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  Discussion on Stringhalt question
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Member:
Sefiroth

Posted on Monday, Jun 16, 2003 - 7:07 pm:

My percheron gelding (4 yrs old, 18hh, 1900lbs) has a slight abnormality in the flight of his right hind leg. When walking he lifts it approximately 3-4 inches higher than the left leg. Then as the right leg comes down he moves it inwards and slaps it down on the last 2 inches of downward motion.

He only does this at a walk. At the trot, the flight path of both hinds are identical. Picking up his feet, he's actually more comfortable picking up the right hind. Backing up he might occasionally hike the right hind up a little higher than the left, but its really mostly noticable at the walk. He doesnt seem to warm up out of it either, although some days its not as noticable as others.

If it is stringhalt, how would stringhalt affect a horse's ability to work as a light duty carriage horse? He'd be working single pulling a vis-a-vis for wedding ceremonies.

~Sharon
Moderator:
DrO

Posted on Tuesday, Jun 17, 2003 - 2:54 am:

Hello Sharon,
This sounds more like fibrotic myopathy but I would have to see it to judge and also to judge its performance implications. See Equine Diseases » Lameness » Diseases of the Upper Rear Limb » Fibrotic or Ossifying Myopathy & Myositis for more on this and see if you agree.
DrO
Member:
Sefiroth

Posted on Tuesday, Jun 17, 2003 - 4:50 pm:

Dr. O,

The symptoms of FM do seem to fit better than stringhalt. Except I don’t know if his stride is actually cut short. I've mostly been ground driving him and have only seen him move from behind since this problem started bugging me.

He's had it since I bought him but I was told it was probably stringhalt, which didn't bother me too much. I know another carriage horse with severe stringhalt that seems to do well, just hard to shoe, but always warmed up well. Golly's problems started bugging me since he didn't warm up out of it.

Also the article on FM doesn’t mention the leg being hiked up more. Everything else fits though.

If it is FM, does that only affect forward motion? I'd be worried about him going up hill and not being able to push off that foot well when pulling a weight if his range of motion is restricted.

Is this only diagnosable through watching the movements of the leg? Or can an ultra sound reliably detect it?

Also, do you have a diagram of the musculature of the hind leg? I have no idea where the muscles, mentioned in the article that can be affected, are located.

Thanks!
~Sharon
Moderator:
DrO

Posted on Wednesday, Jun 18, 2003 - 7:03 am:

How motion is effected depends on which muscles are fibrotic. The most commonly effected ones, yes usually the forward motion only is effected. The scar should be detectable with ultrasound. I don't have the exposed muscle pictured but it is area 43 on the anatomy diagram at » References » Equine Illustrations » External Anatomy: Parts of the Horse.
DrO
Member:
Sefiroth

Posted on Thursday, Sep 18, 2003 - 10:02 pm:

DrO,

Just an update on my horse. After dealing with his abscess, retraining him to tolerate having his feet handled, then having my horseshoer (only one in the area that does drafts) being put out of commission for two months by a runaway pony team running over him, I finally got 4 shoes on the horse and sent him off to the carriage company that was to work him on the streets selling rides and finish off his training.

He was there for 1 week. He drives like a dream. Only no one wants to drive him because of the way he walks. Cant sell rides with a horse that looks "lame" to the layperson. The owner of the place insisted it was either stringhalt or EPM. Said I should take him to the University of Missouri Vet School.

Brought him back to my boarding stable and had my vet out to check him over just today. He doubts its stringhalt since Golly moves backwards just fine, and doesn’t warm up out of it. He doubts its EPM since he doesn’t stumble nor drag his toes. He thought it might be upward fixation of the patella, but didn’t hear or feel any clicking. His stifle does jut out more on the right than on the left though, during the last half of the flight of his right foot. I never noticed this until I DrOve him and saw him move from the vantage point of the vis-à-vis.

My vet agreed it looks most like FM, but he couldn’t palpate any fibrotic areas. But your article states that you cant always palpate it. He didn’t have his ultrasound with him on this run. He's also going to call over to U of MO, and see where they think he should go from here.

My questions are:

Ultrasound would be our next step?

Has anyone else out there ever had to send off a horse for the surgery and had a good outcome/bad outcome? I guess I'm just looking for other's experience with this.

