This is an archived Horseadvice.com Discussion. The parent article and menus are available on the navigation menu below:
HorseAdvice.com » Diseases of Horses » Lameness » Localizing Lameness in the Horse »
  Discussion on Lameness in hindlegs - next step of diagnosis?
Author Message
New Member:
Sschoen

Posted on Monday, Apr 19, 2004 - 11:03 am:

We've owned my daughter's nearly 17 yo Appy gelding (16 h, TB build)for 3 years now (previously owned for the first 12 years of his life by his breeder, ridden by her husband; horse got sold when the husband passed away). When we first got him, even though he moved sound, we did notice that he was ever so slightly reluctant about having his hind feet picked up to be cleaned. But since he had been sitting around being a pasture pet for his most recent owner for a year, we also considered it to be a possible training (or lack thereof) issue. For good measure, and having been able to find out from his original breeder that he had led an active team penning/trailriding/Western pleasure showing lifestyle, we started him on oral joint supplements. We had no lameness or stiffness issues with him for the next 2 years as we worked him back up to a once again active lifestyle. My daughter competed with him in everything from pleasure shows to game shows to team penning to trailriding...indeed a true versatility horse that carried my daughter to a year end championship in all areas. (Have I set the stage for the fact that this horse turned out to be a valuable find worth his weight in gold, a good-natured, dependable horse beloved by the whole family?)
Last fall, competition season ended in October and while his time under saddle decreased, he still got plenty of daily turn out time with his buddies. In November, (with what may have been linked with the onset of cold weather) he became substantially stiff in both hindlegs and he would pick up each hind leg, flex it toward his stomach, while keeping it time abducted away from his body, then set it down. While flexed up in that position, it would tremble. I took him to the vet clinic where he had a thorough exam and the vet felt it was in his hocks, based on the flexion test (he was so sore it took 3 of us to help hold him up to tolerate having the LH flexed for the sufficient amount of time before he was trotted off). LH was the worst, but RH was also involved. But hock X-rays looked amazingly good, with very few changes, considering his symptoms. The vet injected his hocks and was very upbeat that this would be very effective, but suggested that in the spring before competition season started we should have it done again, even if he looked fine. (big sigh of relief...everything was going to be OK, right?) Vet said to take him home, give him Bute while keeping him on stall rest for 3 days, then get him back to work with lots of walking/trotting etc. We weaned him off the Bute after the 3 days, started handwalking and trotting and saw some (but not great)improvement for about 3 weeks. Then he went right back to being sore. Spoke with the vet office and was told to start him back on Bute (1 g twice a day) and give him stall rest for a week or so, then start back with the in-hand exercise. No improvement. Since it was too soon to inject hocks again (2 months minimum required between injections) they suggested the Bute and stall rest regiment for several more weeks, based on the chance that he had torqued something when turned out. No improvement. By this time the brutal winter weather typical of this area was well-established and turnout became rare with the horses getting their exercise when worked in the indoor arena. When he failed to improve in spite of Bute, stall rest or hand-walking (no matter what we tried), it was suggested by the vet that we could try Vit. E and Selenium since we are in the Great Lakes area and it is notoriously low in selenium. No improvement again. We switched joint supplements to see if there was one that might work better for him (we had him on Flex + when we first bought him, then had him on Next Level so switched him to Corta-Flex.(Hock injections were postponed because they wanted to try a different approach because there had been such a limited response to the first set of injections.) Now that spring is here and the weather is warmer, we were hoping perhaps we'd see some relief with the warmer temperatures (we're grasping at straws now). We had another lameness exam done by a different veterinarian (in the same practice)3 weeks ago and he wants nerve blocks done to confirm where the pain is coming from (why didn't the first vet do this? I'm not sure, I guess he felt the flexion test was so convincing.) Both vets agree that the stifles seem fine and the strange movement he does with his hindlegs does not resemble locking stifles. They have mentioned stringhalt, but are not convinced. Both say they have not seen this kind of strange movement in a horse before, but there is no doubt it is a response to pain. We have to heavily Bute this horse and lean him against a wall for the farrier just to trim his hindfeet and even then it is a terribly painful procedure for him. (fortunately, our farrier has the patience of a saint) The lifting movement he does seems to be totally voluntary, not a reflexive jerking typical of stringhalt. He is negative for any neurological symptoms. We always keep him fully vaccinated, on a stringent deworming program, farrier every 7 weeks, and he has been the proverbial "healthy horse" up until the past 6 months. Just recently, I met the woman who owned him while he was a pasture pet for a year and when I told her about his lameness problem, she commented that she had seen him do the lifting movement with his hindfeet so often during the winter that she felt sorry for him. (why she didn't have it checked out, I don't know!) So now I know it's a longstanding problem that seems to have resurfaced.
He is scheduled to go in next week to have nerve blocks done to confirm whether it is truly in his hocks and what more we can do.
After 6 months of trying everything the vets have suggested, with no success, I am at a loss as to what we are going to hear from the vet at this next appointment.
My daughter is heartbroken, as am I. We feel that we have dutifully tried everything suggested by the vets and we have been patient in giving each treatment the time it needs to show results, but we also are feeling terrible about having this horse suffer for so long while we try to find an answer. The horse has been miserable and grumpy, throughout this whole ordeal (can't blame him for that!), not his usual self, so we know he is in pain.
It is beginning to appear that even if the nerve blocks can confirm where the pain is coming from, that little can be done to get this horse comfortable, based on everything we've already tried.
While it looks like he will never compete again, we are dispairing that we can even retire him to pasture because his quality of life even then would not be acceptable.
We are experienced horse people, our whole family rides and competes (we own 4), but we are in the midst of this heartbreaking situation and people equally or more experienced than us are beginning to voice what we are reluctantly starting to admit: that maybe there is nothing we can do to keep this horse comfortable, no matter whether we can arrive at a firm diagnosis or not and that we should consider the very real possibility that we will have to put him down. We can live with that if we know that we have truly tried everything; but we don't want him to suffer anymore or needlessly while we search for answers.
What are reasonable tests to consider at this point? Where do we draw the line with the testing?Without asking this horse to continue to suffer needlessly, are there other treatments out there we should try? Are the vets likely to come up with a firm diagnosis and an effective treatment plan?
I know this message is very long, but it is as complete a history as I can give.
Does anyone have any words of wisdom at this point?
Member:
Suzeb

