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Discussion on Is this really UFP?
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Member:
Bluedog1
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Posted on Sunday, Sep 17, 2006 - 10:05 pm:
Hi Dr. O,
Be forewarned, this is long, so get a cup of coffee….
I have been having a long lasting problem with my paint mare, Roxie. She is 7 years old and we purchased her last July. We purchased her to be my daughter’s Hunter/Jumper. We don’t do much showing, and do pretty low classes when we do go. She is in good body condition, I would score a 6, and well muscled. I’m not sure of her confirmation, but can post a picture.
Her history, in the short time we have had her is, unfortunately, eventful. I will try and condense her history and get to the current problem.
Roxie has had episodes of bucking under saddle, being slightly lame (obscure), having lumbar pain and neck stiffness. Our massage therapist suggested a properly fitting saddle, since all Roxie’s tight, sore spots were very typical of a poorly fitting saddle. We bought a saddle that, according to a professional fitter, fit her perfectly. Many of her problems resolved themselves and we were so happy and confident that we had solved her problem.
Despite her obvious improvement, she continued to have occassional boughts of unexplained pain and tightness in the lumbar spine area as well as in the lower part of her neck. Whenever she showed signs of being uncomfortable like bucking under saddle, we would have the massage therapist out to check her and she often found pain in lumbar area as well as lower neck tightness. We had the vet out several times and have given her methocarbamol and bute, and also a course of Adequan since there was a slight positive hock flexion. Her general demeanor was …. Cranky, but we did notice that her attitude improved a lot when the Adequan was given. Unfortunately due to the management of the barn, I am not confident she got it more than a few times. Roxie is also very afraid of injections in her neck and is very difficult to handle under these circumstances. I started an oral joint supplement instead.
Anyway, earlier this year, Roxie had a really long good period and were able to ride and condition her for a show at the end of May. She had been doing great and everyone commented on how nice she was moving, how comfortable she looked etc. Jumping was great, easy lead changes etc. She was really a head turner. A few days before we shipped out to the show, my daughter said she felt off and the trainer pushed down on her lumbar spine. Roxie reacted quite strongly to that. We gave her a few days rest, with bute, and somehow in a few days she was absolutely fine.
We went to the show at the end of May and did well, Roxie was in a good mood, responsive, and took a 4th in the hunter under saddle class against a field of 25 warm bloods and TBs. She was also great in the jumpers classes with no stops and no rails down. I mention this because it is quite obvious that she was feeling fine and when she feels good she is a responsive and willing horse. She is a horse that tells you when something is not right, she is not stoic at all.
A few weeks after the show, on June 4, we had a lesson in the new arena which was filled with loose, deep, fine sand. I think it must have been 5 inches deep. A lot of horses were having a hard time in there, but the trainer continued the lessons. Roxie had a very hard time with the turns.
Ever since then she has not been right. We noticed she started becoming resistant to picking up her right canter. We gave her some time off and bute and tried again, but this difficulty holding her right lead continued as well as kicking straight out and little bucks. After we saw that it wasn’t getting better with time, we called out the vet.
After examination, vet decided to inject hocks and right stifle. This seemed to give her a lot of relief and once we started riding her again, she looked really nice. She carried her head low and her stride was smooth and sweeping…until the next day. She started showing some head tossing, and resisting again. Kicking out, and little bucks started again at first just when trying to canter to right, but then when trotting or cantering to left.
So I contacted the vet and he said to try a course of bute and if it didn’t improve, we could assume it was mechanical (ufp) like the stifle sticking intermittently and suggested following an exercise program, doing hill work to strengthen the muscles . We gave it a shot and the bute did not seem to do much. Then we started hill work, and things just didn’t show improvement.
We discussed EPSM and he took the blood test and it was normal.
The vet came out again and examined her, flexion tests, hoof testers, had her ridden, took xrays of both stifles. Xrays showed some small smooth spurs, that vet thought were insignificant. He also noted that her lumbar spine was very painful. She tried to bite him when he palpated it. He still thought it was her stifles, both, since he thought he saw her left leg stick. He recommended turning her out to pasture board, a course of methocarbamol, bute and sticking to the exercise program religiously to the exercise program and thought we should try it again.
