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Bone Scan vs..? UPDATE /\/\ back to vet 12/2

KBC we should start a club…
I was telling a friend last night I’m completely paranoid about even thinking of another horse. All I see and hear is one problem after another. Heck, look at the recent thread here about vicious horses. How many of us have stories about how many different ways things went wrong? I’m getting old enough where time matters to me, and what I do with that time. Spending it like I have been… is not what I want to do.

@Old_Mac_Donald. You are the second person to bring up PSSM 2. I doubt it, based on what I’ve read, but would you elaborate?

Can I be third member of club? I don’t even care about riding this horse, but I flat don’t have time or strength to ride the other horse bc sick horse keeps being sick and I’m getting my veterinary nursing degree one weekly farm call at a time with a side of therapeutic shoeing.

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Welcome to the club!! :flushed:. I certainly know how you feel.

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Hopefully your horsie will improve and / or get some definitive answers.

Oh we should, I’m 65, when my boy first had issues I said, “I don’t need to compete, i just want to ride, it’s OK”

Now we can do some walking stuff, but I no longer want to because I can’t tell the difference between can’t, shan’t and won’t anymore. I said he would be my last horse, but I really thought that the 10 year old and I could go a bit longer.

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Exactly. And the thing is, I DID my due diligence. I got a second opinion before buying. I got history. I got a very good PPE. And yet here I am.
A couple weeks ago I had clinic rides, I ended up borrowing the hostess’ horses. I had so much fun! No worries about anything! Just ride, focus on my lesson, that’s it!
Somehow some which way, I WILL come home with answers tomorrow.

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UPDATE: Vet appt 10/21. TL;DR, SI Injections and Shockwave along the back.

The good news is that her hind feet were a +4, instead of 0 to negative. Farrier and I high-fiving over that one.
Otherwise: she palpated very sore on the right SI, and left thoracic back. Which I think is kinda weird for a horse not doing anything but whatever. Honestly, I am GLAD she finally flinched. Went thru the usual gamut of exams including flexions (negative on all counts). Farrier had given the vet a heads up I was coming in, I don’t know what he said if anything more than “X is bringing Y in tomorrow”, but the vet was very attentive and listened quite closely to everything I said and asked.
After discussing all diagnostic options, such as rectal US, bone scan, etc., we decided to go ahead with what my (human) dr calls the “poor mans MRI” which is just steroid injection into the problem area and see what happens.
So that’s that. And vet did shockwave along the back, because throughout all of this miss maresy has developed mild KS.
Anyhow. One week pasture puff, one week light lunging at all gaits, then back under saddle and see what I have. Change absolutely nothing else. No Robaxin, no shoeing changes, nada. Until we see if this has worked and for how long.
The big question I am crossing my fingers for is will (assuming the injections work) relief in the SI allow her posture to change and therefore allow her hind feet to stand more normally thereby alleviating the NPA. Which by alleviating NPA should, theoretically, help to alleviate back pain.
Please to all the horse gods allow this to finally be an answer.

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Fingers crossed that this is the solution/plan you needed.

Crossing fingers and toes!

Updating this for my own sake and anybody else who cares to follow along. Today was first day back on the lunge. I took her sheet off - I have left it on all week and not done much with her. I was very surprised to see how flat her croup was. I’ve never seen it be quite that flat, it’s usually more pointy.
Put her on lunge, could see a muscle working from the lumbar over the croup. One thing about this mare I have had the worst time developing her glutes on the top. Too much hamstring on the backside but not enough on top.
First ask to trot, pushed right off and was quite swingy and relaxed. Things looked decent. Canter, looked pretty good. Not ‘bunny hoppy’ behind, flat, willing to stretch down. Switched directions. Paying close attention to her eyes and mouth. Seems quiet, eyes don’t seem worried, mouth is soft. Other direction looks decent also. Didn’t fall down, switch leads, or bobble at all.
Finished up, grooming. Quiet eye with slow blinks. Licking and chewing lazily. Breathing - and that’s HUGE for this mare. She holds her breath. Didn’t seem too concerned about anything.
Earlier this week I noticed she was pretty quiet when I turned her out and when I brought her in. Quieter than normal.
Please please please please let this all be because things are feeling okay right now.

