Hocks. Riding a lame horse? And some venting...

[CHT]

I have you tried giving him bute for a few days to see if he is better (indicating inflammation as the source of pain)?

I would probably go with blocking though. See if the vet can isolate the issue…or if it turns out he is lame on more than one leg. Bilateral lameness can make a horse feel off ,but be harder to pinpoint for the vet.

[meaty_ogre]

Trying to answer some questions…
The left hock has been x-rayed and ultrasounded. Findings on x-ray were arthritic changes consistent with age (and similar to right hock). US of curb and ligaments/tendons all looked good despite the obvious curb.
I have not done a bute trial but did do a course of previcox with no change. He is on MSM/glucosamine/HA. I did also try BL solution (formerly buteless) in the past.

Hocks were injected twice before vet couldn’t get the needle in any more. Assuming they’re fused. The twisting motion has subsided.

The curb was also injected twice. First time it was drained (lots of effusion) them injected with cortisone. 2nd time I think was HA and cortisone. Some improvement but not complete.

I tried to grab some quick videos. Sorry for lack of quality but he doesn’t longe well without the whip and I am way too uncoordinated to hold line, camera and whip. I also get dizzy when trying to track him in a circle watching on my phone screen, so it’s short. Definitely felt off when I rode him. I also took some free longe video yesterday. I had put him up in his stall due to a winter storm, so he had been wearing his BOT hock boots just FYI.

https://m.youtube.com/watch?v=lZiKn_LnTVc

https://m.youtube.com/watch?v=z4iP8uugqU0

Thank you very much for all the thoughts and suggestions.

[Sansena]

Holycow that horse moves entirely differently without a rider on his back! What a cutie patootie

[Libby2563]

If you have the money and inclination to pursue this now, can you ship him up to New Bolton for a full work-up?

I also would not spend the money on shockwave without a diagnosis. I don’t know about New Bolton but a lameness exam at Leesburg is only $200 for the exam plus $73 per block. $350+ per session for shockwave when you don’t even know what you’re targeting or if it will help seems silly.

[halt]

@meaty ogre

I’ve been struggling with lameness with my paint gelding off and on for several years.

He’s only 12, but was shown western pleasure starting at age 2 before I bought him, so he’s definitely got some wear and tear on his joints. Shortly after I bought him he started showing hind end lameness which turned out to be a combination of negative plantar angles and fusing hocks (both confirmed with x-rays). Corrective trimming and hock injections seemed to resolve the issues at least temporarily.

Then one day he was really lame, and I discovered a sizeable curb on his left hock. Had my vet out, who drained fluid and then injected the tendon (HA and cortisone I believe). It seemed to help a little I think, but since then he has be intermittently lame. The hocks can no longer be injected (vet can’t get the needle in the joint anymore, assumption is that they have fused). I had my vet out again at the latest episode, and she did a chiro adjustment and recommended massage, which I also had done. Vet’s thinking is that it may be muscle memory/referred pain from compensating for the hock pain for so long. Tried that and did not notice any improvement. My regular vet’s final suggestion was to try shockwave. I’ve heard good things about it, but I have to admit I’m very reluctant to spend that much money without a firm diagnosis and a reasonable expectation of results. My vet basically threw out shockwave as something we could try since joint injections are no longer an option. My vet did not feel that it was related to the curb.

I decided to get a 2nd opinion. I admit I am no vet but unfortunately I have more than my fair share of experience with lame horses. To me his recent episodes are different from the hock-fusing-related lameness. His hocks no longer have the telltale twisting motion for one, and his hocks are no longer out behind him, no toe dragging, and he has good articulation in the joint. The lameness did not respond to a course of previcox either. Collectively this leads me to believe the current lameness is related to the curb. Sometimes it is more puffy than others, and this seems to coincide with the lameness episodes.

