Dropped Fetlock in Older Horse

Hello All

I have an older horse (30+ years) who has started exhibiting rather severe discomfort in recent weeks (6-8 weeks). He has slightly dropped rear fetlocks, although by no means severe. He has been fine up until about 8 weeks ago when discomfort looked similar to founder and led us to believe was going through a bout of it with the spring grass, etc and was immediately put on stall rest and other precautions. The vet checked him initially and he was 100% negative to hoof testers and founder was ruled out as the stiffness appears to be originating the hind end.

There is absolutely no heat or swelling in any of the limbs.

He is reluctant to move much, turning is now moderately difficult and he walks in a slow, mosey-like fashion. When he is standing for long bits of time; when he goes to move again the reluctance is obvious and his actions are slow and gauged. He is uncomfortable on both rear legs. often resting and shifting weight side to side. His legs do sound crickety now with arthritis when he starts moving after being stationary.

He was put on stall rest for 2 weeks w/ a daily short walk as it was believed he may have gotten rowdy outside and was just sore from his age. He was placed on a 3 day regimen of Banamine with no obvious improvements that were noticeable. After the first 7 days he was placed on 3 days of Bute with no obvious signs of improvement. He was somewhat back to his normal-self after the 2 weeks (bouncing around and some spring in his step but its hard to tell if that was improvement in the legs or just excited to be out of a stall).
The vet returned and did a full work up on him including flexion and balance tests but nothing conclusive other than he is old, arthritis is taking its toll and his slightly dropped pasterns are likely the contributing cause for his aches and pains at this stage. He also hoof tested him rigorously with absolutely no reaction and founder issues were once again ruled out of the equation.

The horse is on an MSM supplement and also a complete vitamin/mineral supplement for his age.
He has a very cushy mat to stand on in his paddock that he spends a lot of time on. I have contemplated building a sandbox in his run-in for added comfort but unsure if this would actually offer anything. It is understood he cannot stay on a banamine/ bute regimen long term and both drugs did not really take the pain away that were noticeable so they are bit of a non-option at this point.

The vet did not have much in the way of thoughts other than keep him on the joint supplement, and let him outside so that het can walk around and keep the range of motion going. He is outside and will walk around his paddock and graze and he is by no means just standing in a corner reluctant to move; but where he goes and how much effort he puts in is extremely calculated.

I have been linimenting the legs 1x a day each day for the past week. He seems revitalized afterwards and walks much better; but again, a temporary relief.

He is barefoot on the rears but wears shoes in the front. are regular-rear shoes an option to help him? Or will they offer him little support? Is there something else we can be doing externally to bring his comfort level back to something more desirable?

his sudden onset of discomfort is rather surprising to me, especially since his degree of drop to his pastern is not what I would consider lifechanging nor has he exhibited any severe range of motion discomfort in the past. There is another horse on the property that was a rescue and his also of similar age with severe DSLD that it has had for it’s entire life; yet it’s comfort level is much more desirable than this gelding whos onset was sudden. That horse is on a regular dose of equioxx. Equioxx could be an option for this gelding too, but unsure if it will do anything and the vet didn’t have a yay or ney on it either?

Overall the horse is in amazing shape for his age, he has held his weight and looks amazing and has always had amazing spirits up until a few weeks ago when he appears down. But his discomfort level has reached seriously concerning to me and I am hoping someone here has something beneficial I could try to help him improve.

Why not a low dose daily bute, after a loading dose and higher dose for long enough? 3 days of bute at what dose? 3 days may not be enough to notice any real improvement.

I find it very odd that a vet would put an old horse on stall rest just in case he was sore from being rowdy - that’s the opposite of what I would have done.

that entirely depends on what’s really going on. If his suspensories are sore, there may be ways to use shoes to help relieve that a bit, and at his age, something you might not do for a 10yo may be totally appropriate for a 30+yo

it may be worth testing for PPID if you haven’t

Generally, bute works better than firocoxib, as bute is a full COX inhibitor, not selective like firo (and also why bute is more likely to cause ulcers)

My 32yo has been on 1/2gm bute for over a year now, after low dose banamine for 6+ months for a battle with uveitis we lost. It makes an appreciable difference in his arthritis comfort. On occasion when he runs a bit and gets extra sore, I bump up to 3/4 or gm for a day or 2, then back down.