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So happy to hear this. Continuing jingles that you have found the problem and the program to keep her improving.:crossed_fingers::kissing_heart:

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10/29 day 2 lunging. Still no tack, just a halter. Is stretching well, even at canter. Is picking up transitions without throwing head up. Canter to the right looks great but with some tail swishes. Canter to the left, hmm. I’m watching closely. To my eye, not as relaxed as I’d like to see her and seems a bit ‘tucked under’ behind. Am hoping it’s just a lack of strength in the RH.
Her trot looks great. Swinging, stretching, even. Her attitude is good. Soft eyes & mouth. Breathing, licking/chewing, seems ‘ho-hum’ about things.
Might take some video today, might be helpful to review over time. Even if she doesn’t show overt signs of pain, reviewing how she looks “today” vs. a month or 3 mos from now might help me and my vet.
Not slipping, not falling, no bobbles in the hind end. Possibly the bunching up going left is her worrying about this, since it’s happened several times before. Am hoping after a week of careful work the bunching up will lessen. Might have to put tack on and side reins to help ‘hold’ her in a more even frame, just to see if that helps. Hasn’t ever been a problem under saddle, but when I’m on her I can guide her frame more specifically and she’s always been amenable to that.
Hmm. Stuff to think about.

If anyone has rehab thoughts let me know.

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I’d back off from cantering now that you know she is sound from the treatment. Rehab starts with building up her fitness and muscle strength. This is what I would do and comes from https://www.theeverydayequestrian.co.uk/bringing-a-horse-back-into-work-after-time-off/ A anytime you can add poles to help increase workload and range of motion. Definitely use poles if you don’t have access to a hill.

The First 4-6 Weeks

For the first 4-6 week of the fitness plan, you will want to stick to walking your horse. The fitness plan is built upon gradual phases and you want to ease your horse back into ridden work slowly. Ideally, you want to be walking your horse out on soft, flat surfaces or tracks 5-6 days a week for 20-30 mins at a time. Routes with lots of straight lines are ideal. Later on, in the phase start to introduce some hill work which will help slowly build on muscle strength and fitness levels. Taking a trusty companion/friend out with you can be helpful to both you and your horse to build on confidence. Although lunging before a ride at this phase is not ideal if you feel your horse is likely to be difficult and safety will be compromised then a short burst on the lunge is ok.
Trot Work

Over the next 4-6 weeks start introducing some trot work into your fitness programme. Always ensure that you are trotting on surfaces that provide a bit of give such as grass or a sand school/arena. Roadwork tends to put a lot of pressure on joints and ligaments so should be avoided where possible. Start with short bursts of trot and then back to walk. Build on the length of time you remain in trot as the weeks go by. By week 4 you should introduce some trot hill work. You should start to notice your horse’s fitness levels gradually increasing which you should keep monitoring. Always ensure you spend a good period warming up your horse up and cooling off in walk to allow your horse’s muscle to relax.
Canter Work

After 4-6 weeks of progressive trot, you can start introducing some canter into your fitness plan. Start small with blocks of 1-2 mins of canter at a time gradually increasing the length over time. Interval training is also a great tool. Start by doing 1 minute of canter and then 2 mins of trot and repeat. Over time you can increase the length of each trot and canter block. At this stage, you want to introduce schooling into the mix such as including circles as well as straight lines.
Monitor Progress

Lastly, as you continue to build your horse back up to fitness monitor closely any changes and take appropriate action. This could be the shape of your horse where you may need to get a saddle check again (very likely). Or your horse’s energy levels (They may require more or different types of hard feed to be able to carry out the work required). Continually assess your horse’s recovery times and general wellbeing whilst working. If you need to continue walking for longer then feel free to do so. Every horse is an individual and should be treated as such. Take everything in baby steps for the best results.

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SI 8njections can take a while to really take hold.

