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Discussion on Rapid onset acute LF lameness

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elk
Member
Username: ekaufman

Post Number: 836
Registered: 3-2007
Posted on Sunday, Mar 1, 2009 - 10:57 am:   Edit PostPrint Post

I'm really not certain where to post this. I'm looking for help diagnosing a rapid onset acute low LF lameness. It seems like an abscess, except it came on instantaneously mid-ride. I don't know if abscesses can present this way.

Yesterday my 14yo competition horse went suddenly acutely lame in the middle of a ride. She was on soft, even footing, warmed up sound, and was in a collected left lead canter when I felt her suddenly go off. I dismounted, and she was non weight-bearing on her LF. A few minutes later, she was able to limp out of the arena, a grade 4/5.

No heat, no swelling, no dps, no nail or puncture, non-responsive to hoof testers (though I have not pulled the shoe). The lameness flexes low-- below the fetlock.

This morning she is weight-bearing in her stall, probably a 3/5. She is very sensitive to low pressure on the medial side of her lateral heel bulb. Still no heat, no swelling, no DPs, only pain.
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Diane E.
Member
Username: scooter

Post Number: 3735
Registered: 9-2000
Posted on Sunday, Mar 1, 2009 - 11:14 am:   Edit PostPrint Post

Hi Elizabeth, I would pull that shoe. A couple things come to mind. Could the nail have moved slightly...I have had that happen once, which resulted in immediate severe lameness. Not all abscesses respond to hoof testers FME especially if it is one of those "moving" sub solar abscesses and you have shoes on. Could a small piece of gravel or something have worked it's way in the shoe?

That's all I can come up with...and yes I have had a horse go from sound one moment ...to broken legged moving from an abscess...especially a gravel.
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elk
Member
Username: ekaufman

Post Number: 837
Registered: 3-2007
Posted on Sunday, Mar 1, 2009 - 11:22 am:   Edit PostPrint Post

Hi Diane,

Thanks. I've only ever found horses with abscesses-- never actually seen one "hit."

We didn't pull the shoe because it's a super-spidey support shoe (she has low and high ringbone in that hoof). She is always lame without it, and absolutely sound with it (except now). I didn't want to pull it unless it's absolutely necessary for diagnosis/recovery.
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Diane E.
Member
Username: scooter

Post Number: 3737
Registered: 9-2000
Posted on Sunday, Mar 1, 2009 - 12:04 pm:   Edit PostPrint Post

How far in the shoeing cycle is she? Not sure what a spidey shoe is. Hank had a shoe with rim snow pads a couple years ago, at the end of his shoeing cycle the nail came loose in the heel area and shifted back in "the wrong place" I was riding him at the time and you would have sworn he had broken his leg at the moment it happened. I pulled his shoe immediately and soaked...avoided an abscess thankfully. The only tale-tell sign was his shoe was a little loose in that area. Had he done it in pasture I would have never known what happened.

Could her ringbone be bothering her?
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elk
Member
Username: ekaufman

Post Number: 838
Registered: 3-2007
Posted on Sunday, Mar 1, 2009 - 6:34 pm:   Edit PostPrint Post

Hi Diane,

She's 2 weeks into her new shoes.

I suppose it *could* be her ringbone, but sound to non-weight bearing in one stride seems uncharacteristic. She looks more comfortable this afternoon, though still painful in that spot on her heel bulb. Hoping for an abscess....
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 22456
Registered: 1-1997
Posted on Sunday, Mar 1, 2009 - 8:10 pm:   Edit PostPrint Post

Sound to non-weight bearing in a single step would be inconsistent with a abscess unless the puncture happened at that moment and now an abscess would be developing.

Flexing low is not very diagnostic and sensitive at the heel bulb suggests trauma at this point but simple bruising is not usually so impairing. A thorough exam with diagnostic nerve blocks should be considered but in the mean time consider our recommendations in Diseases of Horses » Lameness » First Aid for the Lame Horse.
DrO
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Vicki Zaneis
Member
Username: vickiann

Post Number: 968
Registered: 3-2005
Posted on Sunday, Mar 1, 2009 - 10:10 pm:   Edit PostPrint Post

elk, I did have this happen on a ride when a gravel abscess was the case but it also involved going from a quiet walk, which I guess that my horse was able to tolerate, into a trot. With changing to the trot he became very lame and it was a gravel abscess that with much soaking and coaxing way back in time before Vets considered digging them out, finally drained out at the coronet band.

