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  Discussion on Diagnosis by scintography?
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Member:
Lexi

Posted on Saturday, Sep 4, 2004 - 9:26 am:

My homebred gelding had a fall whilst being lunged in May. His hind end went down under him and out to the right side and his head shot up to compensate. He was lame on his off hind and has been treated for a lateral patellar ligament injury (2 months box rest followed by paddock turnout, physio laser therapy and muscle stimulators to support the joint). He has not made as much progress as expected although the ligament has healed well - his gait is uneven with a pelvic dip apparent on the off side in trot, toe dragging worse on off hind but others clipping ground sometimes. Trotted up he sounds like he's tap dancing!He did have an episode of ataxia, seeming drunk for a few days but I put it down to heat stroke as he recovered as the hot spell passed. Both the vet and physiotherapist now recommend I send him to a university hospital for scintography as they suspect neurological problems. Suggested possibilities were Wobblers, compressed/slipped disc, fracture of pelvis or maybe suspensory desmitis. He was 3 in April and was backed 3 weeks before the fall and moved fine up to then - could the fall when his head went up be severe enough to cause trauma leading to wobblers or similar? He is not lame enough to do nerve blocks and the vet is at a loss as to where to scan or X ray - back, pelvis, anywhere on hind limb? He doesn't seem in pain and will run around bucking and playing in his field although he has skidded over twice. He rolls right over and getss up without problem, he can back up normally, is stiff in hind end turning tight circles and can step over poles but catches it with off hind. You can't pull him off balance by his tail but he always stands with off hind further forward at rest. I'd really appreciate your help as my vet is baffled by his gait and mixed symptoms. Is there a possibility of wobblers from movement trauma or that only presents at 3yrs? Would it have shown progression as he seems fairly stable?
Are there any risks to scintography?
Any ideas what further tests would be useful?
Thanks v much
Member:
Lexi

Posted on Sunday, Sep 5, 2004 - 10:25 am:

Just thought of some further info that may be useful...he is 15.3 hh out of coloured cob mare by thoroughbred x warmblood stallion.After reading your pages I have done a few tests - I can't pull him off balance by pulling his tail at a standstill but he is less secure at a walk. If you lift his near fore and push into him he can't hop, he 'bows' leaning right back with his foreleg outstretched. But he stands OK for the farrier and to have feet picked out. Neck flexes are fine around to his girth and he can stand on 3 legs to scratch or nibble at himself. At canter his gait seems more normal but as he slows both hind legs seem to move together with a strange flick at the fetlock. Sometimes at trot it is as if his front end doesn't keep up and his HQ overtake coming out to the side.
I have videos of him before the fall and he could canter 50' circles on the lunge both ways, trot ridden circles and jump bales of staw cleanly so I'm hoping this rules out Wobblers. The physio can't detect any back pain or abnormality and surely he would be more lame if he had a fracture or slipped disc. Is it possible that his altered gait is a habit from the memory of pain as he is still forward going when asked to trot up? His off hind rotates in towards the mid line but not so bad as at first.He seems to have an excessively long stride behind when asked to move off from a stand still.
Hope some of this makes sense to you - any idea whether it sounds neurological or otherwise?
Thanks again}
Moderator:
DrO

Posted on Monday, Sep 6, 2004 - 6:39 pm:

We will do the easy ones first:
No, he does not have a memory of pain that makes him look lame. I have seen horses lame for many years with an apprpriate block that go sound.

I think the above history and discription best describe a muscoskeletal injury, probably to the stifle, hip, or pelvis but without seeing the horse I cannot make firm judgements and even if I could might be as baffled as vet. I agree with your vet he needs a referral but disagree that you send him for scintigraphy. I suggest he get a complete work up by an veterinarian who specializes in lameness and let the testing fall out from that exam. If scintigraphy is deemed useful you should not worry as it is a very safe procedure.
DrO
Member:
Lexi

Posted on Tuesday, Sep 7, 2004 - 3:03 pm:

Thanks for your advice. It has made me feel more positive. I have been practising trailer loading today in readiness to send him to 'hospital' as he has never been anywhere before and was worried to see that he seemed really weak in hind end, almost drunk after backing off the ramp (hind end lowered and very long loose stride) although this improved after a few strides. Odd that there never seems to be any pain...is this consistent with any type of muskoskeletal injury?
Moderator:
DrO

Posted on Wednesday, Sep 8, 2004 - 6:29 am:

The picture of "weak and drunken" sounds more neurological than your earlier posts.
DrO
Member:
Lexi

Posted on Monday, Sep 27, 2004 - 1:48 pm:

Just an update on things - my horse Ti had scintigraphy today on his neck, spine, pelvis and both hind legs. There was increased uptake on most vertebrae of his neck, his off stifle and off fetlock. The vet said that Ti had very little sedation but was more unsteady than expected and tried to lie down, crossed his legs and leaned against a wall. They did tests like lifting his head, backing up etc which he did well and it made no difference to his gait. Are some horses just more affected by sedation than others or is this a symptom of something? Surely an injury wouldn't cause his whole neck to be a hot spot? Is scintigraphy accurate as surely there's no baseline for 'normal' - could he always have had a 'hot' neck!
Any reassurance and ideas gratefully received.
Moderator:
DrO

Posted on Wednesday, Sep 29, 2004 - 6:51 am:

Hello Jo,
Yes some horses are more effected by sedation and by itself is not a symptom of anything. We explain scintigraphy in » Equine Diseases » Lameness » The Diagnosis of Lameness in the Horse.
DrO}
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