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Discussion on Proprioceptic deficit/SLD in 2-year-old?
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New Member:
Skeeta
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Posted on Friday, Jan 31, 2003 - 8:00 pm:
My 2-year-old Missouri Foxtrotter has stumped all vets, surgeons, equine chiropractors, and farriers with a succession of symptoms, which I'll try to relate as tersely as I can. Last May, we noticed he was slightly dragging his hind limbs, a bit worse on the left. On turns, he dragged his feet and stepped under only after losing balance and was labeled as having some proprioceptic deficit. We tested him for EPM and his CSF was negative. We x-rayed his neck and the radioligist said there were no changes, ruled out wobblers, and didn't think a myelogram would shed any light. His right side worsened a bit till he had an equal deficit in both hind limbs, although the vet still graded it as mild. Following a visit from an equine chiropractor, he began dragging his feet less. We put shoes on him (for the first time) and he began to pick up his feet consistently. We led him on a couple of pretty demanding trail rides and he handled it well. I rode him on the trail (first time riding him) and again, he handled it well. He's never acted lame, he's never evidenced pain or lethargy or fever or loss of appetite. No cranial nerve deficits. His demeanor and energy levels have remained good. Bute and vetalog were administered on separate occasions to see if they made any difference in his way of moving, but they didn’t. But at this point, he still doesn't seem to know exactly where his hind feet are. In addition, he's developed severely DrOpped fetlocks. The vet thinks it's suspensory ligament desmitis, even though this horse is only 2 and has barely been worked. We've corrected the angle a bit with bar shoes but there's just a tremendous amount of "give" in his ankles when he puts weight on them. But he doesn't favor them; no swelling, no heat, no pain. Assuming we've ruled out EPM and wobblers, the working theory has been that he sustained some kind of trauma, possibly to the L5/L6 vertebrae (chiropractor's theory). It has also been suggested to me that the initial neurologic problems could have been triggered by the West Nile vaccinations he had in February/March, preceding the development of the hind limb dragging. Now vaccination time is around the corner and I'm skittish about doing it again until I feel more confident that there's no possible connection with the neurologic condition. Questions at this point: Should I vaccinate for West Nile? Is it possible that things will get better as he continues to mature? Could there be a connection between the neurologic problems and the alleged SLD? Is it even possible that he has SLD at his age? Any idea of the prognosis, if so? Thanks for any insights you can offer. -- Jody
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Moderator:
DrO
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Posted on Sunday, Feb 2, 2003 - 8:07 am:
I know of no reason to believe the symptoms you describe could be caused by the WNV vaccine.
Assuming there are neuro-deficits in the rear, I agree the problem is somewhere in the spinal cord but there is nothing in your post to suggest what the lesion might be. In general early onset spinal cord lesions tend to worsen but as yours are a bit atypical and not in the neck (cervical region) I am uncertain.
I am wondering if the clumsiness behind is not do to the developing laxity in the suspensory/flexors behind. These horses frequently trip and appear unsteady. I would be interested in the results of a hindlimb fetlock flexion test, a reaction to it is one of the earliest diagnostic criterion for DSL in the Paso breed. With either condition, I am afraid that the prognosis for serious trail riding is guarded to poor and any riding may be dangerous.
No one can guarantee that there would be no connection between what your horse is going through and WNV but it strikes me as very, very, very, unlikely.
DrO
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Member:
Skeeta
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Posted on Monday, Feb 3, 2003 - 5:31 pm:
Thank you for the info. I guess I haven't been thinking very scientifically, because as much as I've tried to find (or disprove) some link between the neurologic problem and the SLD symptoms, I assumed that the neurologic came first -- it never occurred to me to consider the reverse possibility. I will look into the fetlock flexion test. Again, thanks for your help; if any other avenues of exploration should occur to you, I'd really appreciate knowing about it. This has been a puzzler. -- Jody
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Member:
Alden
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Posted on Thursday, Aug 28, 2003 - 2:11 pm:
Hello Jody,
I’d like to compare notes with you and hear if your horse has made progress. I also have a two-year-old MFT that is having problems with his hind legs. The only real difference I see in your post, is mine isn’t having any suspensory problems. We first noticed just a slightly awkward gait, particularly the left rear. We began seeing cross-firing when he canters to the left; Now in the left lead his left rear always trails the right. In last month very often when he turns he gets his rear legs tangled and it takes 15-20 seconds sometimes for him to correct; it appears very difficult for him to correct his stance. Unfortunately we let this go too long thinking he was going through an awkward growth stage, this has been coming on about six months now.
