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Discussion on Can kissing spines s&s mimic ESPM s & s ? | |
Author | Message |
New Member: rickityc |
Posted on Monday, Dec 28, 2009 - 9:58 pm: I'm new to this posting--so please bear with me. I have a 7 yr old, 16.3 hand appendix QH gelding. I have owned him since he was 2.5. He has a long history of back issues and lack of desire to go forward when under tack. For years he had a weak topline, and in the last two years or so he has started becoming disunited at the canter (even with professionals riding). Since I have owned him he has lived out 24/7, he has never had shoes and he has great feet. I have competed him successfully at training level in dressage shows and he has done well at the 2'9" level in the hunters although it is always a challenge to get him to go forward and hold his lead. When he was 4 he had a bone scan done that showed remodeling of bone in the SI area and kissing spines in the area under the saddle. He had 2 SI injections with very mediocre results. I have had accupuncture, chiropractic and osteopathic treatments done several times. The best results from the holistic modalities were from the chiropractor (who still treats him every 3 months).Three months ago I took him to a vet for evaluation of his cantering problem also to evaluate the potential for TMJ because he is always opening his mouth. (I have had his teeth done 2 times a year by a professional dentist since I owned him). The vet said he felt his hocks were sore (he was positive to flexion and did have some changes on radiograph. The vet also felt he was "sticking" in his stifle and that caused him to bunny hop and change leads behind. I know what an upward fixation looks like and the horse has NEVER done that. So, the vet injected both hocks and advised that we needed to blister the horses stifles. I didn't feel good about the stifle blistering but the vet had more initials behind his name than I do so I agreed. The horse had his stifles blistered and the vet also did a "microsurgery" technique to further tighten the ligaments. The horse was very swollen and in excruciating pain for 2 days. Eventually the swelling started to diminish the 3rd day and continued to go down. However on about the 10th day the horse started to get worse in his left stifle. Turns out the horse moved excessively when the vet was working on the left stifle and he inadvertently must have scraped the joint capsule which produced a capsulitis which then migrated to the synovium producing a synovitis. I took the horse back to the vet and he kept him for 14 days while he treated the inflammation. He was treated with IRAP and PRP. During this time the horse was on stall rest (I usually ride him 1 hour a day, 5-6 days a week, mostly on gentle rolling trails in the Sandhills of NC). The horse lost a tremendous amount of muscle and top line(which has never been great to start with). The vet was very concerned and called me to tell me he thought the horse had a neurological disease--cauda equina synDrOme. He pulled CSF on the horse-which had no protein and basically was WNL. Also tested the CSF for EPM--negative, and we tested for Lymes--negative. This horse has good muscle tone in his tail, no urinary dribbling. Since the horse has been home the stifle has healed well and he was slowly reintroduced to living out 24/7 in his pasture. I have also started back riding him about 2 weeks ago. I had him trimmed a week ago by my barefoot trimmer and she had a lot of trouble doing his hind feet, she said he reminded her very much of a horse with EPSM. Another thing he has started doing-just since the stifle treatment- is to constantly switch weight back and forth between hind legs when he is standing in the cross ties. Plus he stands with his front feet a little more under him than he used to. I know those are symptoms of EMND, but my research indicates that this is a progressive disease--similar to Lou Gehrig's disease, and my horse has actually gotten much stronger since he has been home. The EPSM info peaked my interest and I researched it heavily--a lot through this site--and I have started him on a high fat diet. 1.5 cups vegetable oil (he weighed 1200 lbs last Monday), he has been on Nutrena Safe Choice for a year anyway, timothy and coastal hay. Here's a problem--he loves the oil--eats it with no problem however he is becoming more lethargic under tack (although tears around the paddock at liberty) AND he has literally put on 30 lbs this week (determined by a weight tape). At this rate there will be some bridges we can't go over in NC! I plan to have a muscle biopsy done soon to see if he does have EPSM. What are the chances of a false negative with the biopsy? And last question-is it possible that all the problems I mentioned--lack of desire to go forward (under tack) disunited canter, weak topline, opening of the mouth, grouchiness when being groomed--could be a symptom of his confirmed kissing spines? I am at my wit's end with this horse but I really love him and want to correctly diagnose his issue so I can (hopefully) help him. |
Moderator: DrO |
Posted on Tuesday, Dec 29, 2009 - 8:01 am: Welcome Cricket,To answer you direct questions: 1) The chance of a false negative is low, in my opinion false positives are more common. Has you horse ever had elevated muscle enzymes in the blood? 2) Since most healthy horses have kissing spines the mere presence of this is not diagnostic. If they are painful then yes this would cause many of the symptoms you see. For more on diagnosing this condition see Diseases of Horses » Lameness » Diseases of the Spine, Back & Pelvis » Lower Back Pain in Horses. I would note that if your horse is gaining weight rapidly you have not instituted the diet correctly. You are supposed to replace carbohydrate energy with fat energy, so you need to reduce carbohydrate further so that your horse maintains his ideal condition. DrO |
