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Discussion on Fall on Arthritic knee
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Member:
erika
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Posted on Wednesday, Jun 6, 2007 - 9:13 am:
Sugar, my 18 year old American Saddlebred mare was kicked in the shoulder yesterday. It appeared to be a soft tissue injury, swollen, with a hoof shaped hairless mark in the middle. She wasn't lame, but I decided that instead of riding, I would just groom her and put her back out.
On the same side as the shoulder kick, Sugar has some osteoarthritis in her knee. She has never been lame, but the knee is a bit "over" and is a little bigger than the other knee.
As I was picking out the opposite front hoof, Sugar tried to pull her hoof from me gently, and I assumed she was just being rude (I don't know why I assumed that, she is not that kind of horse!) so I hung on to the hoof.
All of a sudden she crashed down onto her bad knee full force onto the concrete! Obvious to me now, she was trying to get her foot back to catch herself! Stupid me...now I feel terrible.
So...I reread the arthritis article, and I understand that she should be on bute, but for how long? I gave her one gram yesterday, is that enough for each dose or should it be doubled for a while? I also see that I should be buting her before and after riding for the chronic arthritis, which I have not been doing.
Is there anything I should be doing beside giving her bute?
She is a wonderful, fun jumper, but I guess that common sense tells me that jumping should be out of the question at this point, right?
Thanks!
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Member:
lynnea
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Posted on Wednesday, Jun 6, 2007 - 3:09 pm:
It sounds like Sugar's shoulder was too sore to put a lot of weight on it when you lifted her opposite leg. Falling on an arthritic knee is not the best scenario, and personally I would x-ray that knee before I did anymore jumping on it. I had a horse a few years ago with an arthritic knee, I didn't ride him at all but, as time went by the bones in his knee began a degenerative process that eventually began a fracture. All cases are different, and I only know what happened with my horse. I always go to side of caution before I wind up regretting not checking further into something....especially with my horses.
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Moderator:
DrO
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Posted on Wednesday, Jun 6, 2007 - 9:34 pm:
Hello Erika,
Sorry to hear about the kick. The article gives a number of long term management points for caring for horse with osteoarthritis, read them over and if you have questions about them post your questions here.
As for treating the acute injuries we give doses in the article on bute in the medications section but without examining the horse we do not know if this is appropriate treatment and how long the treatment should go on. The general rule would be until the acute inflammation has subsided. The inflammatory process is best explained at Diseases of Horses » Skin Diseases, Wounds, and Swellings » Swellings / Localized Infection / Abscesses » Diagnosing and Assessing Swellings in Horses.
DrO
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Member:
erika
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Posted on Wednesday, Jun 6, 2007 - 10:27 pm:
Thank you, Lynne and Dr. O.
The knee doesn't look any more swollen than normal today. She does seem to be sore on that side though. Not head-bobbing lame, but when she is grazing I often see her resting that leg--unusual for a front leg, so I know it must hurt. Not sure if the shoulder or knee bothers her more.
Of course I will rest her until all signs of injury are gone. Will read the medication article for bute dose.
She is a tough cookie when it comes to sneaking in medication. Even apple flavored bute in apple sauce on sweet feed had to be coaxed into her by hand! I have some injectable banamine that might be easier to use for the first few days of acute soreness, unless you see reason to object.
I love this sweet horse--my favorite of all time. Taking good care of her is a big priority.
Thanks for the advice.
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Member:
frances
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Posted on Thursday, Jun 7, 2007 - 6:47 am:
Hi Erika,
My 19-year old mare slipped and fell on her arthritic LF knee in March, landing on concrete (it happened in the aisle) and skinning the knee. I was of course concerned that there might be further damage to the joint, cold hosed and buted, gave just gentle exercise for a few days.
There was a period of a few weeks afterwards when her LF seemed to give way beneath her now and then - not that she ever went down. This doesn't happen any more, and she seems fine.
Every case is different of course, and I do hope yours turns out well. All the best.
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Member:
erika
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Posted on Thursday, Jun 7, 2007 - 8:32 am:
Hi LL, well I'm not the only one! Sugar's is over at the knee on that side (right in this case). I know that horses lock their knees when at rest to keep their legs straight. Does being bent a little forward like that prevent the mechanism?
I am also wondering if grazing is difficult for her with a front leg in pain. Like I said, I have seen her stand with it resting on the toe while she grazes. Does anyone think I should give her hay in a raised rack for comfort for now?
Wish I could find my oral syringe for dosing too. This hand feeding bute-laced feed is like feeding a baby vegetables ! "Zoom! Here comes the airplane! Open the hangar! Zoom!"
Any tips for hiding bute? I have apple flavored powder, mix with apple sauce, on a handful of Senior feed. Sugar has had laminitis years ago so I don't give her anything very sugary like molasses, and she usually gets Safe Choice--but it isn't terribly tempting, hence the use of the Senior.
