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  Discussion on Stifle or hock?
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New Member:
rpb88

Posted on Friday, Apr 19, 2013 - 9:22 pm:

Hello. This might be long but I will try to sum up.

I have a 21yr old QH (he acts like he is 10!) who has a medical history of Hock Arthritis of the DIT joint and the TMT joint of both hocks diagnosed via radiographs and exam.

the vet said " it is so bad it is good he is 90% fused both)

He was never lame from hocks throughout that time (just stiff) until recently.

My horse was having a difficult year with abscesses,moving,pastern needing sutures, etc. H was not in consistent work as he was in previous years but he also wasn't really stall rested. he was out almost everyday for at least 8+ hours (sometimes way longer )

He finally was getting back into consistent work and was going well.

in December 2012 during a ride, it felt as though my horse had no impulsion to the left and fairly normal to the right. I figured he was sore and gave him the day off without assessing him and turned him out.

The next day my trainer rode and as soon as she started trotting I noticed obvious lameness of his Left Hind. Short striding,toe drag etc.

I actually believe He started dragging his toe and having a worn toe before this obvious lameness which make me think it was subtle at first.

My trainer said " oh, he is just stiff. I will work him out of it ( which I did not agree with at the time but I figured she would no best...hindsight 20/20)

He DID get better but still not 100% .

I believe I gave him bute and turned him out that day (he is basically a pretty convincing reining horse in his stall when the others are out and much less active in turnout)

next day still lame but better. I decided to give him a week off on pasture to see if he improved.

He did seem better, as I hand trotted him he seemed only very slightly off as well as undersaddle.

It seems the first few rides would be okay and he would gradually get worse (sometimes after only 1 ride)

Took him to my vet who 7yrs ago diagnosed the hock arthritis. He palpated (stifle .5/3 loose) flexion tested him and did NOT nerve block and diagnosed hock pain and injected his hock in the locations "Jack" and TMT.

stall rested 1.5 days (he was a reining horse and told the vet who said put him out if he is calmer)

1st day of ride felt like new horse, impulsion,felt straight. etc. then the next few rides he gradually went lame again but less severed than the initial time.

took him to another vet who diagnosed hock pain after a high 4 point nerve block with no improvement and flexion tests, he also said stifle joint had no effusion.

he re-injected and tried to get into the DIT joint without success. no improvement.(tuned out in small paddock and my horse only walked)

a week later

I insisted on a stifle ultrasound to put my mind at ease (was reading a lot about meniscus injuries and ligaments/tendons of stifle) and he found a small amount of joint fluid but nothing troublesome.

It seems as though my horse gets better with rest which to me is counter-intuitive to hock arthritis pain. I was thinking could it be a bone cyst in the stifle? or any other ideas.

I am sure I left more information out as I was trying to write this quickly. Feel free to ask me! Thanks!
Moderator:
DrO

Posted on Saturday, Apr 20, 2013 - 11:46 am:

Hello Joanne,
It is not counterintuitive that osteoarthritis would improve with rest. Overworking arthritic joints makes them painful and rest can help. Both of these ideas have qualifiers: too little exercise and the joint may stiffen up over time.

I don't see anything above that localizes the pain well to the hock or stifle. The high four point makes more distal lameness less likely but it may be worth repeating. Usually ruling out the hock is pretty easy with a TMt and tibiotarsal joint block, for more on this see HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Upper Rear Limb » Overview of Diseases of the Hock (Tarsus).

In general bone cysts would show lameness much before this age, but not impossible.
DrO
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