Excessive drinking/peeing - now also 3 legged lame aka why do horses break our hearts?

[IPEsq]

As far as kidneys go, vets think the Banamine he got with the injections is a more likely culprit. Sports vet is concerned about joint infection, although this is presenting much like stifle (although still very strange), and the hock was what was injected and would be the thing to get septic arthritis.

Unfortunately he has had had a lot of steroid in his short life and never had a problem before. Both intraarticular, intramuscular (SI region), and oral. Myself, I’ve had one joint injection and it seemed to trigger the worst migraine of my life. Not something I expected but I guess I should have been prepared since hormones are a huge factor in my migraines.

At this point with the stress and change in diet he may we’ll be working on ulcers now too and has had flares in the past from injections—hence giving Nexium until the abnormal bloodwork. He was high as a kite for hand grazing last night which could be ulcers or could be he is finally feeling better and is HANGRY.

[beowulf]

Jeez, you really never do get a break.

Did I miss what the urine sample said or is it not back yet?

Occam’s razor, I would think maybe the lameness is related to the injections. Maybe it’s been the perfect storm, injections, having to stay inside…

One thing, that is a side effect of steroid injections, and this is only an off-the-wall thing, is laminitis. The stress, the change in diet, his past … well… issues (you really never get a break).

Enterolith? It would explain the peeing, discomfort of belly, back pain, ulcers.

These are just off the wall things. I really hope it is just an ulcer flare up, presenting weirdly. Dunking hay, increased drinking, and being sniffy about food are totally signs I have learned to look out for with ulcers. Dunking hay is also something I correlate strongly with kidney issues. In my experience the dunking hay is one of the first signs of Cushings and/or kidney problems in an otherwise asymptomatic horse.

MAJOR jingles for you.

[PNWjumper]

Well all of the eating stuff sounds an awful lot like kidneys. I did Osphos on my TB and it sent him into kidney failure and it was pretty classic symptom-wise - he went off of any feed that was not super bland…he quit eating his grain and his supplements and his alfalfa, but still ate his orchard grass pretty normally. Manure was normal throughout. He was drinking/peeing a lot. He wound up spending 5 days at the vet hospital getting fluids pumped into him. Once the kidneys values were back to normal he went back onto his feed like he normally does (well, “normal” is tough since he’s also a super-gastro-type who goes off his feed whenever anything goes wrong).

Maybe the combo of the injections plus banamine just hit him wrong? Hope you get some answers soon!

[RMJacobs]

I don’t have any words of wisdom for you, but I am glad that you have access to CSU vets. They are amazing. I was pretty surprised and happy when I moved from Colorado to South Carolina, and found out that my vet here was a CSU graduate. When I lived in Colorado, I kind of expected that, but not so much here.

Best of luck sorting this out.

Rebecca

[IPEsq]

He has dunked hay his whole life so that is normal for him. Water intake is back to normal and he took a normal pee today that I saw. But creatine is still 2.0, which we aren’t happy about. We also tested to see if he had any signs of tying up. Nope.

Zero signs of laminitis. He was wild for the exam today and to the right galloping and bucking and tearing. Actually looked back to 100% to the right. To the left, still non weight bearing trying to trot on left hind. Blocked about 75% to femoral patellar joint. Took X-rays. Totally clean and no changes from 2015 X-rays.

Farm vet he has never seen anything like it in 30 years. Waiting to hear more from CSU whether we will ultrasound at the farm or if he should go see an internist at the hospital and then worry about the stifle there. We drew blood for IRAP today cause I figure it wouldn’t hurt the stifle and at least it’s not a drug. I would really like to avoid putting him on the table for a scope or MRI.

The chiro / acupuncture vet was out right after the farm vet left for another horse and she offered to look at him. She said all his pain was on the left side. She had just seen him I think 2 weeks before his injections and he was great—mostly just needed his routine neck acupuncture. His stifle was probably still blocked at the one joint, but she felt he palpated sore towards the medial ligament. His hip and back were very sore on that side at first but cleared after she did some acupuncture and some fascial work—or course didn’t go adjusting anything in the hind end. She also said his stomach points were pretty hot for him.