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Member:
frances
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Posted on Thursday, Jun 7, 2007 - 12:53 pm:
Mine's a little over at the knee too, but sometimes stands with the knees really locked and straight, which always brings a huge beam to my face.  (Doesn't take much to make me happy, as you see!)
Does Sugar sometimes rest the OTHER leg on the toe when she's grazing, or always the arthritic one? Because I think when they're reaching for a choice morsel they get into a stretched position once in a while, and it doesn't NECESSARILY mean the leg that's not taking the weight is in pain.
I mix bute in a handful of chaff, slightly moistened, with bits of apple or carrot chopped in. But my mare is extremely greedy ... 
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Member:
erika
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Posted on Thursday, Jun 7, 2007 - 6:41 pm:
No, LL, she doesn't usually rest either front foot. Just since the kick/fall. At least I've never seen her do it. I do think she is sore, but whether the shoulder or the knee is the worst I don't know.
I think the shoulder is a soft tissue injury that should heal fine. It isn't near a joint and is in the fleshy part of the quarter.
The knee has been brewing for some time, and I am mainly concerned with increased damage there.
BTW, LL, nice picture on your profile. Are you out west?
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Member:
erika
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Posted on Thursday, Jun 7, 2007 - 9:42 pm:
Well, just came back from giving Sugar her bute dose. Shoulder swelling is much better but the knee is now markedly bigger. Knee is soft, swollen, but not noticeably hot.
My assumption is that if there were a fracture, it would have been more immediately apparent, would it not?
I have been giving one gram of but 2x daily. Thought it would help with swelling according to the article I read, but in the case of the knee, it seems to be worse.
She is still out on pasture, but they are a calm group so she isn't running around or anything. Just grazing and the occasional walk to shade or water trough. I am just sick over having contributed to this happening.
Thanks
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Member:
ajudson1
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Posted on Thursday, Jun 7, 2007 - 10:11 pm:
When I was giving Tango Bute daily, I used an empty wormer tube. I would mash the Bute tabs up, mix with water and a very tiny amount of molasses. Suck it up in the empty tube, then dip the end of the tube in the molasses to get him interested, and shoot down his throat.
After many "sticky" episodes, I just mixed it in his Safe Choice. I'd soak the pellets and put the Bute in there, wait a few minutes, then just a light dressing of molasses on top, mix again, and he ate it right down. WHAT a RELIEF after messing with the "tube".
He didn't like applesauce, or any flavored jello.
Only used a 13 oz can of Safe Choice. I think the first time, I left him in all night as he didn't eat it right away.
Hope she recovers o.k. for you. Don't blame your self, we've all got stories of "coulda, shoulda, and oops we goofed." Life happens.
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Member:
frances
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Posted on Friday, Jun 8, 2007 - 7:27 am:
Hi Erika,
Sorry to hear the knee's bigger. If there's no heat it sounds more like fluid (acquired bursitis?) rather than inflammation I would think. Are you cold-hosing it? That seems to help a lot. But if after about 10 days it's getting worse rather than better, maybe you should have it looked at just to be on the safe side.
No, I don't live in the US - I'm from the UK but I live in Greece so the background in my profile pic is Greek - is that how it looks out West?
Best of luck with Sugar - I do hope that knee swelling starts going down soon.
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Member:
erika
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Posted on Friday, Jun 8, 2007 - 9:50 am:
Thanks Angie, but she would have to be locked up for days to eat bute! My picky little Sugar! Even the syringe is a mixed blessing because after a couple of doses she hates me and won't come near me...so, I will continue with the little handfulls of gooey applesauce and Senior--at least she eats it out of hand.
I am thinking that the increased edema at the knee night be just seeped down from the shoulder swelling and settling at the other injury. It increased around the same time as the shoulder went down noticeably. I guess we'll just continue with bute and hosing until all signs are back to normal.
LL, yes, I thought your profile was an American Quarterhorse surrounded by Rocky Mountains!
Thanks guys.
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Moderator:
DrO
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Posted on Monday, Jun 11, 2007 - 6:23 pm:
Erika, if the knee has a fracture you would expect for there to be immediate signs but with so much going on they may have been missed, so it cannot be ruled out from history alone.
DrO
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Member:
erika
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Posted on Tuesday, Jun 12, 2007 - 8:56 am:
Thanks, Doc. I think Sugar is on the mend. There is no more noticeable swelling of the knee, and she seems perfectly comfortable walking around and grazing without compensating.
I am still giving her bute once a day, but I think I will stop that today.
I think I will pick/trim her feet on a softer surface for a while, just in case of another buckle. I don't want that to happen again!
I'll give her a few more days before riding again, and will bute before. Missing all the saddle time with our beautiful weather.
Thanks again, Dr. O.
Erika
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Member:
frances
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Posted on Tuesday, Jun 12, 2007 - 9:02 am:
That's great - glad to hear it!
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