HELP! Hind Leg Dropping, any thoughts?

[Magichorse19]

[B]Hey All,

I am new to the forum world, but I have an issue I could really use some input on! The following description is what I am passing around, and there are links to slow motion video on you tube to actually view what is happening. If there is anyway to help my boy I want to know about it!

Thanks!
[/B]

MESSAGE SENT TO MSU:

Good Morning Dr. ,

My name is Ariel Martin and I was referred to you by Dr. Brandt. I have a 7-8 year old gelding that is having issues with his hind leg collapsing underneath him. He had both stifles cut about a year and a half ago due to extreme lameness and discomfort. We tried several treatment methods prior to the surgery that were unsuccessful. I took a year to really work him into shape and build the muscles up to support his hind end and he seemed to be doing great, reaching really well and tracking correctly. I put him in heavy work (ridden 5-6 times a week, jumping up to 2 ft, long distance gallops). My goal is to use him for 3 day eventing. During this winter I had him stabled at a place where the indoor arena was pretty deep in spots, and when I felt him slipping in the back I chocked it up to bad /deep footing. it only happened occasionally. Three months ago I moved him back to his normal barn with lots of trails and began to notice the tripping happening more consistently. It is very unpredictable, and can occur at a walk, trot and downward transitions from the canter to the trot or walk. In the last few weeks it has gotten to be very frequent (half dozen times in a 30 minute workout). He has also become anxious under saddle, like he is expecting something. I Put him on the longe line to see what was happening, since from the saddle it just feels like he is falling out from underneath me. Yesterday I took a bunch of slow motion footage to try and locate the problem. I took it to Dr. Brandt this morning and he is concerned that it may be caused by destabilization of the Patella, however he referred me to you to see if you have seen this happen before.

Notes:
-He has shoes on all four, about 6 weeks ago, upright feet, but the angle is good and the toe is not too long. I am going to have the farrier take a look again just to be sure.

-He was adjusted by a chiropractor 2 weeks ago. He was a little crooked in the hips, but overall bill of health.

-He is a Heinz 57 breeding. Not registered, sold as a quarter horse but built more like a morgan, very short coupled and upright.

-He has not had any significant feed or environmental changes.

-Performed a tail pull test for signs of EPM, he braced and resisted perfectly.

-The collapse happens with both hind legs, but always the outside leg of the circle. It also happens when traveling straight, or on the trail. It is difficult to get footage of that, so my assessment is based on the footage on the longe, in which case it is the outside leg, both directions.

The video’s a pretty large, so I uploaded them to YouTube rather than emailing them directly. If you could take a minute to look at them and let me know what direction to go I would greatly appreciate it! Please let me know if I need to send the footage in a different format

https://www.youtube.com/watch?v=4-GLqH0TVR8

https://www.youtube.com/watch?v=ZzN0gu6zwBI

https://www.youtube.com/watch?v=GyiOdumnHCI

https://www.youtube.com/watch?v=TTq6q2RvFxI

Thank you again for your time,

[cheerio280]

So, in the videos it looks like he is not completely extending his foot, so when he goes to bear weight his fetlock “knuckles over”. I guess some sort of mechanical issue with the extensor tendon could be involved, but I’d be more concerned about getting a thorough neuro work-up at this point in time.

[caryledee]

I am seeing the same thing. The slo mo videos are a great idea; you can really see clearly what is happening. I think it happens once in front as well. Best of luck with him; he is a super cute horse!

[LarkspurCO]

Looks to me like classic stifle catching. When you say they cut the stifle, did they completely sever the medial patellar ligament?

[Magichorse19]

“knuckling over” is a great description. Tendon injury makes sense, but I would expect to see lameness and heat/swelling, which he exhibits none of. Thanks for the input, I will research that direction and see what I can find. I am still waiting for responses back from the vet’s so I will make sure to bring this up with them.

[Magichorse19]

Yes they did. The stifle issue generally seems to affect a lock in more of a rearward direction, but it’s possible. Thanks

[Magichorse19]

Thanks for the well wishes. I’ve kinda put everything into him. This development is kinda crushing actually.

[LarkspurCO]

The stifle may not be completely stuck so it is not locked out behind. There are degrees to this. When he knuckles over the stifle does not appear flexed as it is during the normal stride, so he can’t reach far enough under to land on the hoof, so falls on the fetlock.