I don’t know if it would be safe to put him on gastrogard?

[IPEsq]

Oops, above was not correct. I misread the form. BUN, Calcium have dropped to normal but CRE is 1.9 (down but only slightly from 2.0).

[Fharoah]

The vets don’t think the lameness could be a flair up from the joint injections?

Hope your boy gets better!

[IPEsq]

@Fharoah

The vets don’t think the lameness could be a flair up from the joint injections?

Hope your boy gets better!

No, they said he’d be lame on the hock if that were the case, and they think the hock is totally fine.

[IPEsq]

Drinking/peeing seems back to normal now. We’ll have to keep monitoring blood for a little while.

He’s been in the stall with some hand walking per the vets. When I put him back in the stall today, he got a little wild and locked up the stifle trying to whirl around to the left. This time it looked like pretty normal UFP in the stance. It was quite stuck and he stopped after it locked. He then forcibly flexed the whole limb up high and then was fine.

I dunno…maybe going from the fittest he’s been in his life to halting work due to kidneys plus being locked in the stall due to mud triggered this. He has had some signs of stifle issues in the past in transitions but ultimately we concluded he was just locking up his whole hind end to protect his back. His back has been doing really well lately, and while it’s been harder to strengthen the left hind, he is still overall quite strong and hasn’t had any of those moments in a long time. And it never has locked while moving forward.

We nevertheless had worked up the entire left hind a few months ago to try to determine why his fitness was not building equally, and that included blocking the fetlock and stifle. There was 0 change in his way of going at that time, so we just upped the core strength part of his routine and now injected the hocks because he does have some bilateral arthritis and we wanted him to have some support while being asked to collect a little bit more.

I had one horse who minorly strained a stifle slipping while getting up in his stall. Perhaps that was part of this on Wednesday night? He does tend to lay down near where he pees, and with the excessive peeing, I could see things getting slick even with a good amount of bedding.

We are going to do an ultrasound tomorrow and start a series of IRAP on the stifle as an NSAID-free way to try to battle any inflammation. I know for UFP he will need more movement, but no one wants him turned out with the lameness this severe with the locking.

Any other reason for sudden severe upward fixation of the patella unilaterally? I’ve read about it secondary to luxation of the patella, but that would certainly show up on xray.

[beowulf]

How did the ultrasound go?

[IPEsq]

Ultrasound revealed some extra fluid on the medial joint pocket but nothing else of note, really. The medial cruciate ligament was larger than the vet was used to seeing, but there was no fiber disruption, and he didn’t look at the lateral to compare. Patellar ligaments looked fine. I suppose it’s possible there’s a meniscus tear somewhere, but nothing he could see on ultrasound.

We put IRAP in the middle and medial joints. I’m supposed to continue hand walking him, but that’s already taking liberal use of a stud chain. I walked over some poles today, and that didn’t do much to help his focus, although we only had 3 squeal, buck, rear combo events. No locking up with that, but I’m mostly walking him on the off side so that if he spins, he will spin around to the right, not left. I got some drugs to use when the farrier comes this weekend (and I may also pick up a 6 pack for my poor farrier), but with the kidney injury, drugs for daily hand walks aren’t going to happen. Hoping at 8 years old he’d behave better than his 5 year old self the last time we had this stall rest routine, but even though we’ve got more groundwork skills installed, the explosiveness is much the same. :no:

CSU will recheck him on the 14th, and second IRAP is planned for the 15th. We may check blood again end of this week.

[IPEsq]

Drinking and eating habits are back to normal, although I’m still withholding alfalfa which he’s not too happy about.

Some days, hand walking is good. Some days he’s barely keeping it together, like today when we are getting a little late snow. He let out a pretty good squeal / buck / spin in hand today and although I turned him around to the right, I think he’s still not sound. And his lower back and SI area palpates quite sore, especially on the left but the right side SI is also sore. Of course, for a horse with history of back and SI problems, all this standing around in the stall is not going to be good for him. I have done some of his core exercises/stretches, but I’m not walking him in the Equicore system because I don’t know what he should and shouldn’t do for the stifle at this stage. Some quieter days, I put out some ground poles.

