BIZARRE ACUTE LAMENESS - input needed

[beowulf]

I can see why he blocked the hoof. There are some strange steps in the beginning.

The second video is so different from the first, it makes me second guess the stifle being the culprit. But the stifle does have abnormal ROM. Sometimes injuries up high can make lower limbs move abnormally. Some pelvis injuries look like the horse broke something in their lower leg just because they can no longer abduct the limb. Pelvic injuries present all over the board, some work out of it and some get significantly lamer, it depends on the point of injury and soft tissue involvement.

Is it possible this horse fell and you are looking at a wing tip fracture? Any swelling above or around the point of hip? Any reaction to pressing the last rib cage or palpitating close to the hip? There is definitely some atrophy happening between her last rib and her hindquarters.

Fingers crossed, I hope you have something that just needs some rest.

[endlessclimb]

How old is this horse, breed, and how long have you had her?

[Sarah616]

I think I’m going to double down on my previous statement about something very high, in the hip, and I’ll try to say exactly what the vet told us and how the horse presented.
Horse came in from the field normal, but wouldn’t turn around in his stall after a few hours to get his grain. Very reluctant to come out of his stall. Initial brief vet visit from an assistant vet to determine that there wasn’t actually an abscess or something drastically broken came away only with - walk smoothed out after moving for a while, but almost non-weight bearing to try and trot. Some resistance to picking the leg up high out behind the horse.
Head vet came out the next day for a more thorough exam, which is when we also noticed edema under his belly near the sheath. Some minor response to hard pressure on the hip, reluctance to pick leg up high behind him (same amount as day before), and again walked better after moving for a while. Vet diagnosed tentatively a hip/pelvis fracture and recommended a bone scan in about two weeks time, even if the horse seemed markedly improved with that time in the stall. He wanted to give the fracture time to be able to really present itself on the bone scan (which it did) but also didn’t want us to think about skipping it if the horse seemed sound because working him before it healed would have been a terrible idea.

The good news is that horses that have been studied with that injury have a very high success rate at coming back to full work, and the one i dealt with is back into almost full work (just not jumping to show height yet) 5 months after the injury.

I’d say go with your gut to keep investigating up high, especially if the second opinion vet was already thinking something high/SI area
Unfortunately the horse that I’m talking about isn’t mine, just one I care for, so I’m not going to share the videos I have, but it really presented similarly to your first video especially.

[JB]

she’s striding up shorter on that RH, than the LH, tracking right when the LH should be the one that tracks shorter by virtue of it being a circle (and without being asked to track more evenly), so she’s still off, just not the dramatic level of lameness in the first video. That’s not a hoof thing. It’s possible it’s a ligament or tendon in the back of the leg, but I don’t think so. And hocks don’t usually present like this, it looks like she’s got good, willing hock flexion to move the leg forward. So to me, it still appears higher, whether it’s stifle or SI area on that side, or some sort of fracture high up, I don’t know.

[TWH_Girl]

Horse moves like my bad stifle guy That same hitch. We blocked to stifle but couldn’t get him sound for riding. He does best on a pasture and lots of movement with natural slopes.
I hope it isn’t a stifle as they can be frustrating. I see lots of other stifle comments so looks like a lot of us may have seen a stifle injury or two.
I would block the left stifle joint if you are able to. My guy went totally sound at the block.

[zelle]

Vet#2 came and was also astounded that she goes from seriously lame to somewhat off.
She remarked that the SI joint was higher on one side and the overall muscling when you stand behind her and lift her tail and look at the tops of her legs - is assymetrical. Not a huge amount of difference. Also somewhat less muscling on the right side than the left at the tops of her haunches, near SI. And also like Beowulf says, behind last rib to hind quarters.

It is Vet2’s feeling that the horse has some issue that can be found on an ultrasound that they do of the whole pelvic area. The probe goes in rectally. A vet from the university is coming to do that.

Vet palpated stifle and didn’t consider it any further. The stifle flexion didn’t change her. It was like she got a massage - she relaxed into it and trotted off better. She didn’t care for the flexion of the SI where they take the right leg across under the belly and hold it from the left side. She did all the hind end chiro manipulations and the mare just loved it all. Except the one where they scooch the butt to make them round their back. She grudgingly obeyed.