New Member: rickityc |
Posted on Tuesday, Dec 29, 2009 - 11:59 am: Dr. O, Thanks so much for your prompt reply! I have never had my horse's blood tested for muscle enzymes. I'll look into that. I will also review again the site you noted. If I understood it correctly I think that we can have the "kissing spines" injected with a steroid/anesthetic solution--if the horse seems more comfortable then we may have part of the solution.One more question about reducing the carbs further. Should I decrease the 3 lbs a day of Nutrena Safe Choice and just replace it with plain beet pulp? My horse likes beet pulp and he seems to love the oil so getting him to eat it will not be a problem. My concern is that he still get enough protein for muscle synthesis. Thanks so much for your time. |
Moderator: DrO |
Posted on Tuesday, Dec 29, 2009 - 6:29 pm: If you replace them on a lb for lb basis you will not reduce calories. Right now it sounds like you need to just reduce the amount of concentrate you are feeding as long as the diet remains balanced. Remember most of the protein in your horses diet comes from the forage: what is it like?DrO |
New Member: rickityc |
Posted on Tuesday, Dec 29, 2009 - 6:41 pm: The forage is coastal bermuda hay, approx 10 lbs AM and PM and at lunch I feed him approx 14 lbs of timothy. I contacted the state today to see how I can get these hays evaluated for their content-will try to do that next week. The paddock he is now has has virtually no grass at present--a little stubble of rye-but that is about it. What kind and amount of hay would you suggest? He weighs approx 1200lbs and is ridden on trails for an hour a day.One other thing I wanted to mention about symptoms/behaviors to be explained. Almost every day when I first get on and for the first 15 minutes or so of our rides the horse walks along with his neck over bent, head and neck below the level of the withers and his mouth is open. I have no rein contact-on the buckle basically. I have two saddles and a treeless saddle. Both traditional saddles have been fitted to him and in the summer they both leave very even sweat patterns. He tends to do this profound over bending sometimes when I am lunging him. Could this be related to the kissing spines? I have made an appt for Monday to have the vet come and do a muscle biopsy that will be sent to Dr. Valberg in Minnesota. Thanks so much. |
Moderator: DrO |
Posted on Wednesday, Dec 30, 2009 - 5:04 am: Cricket why do you think you should change your forage? I was responding to your report that the horse is becoming overweight since getting a fat supplement for suspected ESPM. It is the concentrate that should first be reduced before considering adjustments to the forage.But it never hurts to better understand feeding forages however and if you have some questions about your current regimen check out Horse Care » Equine Nutrition, Horse Feeds, Feeding » Forages for Horses, an Overview. DrO |
New Member: rickityc |
Posted on Wednesday, Dec 30, 2009 - 10:49 am: Thanks, DrO. I am fine with my hay program if is sounds OK to you. I understand what you have said about the concentrates and that is the thing I changed yesterday. I will continue to decrease his Safe Choice and replace it with soaked molasses free beet pulp and oil. I will read the research you mentioned about the forages. What do you think of the feed Re-Leve?Thank you. |
Moderator: DrO |
Posted on Wednesday, Dec 30, 2009 - 1:42 pm: Since I cannot see your hay, I don't know if it is OK, the article I reference above explains how to determine this. But if your horse is doing well on it that is a good sign it is of sufficent quality and amounts. If your purpose is to get your horse to loose weight you should not replace the removed concentrate with more beet pulp and fat than you were already giving.Concerning Re-Leve what is currently in it and what is it's guaranteed analysis? DrO |
New Member: rickityc |
Posted on Wednesday, Dec 30, 2009 - 9:00 pm: I pulled Re-leve up on the internet and it seems like it is basically made up of rice bran, beet pulp and soybean hulls. Digestible energy 3.0 Mcal/kg, protein 12.5%, fat 12.5%, fiber 18.0%, starch 10.0%, Ca 1.0%, Phospherous.65%, Potassium .90%. Cu 90mg/kg, Selenium 1 mg/kg, Zinc 260 mg/kg, vit A 22,900 IU/kg, Vit D 2,290 IU/kg, vit E 900IU/kg. They make it sound like it can be a complete concentrate feed for EPSM horses. Obviously it would be fed in conjunction with forage.My horse had not been overweight before adding the oil which drastically increased his daily calorie intake. But I have stopped feeding the Safe Choice and now will give him some soaked beet pulp as a carrier for the oil but I will monitor his weight this week and make adjustments PRN. Just got copies of his blood work, routine CBC plus selenium and a chem panel. Only abnormals were an ALB of 3.5 g/dl and a borderline high Ca with a reading of 12.9 mg/dl. Did you have any thoughts about the over bent neck posture and opening the mouth when I first get on for about the first 15 minutes, (and actually off and on for the whole ride sometimes)? Thanks-Cricket |
Moderator: DrO |
Posted on Thursday, Dec 31, 2009 - 7:35 am: Those would be good numbers for a EPSM horse Cricket.As to the horses odd way of going when cold they do not have any specific significance to me and may be behavioral and not pain related. If pain related I would expect some other signs also like pinning of the ears. But right now it sounds like you are still dealing with some residual pain from blistering the stifles. Before moving forward with any further diagnostic techniques you have to at least get your horse back to where he was before treatment. At that point you will need to reassess the original hindlimb lameness and decide if that has resolved. At that point your next step should be apparent. Everything else at this time seems like a secondary problem. DrO |