I plan on printing out your article on FM to take with me if we do go to the University. Is the surgery for this likely to cost in the hundreds or thousands range?

Thanks in advance!

~Sharon
Moderator:
DrO

Posted on Friday, Sep 19, 2003 - 7:57 am:

Hmmm, I cannot be sure if ultrasound is your next step or not: does your vet have experience in the normal ultrasound appearance of this area? You will need to really converse with the school about costs as it can vary tremendously. The article gives several case reports on surgery I believe.
DrO
Member:
Sefiroth

Posted on Monday, Sep 22, 2003 - 9:23 pm:

DrO,

I talked to my vet about ultrasounding. He said he doesn't have much experience doing muscle tissue but is willing try give it a try, for me as well as his own education.

He also mentioned he's been reading a lot of info lately about uses for the botox injection in horses with muscle problems and wonders if it would help in the case of FM. Have you heard anything along these lines? I would just wonder if it would only be a temporary fix, as I know the people who use it for cosmetic purposes have to keep going back for more shots.

Your thoughts?

~Sharon
Moderator:
DrO

Posted on Tuesday, Sep 23, 2003 - 6:41 am:

Botox works by paralyzing motor nerves. Fibrotic Myopathy is caused by a band of scar tissue that mechanically limits the range of motion of the leg: I don't see how this would help even temporarily.
DrO
Member:
Sefiroth

Posted on Tuesday, Sep 23, 2003 - 11:53 pm:

DrO,

He said he was wondering about the botox since my horse has no palpable scar tissue. He is trying to find out of the congenital form's treatment differs any from the treatment for the traumatic form of FM. His only experience with FM has been in QH's used for reining and cutting up to this point, and hasn't seen any with congenital FM.

I don't know if Golly has had any trauma to his hind end as he's changed hands quite a few times in his short life before I purchased him, including going through atleast one auction. I think we are going to try to ultrasound next week. Any tips I could print out and give him?

~Sharon
Moderator:
DrO

Posted on Wednesday, Sep 24, 2003 - 5:46 am:

I have not heard of a congenital form of fibrotic myopathy. Whether a scar or not is palpated, if the disease is FM, botox will not help. Hmmm, he could use the OK leg as normal and I would double check any lesions found with someone who is familar with unltrasounding this area.
DrO
Member:
Sefiroth

Posted on Wednesday, Sep 24, 2003 - 9:36 am:

DrO,

Your article on FM states there is a congenital form of fiborotic myopathy and that scar tissue is usually not palpable under the History heading. I believe that is why my vet and I are thinking my horse may have that form.

We'll be ultrasounding on Saturday and I'll be making an appointment with the University of Missouri for the week after. I'll let you know how things turn out.

~Sharon
Moderator:
DrO

Posted on Wednesday, Sep 24, 2003 - 4:58 pm:

That's what happens when you don't review your own articles before you reply. As the article states "it has been described" which is a euphemism for I ran across it when I researched the article. Sure enough looking at the scientific reports at the bottom of the article it is in the one titled:
J Am Vet Med Assoc 1985 Mar 15;186(6):565-7
Semitendinosus tenotomy for treatment of fibrotic myopathy in the horse.
I have never seen one and did not remember the reference. Good luck with the ultrasound.
DrO
Member:
Sefiroth

Posted on Friday, Oct 3, 2003 - 11:43 am:

After my vet consulting with the vets at the University of Missouri and Illinois, I've decided not to do the surgery. The cost would be around $2000 and the prognosis given was gaurded to fair only. My vet feels Golly's case is mild and he is light duty sound. I believe I'm going try to sell him as such and maybe look for another draft horse. I just seem to have no luck with horses lately.

~Sharon
Member:
Sefiroth

Posted on Saturday, Oct 4, 2003 - 5:57 pm:

One last question on one last avenue we haven't explored yet. EPSM. How often does EPSM only affect the hind end unilaterally? Because I still really don't see any actual shortness of stride. His foot doesn't snap backwards. Just down. Do FM horses typically "hike" the affected foot more? I've not seen that described for FM, yet Golly does have more "hike" to his affected leg.

When asked to back, with the halter on, he wont take more than a few small strides. With a bit in his mouth he'll back more readily, but with small short steps, evenly matched on both legs. I haven't had the luck to be visiting the barn when he's laying down to watch him rise so I'm not sure how he does there.