It is bilateral and worse on the limb to the outside of the circle. It fits with his history.

My expert opinion (worth exactly what you paid) is stifle/patella (Dr. Brandt).

By the way, I am very sorry and I completely understand how you feel. It is not an easy thing to watch your horse declining after all you have been through.

[flyracing]

I’ve seen two horses similar to this who had bilateral enlarged suspensories pressing on adjacent nerves.

The only clear evidence or lameness on these videos is the toe first landing and shorter right hind, on a circle to the left. He’s tracking up nicely to the right and drops evenly and well through the fetlock.

The first thing I notice is what appears to be a very very long toe. He is tripping over his toe. Whether or not that is the root cause, you won’t know until you have a good vet and farrier team address his feet, preferably with the aid of a lateral radiograph of each foot.

[LarkspurCO]

That is very typical with a stifle lameness. The toe first landing is the result of the leg being stuck in extension. This may be mechanical (patella not releasing) or may be that the horse has developed arthritis in the joint and is anticipating pain and reluctant to flex the stifle, so the toe is dragged.

In all of the videos you can see that the outside hind limb is not brought forward enough, so the horse knuckles over.

Here’s a draft with upward fixation shown in the walk. Watch the left hind:

https://www.youtube.com/watch?v=sMZUhpMIgLc

[LarkspurCO]

That is very typical with a stifle lameness. The toe-first landing is the result of the not flexing properly. This may be mechanical (patellar ligament not releasing the patella) or may be because the horse has developed arthritis in the joint (common after complete severing of the ligament) and is anticipating pain and reluctant to flex the stifle, so the toe is dragged.

In all of the videos you can see that the outside hind limb is not brought forward enough, so the horse knuckles over.

Here’s a draft with upward fixation shown in the walk. Watch the left hind:

https://www.youtube.com/watch?v=sMZUhpMIgLc

[LarkspurCO]

That is very typical with a stifle lameness. The toe-first landing is the result of the not flexing properly. This may be mechanical (patellar ligament not releasing the patella) or may be because the horse has developed arthritis in the joint (common after complete severing of the ligament) and is anticipating pain and reluctant to flex the stifle, so the toe is dragged.

In all of the videos you can see that the outside hind limb is not brought forward enough, so the horse knuckles over.

Here’s a draft with upward fixation shown in the walk. Watch the left hind:

https://www.youtube.com/watch?v=sMZUhpMIgLc

[Magichorse19]

That video looks disturbingly familiar.

[LarkspurCO]

I have two horses with stifle issues. My older horse began showing signs upward fixation when he was five or six. It looked very similar on the longe line, and always affected the outside hind. We tried blistering, special shoeing, and then I had the splitting procedure done on both medial patellar ligaments (ligaments were scored with a scalpel, not severed).

After the surgery and strengthening he got better, but he did require occasional stifle injections to keep him comfortable. Years later, he is now sidelined because a different issue and he stifle is locking again, though not as badly as before.

Imagine my horror when my young horse began showing signs of goofy stifle ligaments. In his case it is due to weakness, not conformation. After a university workup, he was given a great prognosis and is improving with work and strengthening. But he is still protective of the outside hind during downward transitions.

I sure hope there is something they can do to help your guy. It really is not safe to ride him like that.

[beowulf]

My personal opinion (and it is worth what you paid for it) is to put shoes on him.

1. From what I saw, it was not so much a slipping stifle but a weak one. If you are doing heavy work (including gallop sets) I would be asking your vet if he thinks shoes would be beneficial.

2. Take a look at your ring. It doesn’t look like a terrible set up but there looks like there are rocks and fairly deep footing in a few places - consistently seems to be the places where he trips – AND there was one video where it honestly to me looked like he stepped on a rock. I’d be considering shoes for that alone. He does look like he has a long toe - putting shoes on might help reset the hoof.

3. Ditch the sidereins if you lunge him again - it looks like he needs his head.

I would suggest putting him on 24/7 T.O if you can - and ditching the ring for now. A year and a half after stifle surgery is NOT that long for a ligament - it takes a long, long time to strengthen them.

I’ve seen lots of horses with weak stifles benefit from hind shoes - I would also pull back from the gallop sets and do more walking hill work on trail rides.

