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  Discussion on CANTER INCOORDINATION/LOWER BACK PAIN
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New Member:
Amoh

Posted on Wednesday, Apr 2, 2003 - 5:42 pm:

Dr O/anyone

This is a great site but I am in danger of being blinded by science and am confusing myself more with everything I read. I would be very gratful for your objective advice.

Here is the situation
I have a 9yo Con/TB cross mare who has a successful carreer in medium level showjumping behind her.
When I viewed her she had muscle wastage in the right gluts, sharp teeth and sore lumbar muscles.
These were supposedly treated.
Since buying her however she has had further bouts of lumber pain and has generally been extremely difficult to ride. Her teeth and saddle have been checked and are fine.
In walk she can become soft and submissive with plenty of neck bending, leg yeilding etc and is generally very obediant and willing to please. However in trot she invariably hollows, starts throwing her head about, snatching at the bit and refusing to take a contact. Only with a balancing rein do I feel I have any control. The main problem is at canter ( and she does this on the lunge as well) - she goes absolutely rigid, head in the air, plunging around and bucking and grunting/squealing during the transition. The bucking subsides quickly but she is unwilling to go forwards especially on the right rein. She always favours left canter lead and on the right rein canters on 3 tracks with her quarters in. After several canter strides her right hind will start to trail progressively, to the point where she becomes disunited and then unable to maintain canter. On corners she will bunny-hop. As if this weren't bad enough the real issue is jumping. She will approach the jump slowly but on landing will immediatly throw her head up and shake it and tear off, bucking and plunging. She ALWAYS lands on the left lead and can't do flying changes, which for a horse of her experience and ability is hard to believe.It takes about half the arena to get her back under control again but from then on she becomes very worked up.
When lunged with side reins to keep her head in position she is visably trembling afterwards and all the same problems are displayed as under saddle.
In her stable she often rests her rump on the stable wall.
She will try to bite at the sight of the saddle but is no problem to bridle, or handle in any other way.
Although I can't currently elicit a response from palpating her back she does still seem very sensitive around her poll, neck and stifles, especially the right.
She has been treated by a physio and an osteopath (before I became aware of the hind leg canter thing)
The physio thought there was some deep seated problem manifesting in overall stiffness and soreness. The ostepath was certain she had gone over backwards in the past and needed 2 doses of sedative to treat her. I was advised not to ride her for a month. Bute seemed to help (although maybe not with the hind leg gremlin as again this was before I noticed it). My vet has xrayed her hocks and they seem fine. The next step is nuclear scintigraphy but I know this can be inconclusive and is expensive.

I know this is a lot of seemingly unrelated information and I'm well aware that many of these "symptoms" can be behaviour/training related, but obviously I can't work on those until I know if and why she is in pain. The thing that convinces me most is the right hind in canter which seems to be a mechanical as well a painful problem. I have also had her ridden by several better riders and everyone experiences the same thing. No approach seems to make any difference to the canter and the post-jump reaction.

I would be very grateful for anything anyone has to add
Member:
Warwick

Posted on Wednesday, Apr 2, 2003 - 6:52 pm:

Hi Anna-Marie

You mentioned that your mare showed some hind end muscle wastage prior to purchase - did anyone give you a reason as to why this had happened? When you tried her out at that time, did she act up and did you get her vetted? If so, did the vet find anything abnormal?

Cheers

Sue
Moderator:
DrO

Posted on Wednesday, Apr 2, 2003 - 7:16 pm:

Hello Anna,
If I understand your post correctly depite a thorough and repeated examination: there is no obvious lameness on lunge at a trot either way. Despite this the horse appears painful under saddle. Repeated exam and treatment by several modalities has not given any relief. I too would be interested when this behavior first started, how did it come on, and how long it has been going on.

But more important is what are your goals for this horse? Next to ponder is what are the chances that even with further diagnostic work what are the chances are this horse will be able to meet those goals. I do not see many horses with gluteal muscle atrophy, usually do to injury directly to the muscle or disuse, that are able to perform at anything but schooling levels. Also, just as a shot in the dark, has anyone pulled bloodwork for muscle enzymes following a work out?
DrO
Member:
Chrism

Posted on Thursday, Apr 3, 2003 - 12:33 pm:

Has your vet tried a course of pain reliever (say bute for a week or two) and does it seem she is more cooperative and able to work when on pain reliever?

