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  Discussion on Back Injury
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New Member:
Ghoward

Posted on Thursday, Jan 4, 2007 - 5:33 am:

Dr. O, we have 12 year old Percheron gelding which has very limited mobility. He is very reluctant to move. Specifically, he hesitates to put weight on rear feet. Tail seems to be abnormally limp. When asked to pick up either rear foot he brings it dramatically and uncharacteristically out to the side rather than back. No difference in movement when asked to back. Appetite is good. Drinking normally. Temp OK. Feet are not hot. Vet treated with steriod for "wrenched back" (my words, not his). More specifically, at this point we are assuming he twisted his back some how and has strained associated muscles. Can you think of anything else we should be thinking about? Thank you.
Moderator:
DrO

Posted on Thursday, Jan 4, 2007 - 6:32 am:

Hello Gordon,
Your horse symptoms resemble that of "Shivers" often believed to be a class of the PolySaccaride Storage Myopathy (PSSM) disease group that Percherons are prone to. A lecture I attended last month put on by a british veterinarian who specializes in this condition brought this pathogenesis into question and he does not believe it is well understood, not had found much in the way of therapy that is helpful. So be sure to get rule out other possibilities. You can read more about Shivers at Diseases of Horses » Lameness » Muscle & Tendon Diseases » Rhabdomyolysis: Tying Up, Shivers, PSSM, EPSM but as new research on theses diseases comes n almost monthly this article stays in a perpetual state of updating and so it is now and expect this month for more information on shivers and possible breaking it out into its own article.
DrO
Member:
Hally

Posted on Thursday, Jan 4, 2007 - 5:17 pm:

Hi Gordon,

Do yourself a huge favour and visit the following website www.ruralheritage.com. It just might save your horses life!
Moderator:
DrO

Posted on Friday, Jan 5, 2007 - 9:44 am:

Hello Hally,
There is now strong evidence that Shivers has to separated out from the horses with PSSM and is not the same disease. Studies of large numbers of effected horses in England has not revealed the same abnormal glycogen within the muscle cells nor rhadomyolysis as indicated by elevated muscle enzymes that is associated with PSSM. Nor did these animals repond to the diets that are helpful to horses effected with PSSM.

So Gordon needs to get a careful diagnosis of the condition in order to determine the proper treatment and prognosis of the condition. I do agree however in the face of no other choices I would try the PSSM diet recommended as there are still many questions about both conditions.
DrO
Member:
Hally

Posted on Friday, Jan 5, 2007 - 10:26 am:

Dr O,

Its good to hear that there is always room for new ideas and that the experts and researchers are always looking for new and better ways to treat diseases. Open minds lead to better research and the well being of our four legged critters. But in the end as you say diet is really the only thing out there that we, as horse owners have to work with. And like I have said in others posts it certainly worked for my gelding and many others that I know of.
Moderator:
DrO

Posted on Friday, Jan 5, 2007 - 6:59 pm:

No Hally that is not all we have and that is where the open mind comes in. The first step is a good diagnosis, from there proper treatment and prognosis can be made. There are some odd characteristics of Gordons post, for instance the horse is not worsed when backed, a common feature of shivers. This may be a stringhalt but the article I refer Gordon to deals with this possibility also. But if PSSM is diagnosed or no reason can be found for the odd stance and gait I would recommend trying the diet, but the article I referred him to does that too.
DrO
New Member:
Ghoward

Posted on Friday, Jan 5, 2007 - 8:34 pm:

Thank you Dr. O for the info. I guess I wasn't complete in my question. The condition I described is not a constant thing. The horse was OK one night and had the condition the next morning. As it turns out, the steroid treatment seems to have done the trick. He is much better now although we will let him rest for a few more days. I will, however, be watchfull for signs of shivers etc and provide an appropriate diet based on your articles.
Hally, thanks for your contributions. I look at the Rural Heritage site almost daily (I farm and log with my horses)and have read all the Dr. Beth materials and have her book.
Member:
Hally

Posted on Friday, Jan 5, 2007 - 8:39 pm:

You are most welcome Gordon. Good luck with your horse!
Member:
Hally

Posted on Friday, Jan 5, 2007 - 8:58 pm:

Dr O,

I was referring to the fact that if diagnosed with EPSM that besides the diet there is no other treatment. Is there? If there is I would love to know! It would sure save me a lot of money on corn oil!!

I am not questioning the fact that there are other diseases or conditions that this horse may or may not have that need to be looked into further.

Again the subject of EPSM seems to bring up huge differences of opinion. Which Dr Valentine and any other researcher worth their salt encourages as it promotes more research into this condition. Being open minded works both ways.
Moderator:
DrO

Posted on Saturday, Jan 6, 2007 - 11:24 am:

Gordon, delighted to hear this may be an acute transitory problem and still a bit of diagnostic uncertainty. Hmmm...did the veterinarian run muscle enzymes and if so which ones and what were the levels, also needed is the time relationship between the onset or symptoms and when the blood was drawn.

And with my apologies to Gordon I need to continue my discussion with Hally. Hally there is not much controversy over the proper treatment of PSSM, the controversy here is the way you approach helping people on these boards, which are my responsibility. In your Jan 4th post you state if Gordon does not visit Dr Valentine's web site his horse may die based on a very short description of symptomology, how does that jive with your ideas of getting a good diagnosis and a open mind?

