bounce in her step. She is still dominant over the other two horses. So it looks like she is going to be hanging out on the planet a little longer. 😉
Laurie
-
-
- You must be logged in to reply to this topic.