Not sure either horse or I will escape with our sanity if he needs another extended period of stall rest. And 2 of the rehab barns in this area have closed down since our previous lengthy rehab.

[seabreeze]

Still following. You are a dedicated horse momma. Hang in there!

[IPEsq]

He was pretty sound for his check today. Quite stiff starting off to the left but weight bearing on all legs trotting to the left, and by the end of the exam, seemed to move pretty normally. We only walked and trotted in the exam. Also walked up and down a hill with no issues other than some airs above the ground.

Plan is to try turning him out for a little bit in the morning tomorrow before his next IRAP. I am going to walk him some and then put him out and pray he isn’t a lunatic. He’ll have the third IRAP towards the end of next week with turnout (hopefully) and some hand walking. Recheck and another ultrasound the following week.

We are also going to test blood tomorrow to see how the kidney levels are doing but he has been drinking/eating/peeing normally since my last update, so I hope all the numbers are good.

[flyingchange]

You say he got “two doses of Banamine” with his joint injections. How much banamine did he get (how many mLs) at one time? Not two doses at once I hope??? NSAID toxicity directly compromises kidney function and causes gastric ulcers.

[IPEsq]

He got one dose the day of hock injections, administered by IV by the vet–not sure how many mLs but probably the same as they usually give him. One dose more than 24 hours later which was a 1000lb dose of paste as prescribed (and horse is probably closer to 1400lbs).

I walked him a little this morning and he was very quiet, so I put him out. He wandered around about 10 minutes then bucked and bucked for 10 minutes and then was done. He got turned out last and none of the horses in the neighboring paddocks engaged with him, although the horse who is his neighbor in the barn did come closer and needed to watch his buddy lose his mind. Looked pretty sound especially when he would do some fancy trot before launching into another bronc fest. Did not see the stifle lock at all. Should have the blood results later today from his recheck.

[IPEsq]

Creatinine down to 1.3 Previous baseline was 1.2. Whew!

[Aamira]

I am so happy you are using IRAP! Used this procedure about 7 years ago in my horses hocks and this saved his life! Back then the treatment was expensive and was given two weeks apart in a series. In Oct. of 2017, the process had evolved into something same day that was originally developed for humans. We did both of his knees and it worked like magic! In March 2019 we did his knees again. It helped but was not the miracle result of 2017. Keep in mind this was a very old horse. Actually, had to put him to sleep yesterday; 2 weeks short of his 34th birthday! The early reports on stem cell are very promising but more for soft tissue than joint problems. In people steroid injections eat cartilage so I assume it does the same in horses.
I am confused by all the special stuff you are giving your horse. Could he not spend time out in the pasture eating grass with friends? My horse was PPID & IR so we really had to limit his grazing but I have found that pasture seems to be a know cure all for most problems. Having continuous food keeps ulcers at bay after the flare is over. I have not been on this forum for a while and don’t know what you use your boy for or your situation so please don’t be offended by this question.

[IPEsq]

@Aamira the long answer would be really long (horse has had a lot of issues), but the short answer to your question is that we don’t really have good pasture where he lives, and what good grass there is grows for only a short period of time.

[BabyDentist2021]

I’ve owned my mare for 9 years (she’s 11 now) and she’s always been a major hay dunker and would even sometimes scoop up a mouthful of water with her grain. She’s always been a big water drinker too - I’d leave her 3 buckets full in the evening and the next morning all 3 would be almost empty. I was pleased she was drinking plenty of water and never really thought anything of it. Anyways, we were dealing with a mystery lameness (turned out to be her SI) but in the process we treated her for ulcers. Since treating her for ulcers she no longer dunks her hay and only goes through about 1-1.5 buckets in her stall at night. She had never been a voracious eater and would often leave a bit (usually along with her supplements) but since her ulcer treatment she’s been licking her bowl clean - supplements and all. Her hay consumption never changed - just the hay dunking and now lack there of. Might be worth looking into ulcers - it never occurred to me that they could have been the behind her hay/water habits.