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  Discussion on Sudden mysterious fore left lameness
Author Message
Member:
Mwebster

Posted on Saturday, Mar 29, 2003 - 9:23 pm:

Dear DrO,

This may be one of those impossible questions, but I won't be able to get a lameness eval from my vet for a few more days....

My older gelding with coffin joint DJD has been going great. Three nights ago, however, when I lead him in for the evening, to my astonishment he was headbobbing lame on his front left at the walk.

He hadn't been racing around his paddock, hadn't been ridden that day, and had no heat/swelling anywhere (still doesn't), nor any sign of injury. I'm baffled.

It doesn't feel like a foot problem. His paddock is totally rock-free, and I don't feel any heat in the foot, or see anything on the sole. His feet also have a lot of protection as he's still got his snow rims on.

I gave him an extra gram of his daily meclofenamate Wednesday night and Thursday night in case this was an arthritis flareup -- he was much better -- then backed him down to his daily dose last night to see how he is without the extra stuff, and he's still sore, though not as bad as Wednesday night. Just before I brought him in tonight, it started to rain lightly, and he was wet and itchy, rubbing against the walls of his stall, and wanting to roll. He got his left front knee down into the shavings, but then got up again with a groan without the roll. So whatever it is, it's making it uncomfortable for him to lie down. Does that suggest anything about the location of the pain? I almost think it looks like something higher up -- shoulder maybe. Could a flareup of his coffin DJD make getting down to roll uncomfortable??

Thank you,
Melissa
Moderator:
DrO

Posted on Sunday, Mar 30, 2003 - 9:14 am:

No it doesn't Melissa. Pain in many areas of the leg might make him reluctant to lay down.
DrO
Member:
Mwebster

Posted on Friday, Apr 11, 2003 - 11:26 am:

Hi DrO,
My gelding's improving, though still a little sore on the left front 2 weeks later. When he was reshod yesterday, I noticed some fairly pronounced red coloring at the white line on the toe of that left foot. Most of it came off with the usual light trimming, but after trimming, the white line was still a little yellowish on the toe.

My farrier says there's a name for this "red stuff" at the white line, do you know what that is, and is this significant? (Could it be related to his lameness?)

Thanks,
Melissa
Moderator:
DrO

Posted on Friday, Apr 11, 2003 - 6:50 pm:

This sounds like bruising (hemmorage and serum staining), but being on the outer horn it is old. The question then becomes is it still bruising or has the bruise turned into a abscess. A simple hoof test would be illumative. IF you want to figure this thing out Melissa you need to get messing around with all this detail of unknown significance and localize the pain.
DrO
Member:
Mwebster

Posted on Friday, Apr 11, 2003 - 7:49 pm:

Thank you, DrO.

You're right, I'm getting too preoccupied with details. Partly, I was just curious.

Neither the vet nor the farrier, both of whom have seen my horse in the last 9 days, think he has an abscess. The horse doesn't test positive to hoof testers. The farrier was unconcerned about the staining.

The vet thought more likely the horse had taken a bad step in the mud and wrenched something in the lower leg (that poor arthritic coffin joint).

He's steadily improving, trotting nearly sound now, so I think it's a matter of some more time and patience...

Melissa
Member:
Mwebster

Posted on Thursday, Jun 5, 2003 - 12:14 pm:

Just an update. Sunny was coming along very well on "conservative treatment", and was hacking out for long walks, but as he was feeling better he started racing around his paddock and doing some sliding stops, and suffered a setback. So I took him to an excellent lameness vet for a diagnosis.

The vet found he has a very sore left elbow, and it's a joint problem, not a soft tissue injury. Xrays confirmed substantial arthritis in that joint, and though I hadn't noticed it, the vet also pointed out loss of muscle at the shoulder, and a prominent chest on the uninjured side, so there's some atrophy as he's favored the leg.

Rx is a month of small paddock (20'x20') turnout, some extra NSAIDs for the next 2 weeks, and weekly Adequan shots. The vet is optimistic that he'll be trotting sound in a month on his maintenance dose of meclo, and can be brought back into work gradually at that point; if not, we'll inject the joint with HA/steroids and continue the small paddock rest.

My vet pointed out that Sunny has arthritis in several joints, and it's "systemic" -- either genetic predisposition, or perhaps the consequence of some agent like erlichia in the past. I keep him trim, but he's a big, heavy horse -- very big-boned. So that probably contributes to the wear and tear on his joints.

Anyhow, it's sure hard to keep these older, arthritic horses free of injury, but I know we'll get past this particular episode. I'm kicking myself for not roping off the area in his paddock that had gotten deep and muddy, back in March!

