Do you take Flexion Tests Seriously?

[Maya01]

My horse has been flexed several times and she has never been ‘passed’ by the vet (I only say not passed, because the vet hmmms and hahhhhs about it, making the potential buyer run away) until yesterday when we got our vet to come out and do it just to see. There was nothing at all wrong with her.

The problem with this horse is she has a weak sacroiliac region of her back, which causes her to be stiff but never lame. The only time she is stiff is when it is absurdly, after her heats and when she is out of work. She works out of it after one chiropractor or acupuncture session. I do a lot of long and low to stretch her back out which solves the problem in a ride. She’s had 2 appointments in the last two years.

So my question for you guys is how much does the results of a flexion test effect your opinion on a horse? Would the fact that my horse has had issues in the past with flexions deter you?

I also wonder how many GP horses or top hunters would pass a flexion test. I think there is a reason it’s not legal to do them in FEI vet boxes.

[SidesaddleRider]

I use flexion tests to give me a head’s up that there might be an issue somewhere – could be soreness, could be a hock needs injected, horse needs osteophathy, etc. I personally have known lots of horses that flex “m’eh” but radiograph fine.

The thing about flexions is that everybody flexs slightly differently, and a horse can flex badly under one vet because of the pressure they use, height, etc. and be perfectly fine with another vet. Flexion tests should NOT be the be-all and end-all of an exam.

Would a bad flexion cause me to pass? No, but it would cause me to want to radiograph the leg/joint where there was a bad flexion to see if there was an underlying issue.

Certainly if I was looking to purchase a horse, I would prefer to know if a horse had issues in the past, such as a weak SI or bad flexions.

Edited to add: I have also known horses that flex wonderfully, and have HORRIBLE radiographs. Which goes back to the flexions not being the be-all and end-all of an exam.

[judybigredpony]

[QUOTE=SidesaddleRider;7230328]
I use flexion tests to give me a head’s up that there might be an issue somewhere – could be soreness, could be a hock needs injected, horse needs osteophathy, etc. I personally have known lots of horses that flex “m’eh” but radiograph fine.

The thing about flexions is that everybody flexs slightly differently, and a horse can flex badly under one vet because of the pressure they use, height, etc. and be perfectly fine with another vet. Flexion tests should NOT be the be-all and end-all of an exam.

Would a bad flexion cause me to pass? No, but it would cause me to want to radiograph the leg/joint where there was a bad flexion to see if there was an underlying issue.

Certainly if I was looking to purchase a horse, I would prefer to know if a horse had issues in the past, such as a weak SI or bad flexions.[/QUOTE]

You are a Very Wise buyer kudos to you…

[morganpony86]

Agree with SidesaddleRider. I tell everyone that if a vet were to flex my joints for 60 seconds and then ask me to trot off, I know I’d be lame! But I’m still “serviceably sound”.

Now positive flexions and something on rads/ultrasound? Or reason to suspect it may be a problem (e.g. conformation may predispose to a problem later on)? Or positive flexions on a young horse? I’d walk.

[GoneAway]

Agreed with SSR. There are too many variables with flexions for them to be the end all, be all in the PPE decision making process. But like SSR, a positive flexion is a good indication of a need to get rads of that area. I vetted a 4 yr old prospect who “wasn’t quite right” on his right front during the flexions. Got film, and he had the start of ringbone, which sealed the deal. I walked because I wasn’t willing to take that risk on such a young horse, per the radiographs. Flexions were not the sole decision making tool there.

[Sometimes]

[QUOTE=Maya01;7230307]
My horse has been flexed several times and she has never been ‘passed’ by the vet (I only say not passed, because the vet hmmms and hahhhhs about it, making the potential buyer run away) until yesterday when we got our vet to come out and do it just to see. There was nothing at all wrong with her.

The problem with this horse is she has a weak sacroiliac region of her back, which causes her to be stiff but never lame. The only time she is stiff is when it is absurdly, after her heats and when she is out of work. She works out of it after one chiropractor or acupuncture session. I do a lot of long and low to stretch her back out which solves the problem in a ride. She’s had 2 appointments in the last two years.