We have been doing this for almost 2 weeks and Roxie is not getting any better. Roxie is, however, very happy to be outside all the time. We take her out to the field and walk up and down the hill. She’s pretty placid and doesn’t seem to mind this too much. Asking her to trot is becoming harder and harder to do every day. It is obviously very uncomfortable for her, she kicks out and makes these soft little bucks while traveling up the hill. She also meanders all over the place when on a loose rein. She has always been like this to a degree and my daughter always said she sometimes seems drunk.
My main concerns are: 1) are we certain this isn’t something that is being worsened by exercise? 2) could she have EPSM? Even though the blood tests were negative? 3) could she have an SI joint injury? 4)What kinds of injuries or conditions are not responsive to bute? 5) what would be the best imaging technique, what has the most bang for the buck? 6) what else can we do??
My gut feeling is to ship her up to the University of Wisconsin and have ultrasound, digital radiographs, and or nuclear scintigraphy. I would like to see what’s going on in her neck, back and stifles. If we can get more information and if everything points to intermittent upward fixation of the patella, then I would feel much better about forcing her through this exercise.
I would really appreciate your opinion to either confirm or dismiss my concerns.
Jackie
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Member:
Bluedog1
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Posted on Sunday, Sep 17, 2006 - 10:10 pm:
This picture was taken in early spring.
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Member:
Sully
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Posted on Monday, Sep 18, 2006 - 2:49 am:
I am not sure if this could have anything to do with it or not, but have you ruled out reproductive problems? Like a tumor on her ovary? Very very pretty mare!! 
Sully
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Moderator:
DrO
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Posted on Monday, Sep 18, 2006 - 7:17 am:
Hello Jackie,
Taking your questions in order:
1) No
2) No
3) Maybe
4) Anything inflammatory or painful
5) It would depend on the specific lameness / pain localization.
6) First I think you need to consider how this horse fits your goals. Unless your goals are to train difficult horses this may not be the horse for you. I have seen horses like this that we never could localize a medical issue despite intensive efforts with and in the meantime the horse was a risk to all who ride her.
If this is something you want to pursue, I would find someone who specializes in lameness who following a thorough exam develops a problem list and develops tests for localizing the problem. Once localized the best tests can be determined for the problem. If nothing firm turns up at this point I would consult a behaviorist. Certainly some of your posts suggests recurring back pain that worsens with work and for the diagnosis of this see, Diseases of Horses » Lameness » Diseases of the Spine, Back & Pelvis » Lower Back Pain in Horses.
DrO
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Member:
Erika
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Posted on Monday, Sep 18, 2006 - 8:32 am:
Awww, hi Jackie, I remember your pretty mare (with my sister's name!) from a previous post. Just wanted to say that I'm sorry you are having health problems with her. She sounds like she has such potential.
Good luck,
Erika
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Member:
Bluedog1
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Posted on Monday, Sep 18, 2006 - 10:05 am:
Erika,
Thanks for the good wishes. I posted earlier in the summer about Roxie's recurrent mild colic. We moved barns at the end of June and she hasn't had colic since!
Dr. O,
What do you think about Sully's comment re ovarian tumor? She isn't showing any aggressive behaviors towards horses or humans, but I guess it's a possibility.
As far as my goals with this horse.. unfortunately, I am trying to get out of horse ownership. I have leased my pony and was intending on selling Roxie. It's been a slow financial bleed over the past 5 years and I just can't dip into our kids' college savings to support the horse habit.
I won't sell Roxie until we know what is going on with her and we can get her well. If she doesn't get well, I don't know who would be interested in buying her.
How do I find a vet who specializes in lameness? I assume the teaching hospitals would have excellent vets including ones who specialize in lameness.
I forgot to add a little info...she is out in a big mostly dirt paddock. Each time we go out, I don't see any signs that she has been laying down. We had several days of rain and she had no mud on her belly, sides or back. I'm wondering if she isn't laying down because of pain somewhere.
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Moderator:
DrO
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Posted on Tuesday, Sep 19, 2006 - 6:57 am:
Jackie, since you do not mention behavioral problems other than under saddle your description is not really consistent with the symptoms of GCT, but this is not impossible. For more on this see Diseases of Horses » Reproductive Diseases » Trouble Settling Mares & Stallion Infertility » Granulosa Cell Tumors in Mares.