Has your vet done a complete lameness work up - blood chemistries, flexion all around, any nerve blocking, etc. to locate the area of pain?

How does she move in turnout with another horse or two?

How does she lunge without a saddle at all?

It may be that pulling shoes and turning her out with companions for a bit (the old "benign neglect") will keep her moving, yet give her body an opportunity to heal.

A lot depends on how much you want to put into her financially.


Member:
Amoh

Posted on Thursday, Apr 3, 2003 - 4:44 pm:

Hi All
Thanks for your interest

Dr O - there is a slight unlevelness on the right hind in trot. Have you encounterd the canter dificulty before? Is to likely to be mechanical ie fixated/displaced patella or general stifle joint damage? I assume you suspect Rhabdomyelosis (sp) since you suggest blood workups?
I did buy this horse to specifically showjump, as a schoolmistress to give me confidence(!)over 3'6"+ courses. She is no good to me as a pleasure horse as i can only afford to keep one and I desperately want to compete at this level.
The behaviour was apparent (to a lesser degree)when I viewed her a year ago and I assumed if it was physical she wouldn't pass the vetting and if it was behavioural/training I was confident I could sort it with the help of my instructor who had helped with my previous horse's bad habits.A video of her jumping a double clear 4"6'at Hickstead (big showground in England)was very impressive - she was managable although did have to come back to trot to change leads.I think this was at least a year previously.
At the vetting she was extremely resistant and bucking/plunging atc and when the vet identified sore lumbar muscles, v. sharp teeth and muscle wastage I thought that was it and I would be advised against purchase. There was no explanation for the muscle wastage, which I shoud have said was also in the saddle area, causing the saddle to slip to one side. HOWEVER, the vet was not unduly worried and sent her away to have her teeth and back "done" by the vendors and represent in 2 weeks, saying she had otherwise "passed". At the subsequent examination only the lumbar muscles and teeth were checked and she was ridden in a large circle for a few minutes. I was assured she was now fine and suitable for purchase.Assuming the teeth and back had been the cause of the problems at viewing I went ahead with the purchase only to discover the same behaviour when I got her home. I worked on her with my instructor's help for six weeks getting nowhere and on her advice brought in the phsyio who said she was extremely tight and sore all over. At that point I called out the vet and lo and behold she still had very sharp teeth and sore lumber muscles!!! She was put on a 10 day course of bute which did help to a degree, except for the canter imbalance/stiffness and inability to change legs. Then she saw the osteopath with the vet present, and he was certain she had gone over backwards and and all the problems were stemming from a poll injury.I then switched vets and the new one immediately identified the strange right hind action in canter and took hock xrays. She has now basically had 6 months off (being out all day with companions and in at night) and I've now started to bring her back into work but nothing has changed except for the worse! I really do feel her future with me is short term unless this turns out to be a treatable physical condition.

Member:
Cassey

Posted on Thursday, Apr 3, 2003 - 9:53 pm:

Hi Anna-Marie,
Dr. O's suggestion re: muscle enzymes reminded me of another information source, RuralHeritage.com. Very interesting reading, some postings sound a lot like what you are going through with your horse. Best of luck.
Moderator:
DrO

Posted on Friday, Apr 4, 2003 - 4:01 am:

Without seeing the horse at a canter I am unable to judge if the motion of the leg is diagnostic for a particular problem. There are not many problems of the leg that would show at the canter and not have some lameness at the trot also.

I was not thinking rhabdomolysis, but EPSM. It is a long shot that is treatable, see Equine Diseases » Lameness » Diseases of the Upper Rear Limb » Tying Up, Rhabdomyolysis, and Shivers (EPSM). If the muscle enzymes are elevated and those examining the horse have no other suggestions a diet (see article) aimed at that might be worth a try.

Essentially you have a horse not meeting your goals despite a year of working on the problem. I think your last sentence is about right: it may be getting time to move on.
DrO
Member:
Amoh

Posted on Friday, Apr 4, 2003 - 4:51 pm:

Right!
Thought I had fully educated myself on EPSM (thanx for RH tip Cassie)then did a search for incidence in UK as I had nerver heard of it before & the only thing I found was this

"08 May 2002
Q. EFor the last few months i have been riding a 15 yr old horse that has ’shivers’. It is only noticable when he is asked to rein back,pick up a hind foot or is stood in his stable for too long. I am trying to find out more about his condition, whilst looking on the internet about ’shivers’ it kept being linked to Equine Polysaccharide Storage Myopathy (EPSM). Is this what shivers is? How can shivers be treated? ESPM seems to be able to be treated through a change of diet, could this be the case for shivers?

