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 It Goes On
Posts: 2262
  
Location: Muskogee, OK | Hi everyone,
I'm coming to you for some practical advice. Let me preface this by letting you know I am a 4th year veterinary student at OSU so I have had numerous veterinary eyes on this horse. With that said, any advice or suggestions are welcomed! I also apologize because this may get lengthy, I am going to try and keep it short and sweet.
HISTORY: 3 year old gelding I purchased as a yearling. Before I bought him he was basically untouched. I started breaking him this past summer (just very basic stuff---all at a walk) and in September noticed he was off in his hind end (hind left) while lunging him. It is possible he was off before this and I did not notice but I cannot be for sure. I decided to act conservatively and just turned him out, thinking he just tweaked something while playing out in the pasture.
October 2014: Still was lame so I brought him in to school (Oklahoma State) to work him up. He was 3/5 lame on his left hind. Positive to hock and stifle flexion. We just blocked his stifle that day and subjectively his lameness improved but objectively (lameness locator) it only changed the timing of the lameness (push-off vs. impact). I was concerned he had an OCD lesion, radiographed the stifle and no abnormalities were present. Was advised to turn him out.
November 2014: Lameness still not changed. Radiographed fetlocks, hocks and stifles in both hind legs. No abnormalities found.
January 2015: Lameness still not changed so we got a little more aggressive with our diagnostics. Blocked him from the ground up on that leg and he blocked out 80% to his stifle that day—didn’t block out anywhere else. Ultrasounded stifle--- good amount of effusion present with synovial proliferation but both menisci looked good along with the cartilage surfaces that you can visualize with ultrasound. Figured we were just dealing with a synovitis so injected both stifles with HA and triamcinolone.
February 2015: Still lame. Talked about needle scoping his stifle and possibly CT’ing it as well. Basically we are left with it being either a soft tissue injury that we cannot visualize with the ultrasound or a possible cartilage defect that isn’t showing on radiographs. However, it is a bit peculiar that the stifle injections didn’t really help him out at all. Technically even if it was soft tissue in the stifle I should have seen improvement with those injections, it just wouldn’t last.
SUMMARY: I am stuck on what to do with this guy. I really, really like him. He is decently bred (Future Fortunes enrolled too), has been a quick learner and just overall a good horse. Complicating the mix is a horse with EHV-1 at OSU currently that hinders our ability to do any further diagnostics on him (scoping, CT) for an unknown amount of time--- likely at least 60 days. Money is playing a big factor in my decision making---I get an enormous discount at OSU since I am a student.
What would you do? - Just treat it as it is a soft tissue injury and stall rest him until OSU can work him up further. I am tempted to do this but I also am REALLY just wanting to get to the bottom of what exactly we are dealing with. I also am in my 4th year, graduating in May so my schedule can be very hectic.Would definitely be harder for me to stall rest him. Definitely can do it if I have to, but I’ve been procrastinating on making that decision.
- I also have a theory it could be something higher up that is out of whack, causing him to travel differently with more strain on his stifles. I’ve been debating getting him adjusted to just see if it makes any difference—I have never been big on chiropractics but I’m exhausting all of my options here.
- Take him somewhere else to proceed with diagnostics. If I go this route I would take him to Oakridge--- my only hesitation here is money. I am willing to spend some to get this figured out but I also am a poor vet student.
Sorry for the novel. Any “what you would do” advice would be greatly appreciated. And if you took the time to read through all of this, thank you!
Edited by barrelracingchick16 2015-02-21 9:03 PM
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They Don't Know Me
Posts: 3299
Location: Bastrop, TX | Have you ruled out suspensory. |
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 Take a Picture
Posts: 12838
 
| I am not big on Chiro since one about killed me. I would at least try one to see if he can find something a little higher then you can go from there. |
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It Goes On
Posts: 2262
Location: Muskogee, OK | bobbyjosocks - 2015-02-21 9:51 PM Have you ruled out suspensory.