Vet talked about issues where the nerve can get involved, like a smaller opening for it in the pelvis somewhere (sorry I didn’t catch all the medical terms) kind of like ECVM in the neck. The intermittent nature of this lameness would fit, she says.

To me that doesn’t fit either. I think she pulled something in her back and she’ll repair soon. I bred 12 of these horses so far and they are all totally uncomplicated and sound and never break. So some sort of deformity that is found in overbred horses doesn’t fit in my head. But am investigating for sure. I’ll post whatever I get.

endlessclimb - Mare is 12 and I bred her. With the exception of a 3 year period, I have had her the whole time. Her breeding is very mixed. She is 4th generation on her dam side (of the mixes we made starting with imported Polish trakehner and a wild little mare that came off a Montana cattle truck and jumped Grand Prix) and sire was registered Oldenburg stallion we imported from Germany (his bloodlines are mostly Hanovarian).

[JB]

@zelle

She remarked that the SI joint was higher on one side and the overall muscling when you stand behind her and lift her tail and look at the tops of her legs - is assymetrical. Not a huge amount of difference. Also somewhat less muscling on the right side than the left at the tops of her haunches, near SI.

This seems to point to a “Hunter’s Bump” injury, a tearing of the ligament connecting the tuber sacral to the sacrum. It causes that asymmetry, and the muscle atrophy on that side as well, either due to less use over time, or that things are a bit stretched on that side due to the tuber sacral being pushed up a bit.

If it’s a HB, those usually resolve themselves and are just cosmetic in the end.

@zelle

She didn’t care for the flexion of the SI where they take the right leg across under the belly and hold it from the left side

that would hurt if that ligament is torn a bit

[beowulf]

@zelle

It is Vet2’s feeling that the horse has some issue that can be found on an ultrasound that they do of the whole pelvic area. The probe goes in rectally. A vet from the university is coming to do that.

Wouldn’t it be so much easier if they could talk and tell us where it hurts? I think you are on the right track. Fingers crossed for you and I hope you get some clear answers and a definitive plan.

If it helps at all - I had a gelding break his pelvis in three different places. We had to wait about a month for the huge hematoma on his hip to go down before we image clearly. We x-rayed the day after the injury and saw only a piece of what was really going on - it wasn’t until checkup we saw how much he’d damaged. My vet did a combo of rectal and external ultrasound on check up. My gelding did not present identical to your mare - he literally could not walk - but he also had broken rib involvement on top of the three sections of his femur and acetabulum broken. I was stunned at how rapidly he lost condition; more than once I called my vet wrestling with whether or not to PTS and I’m so grateful to my vet, who was willing to listen to me and also, willing to stand his ground when I was ready to pull the plug. It was a long journey back, but I’m happy to report he’s been back in work for years and has surpassed his prior level of work.

It could be you have a milder version. Hang in there, and fingers crossed for you.

[zelle]

JB What an awesome diagram! Thank you!

[JB]

You’re welcome! It helps demystify the Hunter’s Bump situation, as sooooo many people think any peaked croup = HB, and that’s just not necessarily the case

[NaturallyHappy]

I see this in Quarter Horses. They seem to have a few lines w a pointy croup😀.

[JB]

there are a LOT of QHs and Paints with peaky croups

[IPEsq]

I’ve only ever seen that kind of hopping in a stifle strain. But the horse would be positive to stifle extension (not so much flexion but holding in extension).

If it’s not that, then imaging the pelvis is a good idea. Also possibly a psoas injury, or something that also implicates the lumbar region on that side, or something like that which would also be involved in functionally bringing that RH forward.

You might want to block the stifle just in case, and it does seem like an acute sort of strain or sprain based on the severity of presentation but still being able to work out of it for the most part.

[Amberley]

@zelle

The stifle flexion didn’t change her. It was like she got a massage - she relaxed into it and trotted off better.

Sounds like a psoas injury.

[beowulf]

Any update on your beautiful mare, @zelle ? Fingers crossed.

[beowulf]

I was just thinking of your situation and your mare on my drive in to work. I hope you got some good news from the other vet.