Posted on Monday, Apr 19, 2004 - 11:49 am:

Hello Susan,
So sorry that your first post is such a heartbreaking one. Stay in this section of Equine Diseases/Lameness and go to Diseases of the Upper Rear Limb. Look up Tying Up, Rhabdomyolysis and Shivers (EPSM). There might be something in there as a starting point for discussion with your vet. I hope you find some answers.
Susan B.
Moderator:
DrO

Posted on Tuesday, Apr 20, 2004 - 7:09 am:

While reading your post two things come to mind, one is the shivers form of EPSM as Susan references above and the second was Saddle Thrombus, see » Equine Diseases » Cardiovascular, Blood, and Immune System » Saddle (Aortic-Iliac) Thrombus for more on this. If it is EPSM you will be able to fix this, so don't give up yet.
DrO
Member:
Sschoen

Posted on Tuesday, Apr 20, 2004 - 3:23 pm:

Thanks so much for a new direction! While I don't feel that the Saddle Thrombus possibility fits, I am heartened to read all the information on ESPM and find that there is great hope for horses diagnosed with it. I have already called the vet's office to find out if they have had any patients they have treated for this (they have) and to let them know that I want to consider it as a possibility for our horse. I've read all the posts here and everything on Dr. Valentine's website, so am educating myself in advance of next week's appointment.
I will let you know how the appointment goes.
Thanks again!
Member:
Sschoen

Posted on Wednesday, Apr 28, 2004 - 11:51 am:

It's hard to write this email, since the very day I wrote the above email, feeling encouraged that we had a new direction to pursue, things took a serious turn for the worse. As I was packing to go to the barn that evening (we board) I got a phone call saying that something was wrong with Lucky. They said he had been fine all day and had even been out playing a quiet game of halter tag with his buddies. I arrived to find him in pain, lifting his left hind leg and flexing it over and over; each time he lifted it, he fell into the stall wall to his right. A phone call to the vet resulted in me giving him 10cc Banamine to try to keep him comfortable until the vet could arrive and we also moved him across the aisle to a larger stall because we were afraid that he would go down once and for all. That trip across the aisle (10 feet) was pure torture for all of us, as he struggled to stay on his feet. The vet examined him upon arrival (he seemed a little more comfortable because of the Banamine, but was still obviously uncomfortable) but she didn't know what the problem was. She felt it was something neurological; all of us there compared notes with her on the progression that we had seen recently. His condition that night was alarmingly the worst we had ever seen him, and had come on so quickly.
Sadly, after 3 vets having examined and tested him and having tried various treatments for 6 months, all without success, coupled with the serious decline we were witnessing that night, we made the awful decision that it was time to let him go. We no longer felt it was humane to ask him to suffer while we searched for an answer. We maintained him on Banamine injections and Ace injections every 4 hours to keep him comfortable until his grave could be prepared.
He is buried in the pasture where he grazed, finally free of pain. He went peacefully, surrounded by those who loved him. It was truly the hardest decision I have ever had to make in my life.
I can tell you that we hug our other horses even closer than before.
Member:
Shirl

Posted on Wednesday, Apr 28, 2004 - 12:04 pm:

Dear Susan, My heart breaks for you and what you and your family are going through. Many prayers are being sent your way. Your horse is waiting for you over the Rainbow Bridge, free of pain, running with the wind. Much love, Shirl
Member:
Suzeb

Posted on Wednesday, Apr 28, 2004 - 12:19 pm:

Susan,
I am so sorry for your loss. Your decision for Lucky was the most loving and kindest one you could make. "Lucky" was very lucky to have such a loving family care for him. My thoughts and prayers are with you and your family.
Susan B.
Member:
Annes

Posted on Wednesday, Apr 28, 2004 - 1:15 pm:

Susan, my heart aches for your loss. I have lost two horses, one that I had to make the decision to put down. It is truly the hardest thing I have ever done. My thoughts are with you and your family. - Ann
Member:
Sunny66

Posted on Wednesday, Apr 28, 2004 - 1:26 pm:

I am so sorry...my heart is aching for you.
Member:
Lilo

Posted on Wednesday, Apr 28, 2004 - 1:37 pm:

My sincere condolences. Even when it is without a doubt the right decision, it is still hard.
Lilo
Member:
Aannk

Posted on Wednesday, Apr 28, 2004 - 1:46 pm:

Susan,
I, too, am very sorry for your loss. You did all you could. I am writing to say that, as well as to say that this seems very much like the horse I wrote to the list about who was put down in November. I hope this isn't too cold to ask right now, but are you getting him checked for insurance? If you get a result, I would be interested in learning what it was.
Again, my condolences.
Alicia
Member:
9193

Posted on Wednesday, Apr 28, 2004 - 5:27 pm:

Dear Susan,

My daughter and I send you and your daughter and family our deepest condolences on the loss of your beloved Lucky..May all the good memories of the past help you get thru this painful time.

Lucky was indeed fortunate to have such a caring family in his life..

Debra
Member:
Dres

Posted on Wednesday, Apr 28, 2004 - 6:08 pm:

.. i am so sorry for you loss , for you family's loss....this poor guy to go down hill so fast, must have been awful for you to see...

he is in a pain free place now.. saying THANK YOU....

Ann
Member:
Liliana

Posted on Wednesday, Apr 28, 2004 - 10:02 pm:

I believe it is one of the hardes things to do but he is greatful to you.

In your heart he will always be alive

Member:
Gafarm

Posted on Wednesday, Apr 28, 2004 - 10:54 pm:

This poem helped me deal with the loss of our 34 year old stallion a few months ago. I hope it will give you some peace also.

