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  Discussion on Lameness improving with work?
Author Message
Member:
Jennyg

Posted on Friday, Jul 9, 2004 - 6:37 am:

Hi, I wonder could anyone give some info to be armed with before I go and see yet another vet?

Subject:
16.3hh Bay Thoroughbred Mare, 5yr old.
Bought in October 03' fully vetted and x-rayed with eventing in mind and cleared.

Problem: Intermittent lameness on the right rein improving with exercise.

There has been a number of problems since I got her:

- Bad doer - teeth checked, a quidder (another story), but as a result lacks muscle and is difficult to keep fit, which may be or may not be relevant to lameness.
- Badly shod, needed corrective shoeing and egg-bar shoes. (I know bad shoeing can have adverse effects on the suspensory ligaments?)
- Bad brushing inside fetlocks
- forging
- changing leads (originally thought this was displaying some marishness, not so sure now)
- intermittent lameness believed to be in the off-fore.
- Sound on the straight, dog lame (stiff) taking a right turn to the right in the trot.
- Difficulty making her work and go forward.
- Once warmed up and working from behind the lameness disappears.
- The lameness is definitely more apparent when she has been stood in.
- Told it was bridle lameness!
- Chiropractor thought it might her right knee, asked me to massage the deltoids and triceps but she it hasn't made any difference, he told me to keep going and ride her anyway and see how she goes.

I'm getting a bit tired of the whole situation;
A: because I am getting varying opinions
B: because I don't have a conclusive diagnosis, I'm not sure whether to box rest her, put her out to grass, ride her or not ride her.

She is due to go to the Equine hospital next week for the full works, x-ray, nerve blocking etc (and hopefully get her teeth sorted).

But due to quite alot of mucking about and the coffers running dry I would like to try and be armed with some possibilities as to what may be the problem before next Tuesday.


Any help would be greatly appreciated.
Member:
Christos

Posted on Saturday, Jul 10, 2004 - 5:43 am:

Hi, Jenny,
What exactly do you mean by dog lame? Is her head bobbing up or down when a particular leg hits the ground or is she just very stiff and awkward to the right?
Would she accept her head to be a tiny little bit to the right when trotting straight or will she insist that left is where a horse's head should look at all times?
Will she accept crossing her off hind under her so you can clean the hoof when standing on the near side? The off front?
Member:
Wolfydoc

Posted on Sunday, Jul 11, 2004 - 9:04 pm:

Hi Jenny,

I can totally relate to your frustration. See my post about my horse "Elvis", who had a subtle lameness that I could appreciate only at a trot while free-lunging to the left. I too knew in my heart something was definitely not right, i.e. he was LAME, but got different and incorrect diagnoses twice by vets (I am a small animal vet myself), as well numerous varying opinions by everyone from friends to farriers.

Bottom line is you need to find a vet who is truly skilled and thorough in diagnosing lameness. Hopefully that is the case where you are going. With a whole afternoon's workup including lots of nerve blocks, ultrasound, and of course careful exam over and over after each nerve block, we got a correct diagnosis and a treatment plan for Elvis by a truly amazing lameness doc. It was nothing I expected and it certainly could not have been diagnosed specifically via this website, not that there's anything lacking on this website. You just have to go with an open mind and be prepared for anything. My first post to this site involved a horse I swore was lame but turned out he has a neurologic problem. No matter how much I explained his "symptoms" to DrO, none of us could have guessed the diagnosis, simply because I didn't know at the time what to look for or how to properly evaluate his movement. Certainly not due to lack of expertise on DrO's part!

The diagnoses for both my horses were devastating, but I finally had peace of mind knowing what was going on, what the prognosis was, and what our options were. I spent so much time anguishing over the problems, trying to analyze them in my head, wondering if I was hurting my horse by continued riding even though the vets said to do so, as well as wasting money. I will never do that again.

If you have access to a vet school in your area try there. You will have some of the best possible docs and the latest up to date info regarding treatment, usually at a cost that is no more, and often less, than you'd pay a private practice. If not, find out by talking to as many other horse people as possible, especially competitive ones, who they like. I found out about my new lameness doc from a vet who serves as my preferred local vet, as well as from new horse people I've met in the past few months.

I hope this turns out well for you and your wonderful equine partner. Let us know what happens!

Sincerely,
Cindy Nielsen
Member:
Spyke555

Posted on Wednesday, Jul 14, 2004 - 1:39 pm:

I have had a very interesting and eye opening experience regarding this type of "lameness".

To make a long story short- had a bigger horse, same issues and symptoms-

right HIND hock not finished fusing- had more growing to do- started compensating on right front and other areas-

went back to good basics as far as diet and farrier- buted her before evry ride and excercised it right thru a new set of exrays 6 months later that showed it had indeed finished fusing.