So my question for you guys is how much does the results of a flexion test effect your opinion on a horse? Would the fact that my horse has had issues in the past with flexions deter you?

I also wonder how many GP horses or top hunters would pass a flexion test. I think there is a reason it’s not legal to do them in FEI vet boxes.[/QUOTE]

I agree with the comments above, it is something used in conjunction with overall clinical and undersaddle/in hand evaluations to determine what a positive flexion might be telling you. A radiograph or ultrasound or other diagnostic tool can then further enlighten you as to whether the positive flexion is something to be concerned about, monitor, etc.

As far as why they are illegal in FEI vet boxes, I think the fact that every vet flexes differently and every horse reacts differently making them a tool, but not a definitive determiner of what is going on. I will tell you I have watched some vet do flexions and have pulled a horse from a pre-purchase based on how severely they were trying to flex it.

With the horses I have bought in Europe, any one that didn’t flex completely normally, the pre-purchase was immediately stopped by them (not me). They took it pretty seriously in my experience which I found interesting. They were all under 6 years old though so I think that has something to do with it.

I think it’s important to keep in mind that a positive flexion is always telling you something, the hard part is determining whether that something is maintainable or a more acute issue.

[CBoylen]

As seriously as I take the vet doing them. And most top horses at least fall within the realm of “passing”, because it is almost impossible to sell with really bad flexions. Scares the buyers to death.

[SimonandGus]

When vetting horses, usually one of the first things we see is the flexions. Personally, I take them as a serious indicator of current or soon to be future issues, such as arthritis or deep soft tissue problems. On a younger horse, we have walked away without doing radiographs if they flex poorly, because we don’t want to deal with long lasting issues if they are young. On older horses, we automatically expect some degree of lameness, up to them being gimpy when they are flexed due to arthritis and age related issues. We usually expect to radiograph older horses to see the degree of arthritis because we expect them to be have a bit more wear and tear. As above posters as said, these horses are often serviceably sound but don’t look good at all after a tough flexing.

It is important to remember many issues that appear in poor flexions are easily manageable things such as arthritis, but also in a young horse you wouldn’t expect to have developed issues yet, it can be an indicator of serious long lasting issue in the future.

[equisusan]

[QUOTE=SidesaddleRider;7230328]
I use flexion tests to give me a head’s up that there might be an issue somewhere – could be soreness, could be a hock needs injected, horse needs osteophathy, etc. I personally have known lots of horses that flex “m’eh” but radiograph fine.

I have also known horses that flex wonderfully, and have HORRIBLE radiographs. Which goes back to the flexions not being the be-all and end-all of an exam. ;)[/QUOTE]

I agree the purpose of flexions are to indicate an area for further investigation.
But I also know plenty of horses with lousy xrays that never are unsound.

[horsetales]

I think it also depends on are you doing it on a 5 yr old or a 15 yr old who has worked for years. Because not all vets techniques are equal, I think it could be a flag to investigate further.

[Tha_Ridge]

About as seriously as I’d take them in myself.

But, seriously (ha!), I think they can show you an area to look at further. I do not think they should ever be the end-all.

[equisusan]

[QUOTE=Tha Ridge;7231369]
About as seriously as I’d take them in myself. ;)[/QUOTE]

Oh geez that made me laugh. Please don’t flex me. Bad enough when they take X-rays and start telling me about my degenerative changes. Yea yea…

[hollynanne]

I have a friend with a nice, young gelding (6, I believe). He flexed fine, but after regular training sessions after she bought him, he started moving weird. Not really lame, but most definitely not right. She took him in and had him x-rayed. Ringbone, and not just the beginning stages. Hopefully, with good management, he’ll stay sound to 12, but probably not. Flexed sound…

[Ghazzu]

Flexion tests are a blunt instrument, not a precision one.
And they need to be interpreted within the proper context–as has been mentioned above, a 4 year old vs. a 15 yo, etc.

As for the OP–I’m bemused that a sacroiliac weakness would result in a positive stifle/hock flexion…

[Rel6]

Lots of good answers, but I will also say it depends on the horse. I would react much differently to a failed flexion in a 5 year old jr jumper prospect than in a 14 year old 3ft horse.