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It’s entirely possible that the slight dropping of the fetlocks is changing the angles in all of his arthritic joints and causing pain. At the very least I’d start on Equioxx now and do a full loading dose of adequan. If those don’t do anything I think it’s time to think about quality of life. Bute and banimine not helping is definitely a concern.

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We didn’t want to put him on bute long term for ulcer risk and then have him come off of it and be right back to square one. We were more-so treating him at that point as if he was having a bout of sore feet from spring founder than arthritic/skeletal issues. He was on 5grams 1x a day (1/2 scoop of the bute powder)

He was on stall rest initially as we were throwing caution to the wind that he was having a bout of spring founder. His paddock has a lot of grass and the stall would remove him from that environment. After about 2 weeks, the vet advised to turn him back out as at that point foot issues were off the table and we were looking at solely a ligament/arthritis, leg issue.

He has been tested for PPID and was positive several years ago and he is on treatment for it. He originally suddenly foundered and PPID was discovered and immediate treatment began. He has been fine since that instance several years ago and has remained on treatment and will remain on treatment.

I know that equioxx can have some side effects. I have used it for several years on the rescue-case with no serious issues. I was leaning towards the equioxx for him since I am already purchase it rather than a long-term dose of bute
We do not have a specialty farrier that is capable of making specialty shoes for him; but I am unsure if just a regular set of hind-shoes with change anything for him

Quiet reminder that this horse is 30+.

Quality. Not quantity.

Whatever it takes.

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Constant discomfort all on its own can lead to ulcers. I do understand the concern though, but at his age, you’re facing chronic discomfort, or trying bute for a while and see what happens

Wait - 5gm of bute? Or a 5gm serving of that powder which is a 1/2gm? If the latter, that’s not enough to make a difference most of the time. Ideally, you do 2gm even twice a day for 1-2 days, then 1gm twice a day for 1 maybe 2 days, then 1gm/day, and see how things are after a solid 7-10 days. The loading dose protocol (which is a little different depending on the vet) is there for a reason, to ramp up the amount of effective drug, and then back down the dose to maintain a therapeutic level.

And, 1/2gm twice a day is usually better than 1gm once a day, to maintain steadier levels.

Oh, different picture here. I would re-test him, to see of the Prascend needs to be increased.

the only way to know for sure is it try. Sometimes simply having that support, especially if the heels of the shoe are left longer, can make a difference in their comfort.

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but you would make a euth decision now despite the fact that his quality of life has been fine up until 8 weeks ago and he is in fine health and condition otherwise. I fully understand that decision and support it if we were much farther than 8 weeks into a sudden on set of discomfort (which could be the result of him making idiot decisions one day in turnout, we don’t know if that is concrete)

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No.

I would medicate him with whatever he needs, however much he needs, to get and stay comfortable. Long term organ damage be damned.

If no relief was found there, I would start looking towards humane euthanasia.

You’re not seeing the forest for the trees if you’re hemming and hawwing over whether or not to put a 30 year old horse on Equioxx. Do it. Yesterday.

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I’d also like to add that we recently put him on remission now that he is eating soaked grain/hay pellet mix and can no longer sort out the granules like he was doing. He was originally on remission due to his cushings/founder but was taken off as he wasnt eating it. I put him back on it mixed in his soaked feed but the vet said he doesn’t need since he was on the complete vitamin/mineral supplement as of 6 weeks ago. I forgot to add that he was on remission.

I will have him retested to see his Cushings levels. I have not done so this year, but it was done last fall when he had his annual vaccinations.

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I’m with Endlessclimb on this. Put him on whatever dose of whatever he needs to be comfortable now, today, then investigate longer term options if viable.

My experience with old horses, and I’ve nursed along several, is that, like old humans, they tend to toddle along quite happily, dealing with their minor discomforts, (especially in an unchanged environment,) until they don’t.

It can be a pretty minor thing that pushes them over the edge, but there is an edge, and its our responsibility to watch for that and make appropriate decisions.

8 weeks is 2 months, thats a long time to be in pain.

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Adding to this from a paraphrase from the (Canadian) code of conduct manual in regards to husbandry for horses - if there is no reasonable expectation of relief of suffering, the animal should be euthanized.

