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  Discussion on Weakness and Mild Ataxia in a 4 yr old QH
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New Member:
kmftuc

Posted on Tuesday, Feb 10, 2009 - 8:14 pm:

At the end of his two year old year (07)this gelding was ejected from a trailer by a medium duty work truck that tore open the rear of the trailer where he was riding in the last slot. He flew out rear first and while in the air the lead rope broke and he did a half summersault landing on his head, neck and back in that order. He was down for a short while but got himself up and ran into the vet clinic parking lot which was the destination of the drive. He did not fracture any bones although his skin on legs,neck and hips were lacerated from the sharp metal and extensively abraided from landing on the highway more on the left side than right. He was treated and x-rayed and bone scanned. Due to a non-healing wound on the front of his left hind pastern, he spent over 6 months stalled with a cast on the affected leg. He was three years old by this time. When casting did not help we sent him to hyperbaric treatment which combined with the cast closed the wound with good scar tissue. He was weak from standing so long and abnormally due to the necessity of the casting so we then put him in hyDrOtherapy to overcome the extensive atrophy and abnormal stance he had. After 1 month, he was returned to light training in August 08.

Throughout this rehab period and all during training we note he was quite loose in the hind end. His hocks would bow outward and inward and his hind feet crossed over past midline. When riding him at the canter to the right you could feel him had some odd lateral play in his back instead of rounding up when collecting. He also cannot seem to transition to the canter from the walk although at the posting trot he can fall into it (not a desirable alternative). Everyone who has seen the horse notices how he moves from the rear but laterally he looks OK. He has been in training with the same trainer who takes his time but is good with placing a horse well on the move and setting them up with good body position. He is not progressing though not through lack of willingness. He is not light boned and has solid black feet. He has been tested for EPM since he arrived in TX and has been on a complete program of worming and vaccinations. The vets who have seen him throughout this time period agree he has ataxia but cannot seem to get to a firm diagnosis or prognosis on this horse's future as a show horse in training for hunter under saddle, hunter and pleasure driving classes for the QH shows.

In October 08 a sports medicine vet suggested large doses of anabolic steroids (alternating two types) every 10 days for 40 days. This made him quite rank over time but he did seem to show some improvement. After the steroids cleared he regressed. He is now 4 years old, otherwise quite healthy and stands 18 hands. He is the son of a World Champion English QH and was quite valuable before this accident. Not sure where to go with this horse as exercise does not make him stronger and I can't keep a horse with no future if that is indeed the case. I would greatly appreciate any ideas or clinical suggestions members might provide.
Moderator:
DrO

Posted on Wednesday, Feb 11, 2009 - 6:45 am:

Welcome DrF,
When you say you can't keep a horse with no future, what future are you thinking about? Light Riding vs a QH horse that is competitive in world class English classes will have very different recommendations from me.
DrO
Member:
ekaufman

Posted on Wednesday, Feb 11, 2009 - 10:08 am:

Hello,

I see your goals as "a show horse in training for hunter under saddle, hunter and pleasure driving classes for the QH shows."

The accident is an obvious question mark in his medical history, particularly whether he sustained some sort of neurological trauma that could make this potentially a mild stringhalt or something similar.

His size to me is also quite remarkable, especially for a QH. 4 is very young for an 18hh horse of any breed. My experience with larger horses is that they develop slowly, and many of them take a long time to get strong behind. If he seemed weak and not neurologic or lame, I'd be inclined to long trot him on roads and up hills for several months on a long rein (as possible) to focus on building the topline and hind end. It seems you have ruled out DJD from his x-ray history, but the size also raises that flag as well.

Good luck-- please let us know what you try and what you learn.
Moderator:
DrO

Posted on Thursday, Feb 12, 2009 - 9:42 am:

If elk is right and these are the only goals you can live with I believe your horse has a guarded to poor prognosis.

The diagnosis is traumatic spinal injury and neurological deficits of over a years duration. Further localization using neurological deficits should not be hard and then radiographs of the area the lesions localize to might or might not document vertebral lesions. Sometimes damage occurs despite normal radiography. There has been no permanent improvement since last spring. The improvement with anabolic therapy suggests some of the deficits are reversible, at least were as of October. Localization of the vertebral lesions and consideration of stabilization with surgery would be the only way to improve the prognosis that I see.

If you do decide you want to keep trying despite the poor prognosis yet surgical stabilization out of reach for any reason, enforced rest and glucocorticoid therapy to help relieve inflammatory swelling would be rational for this diagnosis. You should not have the same problems as with the anabolic therapy but will have the same therapeutic efficacy.
DrO
New Member:
kmftuc

Posted on Friday, Feb 13, 2009 - 9:03 pm:

Dr. O and Elk: Thanks for your concise responses. In order to keep having horses I have to be able to sell them. This one was an investment and we have spent $30K on vet bills to do our best to provide top care and best opportunity for his recovery. Can you suggest an equine neurologist in the Dallas-Ft. Worth area who might do a thorough evaluation as you describe in your article and review the feasibility of non-surgical treatment as suggested by you Dr. O.? We are all pulling hard for him, he' a nice kind horse who was a victim of circumstance.
Moderator:
DrO

Posted on Sunday, Feb 15, 2009 - 8:55 am:

DrF,
I am not familiar with practitioners in your area but how far is Texas A&M? With a unlocalized ataxia I would think your veterinarian would be glad to give a neuro-referral and would know best who in your area is qualified.
DrO
New Member:
kmftuc

Posted on Monday, Mar 9, 2009 - 2:26 pm:

Dr. O, Follower your suggestion and gelding is currently at A&M where Dr.s Norman and Chaffin (sp?) are running tests. They did a lot of checks working from cranial nerves back and found he had some reluctance to reach around to his sides with his head to get a food reward but could do it if it was repeated. He has an area of numbness to sharp pain stimulus around the 10th to 12th rib area of the lower barrel that did not improve with repeated blunt stylus pokes. He had odd foot placement like he was not sure where his feet were when walked in a serpentine up, over along a stretch of curb and never really got the hang of it despite repeated trips in an unhurried fashion. A 98 pound female intern was able to pull him really off track by his tail while he walked using one hand(the horse is 18 hands and weighed in that day at 1266 pounds) repeatedly although he was in no danger of falling down. He was ridden and while at the trot started out with a parallel track behind that rapidly became a cross over in a few strides. When asked for the canter he was resistant, his head popped up, tail started wringing and he did the same tracking pattern in the back every time he was asked. (ring snaffle bit, no spurs, thick pad, cushioned cinch) After he got going his head would come down but his back stayed flat with no arch up while collected over the loin area. The docs are going to video the repeated neuro exam and ride today for his records and plan to follow up with radiology and EMG depending on their clinical impressions. Will let you know what develops. Thanks for the insights and a sense of direction for where to explore ways to help this really nice horse.}
Moderator:
DrO

Posted on Monday, Mar 9, 2009 - 7:56 pm:

Thanks for the update Kristin, let us know their conclusions.
DrO
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