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10/31 4th day. MUCH better tonight. Everything was much looser. She trotted along in the “grazing walk” frame, topline swinging. No tail swishing at all. A suggestion to canter and she just floated into it. No bunching up. Stayed soft, nice space between the hind legs.
Feeling very hopeful.

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Tuesday Nov 8, second U/S ride. First, I am seeing on the lunge at canter, more ‘tuck’ (?) in the pelvis during the canter stride. I don’t know how else to explain it. It’s like there is more motion than there was before? Honestly she looks like she could throw in a pretty good buck, except she’s not light behind. So maybe the movement is just freer?
She is quite opinionated about the fact that I dared to saddle up, let alone get on, after so much time off. All I am doing right now is walking her, gentle stretching and just basic reminders of ‘yes, this is what we do’. Of course you know I am starting all this as the weather has really set in, it’s been cold wet windy…none of that is helping! Yesterday the sun spots in the arena were MONSTERS! OMG! yeah okay…
I gotta be honest, I really hate trying to sort out her emotions. Is she still in pain, is she just needing a refresher in work ethic…etc. She’s always been a drama queen. I ignore it. For the moment, judging by her eye and her mouth, I am going to say it’s just “I don’t wanna”. I also know that ‘remembered pain’ is very…mmm. what’s the word I want… I think she anticipates something is going to hurt because it has hurt for so long!
She feels quite solid under me. She feels even. She feels like a whole lot of horse! Here’s hoping I’m up to the task.

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Fingers crossed that it keeps going well. I would stick with it for a while and see if her opinions subside when she realizes there’s no more pain (hopefully.) I definitely understand how fun it is to bring a horse back into work when the weather is setting in! So much fun lol best of luck. Keep us updated!

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This journey is interesting to me. My mare is one of those “I’ve tried everything” type cases - most recently she got kissing spine surgery which did relieve some of her back pain but she still hates being ridden. She basically can’t canter, she’s very bunny hoppy and tight in behind, and exploring the SI I think would be next on my list if I decide to do any further diagnostics.

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Thank you Lunabear. This morning I walked into the barn to find it “raining” in the arena - the frost was melting and dripping. My first thought was ‘oh hell no’, after yesterday’s…attitude! But, she seemed very quiet internally while I cleaned her stall, and by the time I was done and tacked up (I thought if nothing else a good lunging session) the frost had quit melting. So I did get on. I’m glad I did. She fusses when I first get on. Head up, tail swishes. Then she takes off walking like it’s a race. I won’t rule out that there is something uncomfortable when weight is added. However, she needs to give me a chance, so I persist in just gently reminding her “this is what we do”. Everything she ever fussed about before or ways she was crooked are all still there, they didn’t magically disappear. Trotting to the left is still weird. That one I am not sure about. I think a good portion of it is her reluctance to actually bend left. She likes to give you ‘false bend’ so she’s traveling left but her rib cage is bulging and her inside hind is not actually under her midline. It’s a dance between enough inside leg and enough outside rein to keep her ‘straight’ without her thinking she can leg yield over the outside shoulder and avoid the whole bend altogether. Sigh.
One thing she did do today was straight up offer left lead canter. I took her up on it for about 3 strides, just out of curiosity. Even tho it was a crap transition and a crap canter, her back felt much more ‘there’ than it has previously. Hmm.
Sometimes going left with the trot I will slow it waaay down so that I can manage her body parts better; it gives her time to think about what she’s doing since it’s slow. When I did this today, the first thing I noticed was how obvious the side-to-side hip drop was. THAT’S new. Not only that but I could actually feel her hind end. I don’t know how to really explain it. Like, oh! there’s the engine! Anyway I’m just hoping things continue in a positive direction. I don’t have any idea how long the injections and shockwave should last, or will last, I feel like I am going to have to be really careful to know when it’s time to do it again.
The other thing I’m seeing on the lunge is much improved swing of the stifles. I see it most obviously at the trot - more articulation in the joint, less toe dragging.

@greywithchrome given what you describe, I would guess SI.

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