DrO
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Member:
Bluedog1
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Posted on Friday, Oct 6, 2006 - 1:13 pm:
Hi Dr. O,
After reading your comments, I decided to stick with the prescribed program of exercise and see how things progressed. Your suggestion of this being a behavioral problem was on my mind as I entered observations in Roxie’s progress journal. I don’t think it’s behavioral because it happens when she is moving around on her own in the arena and her demeanor is very pleasant while she is being ridden. She kicks out and does these little bucks out of the blue, under saddle and when moving freely.
There are some other symptoms that have been bothering me and was wondering what you think. As I posted earlier, it is very hard to keep her straight and if you DrOp the reins and let her go where she wants, she just meanders all over the place.
Yesterday, my daughter was walking her around in the dressage arena along those low white rails along the perimeter of the arena. She turned her head to say something to me and Roxie just stumbled right through the rails, like she didn’t even see them. That was very weird and she has never done this before.
The other thing is that her lower lip is DrOopy. She has done this before, but only when napping, or getting really relaxed while having a bath. I have noticed this much more frequently now even while riding. It is not permanently DrOoped, but is definitely hanging down a lot more than usual.
Recently, while handwalking her down the paved hill to the barn, she tends to stumble and I can’t put my finger on it, but she just looks funny walking down the hill, the rhythm of her hoof placement is strange. After reading about neurological exams, I asked my daughter to make her walk in a tight circle. She pivots on her inside hoof and swings her outside leg to place it under herself. Is this normal? I talked to our trainer who has been helping us exercise her and she confirms that she is seeing all these things too. I was reading that UFP and back pain can be symptoms of EPM.
I just am thinking that there is something wrong with my horse and just doesn’t seem to be improving with the exercise program, and didn’t respond to bute or rest. After doing some reading, it sounds like she may have EPM or Wobblers. Every chiro or massage treatment we have had done, has found tighness/soreness in the lower cervical spine. I never connected the two, but now I’m starting to wonder.
My vet is out of town until Monday and was looking for your opinion as to these possibilities. Thank you so much.
BTW, I can’t tell you how often I go to the pages of information on this web site and find exactly what I am looking for. Thanks!
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Member:
Bluedog1
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Posted on Friday, Nov 3, 2006 - 12:57 pm:
An update... on Oct 20 I had the vet come out to do the neurological exam on Roxie. She responded normally to most of the exam except she was quite easily pulled over with the tail pull and she was slow to replace the left front leg from a wide stance. She also had lumbar pain. We took the blood serum test for EPM which was positive. (maybe I should post this on the EPM page). My vet said he just doesn't think its EPM. He wanted us to put her on 2 grams bute once daily for a week, keep riding and see if there was any difference.
On the 5th day of bute, she was ridden and seemed much improved in that she didn't do any kicking out, head shaking or bucking. At this point she had 10 days of rest. However, my trainer, who rode her, said she felt like she would run right into the wall if she didn't turn her with the rein. But overall, a big improvement over what we were dealing with before. The only things that were different were rest and bute.
The next day, I got a call from the farm that Roxie was colicing. She was pretty uncomfortable, laying down and gettting up frequently, not wanting to eat. She did pass manure though. 10cc of banamine seemed to instantly cure her and she has been fine since.
I reported both the improvement in the ride and the colic to the vet. He told me not to give her any more bute, but rest another week and see where we are.
That brings us to yesterday, our trainer rode her again. We thought there was a further improvement in the ride from the week previous. There was a small fuss before picking up the canter one time, but that was it. There were two steps however, where the trainer said she felt as if a hind leg got left behind. She started out dragging her hind toes, but this improved somewhat. My trainer said she felt the best so far. On the way down the hill from the arena to the barn, Roxie stumbled.
My question is...given the neuro exam results, her back pain and possible stifle issues, her occasional stumbling and the positive epm result...should I be aggressive in ruling out EPM? I would hate to discard it completely and allow the disease to progress and cause more damage. I have heard of a blood serum IFAT test that UC Davis is doing that is as accurate as the CSF test.