Am I saying to euth right this instant? Nope, but I am saying the same as endlessclimb - put the pain relief to the horse in a meaningful way. If it works, then tweak it to least organ damaging level to see if a long-term maintenance is possible. If the ‘big boots’ pain relief doesn’t make a huge difference, then sadly, it’s time to consider euthanizing sooner rather than later.

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he was getting 5 grams of powder which is 1/2 gram of bute. I have bute tabs too but was using the powder for ease of use.

is there a liquid joint supplement anyone would recommend that I should try? he was put on MSM within the last 8 weeks and prior to that didn’t have any joint supplements. The MSM he is on is just generic but was not sure if something like Corta-FLX or FluidFlex would be something better to try.

Everyone needs to keep in mind that while he is sore and in pain, the pain meds he was receiving was only for a few days as at the time he was being dosed it was with the thought he was having a spring-founder episode. Prior to that and since then he was on no joint support supplements or pain medication.
I am approaching this with the idea that we know what his issue is now and we can provide him the best support and manage the pain of old age and see if he improves. My question to you is what type of joint support supplements should I be seeking and what type of daily pain management should be approached given experience (I think I have narrowed this down)
I think that is the proper path at this point rather than just throwing in the towel. He is content, healthy appetite and munching on grass and wandering around. At this point I think euthanasia is grasping at straws scenario when avenues to make him comfortable have not been sought.

Then seek them!! It’s been two months with you hemming and hawwing and wondering and pondering. No one is saying to euth today. We’re saying to quit screwing around and make this guy comfortable, then optimize from there.

Try the Equioxx. Up the bute. Do SOMEthing for this old guy.

Re: joint supplements. Might be an unpopular opinion, but I (and the vets at Purdue) don’t believe any of them work worth a damn. If you want to go that route, I’d try Adequan or Legend. At least you know it ended up in the system and wasn’t getting pissed out.

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For a 30+ year old, I don’t think joint supplements are going to relieve any pain and prevent further damage. I’m with the others saying increase your drugs for pain management. I remember the days when old school horses used to live on a a gram of bute a day for years and years.

My older horse has been on 1 pill Equioxx daily consistently for 2 years, but that makes one of the vets in the practice I use uncomfortable due to possible effects on the kidneys. He was a high-anxiety horse but now that he’s moved to a quiet retirement farm, I might try bute and hope his stomach isn’t affected any worse than his anxiety used to impact it.

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My old man horse has been on 1 equioxx a day for over 10 years. No problems.

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If you want to try a joint supplement, I have my 28 year old on Phycox (the regular not the max) and 1/2 tab of Equioxx daily. It seems to keep her pretty comfortable. I adopted her about a year and a half ago and she was quite stiff and uncomfortable when I first got her - the shelter vet reported that she had significant arthritis but nothing else notable. Anyway, she is much more willing to canter around in turnout now than she ever was before, so I’m pretty happy with this cocktail. It seems to actually be more effective than one full pill of the Equioxx and no supplement.

FWIW, my vet highly recommends the Phycox.

1/2gm bute for a few days isn’t a valid trial. I hate to say it, but your vet doesn’t really seem up to speed on any of this :frowning:

Supplements are VERY hit and miss in what they can do. If I was going to recommend one, it would be ActiFlex, or Joint-X. Yes, even outside of the “tried and true” Cosequin, due to the higher levels of HA In those products.

You can give one of those a month trial, but honestly, since there’s a serious situation now, I would get on the bute for a couple weeks, with a proper loading dose, and see what happens. THEN start one of those supplements, or go right to IM Adequan.

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I’ve used Conquer HA old my older ones with some luck. My old pony gelding was on equioxx from 28 until he passed at 32, and my older mare was on it about 3 years. Neither had any issues while on it. With your boy’s issues I’d go to the equioxx or bute and get him comfortable. You can always stop it or decrease the dose if he improves to the point he no longer needs it. At his age I would be worried the constant pain could lead to other health issues, compensatory lameness or founder if he’s overloading his front end.

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Last fall, I noticed that my 33 y/o was starting to have a hard time getting up after rolling. I decided it was time and called my vet. He recommended 1 gram of bute daily to see if it would make him more comfortable. If it did not, then we would euthanize. All be darned, he pops right back up now after rolling and is much more comfortable. My vet assured me that this was a safe daily dose. It’s been over 6 months now and I have not noticed any decline in his health or any ulcer-like behavior. I actually regret not starting him on pain management earlier because I feared organ/gastric damage from the bute.

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