Now understand it is a common area of mis- dignosis in some of the larger breeds when they are still young and growing- we thought it was stifle, then hock, then tying up- you name it, we questioned and or looked at it. Took her to Charlestown, WV- there 2 hours(very professional) explained and showed us hers and others xrays- it all made sense. Good luck- I know it can be an exasperating and costly trip down that "what is it" road!! Terri in MD
Member:
Wolfydoc

Posted on Thursday, Jul 15, 2004 - 12:42 am:

Terri,

I'm confused and may be misinterpreting your post, but why would an immature horse's still growing hocks, with open growth plates, cause the horse to "compensate" with other limbs? It is normal for the growth plates in the hocks to close fairly late relative to the other joints, but I wouldn't expect that normal natural process to cause any problems assuming the horse is not overworked - ?

Sincerely,
Cindy N.
Member:
Jennyg

Posted on Thursday, Jul 15, 2004 - 4:26 am:

Hi Everyone,

Thank you for your contributions.
Following extensive testing, nerve blocking, ultra-sounds and x-rays a diagnosis has been made.

She has an Avulsion fracture of the navicular bone, very small about half the size of a small finger nail. Seemingly it it one of the hardest of injuries to diagnose as it may take sometime before symptoms show clearly. The vet believes that it was possibly caused by the tendon being overstretched resulting in the fracture. The condition of her feet and resulting very low heels probably lended itself to the stress on the tendon.

She requires six weeks box rest, raised shoes and then a re-assessment. The vet seems to believe that there is a fairly good prognosis in this case (hopefully) and that she should return to completed soundness.

Has anyone else had any similar situations? if so any information would be greatly appreciated.
Member:
Dres

Posted on Thursday, Jul 15, 2004 - 9:29 am:

Jennyg, run a search on Avulsion fracture.. i posted about one found on my horse... same place..!!~ your prognosis sounds better then mine.. i was told that an avulsion fracture cannot heal completely becus of the nature of the problem.. there is always tension on that healing bone.. it will nit together, but will always be weak...that being said , we gave him HA joint injection and he is wearing natural balance shoes.. he is sound and has been now for 2 1/2 months ,.. of course i have to be careful of how i ride him ,and the conditions.. a smooth flat surface NOT HARD .. he will bobble if he hits a divit in the sand , but does recover quickly.. oh.. was told not to do any lateral work on him for 3 months, cus when they cross over the foot fall is not flat, but slightly rolls... with hope / prayer and continuing care, i hope to get a few good years out of him.. most likely injections twice yearly..

Please keep me informed on you guy.. as this is the only time i have heard of this kind of fracture in this location... AC1@jps.net

Ann
Moderator:
DrO

Posted on Saturday, Jul 17, 2004 - 6:47 am:

We also have a article on navicular fracture see, Equine Diseases » Lameness » Diseases of the Hoof » Navicular Bone Fracture.
DrO
Member:
Dres

Posted on Saturday, Jul 17, 2004 - 10:31 am:

Dr. O , i have another question to you re the avulsion fracture..

i just reread the articles you referred 'us' too.. my horse was never put on stall rest,nor the elevated shoe, .. his lameness came on very slightly.. hardly noticeable.. being a dressage rider, i could see/feel it , where as some might not notice.. that being said he was x-rayed and the fracture was found.. he has received HA joint injections and wearing natural balance shoes.. gave him a week off after injection, and he is back to LIGHT work.. big oval circles, walk/trot/ canter.. ... staying sound..

i do have him shod every 4 1/2 weeks.. seems about that time he 'shortens' his stride, no bob..

my question is, the stall rest, is that for an acute fracture.?. ( with this horse i have no idea when this happened or if it did at the time of slight change in gait) i was told that x-rays can't really tell you in this location how old it is.. so .. do you think i should stop riding him now.. and rest him.. been almost 3 months, change the elevation of his hoof to help knit the bone together.. ?

would you recommend more x-rays ? and how soon after.. or wait till symptoms start again.. and or joint injections before symptoms occur on a regular time frame every 6-7 months..?

so many questions..

thanks as always Ann

Moderator:
DrO

Posted on Saturday, Jul 17, 2004 - 6:11 pm:

Yes stall rest is for acute injuries and your problem certainly sounds like a chronic navicular disease. The decision to do more diagnostics should be based on the idea that the increased amount of information can lead to a better diagnosis, therapeutic regimen, and/or prognosis. Unfortunately that is not likely from diseases of this region. If further workup is felt to be needed I suggest you get a CT for more information on a bony lesion.
DrO
Member:
Jeng

Posted on Monday, Sep 12, 2005 - 11:23 am:

Update on Avulsion Fracture:

Over a year ago now I posted my first message asking for help in relation to undiagnosed lameness, which turned out to be an avulsion fracture of the navicular bone. I promised myself that I would provide an update 1 year on. A little bit overdue but here it is.