A. EPSM is NOT in anyway related to ’shivering’, it is an entirely different disease - and not very common in the UK. Shivering is a neurological disorder, causing an involuntary leg movement, when someone tries to pick up one of the hind legs. It is usually a benign condition, although in severe cases it can make the farriers job almost impossible. As a rule it does not affect the horses usefulness, except in as much the shoeing can be a real problem.

Pool House Veterinary Hospital"

So is it rare here and if so why?

Member:
Apcohrs

Posted on Friday, Apr 4, 2003 - 5:58 pm:

Cant imagine that it is really rare. It IS rarely diagnosed. It is not a communicable disease and there is no reason to believe that it is any more rare than in any other country.
Member:
Cassey

Posted on Friday, Apr 4, 2003 - 7:25 pm:

Unless it hasn't been genetically passed along as much? I do, however, agree with Ann in that it is maybe just not being diagnosed. What would be the cost of a muscle biopsy in the UK?
I wonder if the seemingly different definitions of shivering vs. EPSM might just be based on where one lives? The RH site seems to consider shivers synonymous with EPSM, while what Anna-Marie describes as shivers sounds more like what we would call stringhalt. (You say tomaaato, I say tomahto :-))
Moderator:
DrO

Posted on Saturday, Apr 5, 2003 - 3:04 pm:

The first thing to understand is that shivers is not a diagnosis really. It is a set of symptoms that really is poorly understood and which little research has been done.

I have never had a case of shivers, and when the first member suggested it was related to EPSM (Equine Diseases: Lameness: Diseases of the Upper Rear Limb: Tying Up, Rhabdomyolysis, and Shivers (EPSM): Anyone heard of "shivers?"}, I resisted the idea. EPSM was the cause of tying up in my mind. But visiting Dr. Valentines site she speaks of cases of shivers that were positive on the histiological studies for EPSM and responded to the diet. I think we have a case study on the site of horses that could not be shod because they "shivered" when a hind limb was raised. There are no published cases in the main body of scientific literature in support of this or the nerve theory. I would be interested Anna-Marie of any research your veterinarian has supoporting the neurological hypothesis.

However your problem is not a shivering problem what I wonder is if the problem isn't stiff painful muscles and I know of no reason the condition could not exist in your country, though like I write above, it is a long shot and the dietary change based on finding elevated levels of muscle enzymes following exercise.
DrO
Member:
Fpony

Posted on Sunday, Apr 6, 2003 - 7:45 am:

Ann-marie,

I went through a year of trying to fiquire out what was causing my horse to have odd gait irregularities, muscle pain, behavior issues on and on-we did everything (from saddle changes to going to local equine hosp for a full work up) I switch him to the high fat diet on RH site as it seemed like it couldn't hurt and he started to improve right away (a month later) It took almost 9 months before he was doing very well. There is a muscle biopsy that can be done for diagnosis.
Good luck, Kim
Member:
Scooter

Posted on Sunday, Apr 6, 2003 - 9:55 pm:

Hi, I am curious how your horse is trimmed or shod. My 5 yr. old gelding went thru sore back, couldn't pick up right lead and a very disunited canter, plus the bunny hopping occasionaly. I was very frustrated all summer as he is naturally a very round moving horse and perfect at picking up leads, we don't jump much however. Going up hills was a nightmare when he had to push off his rear and going down hills he would rush. Well it turned out to be his hind feet, His heels were to low & underrunn and it was sraining his rear(hard to believe I know) Shorly after corrective trimming started and 2 weeks of rest for sore muscles his beautiful canter and right lead returned and has never left again and he also can go up and down hills again. Might be worth checking out. Good Luck I know the frustration.
Member:
Amoh

Posted on Friday, May 16, 2003 - 4:16 pm:

Hi again all
Just thought I'd update you with the latest news of my mare which isn't good I'm afraid, but I thought you'd all be interested to know the diagnosis.
I took her to the referral centre in Mewmarket for a bone scan and rode her while I was there, on the flat and over some jumps. The vet's observations were
- muscle tension in the lower back (characterized by dipping of the back and flexing of the hind legs)
- slight left hind lameness
- frequently became disunited in canter
- unable to switch left to right canter lead at all, right to left often changing only in front
- canters crooked on right rein (quarters in)
- always lands with left lead after jump
- general resistance and hollowness especially at canter