My jumper failed her flexions miserably. Being that it was a vetting on a 13 year old packmaster who was due to get her hocks injected and that it was for a 6 month lease, it was not a deterrent for me.

[dani0303]

My 20yo is 100% sound. However, he’s been a jumper (and occasionally a hunter) for his whole life. He would never pass a flexion test but had cleans rads.

I agree with those who say that it’s a tool to use. You have to use your discretion and look at the big picture. If a 2-3yo with little to no under saddle time has a positive flexion, that might be a red flag. However if an older schoolmaster flexes positive I wouldn’t be as concerned.

[Lostboy]

I also wonder how many GP horses or top hunters would pass a flexion test. I think there is a reason it’s not legal to do them in FEI vet boxes

Is your horse a GP horse?

I don’t use flexions to make or break a deal. There are so many ways vets flex and I know some horses are more sensitive AND have good xrays. It’s more a guide for where to start looking for possible problems. If a horse shows a slight soreness in both sides equally, I am inclined to think that horse is more sensitive than another. But I look closer anyway. Age and intended use are also factors… a horse with a ton of mileage that is a bit stiff to flex may have decent xrays so I have to consider what he has been doing. It’s a tool. I would want to know about previous vet checks before I start.
My clients are usually more interested in the “what is the maintenance going to be” side of the vet check than in finding a perfect vet check.

[Renn_aissance]

Flexions tell me I want to take an x-ray of that area if I hadn’t been planning to do it already. I take the individual results of a flexion test much more seriously on a young horse than a 11-year-old who’s had a bit of a career= in fact I pretty much expect a horse in his teens to flex positive somewhere- but even if a 5-year-old I was trying flexed positive, if the radiographs were good, that wouldn’t make me pass on the horse.

@Ghazzu

As for the OP–I’m bemused that a sacroiliac weakness would result in a positive stifle/hock flexion…

I’m asking this for my own edification. Isn’t it possible that a SI weakness could lead the horse to compensate by overloading lower joints, thus causing more wear on the lower joints and leading to the positive flexion? So the actual problem is up high, but the horse appears symptomatic down low?

[Ghazzu]

[QUOTE=Renn/aissance;7231976]
Flexions tell me I want to take an x-ray of that area if I hadn’t been planning to do it already. I take the individual results of a flexion test much more seriously on a young horse than a 11-year-old who’s had a bit of a career= in fact I pretty much expect a horse in his teens to flex positive somewhere- but even if a 5-year-old I was trying flexed positive, if the radiographs were good, that wouldn’t make me pass on the horse.

I’m asking this for my own edification. Isn’t it possible that a SI weakness could lead the horse to compensate by overloading lower joints, thus causing more wear on the lower joints and leading to the positive flexion? So the actual problem is up high, but the horse appears symptomatic down low?[/QUOTE]

Wouldn’t degeneration of the lower joints constitute a a lower limb lameness, by definition, though? It could certainly be secondary to something else.

The OP seems to be maintaining that the horse is sound, and has no lower limb problem.

[Maya01]

The horse is 7 years old, when I purchased her as a young horse, she was flexed sound. The issue is predominantly after her heats, in the cold and when not being ridden on a consistent basis. That being said, I haven’t been riding much (away at school) and she passed the flexion we did on her the other day just to see.

No she is not a GP horse (what an assinine comment by the way). Please spare me from your apparent need to behave like a passive aggressive troll. Moving on…

She does not have any lower limb issues because I have never allowed her to be stiff enough in her back long enough to warrant any compensation issues. I had a horse in the passed with a roached back who developed stifle and hock problems from being chronically sore in her back before I acquired her. She now has severe arthritis in her back and joints.

Thinking about the flexion logically, is it not possible for a vet to make a horse lame by either holding it too long, holding the leg too high, or the horse generally being sensitive? This seems like a very arbitrary art to base your decisions off of.

Not only that but when the apparent issue is something as easily maintained as a stiff back, why does that heavily deter people when in the grand scheme of things it is one of the easier ailments to treat?