Unlimited access >

Figuring out a NQR horse is like peeling an onion. Buckle up! (another good update post #32 MFM diagnosis)

Did you inject the SI or just the neck? Sorry if I missed it. Despite the shifting front limb lameness, I would go there next. I have plenty of SI sagas discussed on this board. Had one mystery case horse who had a lot more wrong than his SI, but the SI was a definite thing despite normal ultrasounds and bone scans (ultimately this was confirmed on necropsy).

One of my current horses will have front limb stuff (though in my view, it doesn’t block…vets occasionally disagree, and to me I think there is some unintentional bias that can happen during those tests), and he even got to the point I thought he was neuro because he would trip badly in front and even went to his knees on some occasions. But it was primarily the SI (his was confirmed via ultrasound luckily being in a spot that could be seen) keeping him from carrying weight behind properly and somewhat complicated by other issues (like a couple of fused lumbar) and asymmetries that would have kept us spiraling in diagnostics had the one ultrasound not been helpful.

Yes, neck injected after the bone scan visit. At that point, the LF was still an issue, and while it did seem to make things more comfortable in a way, it did not resolve anything… Her SI was injected 3 or so years ago and was very helpful at that time.

Really interesting about your horse. I keep thinking about all the biomechanics/anatomy and how it’s all related and how hard it can be to pull apart what makes what hurt where.

Thanks for sharing.

1 Like

I’ve seen this point to SI pain on two separate horses. You may need to re-inject the SI. After what you went through with the surgery and the rehab, she may need some support there due to compensation. I’ve seen a couple of horses come off a rehab and they’re lame/stiff somewhere else once you really start putting them back to work.

Also depending on the hoof block, the whole hoof may or may not have been fully blocked. My vet started with just a heel block and that ended up improving the lameness but not more than 75% or so. He was still obviously lame after the block. He ended up having an abscess after we injected his coffin joints, so that wasn’t hidden with a block. So might be worth asking where all the blocks were done. Have you shown the x-rays to your farrier? Might be worth another eye if you haven’t already.

She’s beautiful. She does seem to have a LOT of hoof/toe (at least that’s how it appears in this pic). You mentioned trying different shoes, so I assume she’s close to being due. But even so, that’s a lot of toe on the left fore and hind (or…again…it appears that way).

I know you’ve turned over every rock trying to fix her, but I tend to always think feet when it’s tough to pin down. Problems usually start there and travel up to cause issues above.

I wish you luck in figuring her out. I’ve been there.


definitely keeping injecting the SI on the table as well at hock and stifles at some point. Right now, I’m just trying to get a handle on the PSSM diagnosis and what to do about that. Good thought about the heel block and absesses, she did not improve at all with the heel block, so we went higher…she was completely sound with the high 4 block. There’s still a niggling part of me that thinks feet are involved somehow.

1 Like

Thank you! This is a picture from a couple of months ago, and it could be very likely she was at the end of the cycle. She grows toe like crazy, and right now, with the farrier due next week, she looks similar to this. We have done x-rays in the past but won’t this time. As I mentioned above I’ve always had a back of mind feeling about the feet. I’m really looking forward to seeing what the different shoe setup might do for her.

1 Like

Did I miss it? What did you do to RF after it high blocked sound? Have you injected joints or?

So, first, lucky mare to have you as a mom–I love how you’re really doing everything you can for her.

two out of the box thoughts:
1: I have a lovely worth-her-weight-in-vetbills mare. At one point she came up lame RF. No real improvement after rest and conservative treatment. Would block sound, but no sig finding on rads or US (MRI and bonescan were not in my budget). We injected but no real improvement. What worked was a steroid mixed w/ DMSO painted on and around the area 2x/day. Within a week 85% better, 2 weeks completely sound and it stuck. Maybe two years later came up a bit sore on same leg/same presentation. We immediately took her out of work, painted the area twice a day with same concoction, and we haven’t had a recurrence since (several years ago)
2: don’t laugh. ask an animal communicator. I have a homebred mare that is VERY quirky and who I suspect has some NQR-ness that contributes to some training and work ethic challenges. I consulted an animal communicator about her. Truth in advertising, I did not get a magic cure or diagnosis on that mare. However, with time left over, I did ask about a couple of other horses, and the communicator identified tack problems and a farrier issue that I had no idea were problems. I kind of laughed it off, but for the heck of it, I swapped out a girth on one horse, and put a frog support pad on another. Instant improvement on both! Maybe a coincidence, maybe not. But in this case, both horses are happier and performing better as a direct result of that phone conversation. It wasn’t expensive and you won’t lose anything by trying it. I’m generally not into that sort of thing, but I’d kind of run out of ideas on my quirky one, and someone else had suggested the communicator because it had worked for them in solving a tricky soundness problem.


Hi there - going to update a bit in another post but wanted to reply to you here.

No injections after the RF block. I’m trying to take one thing at a time, especially now after the PSSM2 diagnosis. We did inject coffin joints and fetlocks after the lameness vet who said to get another horse but there was no improvement. It’s super interesting about the DMSO/steroid treatment, Thanks for sharing. Always good to have another tool in the pocket.

I’ve definitely mulled over the animal communicator…my hesitation has been just looking someone ‘up in the phonebook’ but if you have someone you’d recommend over private message, I would be thankful. But no worries if not!

A bit of an update…last week we had a PEMF treatment and our chiro/dvm was out. I rode her Thursday, and she felt pretty stiff, so we mostly just walked. Yesterday and today, due to not having a lot of time, I lunged her. Lo and behold, after her initial stiffness/weird front bunny hopping, she was sound. Because I couldn’t actually believe my eyes, I had a couple of barnmates confirm. She honestly looked better than she has in a very long time.