My mare was put on 6months box rest on elevated shoes (more like stilettos).The angle was gradually reduced after 6 months and she remains on wedged heels. She was re-assessed every 6 weeks and after 6 months walking was introduced one a day for 20 mins, again for 6 weeks and then a further 6 weeks of walking 20mins twice daily. She was then re-introduced to light work and has never looked back since.

There has been no further lameness (touch wood)and she is back doing everything even fairly tough x-country.

Patience is the key to success in this instance.

Tks Jen
Member:
Dres

Posted on Monday, Sep 12, 2005 - 12:06 pm:

Jenny, great news.. thanks for the update...


On the first day God created horses, on the second day he painted them with SPOTS..
Moderator:
DrO

Posted on Monday, Sep 12, 2005 - 12:32 pm:

That is great news Jenny, congratulations!
DrO
Member:
Jeng

Posted on Monday, Sep 12, 2005 - 1:05 pm:

Ann, as far as I can recall your horse had a very similar problem. How are things going?
Member:
Dres

Posted on Monday, Sep 12, 2005 - 4:14 pm:

ahh yes, thanks for asking... only my boy has two very different broken front hoofs... the left being the avulsion fracture of the navicular , the right an extensor processor fracture... I know it seems odd, Jack Snyder, at UCD cannot explain why this has happened to him both at different times, confirmation / shoeing / diet / exercise all are good... it is just that S#@! happens, and this horse is self destructive, stall banging with front hoofs, pawing.. tearing up the pastures etc...

It is hard to tell somedays if the right or the left front are sore... I do know that he has to be shod often, he grows a ton of hoof fast and his angles get all messed up within two weeks... really....not to mention the extensor fracture hoof has the buttress hoof look, an old shape because of the inflammation around the fracture I think...

so all this being said... his hind end went out a few months ago.. very short strided on both hinds... I figured he pulled something compensating for his front end... I put him out to pasture, its been 8 months now... I brought him in to test... he is 100% now front and back... on level soft ground that is... will give him another month before I start him back up slowly...

I also give him legend shots every 6 weeks... I hope this is helping him....
This was my first born, and i had / have such high hopes for him... i will give him time..

On the first day God created horses, on the second day he painted them with SPOTS..
Member:
Jeng

Posted on Monday, Sep 12, 2005 - 5:53 pm:

It can be extremely frustrating and I sympathise especially as you are doing everything in your power to help the situation while he is doing everything in his power to screw up your best efforts. The one thing that I did notice was that many good vets are brilliant within their own specialised fields and what was the clincher for me was finding someone who specialised in lameness of the foot in particular.

Where are you based Ann..'Pasture' suggests the US but we have UCD veterinary college in Ireland?
Member:
Dres

Posted on Monday, Sep 12, 2005 - 7:07 pm:

Sacramento California,... J.Snyder is the US team Olympic vet very well known in his field.. I agree with you too that some vets are better at something's then others... my house vet is NOT a lameness vet but VERY good at all other emergencies...

I will be keeping my gelding out 24/7 this whole year because of his actions.. I hate that he will be out in the elements, but they are not as bad here as other places... we have built him a three sided shed, put gravel under the rubber mats... we ARE doing all that we can to keep him sound... much to the husband's ill humor of it all...

On the first day God created horses, on the second day he painted them with SPOTS..
Member:
Imogen

Posted on Tuesday, Sep 13, 2005 - 3:41 am:

Jenny, just out of interest, who diagnosed your horse at UCD?

And how did your horse cope with 6 months complete box rest? I have had horses cope surprisingly well with 3 months box rest due to severe injuries as long as they have company and a routine that breaks up the boredom, but I do think a lot of it depends on the horse's basic temperament. 6 months sounds like very hard work both for you and the horse. Congratulations for following the advice and getting a result!

All the best

Imogen (based in Cork)
Member:
Jeng

Posted on Tuesday, Sep 13, 2005 - 4:56 am:

Hi Imogen,

My horse was actually treated by Somerton Equine Hospital in the Curragh, CO. Kildare who are amazing. The Hospital is headed up by Heinrich Zieg but all the guys there are brilliant, Fidi looked after my mare and he really knows his stuff.

6 months box rest is tough but for some reason or another she just accepted it extremely calmly! And she is thoroughbred and can be quite hot when she wants. Even when I had to take her out every 6 weeks for checkups she would walk out and load really quietly with just a headcollar and lead rope.
She was in a large yard so their was plenty to see going on and of course we gave her some toys...turnip on a string works really well actually.
As you pointed out..some horses (I'm sure not all) seem to cope surprisingly well with box rest..better than we would. I could actually groom Alaska with the door wide open and she never once attempted to get out!

Jen
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