She then had the bone scan and was ridden by someone else yesterday and today and the above symptoms just got worse
The bone scan revealed 2 hotspots, one in the right sacro-iliac joint, the other in the lumbar sacral area. Xrays revealed spinal processes were close but not quite touching.
She was then injected with anaesthetic in the sacroiliac joint and lo and behold a different horse (the vet's words)going forwards, tracking up, working in an outline and doing SPONTANEOUS FLYING CHANGES!
So that's that - a severe sacro-iliac injury. The prognosis is not great - the vet thinks she will only be suitable as a hack if kept on painkillers. That poor mare. I am gutted as she is a fantastic careful jumper and is very smart with the sweetest of temperaments. All the time she has done whatever I asked only she was telling me it hurt.
Dr O what is your experience of the prognosis of this type of injury?


Moderator:
DrO

Posted on Saturday, May 17, 2003 - 7:55 am:

Anna, I do not see enough of these injuries to have an opinion of my own but the literature agrees with your vet, the prognosis for return to her previous level of use (show jumping) is poor. It is not just the localization that suggests this prognois, the injury has already had plenty of time to heal, and hasn't.
DrO
Member:
Amoh

Posted on Saturday, May 17, 2003 - 12:03 pm:

Thanks Dr O thats pretty much as I thought. i now have to decide what the best future is for this horse as she so deserves to have a good life. I'm so glad I followed my own gut instinct and pursued a diagnosis rather than listening to the many many others (all much more experienced than me) maintaining it was a rider/training issue. I suppose the one positive is that I have learnt so much in the process. Thanks for running such a great site
Anna-Marie O'Hanlon
Member:
Amoh

Posted on Wednesday, Apr 13, 2005 - 2:31 pm:

Hi Dr O and everyone else who followed this thread 2 years ago - I can't beleive I'm doing this but it would appear that lightning can in fact strike twice. Here's why.

When the horse referred to in the above thread was retired I did everything I thought possible to avoid the same thing happening again - I went directly to a very well-respected breeder in Holland and purchased my dream horse - a fantastically well bred and trained jumper with talent and temperament to match. For 18 months she was everyhing I hoped for and was universally admired.
Then about 10 weeka ago she started showing signs of resistance - rearing under saddle and constantly switching leads at canter. She had physio and magnet therapy and was given 8 weeks off. When worked again she was even worse. Hock stifle and fetlock xrays showed nothing. She was negative to all flexion tests. She would work in an outline in walk and trot and look fantastic but feel like someone had left the handbrake on somehow.Canter was a demonstation in one and two time tempi-changes which she hadn't been taught!

To my very paranoid eye she was displaying very similar symptoms to the previous horse (spookily they are both grey mares...).The diagnosis was received today from the vet at Newmarket and it was like hearing an action replay - pain emanating form the sacro-iliac joint, only this time most likely as a result of early osteoarthritis rahter than trauma.Prognosis - pasture sound/broodmare only. Extemely promising showjumping career cut short and she's not even 7yo yet.It's hard to believe that she had been going so well at the end of January that she was about to be entered in her first Foxhunter class (1m25) and she was jumping 1m40 at home.

I thought you might be interested in hearing about this Dr O since both cases did present so similarly, with neither showing "lameness" at trot and only seeming to have hind-end inco-ordination at canter. You also said at the end of my previous thread that you had limited experience of these kind of cases - I just wonder if there is a significantly higher incidence than is ever diagnosed - or is my luck really just that bad???!!!!
Moderator:
DrO

Posted on Thursday, Apr 14, 2005 - 7:04 am:

Wow Anna-Marie! Since your original posting there have been significant reports on improvement in the diagnosis of this disease and you are right: many of our poorly defined diagnosis of lower back pain appear to be si problems. A lot of this work is coming out of your local hospital and warmbloods definately seem predisposed. Together they help explain your poor luck on this. Can you tell us how this case was diagnosed?

This is a good overview of the work in the last view years:
Equine Vet J. 2003 May;35(3):240-5.

Pain associated with the sacroiliac joint region: a clinical study of 74 horses.

Dyson S, Murray R.

Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK.