GOD'S FOAL

I'll lend you for a little while
> My grandest foal, He said,
> For you to love while she's alive
> And mourn for when she's dead.
> It may be one or twenty years,
> Or days or months, you see.
> But, will you, till I take her back,
> Take care of her for me?
>
> She'll bring her charms to gladden you,
> And should her stay be brief,
> You'll have treasured memories
> To bring solace in your grief.
>
> I cannot promise she will stay,
> Since all from earth return.
> But, there are lessons taught on earth
> I want this foal to learn.
>
> I've looked the wide world over
> In my search for teachers true.
> And from the throngs that crowd life's lanes
> With trust I have selected you.
>
> Now will you give her your total love,
> Nor think the labor vain,
> Nor hate Me when I come
> To take her back again?
>
> I know you'll give her tenderness
> And love will bloom each day.
> And for the happiness you've known
> Forever grateful stay.
>
> But should I come and call for her
> Much sooner than you'd planned,
> You'll brave the bitter grief that comes
> And someday understand.
>
> Author unknown
Member:
Pbauer

Posted on Wednesday, Apr 28, 2004 - 10:58 pm:

Susan,
You have taken a lot of time, and great care, trying to help your Appy. I so admire your strength and determination...
I'll be praying for you and your family.
Sincerely,
Tonya
Moderator:
DrO

Posted on Thursday, Apr 29, 2004 - 7:59 am:

Our deepest condolences Susan. When you feel like discussing it I would like to more carefully go over what happened the last day.
DrO
Member:
Canter

Posted on Thursday, Apr 29, 2004 - 8:12 am:

With deepest sympathy to you & your family. I hope you take comfort in knowing that you did the right thing.

Fran
Member:
Frances

Posted on Thursday, Apr 29, 2004 - 11:36 am:

I am so very sorry that things turned out as they did. It must have been terrible for you, but you did everything you could and more, right up to the end.
Member:
Cowgrl

Posted on Thursday, Apr 29, 2004 - 11:44 am:

Susan, my heart just breaks reading about your poor Lucky. It must have been awful for you and your family to watch his decline and to make the hardest decision an animal lover ever has to make.

I'd like to relate a story from my husband's experience that might make you feel better.

We had to make the decision to put down a very special horse that had colicked severely and twisted a gut. While this was terrible in itself, we were relieved that he was in no pain but we still felt guilty even though there was no hope.

My huband had a very realistic dream about a week later that he was walking through a wood that opened into a huge meadow filled with horses grazing. Horses of every shape, size, color, and age were there as far as the eye can see. As he walked among the horses, not one of them paid the slightest bit of attention but he saw his beloved horse "Fly" grazing along with them. He called out and Fly came running over to him and pranced around him in a circle and then came and laid his head against his chest. He felt Fly was telling him that it was okay, he's okay, and not to feel bad about what he had to do. Ken woke up at that point and immediately felt so much better then went outside to visit the other horses and talk to them about the dream. He and I both think he had subconsciensly crossed the Rainbow Bridge to see Fly and see how happy he was and not to blame himself for the decision he had to make.

My prayers to you and your family.

Holly
Member:
Liliana

Posted on Thursday, Apr 29, 2004 - 10:19 pm:

So sorry Susan,

You did your best, nothing can be said to take the pain away, you did the right thing by him,its very hard but as you said he is with his friends in the field, it was so nice of you to give him that not many people are so caring. You will always have the best memories about him to keep him alive in your heart

My heart goes out for you and your family

Time heals all wounds so they say
Member:
Sschoen

Posted on Friday, Apr 30, 2004 - 12:47 pm:

I am so grateful for all the letters of support I have received. They are a great source of comfort as we go through this grieving process. It's so comforting to hear that we made the right decision, hard though it was, and to know that other people have been through this and understand. I will respond to each of you individually as I feel up to it, but I wanted to post this message to let you know that you are a wonderful, caring group of people and your messages have been such a source of comfort. Thank you!
Member:
Sschoen

Posted on Wednesday, Jun 30, 2004 - 1:21 pm:

Dr. O.,
You said that when I felt up to discussing it, you wished to know more about what went on in Lucky's final day(s). It's been 2 months now and the pain has eased, although it is still there, just not as fresh. My daughter rides my young paint gelding now and with their combined talents, have been winning championships again at everything they have tried. It is good to see her moving on and being successful, while at the same time, I catch her, tears in her eyes, leafing through the memory book she created for her beloved Lucky. He will be forever in our hearts.
What questions do you have for me, Dr. O?
Moderator:
DrO

