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Discussion on Sudden lameness, ?stifle.

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Dr M Dawson
Member
Username: Lottie

Post Number: 6
Registered: 10-2003
Posted on Tuesday, Nov 15, 2005 - 11:33 am:   Edit PostPrint Post

Hi DrO! 2 weeks ago I moved yards with the horses so also moved vets. I think this was seen by my horse as a challenge so she's found a reason to meet him. She's 12 years old, very fit and schooling advanced (4th level) dressage. We've just started canter pirouette work which is hard for both of us but since she's a mare she's never forced to do anything, just asked.

Last night I was schooling her, we'd done the working pirouettes which had gone well and were doing some easier work in trot with quarters in on the right rein. She went from absolutely fine to hopping lame behind (left hind)in a single stride. It was so sudden I thought she'd pulled a shoe off. Sadly it wasn't that simple.

I got off and she seemed sound in walk but when trotted up was hopping lame on her left hind with difficulty pulling the limb through. I trotted her up again and she appeared sound, turned her, trotted her up a third time and she was very lame again. I then put her in her stable for half an hour, did yet another trot up and she seemed sound.

The vet came to see her today. She has no heat, no swelling and no tenderness anywhere. However she was sound in walk, on first trot up on a straight line she was very lame, second trot up on the straight line she was sound.

We then lunged her in the school (a deeper surface) and she was intermittently lame circling to the left but very lame to the right with her left hind toe dragging. She is a reactive horse, if something hurts she'll tell you about it but no palpation or flexions bothered her at all. The flexions also made no difference to the lameness.

In summary I have a 12yo dressage horse going suddenly lame on their left hind. There is no heat or swelling. Palpation and manipulation don't appear to hurt. The lameness is intermittent on a straight line but very marked on the lunge and worst on the right rein with the bad leg on the outside of the circle.

The new vet does not know what the problem is although he thinks it's most likely a muscle strain and he's pretty sure it is located around the stifle. The plan so far is to give Bute for 48 hours and reassess.

I've read your articles and think that if there isn't rapid improvement we're going to need nerve/ joint blocks. The problem here is that my horse hates needles. The vet wanted to inject her with analgesics today so we could reassess her after an hour but she did her usual standing on two legs routine and wouldn't let him put the needle in. Is it possible to sedate a horse for the nerve blocks and still assess their response afterwards? I don't fancy lungeing a sedated, nerve blocked horse!!!

Your usual sage advice is sorely needed.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 14136
Registered: 1-1997
Posted on Wednesday, Nov 16, 2005 - 6:02 pm:   Edit PostPrint Post

The last horse I saw like this DrM had muscle spasms in the semitendinosus muscle belly. Also I personally had a TB with this problem while doing dressage many years ago. The clue is the rapid on and off nature of the lameness, not much else can do this. I would expect a muscle strain to be consistently lame. Muscle enzymes might further localize this to a myopathy. If the diagnosis pans out, or no one comes up with a better idea, back off a bit and take it easier. Once the problem resolves work up to those canter pirouettes a good bit slower. Robaxin might be of some help and these muscles are amenable to massage also. I went and looked at the article on Robaxin we have and I think it could use a rewrite, I will see what I can get done this week.

Concerning analgesics in the hind leg, yes I have had pretty good luck with acepromazine or even very low dose detomidine but I have also had horses I good not get a good block on because of their fractious nature. Something that has helped me is a farrier's foot stand so I could work on the leg pulled forward.
DrO
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Dr M Dawson
Member
Username: Lottie

Post Number: 7
Registered: 10-2003
Posted on Thursday, Nov 17, 2005 - 4:37 pm:   Edit PostPrint Post

Thankyou DrO that's very reassuring. The horse is much improved today and taking more sound steps that lame ones. My vet's fairly confident the problem is muscular. Having read your post I'm confident too.

She's on quiet walk work only for the next few days. Well I'll try to keep it to quiet walk, she may have different ideas. I'll also ask for a referral to the physio who is very good. I've been worrying myself silly about this wondering if it was her stifle. I'm so glad it isn't!

Do horses tend to make a good recovery from this or does it recur? Obviously I'll build the work back up very slowly. Do you know how long it tends to be for them to get back to normal? (We've got some dressage championships in February and I'd love to go. It's 3rd level so no pirouettes required! If she's not right though we won't go.)

Do you remember the 3yo who had Botulism as a foal? She's now 3, rather immature and small but very sweet and very healthy. She should have made 16.2 but she's only 15.2 at the moment. I'm still hoping she'll reach 16hh as she's all leg. She's been gently backed and is doing well. I'm still grateful for your help while she was ill. Thanks again! I'll get some up to date photos and post a link.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 14141
Registered: 1-1997
Posted on Friday, Nov 18, 2005 - 7:38 am:   Edit PostPrint Post

Thanks for the kind words, DrM. Romantico went through a period of about 6 months where spasms would recur during work. When they occured we would stop and walk him out of it, then back off a bit on workouts, slowly increasing the work load eventually working through it. February is a good long time to work through a single injury but this might be a recurring problem and difficult to prognose when soundness will dependably return.
DrO
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Mrs. Nancy Lennon
Member
Username: Lennon1

Post Number: 6
Registered: 12-2004
Posted on Wednesday, Dec 21, 2005 - 8:24 pm:   Edit PostPrint Post

Hi DrO. My horse has a problem just like DrM describes. Intermittent lameness in left rear leg, high up, appearing like the stifle, but no pain to palpation, in fact, he drops down when you do massage the stifle area after work. Shows worse in COLD weather, after standing in stall for hours, early in the work, after big trotting, better after easy loping, fixes going straight, shows mostly traveling to the right with the effected rear leg on the outside. Horse gets sounder with work and then when tired, gets uneven again. Doesn't show pain, just short in back and uneven in front (catching up with self almost). The left hind does not track straight (crosses under towards the right rear) and travels very close behind. Would ACUPUNCTURE help? Massage before work to warm and loosen the muscle? He is a reiner that has had a lot of slide work, was in a truck accident that injured his left front foot & hip and has straight back legs (clean hocks). He is no longer reining, but work includes circles.
Intermittent problem, but with this cold NJ weather, it is showing just about every day that is below 30 degrees.

As he doesn't appear in pain and thus far, has been improving with light work, I want to think muscle spasm. Would like to ease through the Winter and see if it improves with warmer weather. Do you think there is any logic to this idea? Brainstorming with you is most valuable!
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 14361
Registered: 1-1997
Posted on Thursday, Dec 22, 2005 - 8:39 am:   Edit PostPrint Post

No your problem really does not sound like DrM's Nancy. While his onset is acute and turns on and off unexpectedly yours is chronic and very regular. Before we completely overrun his discussion post this in a new discussion and we will address it there. I would also be interested in any diagnostic work that has been done on the horse for this problem.
DrO
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