Hey all. Need some encouragement in my life, I’ve been really down this year trying to get my mare back to normal. If you like long reads and slow moving train wreck mystery lamenesses continue on. This is just a post to get this all out somewhere into the universe but maybe someone will have some positive input or advice too.
March this year my 10 year old draft cross mare started having some issues - first rushing jumps which was really unlike her, kicking out at right canter, more difficulty bending right (she has always been stiff to the right, with her right shoulder wanting to bulge out), and some soreness over SI. I had upped her work load this year and thought maybe we were asking too much physically so then I would try working her more conservatively but the behaviors kept coming back. She did not appear lame when I would lunge and video her, but she felt kind of off. Finally one day she did not want to go forward at the trot and was craning her neck oddly to the right. At this point I had my trainer take a look and he thought she had a high up right hind issue, but could only see her do anything out of the ordinary when I really had her bending on a small circle to the right (to which she reared as an answer).
I took her in for lameness eval end of April. Vet found: RF lameness, and right SI pain. She was lame ONLY to the right on a small circle on hard ground. Flexed mildly positive on RH spavin. Flexing RF did not result in increase in lameness, but mare highly resented them flexing this leg. Not lame on a straight line or on the lunge line in the arena; guess it wasn’t just me! Nerve block indicated something in the hoof, x-ray showed sclerosis where the collateral ligaments attached to the coffin bone, a thin-ish sole (11mm), and a slight lateral high hoof imbalance (.5 cm). No navicular changes, good PA angle. Ultrasound above hoof clear. Right hock x-ray clear. Right stifle x-ray clear. Her diagnosis was collateral ligament injury so we did PRP and shockwave, then stall rest w/hand walking and a specific rehab protocol. Vet suggested injecting SI if pain did not resolve with the foot rehab. Mare did slip and fall while running in the paddock this winter, late January and early April were ones I witnessed so I figure she must have strained the ligament at some point and it got worse with work.
End of May she was cleared for tack walking, had just a tiny bit of lameness remaining RF (.5/5). No SI pain. Told to continue small paddock rest until sound at canter. End of June she was cleared to add trot, sound on the foot. One week into July I add the trot. She seems relaxed other than being kind of put out that work might be back on the table because she’s a bit lazy by nature. A week later I come home from work to a broken fence next to her paddock and she has a couple minor scrapes and seems extremely agitated. Maybe cast? I hand walk her only for a couple days. Three days later I try and walk and gently trot under saddle and she feels just like she did before we went to the vet the first time. Doesn’t want to go forward, wringing head to right, threatening to buck. I put her on the lunge line and she looks weird but not lame anywhere specifically. She does trip a few times. I play phone tag with the vet for over a week, who tells me she might have just aggravated something if she got cast and I should should continue to work with her and then bring her in if she hasn’t improved in a week or two. We discuss possible ulcers and SI pain but she really can’t say what it might be.
August 10 I finally get an appointment because we have no improvement. Mare is not lame on the foot but has mild SI pain R/L and swaps leads only to right. We decide to rule out ulcers first because of some of her behaviors - she’s very right side problem dominated, kicking out at leg, not wanting to go forward, some eating issues, etc. She is found to have grade 2/4 glandular ulcers so I start a 28 day treatment with omeprazole/sucralfate (a mistake because then I’m immediately broke, GastroGuard pricing should be illegal). Vet says to continue working and add canter. At first I thought the ulcer meds were helping, the trot got a little more relaxed but still doing the head wringing. So I go ahead and add the canter and lo and behold it feels pretty good? Which boggles my mind that the lameness is basically 99% at the trot. Unfortunately after cantering twice the trot feels significantly worse so I just full stop riding. Vet thinks we should go ahead an inject the SI but I decide to get a second opinion because it doesn’t feel like an SI issue.