I’m trying very hard not to get my hopes up, but maybe just maybe we are on the right track?


Weird front bunny hopping is often gut related in my experience. When I started a lot of 3yos I learned from more experienced staff that in babies it often meant they needed to poop or pee and were holding it and getting really uncomfortable behind. I would never have guessed that on my own.


Hello! Hi! Just wanted to update. Her muscle biopsy results came back last week as MFM. I had proactively started treating her as a PSSM2/MFM horse before I saw the full report, and I am glad I did because she continues to improve every day. I am taking things very slow and following the recommendations from Dr. Valberg but I am absolutely thrilled that I seem to be getting my horse back. I also changed her shoeing to a more ‘therapeutic’ set up, and I feel this has contributed as well to helping her be more comfortable.

As I put all the pieces together from the last year and even before that, so much of the MFM diagnosis makes sense, and having watched quite a few videos of other horses with the same symptoms, I feel terrible that I did not look into this earlier.

So currently, she is on:

Buckeye Gro n Win
Uckele Tri-Amino Amino
PlusVital EnerGene-Q10 (I found a great deal on this)
Equithrive complete joint
Emecelle liquid vitamin e

I have ordered the MFM pellets from KER to replace the tri amino when it runs out, super pricey, but I am interested to see if this will be better for her.

I just wanted to update in case someone else is on the same road. These muscle disorders are complex and while not always the reason for an undiagnosed lameness, it can be something to look into when you’ve covered all the other diagnostic bases


Hey I have a couple questions as dealing with a similar problem - horse NQR, in a number of ways. Leaning towards cervical issues but haven’t ruled out a couple others including MFM.
First, just curious where you are (general geography)
Muscle biopsy - was it done w/ a needle or the little incision process?
How long did it take for test results?

For much cheaper you can buy separately human NAC and BCAAs from Bulk Supplements and Tri Aminos/Nutramino/Three Amigos, also human CoQ10 powder or capsules vs NanoQ10. My total comes to about $2 per day vs $7 for MFM pellets and my horse eats it just fine.

1 Like

Hi -

Muscle biopsy was done by a small incision on her rear, super quick and easy, and she healed quickly with no issue. Results took about 4 weeks probably a bit longer than usual because the consulting vet (Dr. Valberg) wanted to do the hair sample for PSSM 1 just to rule that out before sending recommendations.

I was convinced my horse had cervical or hind suspensory issues as nothing was really adding up. The bone scan in March had shown some lit-up areas in c6/c7 but x-rays revealed nothing dramatic. When the vet was up to us in August to once again try and track down the source of whatever the heck was going on, he ultrasounded her neck (along with all 4 limbs, SI, and back) with no significant findings. That was when we decided to do the biopsy.

I am in Maine. Please feel free to ask any further questions. The last almost 10 months has been a real rodeo trying to get to the bottom of this. Both frustrating and heartbreaking!

1 Like

Thank you!!

1 Like

My 12 yr old Dutch mare was diagnosed with pssm2, MFM and VEM one year ago. I already treat and manage her for IR so she already ate a low sugar /starch diet and low sugar hay , no pasture because she got acute laminitis in June 2020 from steroids…her meals are soaked Timothy balance cubes /Vermont Blend Pro/Flax/Vitamin e / 1 cup Hygain Zero …supplements are Insulin Wise , and for the pssm2/MFM she gets KER MFM pellets, NanoQ10, and EO3 oil …Smartbreathe Ultra , and added Spirulina & Jiagulon for her asthma

1 Like

Thanks for sharing @ladipus. It’s great to see how others are managing their horses with IR and PSSM2/MFM, my mare is both as well. Would you mind sharing what symptoms your horse had that led you down the PSSM2/ MFM route to diagnosis? I am so curious about these muscle myopathies and how they present, especially given I think my gal had been struggling for quite some time and it was often chalked up to ‘just her’ and training issues.

1 Like

@Junebuggie you’re welcome…my mare was always super quiet from when we imported her as a 4yr old …but throughout her training it was always deemed that she was lazy -which as we found out all these years later wasn’t the case …for me it was exercise intolerance…she would get fatigued easily and also would seem out of breath /winded …she also really likes and prefers to be ridden long and low /loose rein…anyhow I brought her to New Bolten center where they did a full work up and a muscle biopsy sent to Dr Valberg …it came back positive for pssm2, MFM and VEM…she also was diagnosed with asthma via a BAL wash, scoping , bloodwork and exam

Nothing too glaringly obvious though …she didn’t ever have any muscle wasting or that type of stuff …maybe sensitive to grooming in some spots …but she’s also a mare so I can’t say it’s from that …it was just a combination of some subtle things where I knew she didnt feel 100%

Taking her to a lameness vet /medicine specialist is where they did the work up …regular vets didn’t even scratch the surface or really entertain any of it …

1 Like

@ladipus This sounds quite similar to my mare. I think in her heart she is a mellow horse, but through the course of our almost 5 years together, she has been deemed ‘lazy’ and often times difficult at the beginnings of our rides. It’s interesting that once she gets going, there is always a moment where you can feel the release, and then it is amazing, BUT if pushed even a bit more, then she will go in the other direction and seem fatigued.

As with your horse, there was no muscle wasting, but I can pinpoint the time last fall when she became very sensitive to grooming and started being even more difficult under saddle. As with you, something just didn’t feel right. Unfortunately, I think the synovial herniation in her fetlock derailed and led us down a different path that exacerbated her PSSM2/MFM.

1 Like