REASONS FOR PERFORMING STUDY: There has been no large study of horses with suspected sacroiliac (SI) joint region pain in which the clinical diagnosis has been supported by either abnormal radiopharmaceutical activity in the SI joint region or by periarticular infiltration of local anaesthetic solution. OBJECTIVES: To describe the clinical features of horses with SI joint region pain, to document the age, breed, sex, discipline, size and conformation of affected horses and to compare these with the author's (SD) normal case population and to document the results of infiltration of local anaesthetic solution around the SI joint region. METHODS: Horses were selected for inclusion in the study based upon the exclusion of other causes of lameness or poor performance, together with clinical signs suggestive of SI joint pain and abnormal radiopharmaceutical activity in the SI joint region and/or a positive response to periarticular infiltration of local anaesthetic solution. RESULTS: Sacroiliac joint region disease was identified in 74 horses between November 1997 and March 2002. Dressage and showjumping horses appeared to be at particular risk (P < 0.001). Affected horses were generally slightly older than the normal clinic population (P < 0.0001), taller at the withers (P < 0.0001) and of greater bodyweight (P < 0.01). There was a significant effect of breed (P < 0.001), with a substantially higher proportion of Warmblood horses (51%) in the SI pain group compared to the normal clinic population (29%). There was no correlation between conformation and the presence of SI joint region pain. The tubera sacrale appeared grossly symmetrical in most (95%) horses. Poor development of the epaxial muscles in the thoracolumbar region and asymmetry of the hindquarter musculature were common. Twenty-six horses (35%) showed restricted flexibility of the thoracolumbar region and 10 (16%) had an exaggerated response to pressure applied over the tubera sacrale. Fourteen horses (19%) were reluctant to stand on one hindlimb for prolonged periods. The majority of horses (75%) had a straight hindlimb flight and only 18% moved closely behind or plaited. In all horses restricted hindlimb impulsion was the predominant feature; invariably this was most obvious when the horse was ridden. Stiffness, unwillingness to work on the bit and poor quality canter were common. Sacroiliac joint region pain was seen alone (47%), or in conjunction with thoracolumbar pain (16%), hindlimb lameness (20%), forelimb lameness (7%) or a combination of problems (10%). Seventy-three horses (99%) had abnormalities of the SI joint region identified using nuclear scintigraphy. Infiltration of local anaesthetic solution around the SI joint region produced profound improvement in gait in all 34 horses in which it was performed. CONCLUSIONS AND POTENTIAL RELEVANCE: Careful clinical examination combined with scintigraphic evaluation of the SI joint region and local analgesia can enable a more definitive diagnosis of SI joint region pain than has previously been possible.
DrO
New Member:
Nrosen

Posted on Thursday, Apr 14, 2005 - 7:38 am:

I have a warmblood in my barn who was imported from Holland two years ago. He was trained to Prix St. George in dressage and was a wonderful boy. Within 3 months after arriving, he began to sour on his work, thrreatening to kick the mirrors, resisting the canter,refusing to go forward and generally being unpleasant. We also noticed that he carried his tail to one side. After nearly a year and still no diagnosis, we took him to Tufts Veterinary School where scintigraphy diagnosed separation in the sacroiliac area. He was injected with steroids and we were told to rest him for a month and start back to work. There was a brief period of improvement and then he reverted to his previous level of disomfort. We have now laid him up for 3 months (stall rest and then hand walking), now turnout in a tiny level paddock and handwalking in long side reins to keep him from twisting his body as he walks and to encourage more even muscle development. Accupuncture seems to be giving him pain relief. At his current level of work (handwalking) he is very happy and cheerful. I don't know if I am being delusional, but I hope with months of careful care and very slow introduction of work, he could recover. Is there research out there, or am I wasting my time. It is so heartbreaking.
Member:
Amoh

Posted on Thursday, Apr 14, 2005 - 10:52 am:

Dr O it looks like I'm lucky to have been referred to Newmarket both times as Sue Dyson was the vet on both cases - she's the author of the above study and it would seem is at the forefront of this research. It would suggest that there are many horses suffering undiagnosed pain from this area. For your interest both cases were treated with the local analgesia in as she describes which each time led to a profound improvement.