So I wonder if something changed in the way of going during the course of your ride, such as the gait.
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elk
Member
Username: ekaufman

Post Number: 839
Registered: 3-2007
Posted on Sunday, Mar 1, 2009 - 10:51 pm:   Edit PostPrint Post

DrO-- would you consider a non-displaced coffin bone fracture or other fracture as a significant rule out? I ask because I'd considered doing x-rays before blocks, to avoid forcing her to trot for a lameness exam on a possible fracture.
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Julie Masner
Member
Username: juliem

Post Number: 528
Registered: 9-2002
Posted on Sunday, Mar 1, 2009 - 11:17 pm:   Edit PostPrint Post

Elizabeth, I did have this same rapid onset happen once. I hauled immediately to the vet since it was really a three legged horse in an instant. He first radiographed just to rule out coffin bone fracture. My horse had a history of founder, so perhaps that influenced the vet. It did turn out to be an abscess.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 22460
Registered: 1-1997
Posted on Monday, Mar 2, 2009 - 7:35 am:   Edit PostPrint Post

Elk, they are possibilities that must be considered.
DrO
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elk
Member
Username: ekaufman

Post Number: 842
Registered: 3-2007
Posted on Monday, Mar 2, 2009 - 10:03 am:   Edit PostPrint Post

Thanks DrO and thank you everyone else. I will check in with my vet again today and proceed cautiously.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 22463
Registered: 1-1997
Posted on Monday, Mar 2, 2009 - 10:46 am:   Edit PostPrint Post

Concerning those folks who have experienced acute onset abscesses while riding I don't anyone left with the idea this is how abscesses present.

I would purpose either a penetrating injury or a severe bruise on the trail which becomes infected. I could conjecture a pocket of puss in the insensitive horn which suddenly breaks through to the sensitive tissue but I have never seen one. The lameness from an abscess usually starts mild and then develops over a day or more.
DrO
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Vicki Zaneis
Member
Username: vickiann

Post Number: 971
Registered: 3-2005
Posted on Monday, Mar 2, 2009 - 12:36 pm:   Edit PostPrint Post

When this happened to my horse it was one who is ordinarily very, very stoic and it took the change in gait before I noticed that there was a problem. He was barefoot and had a crack in the front center of his toe, which is where I think that the infection worked its way into his foot.

Had he been less stoic, I probably would have noticed that something was "off" sooner.

Perhaps at the walk he was able to compensate in his way of going to control the pain level better?
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elk
Member
Username: ekaufman

Post Number: 844
Registered: 3-2007
Posted on Monday, Mar 2, 2009 - 12:37 pm:   Edit PostPrint Post

My mare is significantly improved today. My working theory is that she over-reached at the canter, and caught her lateral heel bulb hard during the upswing of the LF. My vet and I have agreed to rest her until Weds., and then evaluate her, and decide on further diagnostics based on what we see. Obviously an impact sufficient to cause non weight-bearing pain could have done some serious damage. I still have no swelling or heat, and the heel bulb is exceptionally painful.
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Vicki Zaneis
Member
Username: vickiann

Post Number: 974
Registered: 3-2005
Posted on Monday, Mar 2, 2009 - 3:11 pm:   Edit PostPrint Post

That sounds like a reasonable explanation, elk, though it seems odd that there is no swelling or heat with so much pain. I hope that the impact was not enough to cause a case of quittor.

Let us know how this goes. Good luck.
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elk
Member
Username: ekaufman

Post Number: 865
Registered: 3-2007
Posted on Wednesday, Mar 11, 2009 - 11:29 pm:   Edit PostPrint Post

Here's an update: I stall-rested my mare for a week, and saw steady improvement until Sunday, when she was suddenly again a grade 3 on the LF. No heat, swelling, or elevated DPs, though she was pain sensitive on the lateral heel bulb.

We radiographed her on Monday to rule out fractures, and the radiographs are quite clean (except the cruft we know about already, which is unchanged).

Our working diagnosis right now is soft tissue and/or bone bruise resulting from an over-reach in the canter, with the backsliding attributed to fruiting around. The plan is to apply time and expect recovery, with handwalking etc. as her soundness allows, until she's fit for work.

Under the circumstances, it's a very hopeful outlook. I was relieved to see those radiographs.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 22532
Registered: 1-1997
Posted on Thursday, Mar 12, 2009 - 8:58 am:   Edit PostPrint Post

Very good elk, now is a good time to evaluate balance, length, and other factors involving the health of the hoof.
DrO
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