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  Discussion on Sciatica
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Posted on Wednesday, Jan 10, 2001 - 6:41 am:

Hi Dr O
I have posted before on this horse, but not for more than a year.
In brief, she's an 8-year-old warmblood I've had a little more than 18 months. Vetted sound.
Within a week she reared the first time. Physiotherapist found swelling on one side of the wither and a patch of muscle atrophy in the gluts, same side. No obvious gait abnormality although wearing down of her hooves indicated she was throwing more weight on the opposite front leg to where the atrophy was found.
She was treated with massage and an electrical muscle stimulator and gradually brought back into work.
However, 18 months on, while the atrophy can't been seen anymore and her hooves no longer wear down unevenly, I'm still battling. She's gone through periods when she's been better, but under saddle the picture is of an unhappy horse. Apart from the rearing (rare and only when other behaviour has been worse), she has consistently shown an aversion to a saddle being placed on her back and is tense under saddle - ears back, rushing and refusing to slow down, high head carriage and hollow back. Sporadic bucking. Lunging shows a different horse, calm and relaxed.
I eyed the saddle as a possible culprit (tried many, this was professionally fitted and regularly checked), read Chris's review of the Ansur on this site and thought a treeless saddle might be the answer to my problems. Local saddler agreed to make one and I rode in it a couple of times when she went dead lame. That was a month ago and she's still lame. She had been in a downward spiral for a couple of months before I got the saddle, so it might not be the cause, but could be a contributing factor.
My vet referred me to another vet who does acupuncture and he was out earlier this week and did a thorough lameness exam. He picked up on a few things I'd never spotted before, including that she swings the one side of her pelvis more than the other at the walk, and raises the one hip higher. One hind toe is dragging. Head bobbing more obvious on the lunge than on a straight line, and much worse when the atrophy side is the inside. He also found an old scar (wound not surgical) on the inside of that hind leg at the stifle.
He says he thinks the problem is similar to sciatica in humans. He's guarded about prognosis but wants to see how she responds over 3 or 4 treatments of acupuncture. He also used heat for muscle areas where she showed sensitivity and I'm to continue with that, and anti-inflamatories.
Any comments?
Karen

Posted on Thursday, Jan 11, 2001 - 5:45 am:

Hello Karen,
I really do not have much of a comment, there does not seem to be any objective testing or evidence presented to localize the lameness so that a diagnosis or treatment could be proposed. You have more patience than I would.
DrO

Posted on Thursday, Jan 11, 2001 - 10:12 am:

Hi Dr O,
Well, she's a special horse. Exceptionally talented and very sweet-natured.
I understand what you're saying, that there should have been nerve-blocks and other tests done, and I'll discuss it with the vet the next time he comes.
Have you ever seen, heard or read of horses with sciatica or inflamation of the spinal nerves?
In the last 3 months it's been so up-and-down, it's really odd. First a sore back behind the saddle on the opposite side to the original injury site, then as that improved with physiotherapy treatment, the opposite hind leg showed a stiffness which improved with excercise. Then a week when she went exceptionally well under saddle, the most calm and relaxed I've ever seen. Then tensed up again, and finally the lameness which started a month ago and which shows no improvement to date.
Patient, yes... but I feel like my options are rapidly running out and I'm not sure where to turn if this vet doesn't come up with something.
Karen

Posted on Friday, Jan 12, 2001 - 4:20 am:

Wobblers, stringhalts, and neurogenic muscular atrophy are examples of peripeheral spinal nerve disease I have seen. But as a diagnosis for the type of behavorial problems you have or for a lameness problem it is near impossible to prove (or disprove) and leaves you no where for treatments.
DrO
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