Nancy I'm sure Dr O can enlighten you as to whether your warmblood has a future - my mare is also cheerful and happy in herself, but she has no future other than as a potential mum.
Member:
Chohler

Posted on Thursday, Apr 14, 2005 - 6:44 pm:

Anna Marie, just curious but what was average cost to do this?
Member:
Fpony

Posted on Friday, Apr 15, 2005 - 6:55 am:

Hi,
I posted too 2 years ago.
My horse who was dx with EPSM and seemed to respond to the high fat diet was finally biopsied last winter. It came back mild. The reason for the biopsy was his symptoms were never totally under control and he never was completely better. Sore muscles, back(hard spams),toe dragging and loss of power behind.He has never really cantered well but we would have good periods but as I got closer to having a horse that might be in shape he would regress.

-So i started looking for more answers. I have taken him off the high fat diet and kept the low starch. He had the appearence of an IR horse. He has had a winter of no muscle pain and was galloping around on his own in the snow. In March, boom severe toe dragging and lack of energy.(no muscle issues no elevated enzymes)My vet did flexions and neuro exam all neg. He just has no strength in the hind end. The week before he was moving nicely and had energy. My vet referred to the research you have mentioned above and that he may have SI instabilty.

He didn't give me much hope, but at least we may finally have an answer.

My horse is an Arab which is certainly not the build of an expensive warm blood, but I know of other Arabs that have similar gait issues as mine. Makes you wonder if it is in the design of the pelvis. I'm a physical therapist so i will probally keep trying to "fix" my horse. My vet suggested accupuncture followed by low intensity strengthening 2 times a day. There are also some proprioceptive taping techniques that have worked well on horses that I plan to try.No, you can't hold the pelvis in place, but you can facilitate muscle to help hold it in place. Kim
Moderator:
DrO

Posted on Friday, Apr 15, 2005 - 7:44 am:

Nancy,I wish I had better news for you but this appears to have been going on for almost 2 years now which I think worsens what already was a quarded to poor prognosis of return to previous level of exercise.
DrO
New Member:
Ryon

Posted on Saturday, Feb 25, 2006 - 3:28 pm:

I just recently (last week) had my mare diagnosed with a sacroiliac joint problem. She is a 6 yo QH mare, that I claimed on the track in Nov. 2004. She had 17 outs. I started competing on her in barrel racing this past Aug., 2005. She has been doing great. After a run 2 1/2 weeks ago she came up lame on her right rear (3 of 5). She also had some inflammation and tenderness, with palpation, on the right side of the lumbar vertebrae. I gave her 2 days off then had massage and chiropractic done 5 days later. Meanwhile, I gave devil's claw and yucca w/B12 and continued with light exercise - hand walk/trot. She stays turned out on 1/2 acre tract so she can continue to move around. With exercise she seemed to improve and not be so stiff. After nearly 3 weeks she has no apparent lameness, to most everyone. But I see it. She does not exhibit a limp - but she does not extend the same on the right as she does on the left. Although it is barely noticeable to most, it is there. I am fortunate enough to have a very good sports medicine veterinarian in my area and I went to him. He did see the problem in her gait, assured me that I wasn't crazy, and began looking for the cause. Hocks and stifles checked out fine, and blood work, muscle enzymes, etc... are all normal. We are scheduled to inject the sacroiliac on Monday. Fortunately, he is very familiar with this procedure, has done many, and assures me that she can return to light work in as little as 3 days. Fortunately, I did not listen to everyone when they said that she was fine. I know my horse, and I know when things are not right. I believe that most horses have a high tolerance for pain and will generally try to work through it. It is up to us, to know what is right for them. I am going to list the symptoms I saw in her, since I had such a hard time finding a place that actually listed symptoms, other than vague ones...
*soreness in loins and lumbar area
*slight inflammation in muscle on right side of lumbar vertebrae and to just before start of sacrum area.
*possible lameness 1 to 5 on rear - generally one side (right side on my mare)
*irritability when back was palpated
*this was the kicker - on lunge line, when not bitted-up, did not appear lame on right leg - but when bitted-up with surcingle, and asked to stay collected, she could not relax and hold the right lead. Without being collected she did ok, and did fine on left lead. Keep in mind that her lameness was ever so slight, most people never noticed it.

I have been doing much research on this and have found that, in race horses and others tested, many are able to return to the same work, and at the same level with no more problems, after injection. I guess it would depend on how long the injury went diagnosed and how severe it is. My vet, in charge of this situation, says I may never have another problem with this mare, regarding her sacroiliac joint}. I'll keep everyone posted on the outcome. I hope this information will be useful to someone else with a similar problem.

Thanks for such an informative site! JC
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