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  Discussion on Growth related Stifle problems
Author Message
New Member:
Lindgren

Posted on Thursday, Jul 14, 2005 - 10:41 am:

Hi, i own a 7yr old Irish Sports Horse (thoroughbred/irish draught/hanovarian cross) mare who i have owned for the last 2yrs. Unfortunately she tends to be a bit accident prone and we have been through a lot together already. Last year she damaged the joint capsule on her hind fetlock and we had intra-articular cortisone injections. She improved approx 50% over the next three months but then stayed at a low grade level since. Having her back look at by a physio they noted that her stifle joints were 'loose', the right more so than the left, but this has improved on the left.

Over the past year, if you ran up Polly she looked lame on the right hind, my vet still felt it was due to the fetlock injury. If you put her in the school/arena she seems to roll her stifle joint but is forward going, tracks up, can show-jump 5ft and novice dressage with ease, you can not 'feel' it in the trot once she has warmed up, however comments are made about her action behind. If you keep her box rested her hind leg gets worse, better the more we do with her, esp lunging. Bute seems to make no difference in the short term.

Today i bit the bullet and my vet came to start investigating it. we so far have blocked out foot, fetlock and high suspensory, and surprise, surprise she still looks lame. He finally agrees it is not the fetlock! He is due out early next week to block the stifle joint and possibly x-ray.
He has mentioned the possibility of Bone scans and OCD, however she doesn't act or ride like a horse in pain, gets better the more you do with her and is an athelete. What else could it be?
New Member:
Lindgren

Posted on Thursday, Jul 14, 2005 - 10:43 am:

P.S. I forgot to mention that she was only 16hh when i bought her and now stands 16.3hh, 2 inches of that occurred over a 6 month period last year
Moderator:
DrO

Posted on Thursday, Jul 14, 2005 - 11:42 am:

Though you do not feel she acts like she is in pain it is easy to believe the change in gait seen by you and your veterinarian are still likely to be do to pain. The trot is such a beautifully even and symmetrical gait that even very low levels of pain cause a marked change in the appearance of the gait. Changes that may not be seen at the walk or canter and difficult to feel when riding though this is very dependent on experience levels. For more on the difference between some of the mechanical causes of gait change vs pain on weight bearing vs pain on motion see, Equine Diseases » Lameness » Localizing Lameness in the Horse.

Lastly with the history of the ankle I would consider reblocking it with a complete ring before ruling it out: there are 6 major and several minors nerves that innervate the horses hind leg and it is easy to miss a few so unless there is absolute surity that the blocks were in force (something that may be hard to do when there is a sequence of blocks preceeding the ankle block) I would go in and repeat this just to be sure.
DrO
Member:
Ejar

Posted on Thursday, Jul 14, 2005 - 1:17 pm:

Is it the age?!

I appreciate your post, since my own 6yo Hanno-TB cross is accident prone and has developed a similar stifle issue over the past three weeks!

She also has looser stifles (I was told this can be genetic, another thing we have in common). She is much better in collection rather than on her own.

She reacts strongly to pressure on the inside of her stifle, and manipulation of the patella on the side that is lame. I am treating it like my own knee ligament injuries - light work (no twists) and mostly rest for six weeks. The big difference in our experiences is that mine is responding to bute.

I'll let you know what my vet offers, and I look forward to hearing more about yours.

Good luck

Erin
New Member:
Lindgren

Posted on Monday, Jul 18, 2005 - 3:54 pm:

Thanks Erin, i appreciate your support. Polly also reacts strongly to pressure to the inside of that stifle, your likely to get kicked if you try!!

Dr O, we have done a complete ring block of her fetlock, we did just the fetlock first, then higher to a ringblock for fetlock and foot and then ring block around high suspensory. All negative i.e. she was still lame!

I am fairly experienced, had my own horses for 10 years and competed at a novice event level with special interest in dressage, i can feel her hind leg in trot when she is not fully warmed up but this disappears as she does more and starts to use her hindquarters properly. It difficult to realise that although she is capable of full dressage work and jumps so well and with such ease and grace that she is in pain, she probably has learn't to live with it.
Being a Human surgeon myself with an interest in orthopaedics it is hard sometimes as i have all the diagnostic techniques to hand when i want to , plus my pts tell me where it hurts.

Tomorrow holds the actual stifle joint block itself and i will keep you posted with the results.

My friend specialised in TTEAM (Tellington-Touch) technique and picked up coat changes over that stifle and her back just in front of her iliac crest, ?are they related.

Thanks for your interest, help and support

Andrea
Moderator:
DrO

Posted on Tuesday, Jul 19, 2005 - 7:52 am:

Coat changes (?) what type of changes. I do not know in any way this could be related to a lameness that is not from a painful skin condition. Do folks with osteoarthritis of the joints over the wrist have changes in their hair patterns?

Yes diagnostically we are far more limited by cost, temperament, and just the sure mass of much of the equine muscoskeletal system.
DrO
New Member:
Lindgren

Posted on Tuesday, Jul 19, 2005 - 1:23 pm:

Well, just the coat is slightly rougher in these areas than elsewhere, i have no idea!

Well, the stifle joint and hock joint blocks have also failed. No improvement at all, she is approx 3/5 lame in a straight line and 1/5 on the lunge on a hard surface. My vet has no ideas as yet so we are heading for a bone scan as it may be higher up still.

Thanks again for your interest and support

Andrea
New Member:
Lindgren

Posted on Tuesday, Jul 19, 2005 - 1:57 pm:

Forgot to mention that she has my vet stumped! He doesn't think she has a back problem and today saw her for the first time on the lunge. This was after the blocks had failed. His comments were that she moved exceptionally well, looked like she was a showjumper (well her Dad is anyway) and that she looked almost sound, the only way of telling the lameness was the roll in the stifle joint and the occasional stride where she just seemed to cross over slightly with her hind leg.
We now just have to wait and see if her insurance company will want to pay up for the bone scan. Whilst we wait we have decided to try a 2 week trial of Bute, she is already on Cortaflex, has been since her accident last January when kicked by another horse and ended up on the operating table. I do still wonder if this all stems back to that, only because she had a neuropraxia of her right front leg post-op (op on left front). May something have happened then?
Andrea
Moderator:
DrO

Posted on Wednesday, Jul 20, 2005 - 7:19 am:

Though a consistent variation in gait may be do to pain, an inconsistent variation in the anterior phase could be a proprioceptive problem. Be sure to have the gait reevaluated for neurological disease before spending the money on a scan and let us know what they find.
DrO
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