Your opinion would be most helpful. Please let me know if I should move this post to another subject. Thanks!!
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Moderator:
DrO
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Posted on Sunday, Nov 5, 2006 - 10:27 am:
I think those 2 test results are pretty vague and without definitive signs of incoordination open to interpretation. Stumbling can be such a sign but is a common problem in horses not associated with EPM. You should review the diagnosis of EPM in the article Jackie but the bottom line is that there are no tests that are 100% accurate. The reason this is, is that horses commonly contract the organism but most don't fall ill. No matter how good your test it cannot differentiate between those who succumb and those that don't.
So review the article and take up your concerns with your vet, his ability to exam the horse makes him a much better judge than I can be what the chances your horse might have EPM are.
DrO
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Member:
Bluedog1
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Posted on Sunday, Nov 5, 2006 - 10:24 pm:
Thanks Dr. O,
I guess I feel like I really want to know since, unfortunately I will be trying to sell her. Obviously, I don't want to sell someone a horse that has EPM brewing. If we don't see any progression of neurological signs, would that mean she doesn't have EPM?
I am encouraged that we are seeing some slight improvement in her performance, which may indicate it's not EPM. Maybe, whatever the problem is, just needed some rest. We'll keep exercising her every other day and see how she goes. I'll keep you posted. Thanks!
Jackie
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Member:
bluedog1
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Posted on Sunday, Feb 18, 2007 - 9:39 am:
Good News! After getting nowhere with Roxie's progress, I went ahead and treated Roxie with Marquis, which she finished Dec. 13. She was given complete rest out in her pasture and we started her back to work very slowly in early January. She is doing extremely well. She rides very straight, she goes well in both directions, she is light and even in her gaits..so needless to say we are thrilled. The trainer I have working her says she feels like a different horse and feels awesome. We just started cantering a few weeks ago and so far everything is good, no kicking out, no fussing. She also has had no episodes of lumbar pain, something she had quite regularly.
We just had the vet out to do another exam to see how she's progressing and I was amazed at the difference in her response to the tail pull. Back in October she fell over quite easily and last week, she resisted quite strongly. She also stands straight in the cross ties. She used to always have to have her butt up against the wall. The vet gave her the go ahead to continue exercising and even do some low jumping to help strengthen those hind legs.
I wanted to follow up because of the difficulty in diagnosing this problem. The stifles were certainly an issue, but it may have been EPM causing muscle weakness in her hind end. I am glad I took a chance and spent the money on the Marquis. Hope this is a helpful posting to others.
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Moderator:
DrO
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Posted on Sunday, Feb 18, 2007 - 11:27 am:
Delighted to hear your horse is doing much better but I do want you to realize that improvement following treatment does not mean it is because of the treatment. I notice rereading the posts above the horse was improving following the beginning of therapy. Then again we don't know, just keep it all in proper perspective which will become most important if there are problems in the future.
DrO
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Member:
bluedog1
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Posted on Sunday, Feb 18, 2007 - 3:06 pm:
Will do Dr. O,
Thanks!
Jackie
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Member:
bluedog1
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Posted on Thursday, Oct 4, 2007 - 4:00 pm:
Hi Tod,
I'm sorry you are having troubles with your gelding.
Roxie is doing very well and I sold her to my trainer who now uses her as an advanced beginner lesson horse. She has gone to a few shows and has won the under saddle classes, which may be a testiment to how well she is doing.
She still occasionally kicks out when asked to canter to the right, never to the left or for the trot. She still has some minor steering issues and tends to drift outwards to the rail when going to the right. These persistant issues are so very minor compared to how she was before. She is now very happy, healthy and very usable.
In hindsight I think she had a couple of things going on. One of which I believe was EPM, which we treated with Marquis and the other I believe was either a stifle injury, lumbar injury or a sticky patella. I believe her improvement was from the Marquis and the very slow progression back to fitness, which may have also helped develop the muscles supporting her stifle.
Also in hindsight I wish I had taken her for a nuclear scan to determine where her "Hotspots" were. This may have helped determine where the problem areas were without all the guessing.
Good luck with your gelding. Maybe you should post a new discussion. Here is a picture of Roxie at the show in July. It was about a year from the onset of her problems to this date.
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