I'll talk to my vet about possibly pulling blood or doing a muscle biopsy. He's just so perfectly what I want other than his leg problem, I guess I'm not ready to give up on him yet.

~Sharon

PS. Forgot to mention that he's not entirely comforable picking up his hind feet. We can get shoes on him, but for the first minute he's got his feet in the air he holds them up himself and you can feel his whole leg tremble. Then he relaxes and makes no further effort to hold the foot up. Just DrOps it into your hand or to the ground if you can't hold his weight (I'm a small woman and dont have the strength to hold his feet up very long, just long enough to pick them out!)
Member:
Cassey

Posted on Saturday, Oct 4, 2003 - 8:12 pm:

Hi Sharon, the rural heritage website and Dr. Valentine are excellent EPSM resources. Sounds like the the muscle biopsy would be a logical idea. I bet I know what Dr. V. will say..."try the high fat diet, it can't hurt."
Moderator:
DrO

Posted on Sunday, Oct 5, 2003 - 6:10 pm:

Considering the vagueness of the symptoms and the changing diagnosis you have gotten and the response to raising a leg, I too think it would be worth a try, see the article on EPSM for dietary recommendations.
DrO
Member:
Cassey

Posted on Monday, Oct 6, 2003 - 11:49 pm:

Hi Sharon, Dr. V. doesn't reply to posts quite as quickly as Dr. O., but she generally does within a day or two.
Member:
Sefiroth

Posted on Saturday, Oct 18, 2003 - 5:00 pm:

The muscle biopsy has been taken. One weird thing though, while under sedation and walking the horse back to his shed (it was starting to rain) he hiked his LEFT hind leg 1 step in about 10. The right hind looked like it always does.

Once my wedding is over next weekend and I actually have free time again, I'll be switching him to the high fat diet.

I'll let you know how things turn out. What a saga this has been! Thanks again DrO for providing horse owners with such an excellent resource.

~Sharon
Moderator:
DrO

Posted on Sunday, Oct 19, 2003 - 10:40 am:

Perhaps you have 2 problems: a mild FM on the right and EPSM. This now accounts for the persistant deviation and slap of the R hind and the stringhalt like movements(?).
DrO
Member:
Sefiroth

Posted on Thursday, Oct 30, 2003 - 6:18 pm:

The biopsy results are in. Golly has mild EPSM. He's been started today on the diet. Dr. Valentine, my vet, and I are interested to see how he responds to it. DrO, I have a feeling you are right. His problems are going to end up being a combo of the two.

I'll give an update again in a few months after he's been on the diet for a while.

~Sharon
Member:
Sefiroth

Posted on Wednesday, Nov 26, 2003 - 8:04 pm:

Golly's been on the EPSM diet for almost a month now. He gets 5 lbs of alfalfa pellets with 2 cups of corn oil twice a day. He has free access to a very very nice grass round bale. Now that the weather is finally getting colder I'm going to also add a few pounds of one of the Buckeye feeds (not sure which one yet) for added calories as well.

He seems to be showing some improvement. The "hike" to his stride is becoming more and more intermittent instead of all the time. He still wings the foot and slaps it however.

Also today my vet was back from a convention in Colorado where one topic was hind end lameness. He said he saw a video of a horse that moved exactly like mine, which they said had stringhalt. He still doesn't exaggerate movements while backing up nor is it worse if he's moved off after standing still for a while, nor does he ever warm up out of it.

Round and round we go it seems like. Wish I had a video camera or some way of posting a video of his movements.

~Sharon
Moderator:
DrO

Posted on Thursday, Nov 27, 2003 - 10:51 am:

If you have a digital video of the movements, I will see if I can get them posted. Just email them to us as a attachement. There were several videos of stringhalt horses during that presentation and they were all pretty typical of stringhalt though they varied from mild to very severe.
DrO
Member:
Sefiroth

Posted on Thursday, Nov 27, 2003 - 11:26 am:

DrO,

I'll see what I can do to beg, borrow, or rent a video camera. Should I get side, front, and rear views of him walking and trotting a straight line. Anything else?

Thanks!
Moderator:
DrO

Posted on Thursday, Nov 27, 2003 - 4:38 pm:

Yes all angles and keep the sun directly behind the person with the camera. If at all possible have the camera on a tripod.
DrO
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