I had our vet look at him yesterday and he did some tests. At first just watching the horse trot he thought there was problems in the stifles. But then we walked the horse while pulling on the tail, the horse nearly fell down and the vet isn’t a real strong guy! He was weak on both sides. We also placed the left rear foot in front of the right and again he had difficulty correcting. With this test the left is worse, that is it is more difficult for him to correct the left foot than the right.
The bottom line is the without more tests (expense) the vet isn’t real sure and we don’t have the resources for extensive testing. He is hoping for soreness due to growth and because we had been riding him very lightly. The treatment right now is Adequan shots once a month, a daily joint supplement (Corta-flex) and no riding.
Dr. O
I do have a question in this ever-growing post! J I’ve read through different articles in “Nervous system” and the clinical signs of EDM seam a pretty good fit. This horse has never been on green pastures, he has been entirely raised on 60/40 oat/alfalfa hay. We also just torn down the old wooden stalls because of hazards materials (the list of hazards I’m not privy to) and built metal stalls (hopefully non-toxic!).
Is the dosage of 6,000 IU vitamin E daily safe with the Adequan and Cora-flex even if this isn’t EDM?
I’ve probably missed something here, so please ask questions. Thanks
Alden
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Moderator:
DrO
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Posted on Thursday, Aug 28, 2003 - 5:52 pm:
Yes it is safe. It strikes me Alden that basic exam questions are not getting answered: is your horse primarily lame, weak, or uncoordinated. The rule out for eace is different.
DrO
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Member:
Alden
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Posted on Thursday, Aug 28, 2003 - 6:41 pm:
Dr. O,
I had to stop and think about your question, I still might not be answering it. Thanks for the quick response. I’m going to start the Vitamin E for the time being.
Presently he is primarily uncoordinated in the rear. I say he appeared weak during the examination because the vet was able to easily pull him sideways by the tail, both to the right and left sides. But he doesn’t seem to have trouble carrying a person. I have been on him several times, for 10-20 minutes each time, and he didn’t feel weak. The lack of coordination is the primary concern of my vet followed (or supported by) the weakness to the sides.
When a horse is pull sideways by the tail they are supposed to resist; are they not? Is that a reflexive response that they cannot control or can a horse be trained to give and allow themselves to be pulled sideways. I ask because this horse was gelded May of this year and due to him thinking he was a big shot stallion lots of groundwork has been done, including pulling on his tail.
If you define lameness as a changed in gait, then he would be lame also. But this horse doesn’t really look like he is in pain to me, at the trot and canter it looks the backend just isn’t doing it right. Maybe I’m way off base with that statement but that is what I see. When turned out by himself he will run, buck and carry on like a two year-old. And he plays with the other horses when out with them; except the wife’s mare; she decides when and with whom she plays with!
Also, can you describe the “slap test”, I don’t think that was done to him.
Thanks again
Alden
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Moderator:
DrO
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Posted on Friday, Aug 29, 2003 - 7:09 am:
Yes they should resist having their tail pulled, it is largely refexive, but this is just one of many tests performed and should be combined with other exam findings. A horse may fail the tail pull test for several different reasons including muscle weakness and/or incoordination. A 2 year old with bilaterally symmetrical hind limb incoordination certainly the top of your list would be Wobblers and Equine Degenerative Myeloencephalopathy.
The slap test is explained in detail at » Equine Diseases » Nervous System » Diagnosing Vertebral Disease.
DrO
DrO
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Member:
Alden
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Posted on Monday, Sep 1, 2003 - 7:08 pm:
DrO,
Thanks the info, I have to see how much my wife wants to do. He is on vitamin E now, we'll see.
Alden
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