End of September I get into a second vet who is known for dealing with mystery lamenesses, because at this point, what even is going on. Is she continually injuring herself or is this something ongoing? At this vet mare palpates moderately sore at the base of her neck, both sides. She tries to sit back when he hoof tests her, especially the right, but is negative to the testers. She flexes mildly positive RH proximal - I think the same as the RH spavin from the previous flexion test. Isn’t lame on anything going straight, on a circle, on soft ground, or hard ground. He does make a comment that she is very flexible (she is draft cross and seems to have looser joints) and when I ask if she is too flexible in regards to DSLD, as she does have a straighter hind leg and lower fetlocks, he makes a comment with the gist being we aren’t going to go there yet. He is pretty positive her neck makes the most sense instead of an SI issue or anything else, and this does make sense to me as well considering what she feels like under saddle, so we x-ray it. He doesn’t find anything too exciting, but gives me several options on what to do next. I choose to inject the neck as it seemed the most logical place that the pain was coming from after discussing it with him and phoning a friend who had commented “looks like the neck” in a video I had sent previously. During the US guided injections, he was able to see some mild remodeling on c5/c6 and said there is possible sclerosis on c7/t1 but isn’t 100% sure because it’s such a hard area to see. Tells me we should see improvement in 3-4 weeks, and if not to let them know.
I did some light reading about cervical arthritis that night and wasn’t thrilled with what I found (mainly neurological symptoms and quick decline). So I told myself I would just get through the 4 weeks and if there was no improvement we could get a myelogram to see if she was safe to continue riding. I spent the first two weeks walking, doing exercises to get her to relax her neck muscles and stretch, and ground work to start to improve her sadly depleted topline. It’s now been just over 3 weeks, with 3 rides W/T/C and I would say we have little to no improvement from the neck injections.
I did get referred to an equine physical therapist (licensed and all), and she came out on Sunday. Apparently mare has less than ideal range of motion on her right shoulder, and has a very over developed underneck (the latter I was painfully aware of and had hoped one day would turn into proper neck muscles). She worked with me on the ground and in saddle with specific exercises to get mare to relax and use her neck properly. I would say that this has been the most beneficial part of trying to rehab my mare in the last 6 months.
My ride yesterday was okay. It started off feeling worse than the two previous rides, and I almost cried mid ride, but I was able to get mare to relax and flex correctly a tiny bit on both sides at the trot, not bronc at the canter (which happened when the PT was here) and halt without bracing her neck. I’m really grasping at straws though because I’m barely holding it together and have gone down all kinds of rabbit holes for what might be going on. But at this point there isn’t much I can do because, who am I kidding, I can’t afford a myelogram or additional major disgnostics at this point. When I got on again after the injections and she was pretty much the same, pretty decent canter, terrible and obviously uncomfortable trot, really my heart sank. I feel so down after these last 6 months and despite this not being a “dramatic” injury or occurrence, I have seriously considered retiring from riding. It’s all just so expensive, stressful, and heart breaking.
Looking back I think something has been going on for a while. She has always been difficult for the farrier in the 3 years I have had her - tries to sit back on at least one foot when working on fronts and mildly difficult with hinds. She will be super forward and relaxed one day then fussy and tense about taking contact another. Has had mild muscle tremors on her shoulder region (hair test 2022 - HYPP and 5 panel neg), added Vitamin E, thiamine with no change. Unsure if related to work intolerance, nervousness, nerve injury, or mineral imbalance. Vets just think the tremor is weird but no real concrete suggestions, first vet suggested PSSM2 biopsy if it got worse. Tremors seem to have subsided since she’s been on rehab.
Her personality is easy going, friendly and curious although somewhat withdrawn. Extremely food motivated. I was able to teach her to side pass on the ground in one go. She was range bred, so we still have to work on domesticated horse things, like, don’t kick at the hose on the ground when it moves. She’s generally really pleasant to work with and have around, and I appreciate her so much. I don’t know what to hope for though.
Bloodwork normal January
Vaccines (5 way, WNV + rabies) April
Will update in 5 weeks at next PT appointment or with any significant changes.