Do you have any videos of him not on a lunge-line?

[Magichorse19]

[QUOTE=beowulf;8156412]
My personal opinion (and it is worth what you paid for it) is to put shoes on him.

1. From what I saw, it was not so much a slipping stifle but a weak one. If you are doing heavy work (including gallop sets) I would be asking your vet if he thinks shoes would be beneficial.

2. Take a look at your ring. It doesn’t look like a terrible set up but there looks like there are rocks and fairly deep footing in a few places - consistently seems to be the places where he trips – AND there was one video where it honestly to me looked like he stepped on a rock. I’d be considering shoes for that alone. He does look like he has a long toe - putting shoes on might help reset the hoof.

3. Ditch the sidereins if you lunge him again - it looks like he needs his head.

I would suggest putting him on 24/7 T.O if you can - and ditching the ring for now. A year and a half after stifle surgery is NOT that long for a ligament - it takes a long, long time to strengthen them.

I’ve seen lots of horses with weak stifles benefit from hind shoes - I would also pull back from the gallop sets and do more walking hill work on trail rides.

Do you have any videos of him not on a lunge-line?[/QUOTE]

1&2 He has shoes on all four.

He is on turnout about 12 hours a day, but longer can never hurt! I currently don’t have any other footage, and I will not be riding him again until he undergoes a full examination.

At this moment I am branching out from MSU and reaching out to all of the ACVS Certified Surgeons in 500 mile radius to see who is familiar with this exact issue. The Surgeon at MSU said it was a very unusual issue and that he had not treated it before. Obviously they will admit him and do the exam, however if I can locate someone who has dealt with the exact issue before I would feel better about it.

Thanks for your input!

[LarkspurCO]

I am surprised a university vet school would not have seen something like this before. Are you working with someone high on the food chain there? Where did you have the surgery done?

In any case, please let us know what you find out.

[beowulf]

[QUOTE=Magichorse19;8156480]
1&2 He has shoes on all four.

He is on turnout about 12 hours a day, but longer can never hurt! I currently don’t have any other footage, and I will not be riding him again until he undergoes a full examination.

At this moment I am branching out from MSU and reaching out to all of the ACVS Certified Surgeons in 500 mile radius to see who is familiar with this exact issue. The Surgeon at MSU said it was a very unusual issue and that he had not treated it before. Obviously they will admit him and do the exam, however if I can locate someone who has dealt with the exact issue before I would feel better about it.

Thanks for your input![/QUOTE]

Good lord, maybe my eyes are failing me but I didn’t see shoes in the video, sorry :eek:

[Magichorse19]

I sent the video’s to a Lameness Specialist and he is very suspicious of Chronic Suspensory Desmitis. I am going to be taking more pictures and video at his request for further review and schedule to take him in for an ultrasound. We shall see what happens.

[Lieslot]

Your last post answers my thoughts entirely when I saw the videos.

My horse had the slipping stifle problem too, catching, losing his balance in the hindend as a result. If you are interested I also have videos of him doing the same thing your horse did, I just don’t have it in slow motion.
He had it on both stifles, but left moreso than right. We tried to treat it, but no surgery. Then we figured he had SI problems, treated SI & lumbar & greater trochanter.
Did lots of strengthening work, it never really got better.
After a myriad of injections and treatments and every diagnostic available including a full bone scan that all came back negative, I just gave up an retired him. 2 yrs into retirement we couldn’t miss it anymore the fetlocks dropped and he was finally diagnosed with DSLD.

Your horse may not have the degenerative part, but he could well have the onset of desmopathy.
Now I realize that the stifle, the SI, the lumbar pain my horse exhibited, those were all secondary to the primary problem being the suspensories that hurt upon each stretch and in an effort to protect himself he wasn’t using his stifles correctly.

I suspect suspensories over a real stifle problem when I don’t see a distinct shortened stride. My horse had a long stride and to this day still does with his very dropped fetlocks, but the pain is there. If you have a more distinct shortness of stride, than I’d be more inclined to think stifles first and the rest secondary.

FYI, it took a couple of years for the degeneration of the suspensories to be diagnostically visible, but the pain & lameness were already there. Bonescan & ultrasound in my guy’s suspensories were totally clear only, 2 yrs later when he fully dropped was the degeneration suddenly noticeable on the ultrasound.

Good luck!