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  Discussion on Undiagnosed Lameness
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Member:
Rach

Posted on Thursday, Aug 19, 2004 - 3:11 pm:

My mare is severely lame on her right front leg. She exhibits a significant headbob at the trot, and sometimes even limps at the walk. She stumbles frequently now (has always been somewhat of a stumbler, but now stumbles all the time) and rests her foot with the affected toe/leg forward ahead of her body. This has been an ongoing problem for more than a year. Early last summer, she stumbled badly, fell on her knees, and came up limping - it was after this that she really began having problems. Had the local vet out several times. Through flexion tests, hoof testers, and x-rays, the vet found she had a small bone chip in her right knee (likely happened when she fell on her knees). The vet also said she had some bony changes due to arthritis, but that the arthritis didn't look too bad. The vet also mentioned the possibility of navicular disease and carpal tunnel synDrOme. Since surgery wasn't an option for the bone chip (there's no one here that can perform this type of surgery), we treated her with rest, DMSO, and IM injections of Adequan beginning last summer. By last fall we were able to ride her again and she seemed to be responding to the treatment. However, this spring it all started over again and she is now limping terribly again. Since she was no longer responding to the Adequan, we tried injecting her joint directly with Legend along with an anti-inflammatory and that seemed to provide some relief, but not total relief and it was only very short-lived (about 3 weeks of decreased limping). My guess is that the Legend had no affect, while the anti-inflammatory provided temporary relief. We also recently tried SURPASS and that also provided a little relief, but it did not eliminate the head bob entirely. About 2 days after the last SURPASS application, she's back to severe headbobbing and related pain. (Note - even during the course of all the treatments mentioned above, she still rested her right leg forward whether or not her headbob had decreased). She doesn't seem to respond at all to bute, aspirin, or DMSO. She is shod and the farrier knows there's a possibility of navicular and is treating her accordingly but to no avail.

I may have reached the end of the line with her, but still grasping and hoping for something that will work. Still don't have a definite diagnois of what's going on and how to treat it. It could be the bone chip floating around that's causing the problem or maybe one of the other things the vet mentioned. The mare is 15 years old. Her background is sketchy. When I bought her 4 years ago she was sound. I do know that she was a rescue horse at one point and that she was not trimmed regularly during that time - the vet thinks this contributed to the problems she's having. Although I do not want to invest much more $$ into this, I need to know what's going on and if she will ever be sound again. Maybe someone can offer some suggestions on the next step???? Is there a permanent nerve block that can be performed to keep her pain free?
Member:
Ryle

Posted on Thursday, Aug 19, 2004 - 3:43 pm:

Rachel,
Have you considered taking this mare to the nearest university with a Veterinary department? That might open up some new options for you in the way of further diagnostics and even surgery for the bone chip if that is what is causing the problem.

Cindy D.
Member:
Mrose

Posted on Thursday, Aug 19, 2004 - 6:02 pm:

We have a mare that tore her ACL (I guess it's called the same in horses as people.) At any rate, she was extremely lame & could barely walk. We took her to a clinic in S. Calif. where they did surgery. It wasn't nearly as expensive as I had thought it would be, even including 10 days board. I had to do therapy with her and gradually bring her back. Even though her knee is unsightly due to arthritis now (almost 4 yrs. later) she still has few problems. She will get a little lame if she bounces around too much in the pasture, but is sound enough to ride out on the trails, and even do a little dressage.(I do keep her on a glucosimine supplement.) In her case it was well worth the effort and expense. So, imo if there is someone within a days drive or so that could do the surgery you might look into it.
Moderator:
DrO

Posted on Thursday, Aug 19, 2004 - 10:09 pm:

Rachael has the lameness ever been localized as described in the article on Diagnosis of Lameness? If it is the knee joint, it is easily blocked to better localize the source of pain and if the knee removal of the chip may help if the osteoarthritis is not bad.
DrO
Member:
Ajudson1

Posted on Saturday, Aug 21, 2004 - 9:30 am:

Rachel,

Your horse sounds very similar to ours as to what's been going on. I was wondering, has her knee(s) bowed out at all, or is she straight when you look at her from the front?

See my new post, "bowed knee" with more details, btw.
Member:
Rach

Posted on Saturday, Aug 21, 2004 - 12:50 pm:

Thanks for the replies. I live in a fairly isolated area - the nearest veterinary university is thousands of miles away unfortunately.

Angie, no, her knee is not bowed.

Dr. O, the vet here says the lameness is mostly associated with the knee, but that other things may be factoring in such as carpal tunnel and/or navicular disease... pretty vague. I'm still grasping here. Since surgery is out of the question, I guess I'm wondering if there's some kind of long-term nerve block to keep her comfortable? I'm worried that if I don't find something that works, she'll have to be put down if she continues to deteriorate.
Member:
Ajudson1

Posted on Sunday, Aug 22, 2004 - 10:44 am:

Rachel,

If you read my bowed knee posts, you'll see that we are probably in the same boat here. This is so hard, how much do we do to try to find answers, how much do we spend? where to draw the line as to decide when to put your horse down? My husband doesn't want to spend $1000's for all kinds of tests just to be told "well, make her comfy, feed her for the next 10-12 yrs, but don't ride her" Like in your case,I don't have good horse vets close by. Seems unless the horse can talk and tell us what's wrong, it's a guessing game sometimes even for vets.

Right now I have 5 horses; the one who's lame. Two 2 yr olds, just started under saddle. A 15 yr old who's a real nut case as she hasn't been on trails ALONE for about 5 yrs. And a green broke 5 yr old. I am about ready to sell them all, and get just one sound, sane horse!!!!

The point is (I am trying to convince myself here too), there are alot of horses out there. we do the best we can, make the best decisions we can based on what we know at the time, and where we are in life.

If this is your only horse, you aren't having much fun with her now. Just a lotta stress and false hopes. you have to trust that what you decide is right.

I understand what you are going through and my heart goes out to you. Sometimes there are no answers, so all we can do is weigh the pros and cons.

My opinion about the nerve block: although it may mask her pain, she may still go down because she's useing the leg and feeling no pain. That would not be good if you were riding her.

Good luck
take care
Moderator:
DrO

Posted on Monday, Aug 23, 2004 - 6:13 am:

No there is no such block for the knee. If the vet is convinced that it is the knees, then your next step for a definitive diagnosis would be radiographs to detail the cause and I strongly suspect there will be remarkable osteoarthritis.
DrO
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