The purpose for this web site is to help folks solve their horse's health problems and not scare them with dire predictions. Do you see the difference?
DrO
Member:
Hally

Posted on Saturday, Jan 6, 2007 - 1:06 pm:

Dr O,

In my previous post I do not see any mention of Gordons horse dying. Do you not agree that some draft horses diagnosed with EPSM if not treated with a change of diet, do in the end die? And by suggesting that Gordon take a look at Beth Valentines web site (which he does)I did not realize I was scaring him with "dire predictions"! Are you suggesting that by researching and finding other web sites that have information that might shed some light on some conditions is not being open minded???????? If I look at some of your postings on your "Equine Diseases" link, there certainly is information there that would scare people.

Sorry if you dont like me mentioning other websites that have veterinarians with opinions that differ from yours, however I do not apologize for having a difference of opinion to yours.

And Gordon if I have scared you with "dire predictions" I apologize. (But somehow I dont think so)
Member:
Corinne

Posted on Saturday, Jan 6, 2007 - 1:39 pm:

Just to play devil's advocate Hally, if I may, I think that if a person were to read your post out of context like many do via email, that it might indeed lead some to believe that you were directing Gordon to that site or else his horse might die by you stating it just might save his horses life. I am not saying that is what you had intended nor that Gordon took it that way but when reading it as an email out of context it sure could be interpreted that way as I could see it that way, until I read the post in it's entirety.
Remember sometimes the written word is interpreted, without the benefit of voice inflection or body language, entirely different from what was intended, and I think that Dr. O was just pointing that out and not trying to be confrontational as I think you think he might have been in his replies to you. Just being a good moderator.
Anyway, regardless, good information from everyone and Good luck Gordon glad to hear your horse is doing well. And Hally if you have a horse with any of these conditions...best of luck to you and them!


v/r
Corinne
Moderator:
DrO

Posted on Saturday, Jan 6, 2007 - 8:37 pm:

Hally, as I have pointed out to you before, we have referred to Dr Valentines site in our article on PSSM for years, and just recently edited that. Many folks have referred to Dr Valentines site on these boards over the years with my blessing. It is the way you want to make many problems fit in one hole and, in the case of this post in particular, the way you do it with a sledge hammer that is the problem. Just tone it down a bit and choose your words a bit more carefully.
DrO
Member:
Liliana

Posted on Monday, Jan 8, 2007 - 10:49 am:

Hally,

Knowledge comes mostly from research, but, also from first hand experience. I personally have found Dr.O's articles accurate and educational. I also find that most of us are indeed open minded and take what applies in a particular situation, after all Dr. O bases his advice on the information that we provide him with, I for one would be pretty lost without this site.

I guess what I am trying to say, is that I agree with Corinne, without the reinforcement of body language and tone of your voice your comment does come across a bit too critical and not at all open minded.

But I guess it is something that we all have to learn when writing, how to express our thoughts without sounding offensive. Easier said than done sometimes.

Liliana
New Member:
ghoward

Posted on Wednesday, Feb 14, 2007 - 11:11 am:

Dr O, as a follow-up, vet confirmed back injury. We have given our horse bute and stall rest for the last 40 days or so. He is off bute now but is still on stall rest. He shows no obvious signs of lameness and tail has lost most of its "limpness." Where should I go from here? Would you recommend I start working the horse again (lightly at first)? If not, is there something we should look for to indicate he is ready to exercise again? Thank you.
Moderator:
DrO

Posted on Thursday, Feb 15, 2007 - 6:13 am:

Gordon it really is going to depend on the nature of the back injury. Can you give me more details of what was diagnosed and how it was diagnosed?
DrO
New Member:
ghoward

Posted on Friday, Feb 16, 2007 - 7:03 am:

Dr. O, vet didn't give us any specific name for what was diagnosed. From our discussion with the vet, we got the impression that the injury was like a pulled muscle. The vet exam was done after the horse had been on six tablets of bute a day for three days.

(I should add that this was the second vet to examine the horse. The first (a substitute for our regular vet) vet, said he thought it was a pulled muscle and prescribed three days of steroid shots. About two days after the steroid treatment ended, the horse was lame again. This caused us to call our usual vet who asked us to start the six tablets of bute per day and that he would stop by to see the horse in three days. This is when the exam I am describing was done)

The horse was moving naturally but tail was limp and there was some hesitation to move in a very tight circle (one direction more than the other). The vet pinched the horse near the anus and got only a very little reaction. He also put pressure on various areas of the back and got little, if any, response. Of course, before we started the bute, the horse was vary lame in the rear. He moved by taking short, choppy steps with hind legs. Hope this helps.
Moderator:
DrO

Posted on Saturday, Feb 17, 2007 - 7:50 am:

Not really Gordon, at least with respect to your questions above. The exam you describe is difficult to follow as to what the meaning of the findings are and how you get back injury as a diagnosis with those findings. Perhaps the best advice would be from the veterinarian who examined the horse, he may have a better understanding of the injury.
DrO
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