For the most part. We blocked him from the ground up... Foot, abaxial, low four point, high 4 point (which is the block that horses will block out to if there is a suspensory problem), then both lower hock joints and finally the stifle. The only place he blocked out to was the stifle, and that block made him about 80% better. |
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Rad Dork
Posts: 5218
Location: Oklahoma | Pelvis? I'm not familiar at all with the area, but I have an anxious feeling that I soon will be. I would give chiro a try and stalk him for a few fays afterward and see where he's at. If that didn't work then I'd probably haul somewhere I could get more in depth with digging. |
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Elite Veteran
Posts: 926
| MRI? |
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It Goes On
Posts: 2262
Location: Muskogee, OK | chicks2 - 2015-02-21 10:11 PM
MRI?
A CT with contrast arthrography is one of the next options on our list.. Will show us more than an MRI can as far as the stifle goes. Also not many places have the capability of MRI'ing a stifle. |
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I Am a Snake Killer
Posts: 1927
Location: Golden Gulf Coast of Texas | If you can get a good discount I would scope that stifle. I did same thing basically. I xrayed and Ultrsounded and it didn't show very much but when they did arthroscopic surgery they found his cartilage was messed up. It took me five vets and two years to find this out along with a lot of money. Wish I had gone to the last vet first. We did PRP injections and I'm legging him back up now. Anyway, I would just go ahead and scope it. |
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I Am a Snake Killer
Posts: 1927
Location: Golden Gulf Coast of Texas | Oh and the stifle injections did not help mine at all either! |
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The Advice Guru
Posts: 6419
| EPM if possums are found in your area or where the horse came from
Have you palpated the pelvis for a pelvic fracture
Si joints since he isn't blocking 100 sound at stifles
Pssm would be another thing I would rule out |
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It Goes On
Posts: 2262
Location: Muskogee, OK | mreklaw - 2015-02-21 10:22 PM If you can get a good discount I would scope that stifle. I did same thing basically. I xrayed and Ultrsounded and it didn't show very much but when they did arthroscopic surgery they found his cartilage was messed up. It took me five vets and two years to find this out along with a lot of money. Wish I had gone to the last vet first. We did PRP injections and I'm legging him back up now. Anyway, I would just go ahead and scope it.
Thanks for sharing! How old was your horse? After the arthroscopy how long did you stall rest for and how many rounds of PRP? |
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I Am a Snake Killer
Posts: 1927
Location: Golden Gulf Coast of Texas | barrelracingchick16 - 2015-02-21 10:35 PM
mreklaw - 2015-02-21 10:22 PM If you can get a good discount I would scope that stifle. I did same thing basically. I xrayed and Ultrsounded and it didn't show very much but when they did arthroscopic surgery they found his cartilage was messed up. It took me five vets and two years to find this out along with a lot of money. Wish I had gone to the last vet first. We did PRP injections and I'm legging him back up now. Anyway, I would just go ahead and scope it.
Thanks for sharing! How old was your horse? After the arthroscopy how long did you stall rest for and how many rounds of PRP?