Melissa
Moderator:
DrO

Posted on Friday, Jun 6, 2003 - 2:58 pm:

I am sorry to hear this Melissa, I do not see much arthritis in the elbow and when reactive appearing radiographically has not had a good prognosis for return to soundness, do let us know how this works out.
DrO
Member:
Mwebster

Posted on Saturday, Jun 7, 2003 - 8:42 am:

Thanks, DrO.

Can you tell me anything more about what typically causes DJD in the elbow? I guess the broad answer is trauma or a conformation flaw? How do horses typically injure their elbows?

His prior owner said he'd had a left shoulder injury at some point years ago, back when he was eventing, but she never had it looked at by a vet, or diagnosed, or treated with anything but some time off. Maybe it was an elbow injury.

Though his prior owner claimed it had healed, I've long felt there was something in that left shoulder area that wasn't quite comfortable. Even back 5 years ago, there were times when he'd be off, circling to the right, then warm out of it. When we first diagnosed the coffin DJD, it felt just like those episodes, just worse. I couldn't quite understand how coffin DJD -- which the vet said was worse in the right foot -- could quite explain this.

We'll see if we can get him back to hacking sound. He's 22, and retired, so we're not looking for more than that. It seems all I can do is conservatively manage these injuries (he's a stoic horse, so I have to enforce the rest), give him his maintenance NSAIDs and Adequan so he's comfortable enough for light exercise when he's better, and keep him moving so he retains some fitness and some quality of life. It's very hard to watch a horse that's so brave and such a tremendous athlete, who knows so much and is so kind, slowly go downhill. Every little setback takes some more muscle off him. If there's anything else I can do to help him, please let me know.

Thanks again for all your help,
Melissa
Moderator:
DrO

Posted on Sunday, Jun 8, 2003 - 7:44 am:

Trauma from the outside usually sets up the DJD with a kick most likely. For many suggestions on treatment see the article on arthritis at, Equine Diseases » Lameness » Arthritis, DJD, OCD, and Joint Diseases.
DrO
Member:
Mwebster

Posted on Sunday, Jun 8, 2003 - 5:06 pm:

Thanks, DrO. I guess a fall could also be the trauma that triggered this initially?

Just to put my mind at ease, his DJD would be chronic stuff from an old injury, not from whatever made him sore 10 weeks ago, right? (He has an individual paddock, wasn't kicked, didn't have any mud or any mark on him, no heat or swelling, etc. when this latest lameness appeared.)

M

PS, Sorry for the redundant question about "what else I can do". I know the article pretty well by this point!
Moderator:
DrO

Posted on Monday, Jun 9, 2003 - 4:14 am:

While that is certainly a possiblity, it is also possible these radiographic changes are recent or it could be that a chronic arthritis problem has had an acute exacerbation from the trauma. These are really questions best asked of the person who examined the horse and has the radiographs to review.
DrO
Member:
Mwebster

Posted on Monday, Jun 9, 2003 - 10:06 am:

Thanks, DrO. I just called the vet, and he thinks we're looking at pre-existing (chronic) DJD, exacerbated by this latest event.

As for conjecture on how the horse could have re-injured his elbow, the vet pointed out that the elbow is a high motion joint subject to hyperextension when the lower limb goes in one direction and the upper body in another -- something that can happen easily in mud, when the lower limb is "stabilized" in the mud and the horse loses his balance. My horse's age, lack of fitness, size, and chronic elbow problem must make him especially vulnerable...

Melissa
Member:
Mwebster

Posted on Saturday, Aug 2, 2003 - 10:34 pm:

This is just an update on Sunny's elbow arthritis.

He didn't come sound again on his maintenance dose of meclofenamate with the small paddock turnout (20x20 feet), so I took him back to the lameness vet 2 weeks ago. A block of the left foot showed that about half his discomfort is that elbow. So we injected the elbow joint (triamcinalone/HA)and he's back to his usual self.

I hope he'll be one of the horses that find relief for 6 months or a year, rather than one of the horses that seems to need another injection in 6-8 weeks, as it's too expensive for me to repeat with that frequency.

He departs for a hack feeling very slightly stiff -- I'm not sure it's even visible, but I feel it -- but he warms out of it quickly. Perhaps it's partly due to his loss of muscle over the past 6 months, though I'm sure it's largely being a 22yr old with arthritis in that elbow, the coffin joints, and probably some other places too. His range of motion in his knees is also somewhat reduced, per my lameness vet. But all that said, his attitude is hugely changed -- he's a galloping fool in his paddock. He's so much happier going out for some work. He was morose being a pasture ornament.

M
Moderator:
DrO

Posted on Sunday, Aug 3, 2003 - 9:39 am:

That is great Melissa, we too will hope for the best.
DrO
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