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  Discussion on Myositis?
Author Message
Member:
Annknigh

Posted on Wednesday, Jan 18, 2006 - 11:10 am:

I wanted to post this case and see if anyone has seen anything similar. I have reviewed the neuro and back pain articles on this forum, but I cant correlate those discriptions to this case. This horse belongs to my friend and I am trying to gather information. The horse is a 13 year old upper level dressage warmblood. He had been performing at a very high level, but needed time off I think for sore hocks. I think his hocks may have been injected a few months ago, but I am not certain. After a bit of time off, the horse was brought back into work. He was a little bit sore and stiff after the first few days back into work, but each time he would work out of it after exercise. However, each day he was getting stiffer and stiffer. One day he was walking very short on all 4's out of the stall. The vet was called and blood work and eval were all normal. The horse had swellings in the lumbar area that were ultrasounded and it was found that there were large fluid pockets paraspinally bilaterally and I believe evidence of muscle sprain. He is being treated for that as the primary diagnosis.

Onset was about a month ago. He has been given daily bute for the last week or so and was turned out at first, but turn out seemed to aggravate him as he would loosen up while out, but the next day be worse. He still walks very short on all feet and when he lifts the front feet he will circumduct them at the shoulder to lift them. In the stall, to move he will shift his weight around alot before moving and keeps most of the weight on his right hind. And lately, he seems to stand with it underneath him more so. The standing underneath began with the stopping of the daily bute, but he has been reluctant to move the right hind generally. He will lift the right hind and rest it from time to time, but only for very short periods. The right lumbar area is more swollen than the left and he will bend his body to the right but not as much to the left.

Would this presentation be typical of a horse with lumbar strain, or would this presentation involve a neurological component? I am uncertain if the exaggerated front leg lifting from the shoulder would be considered hypermetric movement. If you ask him to pick up his front feet, he does it very quickly and lifts them up from the shoulder.

He is starting to show some swelling on the right fetlock and in the anterior aspect of the right hock, and the other fetlocks swell some too. The anterior hock swelling has started more recently, and but the fetlock swellings have been present since the stall rest began.

The horse is alert and eating and is able to walk and negotiate uneven terrain, however all of his steps are very short. He is able to lay down and get up, but he stands up most of the time. If pushed to the side, the horse will step appropriately and regain his balance.

One text we read, indicated that it could take a month or more for myositis to resolve and that selenium and vit E could help.

Dr O, would this be a typical presentation for a lumbar strain and paraspinal swellings bilaterally or does it sound like there is something else complicating the picture?

Also there is a concern that founder may be a risk due to the stress of the condition. Any suggestions as to help minimize that risk would be appreciated.
Moderator:
DrO

Posted on Thursday, Jan 19, 2006 - 9:00 am:

Ann, we avoid doing second hand consults for a number of reasons with time taken away from the attending to the members of the site being the most important.

I can say from your description I cannot tell if there is a neuro component and I am concerned about the diagnosis of muscle strain if muscle enzymes were normal on the blood work.
DrO
Member:
Annknigh

Posted on Thursday, Jan 19, 2006 - 9:20 pm:

I am a member of this site, this horse belongs to a good friend of mine and it is very important to me as I have a personal interest in this horse. I thought, that as a member of this site, that I could ask questions about things related to horses that I would like clarification on or that would allow me to gain further understanding.

I dont understand why it makes a difference as to whether or not I own the horse. I am a paying member of the site and I have asked the question. I have a medical background and my interest is from that of learning to add to my knowledge of the equine realm in addition to the human realm, as well as to assist my friend. I understand much about human neurology and physiology and I am attempting to correlate that to what I have observed in this particular horse.

I dont understand why you would favor other members over me as I have paid my fees to this site just as everyone else has.
Moderator:
DrO

Posted on Friday, Jan 20, 2006 - 7:53 am:

The problem Ann is one of time. Everyday it is a real struggle for me to get just the members questions answered. I am perfectly glad to answer any questions you have about horse care and medical issues but what I am unable to do is review medical cases of non-members.

It is not just the time, there was a period when we did these and found that often we were missing some important piece of the puzzle that changed everything. So all that time was wasted. Please ask any medical question you like but don't ask me to review medical cases that do not belong to you or are not under your direct care. I have not singled you out on this as this has been our policy for years and I don't think this is a lot to ask for the cost of your membership which is less than 3 dollars a month.
DrO
Member:
Annknigh

Posted on Friday, Jan 20, 2006 - 3:17 pm:

Please just delete the post, If I require additional knowledge, I will seek it elsewhere
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