He is six now and we did the scope in August and he was on stall rest for 60 days then after vet checked him he had me start him back slow. Walked only for two weeks then walk and trot slowly building trotting time up over the next 6 weeks. Then took him back at first of December and he gave me go ahead to really start legging him back up. Course the weather has really messed that up so I'm hoping to try him back on barrels in a few weeks. We only did one round of PRP. He said mine didn't have any flaps in the cartilage to clean up but it was "roughed up" and did have a few holes. He thinks PRP is more effective than stem cell for the stifles. Good luck with yours. I think mine actually injured his when I first bought him home as a yearling. Just didn't really bother him til I started asking him for a little run on the pattern. |
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 Lady Di
Posts: 21556
Location: Oklahoma | Have you tested him for EPM? I am finding that it masquerades as stifle and hock problems, and vets rarely look for it first. If he was basically untouched when he came to you, he certainly has been through some stress which is enough to trigger it. I would sure do that just to rule it out. |
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Extreme Veteran
Posts: 413
| I would try the SI as well. If they have an old injury they can be "uneven" and be traveling different, putting strain on that leg. |
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Sock Snob
Posts: 3021
| I would also say epm, mine showed negaive at uc davis, sent blood to dr. Ellerson at pathogens in florida. My gelding was dragging his toes. Gave mine treatment in nov. Checked him as i have been sick all winter with an infection they cant cure, but no soreness anywhere alosn back and no toes dragging wearing shoes flat as soon as this snow melts he will get new shoes and get a report from my farrier. Last time he was done he could hardly stand on one leg. It only cost like the test is 34.00 and meds are like 200.00 to me it was a win win. |
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  Neat Freak
Posts: 11216
Location: Wonderful Wyoming | I am really thinking pelvis too. I went to just about as many vets and did the x rays and the nerve blocks and injected hocks and SI. All the vets suspected hocks even though his x rays showed really clean hocks. Finally had a vet spend 4 hrs on him and blocks made him sound one minute and lame the next. Last thing was to palpate his pelvis rectally and he was assymetrical. I'm sure it happened when he was out in pasture while I was pregnant with my 2nd son. It is a cheap thing to check for. Just make them a little sleepy and they can just go by feel or even ultrasound. |
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Elite Veteran
Posts: 953
| I'd move on. To many out there  |
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Expert
Posts: 3514
| I would inject the stifle ligament. Also try the Ultra Oz . I can give you the reps name that I use. |
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It Goes On
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Location: Muskogee, OK | readytorodeo - 2015-02-22 11:22 AM I would inject the stifle ligament. Also try the Ultra Oz . I can give you the reps name that I use.
As in a blister? That has been lower on my differential list but definitely still there. I've never seen him lock and both me and the veterinarians who have looked at him do not think he is, but its always a possibility that there is just ligament laxity there causing the lameness. Thanks for your input! |
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I Am a Snake Killer
Posts: 1927
Location: Golden Gulf Coast of Texas | If he blocked 80% on stifle that's probably where your issue is. Yes he still might be sore but if it's been injured for awhile you will have compensation soreness in other areas-hip, pelvic, lower back and hocks. I would also consider testing for EPM like Diane stated. |
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It Goes On
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Location: Muskogee, OK | cowgirl156 - 2015-02-22 9:53 AM I'd move on. To many out there
This has definitely crossed my mind. I do really like him however and don't have that much money in trying to get him right....yet. I am willing to spend a little more money and time in trying to figure it out at this point. |
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It Goes On
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Location: Muskogee, OK | mreklaw - 2015-02-22 11:46 AM If he blocked 80% on stifle that's probably where your issue is. Yes he still might be sore but if it's been injured for awhile you will have compensation soreness in other areas-hip, pelvic, lower back and hocks. I would also consider testing for EPM like Diane stated.
Absolutely...that's why we are going after the stifle. 80% is absolutely considered a diagnostic block..especially for a joint like the stifle that is so big and hard to truly block everything within it. |
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 Elite Veteran
Posts: 886
Location: Where its cold and hot | barrelracingchick16 - 2015-02-22 11:44 AM
readytorodeo - 2015-02-22 11:22 AM I would inject the stifle ligament. Also try the Ultra Oz . I can give you the reps name that I use.
As in a blister? That has been lower on my differential list but definitely still there. I've never seen him lock and both me and the veterinarians who have looked at him do not think he is, but its always a possibility that there is just ligament laxity there causing the lameness. Thanks for your input!
Had this problem with a youngster of mine early 4 yr old yr. wasn't lame per say but stiff. Looked a little off everywhere. X rayed everything, injected hocks, stifles, coffin joint, whorl bones, chiro, teeth, ulcers. Nothing made a significant difference. At one of his many lameness exams I was lunging him and he tripped one time in the hind end. Vet asked me if he always did that, I thought about it and sure enough he always tripped once within the first 5 min of me riding him. The vet thought his stifle was catching, blistered internally and the problem completely resolved itself within 6 months (had to blister twice). |
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 Expert
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Location: Texas | Have you blistered the stifle? |
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Expert
Posts: 1526
Location: Texas | I have had a lot of experience with stifles and have blisted one around 5 times to get him right. Blister is cheap to. Can you send me a video of him trotting around you
Edited by mollibtexan 2015-02-22 1:36 PM
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It Goes On
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Location: Muskogee, OK | mollibtexan - 2015-02-22 1:35 PM I have had a lot of experience with stifles and have blisted one around 5 times to get him right. Blister is cheap to. Can you send me a video of him trotting around you
This is a video I have soon after I first noticed he was off in September/October. It may be a little bit improved now but hopefully this can give you an idea. Sorry for the poor quality, it was taken with my phone.