Posted on Thursday, Jul 1, 2004 - 8:18 am:

Susan, your post on April 28th made me think of saddle thrombus, a possiblility we had discussed earlier. Unlike EPM and the many viral diseases of the central nervous symptom ST would be very painful. A tying up episode could look similar but I have not seen a case that leaves a horse falling over, stiff and painful yes but not falling. Were there any clinical findings or blood work run that last day that might further our understanding of what happened?
DrO
Member:
Sschoen

Posted on Friday, Aug 6, 2004 - 7:25 am:

When Lucky went into crisis that Tuesday evening, the vet came out and examined him, but didn't do any bloodwork. Her examination was quite limited because he appeared to be in so much pain from any manipulation she tried. (That was even with 10 cc of IV Banamine on board.) And having been very familiar with his case already, I would gather that she felt there wasn't much more to examine him for that she hadn't already looked at prior to this. She gave him an injection of Ace to help keep him quiet and minimize his movement. She ruled out tying up or any acute injury. Over the next 2 days as she consulted with the vet from Cornell etc. we maintained him on IV Banamine twice a day and Ace injections every 4-6 hours to keep him quiet and comfortable. His symptoms improved with this treatment, but only on a limited basis. The symptoms would worsen again as the medication wore off and it was time for another dose. He did eat, drink and have normal bowel and kidney function during that time. He actually started to look comfortable again with all the medication on board. However, any stressor, such as the vet doing a brief exam, was enough to bring back on the leg hiking and subsequent falling over to the right.
Does this give you any further clues?
Moderator:
DrO

Posted on Friday, Aug 6, 2004 - 10:19 am:

How did she rule out tying up? I still think these 2 most likely and don't see that they have been ruled out.
DrO
Member:
Sschoen

Posted on Friday, Aug 6, 2004 - 2:24 pm:

She didn't explain exactly what she was looking for that made her rule out tying up, neither that Tuesday night when he was in crisis nor during any of his prior exams (which included several vets, none of which felt it was tying up). None of them mentioned saddle thrombus as something that came to mind. He didn't have the tight muscles, the discolored urine etc. that I have seen associated with tying up, which I did watch for. His symptoms throughout the course of his illness were sometimes suggestive of tying up in that the symptoms would get progressively worse, and he would seem stiff, but he also spent a great deal of time on stall rest, with no exertion to bring on a tying up episode, yet the symptoms still presented themselves.
Wish I had better answers, but this had no less than 3 vets stymied.
New Member:
Nellmann

Posted on Friday, Aug 6, 2004 - 4:11 pm:

My apologies for stepping in but I am new to this site and I can't find the venue for my question below. Any words of advise are most appreciated.

I am considering the possibility of buying a specific horse. I've been told that one should have the horse "vetted." I don't want to use the owner's vet for this process. The horse that I am interested in currently has a twisted suspensory ligament and is on Bute Am/Pm.

He's a strong horse with an enormous spirit and is mannered; although can be a little mouthy at times.

He is stabled in New York City in a rather intense environment. Word has it that he twisted his suspensory ligament going down the ramp (he's a school horse). His front legs are in leg bandages.

Do you know of a Vet in New York City that you could recommend for someone in my position to work with on this issue?

This is an awesome animal that deserves to be rehabilitated and a good life. Any direction that you can you offer is greatly appreciated.

Kindest regards --
Moderator:
DrO

Posted on Sunday, Aug 8, 2004 - 10:58 am:

Hello Mae-Mae,
This would be a proper forum for a lameness question but you may get a better response if you post it in it's own discusssion. To post a new question, back up to this forum's list of discussions (select The Diagnosis of Lameness in the Horse off the navigation bar at the top of this page) and then at the bottom of the list of discussions you will see a Start New Discussion link. Press it, enter your title and you can copy and paste your discussion from here to a new discussion which might get more attention.

I am sorry I do not know any equine vets in the NY city area.
DrO
Home Page | Top of Page | Join Us!
Horseadvice.com is a BBB Accredited Business. Click for the BBB Business Review of this Horse Training in Stokesdale NC