https://www.youtube.com/watch?v=x9L6XhTWYd8 |
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 The BHW Book Worm
Posts: 1768
| I spent thousands I mean thousands + 4 vets and after2 years of suspected stifle problem it finally lameness came out to be pelvis vet recommended MRI but that would just cost another couple thousand and it still wouldn't have made her sound. Sold said filly as a 3 year old disclosing everything.....those people for some reason thought thy could make her sound they are still trying and she is still lame 2 years later. I'm glad I cut my losses even though she had so much potential still makes me sick.
Edited by Thistle2011 2015-02-22 4:45 PM
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 Ms. Poutability
Posts: 2362
Location: In my own world | I had to have my mares strifles split. X-rays were always clean and injections did not help. Tried to blister but didn't work. I went to Oakridge and saw Dr. major. Stifle would catch only when walking down hill but it was doing some damage to a ligament in ther joint. Not her meniscus it was fine. I start riding her in circles next week. We've been doing straight lines only for a while now |
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It Goes On
Posts: 2262
Location: Muskogee, OK | Thanks everyone for sharing all of your experiences. I too worry that it is a pelvic issue that may not ever be able to be fixed. During his 2 year old year he slid out from under himself (rubber mats slid) while backing off of the trailer and ended up "dog sitting" before catching himself and standing back up. I've always wondered if he did something to himself then.
If I decide not to wait on OSU for further diagnostics I will be taking him to Oakridge, that is just the decision I am trying to make right now. Definitely helps hearing everyone elses experiences, appreciate you taking the time to read that novel of a history! |
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Rad Dork
Posts: 5218
Location: Oklahoma | barrelracingchick16 - 2015-02-22 7:51 PM
Thanks everyone for sharing all of your experiences. I too worry that it is a pelvic issue that may not ever be able to be fixed. During his 2 year old year he slid out from under himself (rubber mats slid) while backing off of the trailer and ended up "dog sitting" before catching himself and standing back up. I've always wondered if he did something to himself then.
If I decide not to wait on OSU for further diagnostics I will be taking him to Oakridge, that is just the decision I am trying to make right now. Definitely helps hearing everyone elses experiences, appreciate you taking the time to read that novel of a history!
Does that mean that OSU isn't taking in new horses right now? Talking ahead of myself as I'm not sure that my vet won't be able to find my problem, but I was told that I may need to go to Stillwater for a more advanced diagnosis. |
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It Goes On
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Location: Muskogee, OK | Longneck - 2015-02-22 8:26 PM barrelracingchick16 - 2015-02-22 7:51 PM Thanks everyone for sharing all of your experiences. I too worry that it is a pelvic issue that may not ever be able to be fixed. During his 2 year old year he slid out from under himself (rubber mats slid) while backing off of the trailer and ended up "dog sitting" before catching himself and standing back up. I've always wondered if he did something to himself then.
If I decide not to wait on OSU for further diagnostics I will be taking him to Oakridge, that is just the decision I am trying to make right now. Definitely helps hearing everyone elses experiences, appreciate you taking the time to read that novel of a history! Does that mean that OSU isn't taking in new horses right now? Talking ahead of myself as I'm not sure that my vet won't be able to find my problem, but I was told that I may need to go to Stillwater for a more advanced diagnosis.
PM'ed you  |
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Expert
Posts: 1526
Location: Texas | Yes get him blistered. That's exactly how mine did. Is he a stud by chance? |
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3 year old with unsolved lameness.. What would you do?