2nd opinion vet did an exam and ultrasounded the curb. The ultrasound actually looked good considering how bad the curb itself looks to the naked eye. 2nd opinion vet also feels it isn’t the curb causing lameness. 2nd opinion vet wants to do further diagnostics (don’t they always…I sometimes miss the days back when we didn’t have so many diagnostic options and vets would just attempt treatments to see if something worked…but I digress). 2nd opinion vet wants me to ride the horse and get him “more lame” so that we can do a block or series of blocks to isolate the source. He didn’t feel that my horse was currently “lame enough” for the block to be helpful.

I’m mostly just frustrated. I’ve spent a small fortune, well over the purchase price of this horse, and I have no idea what is going on. I don’t really have a lot of faith in either of the vets I’ve used right now. I also have reservations about riding a lame horse. I feel that my horse is significantly lame. I’m not particularly good at spotting or feeling lameness so it has to be pretty obvious for me to see/feel it. I’m a little surprised the vet didn’t feel he was lame enough to block. I don’t think it’s particularly fair to ride a horse until they are “good and lame” so we can do the blocks as the 2nd opinion vet suggests. My horse is a generous soul and I feel that would be a good recipe for causing him to become sour. However my regular vet also told me that I need to continue riding him to help the fusion process along.

At this point I feel like my options are:

1. Give him the winter off while I save up money and try the shockwave, even though we don’t have a solid diagnosis (shockwave is $350 per session, which does not include the sedation and farm call; I was told at least 3 sessions, probably 5).
2. Get a 3rd opinion. I have no idea from whom. Both the vets I used are highly recommended.
3. Do what the 2nd opinion vet suggested and ride him until he’s “lame enough” to do the blocking to see if we can determine if lameness is from the hock joint vs. the curb/tendon.
4. Whine to my husband until he no longer wants to hear about it and go post a thread on COTH.

Sincere thanks to anyone who has read this far, and thanks in advance for any suggestions, commiseration or success stories you might want to share.

The riding a lame horse thing is a diagnostic tool. It sounds cruel but some vets want to have the horses “hot” so it is easier to block/diagnose the issue.

I usually have only seen it in conjunction with nuclear/bone scans or MRIs though.

The video you posted on the second page, that movement doesn’t seem too hocky to me. No twisting of hock, trailing hock, or snappiness. but he does look uncomfortable behind. Your vet did not feel it was stifles? In the video of him loose (he’s really cute, BTW) I thought at the end he looked like his stifles were sore.

[meaty_ogre]

Thanks guys. I’ve had mixed results with New Bolton. I would go there if I knew a specific vet to request. In my experience they have been significantly more expensive but not necessarily significantly better than other options, but that’s just my own experience. I know several people they have performed miracles for.

I think maybe part of the issue is that vets look at him and see a clunky stock horse and expect a certain type of movement. I know how he can and has moved both undersaddle and free and I know he’s not right.

For those who suggested he might not be cut out for dressage, I do think there’s some merit to that. I think he’s capable, but maybe not willing. Although it has definitely changed his build, musculature and way of moving. He’s a completely different horse than his sales videos. I had planned to go back to hunt seat with him and introduce some jumping but I’d like him to be sound and more comfortable first.

I definitely do have limitations with budget. MRI or a carte blanche vet workup are not realistic options. And I agree shockwave without a definitive diagnosis doesn’t make sense.

[Sansena]

He may become more forward with this change in careers. With him being more forward (i.e.: “happier”) you may find it less torturous to work him as the vet requested; until he breaks, as it were.

Certainly, working over ground poles in more of a correct hunter frame might alleviate much of what you’re feeling.

What’s he like out on the trails/ out of the ring?

[halt]

@meaty ogre

Thanks guys. I’ve had mixed results with New Bolton. I would go there if I knew a specific vet to request. In my experience they have been significantly more expensive but not necessarily significantly better than other options, but that’s just my own experience. I know several people they have performed miracles for.

I think maybe part of the issue is that vets look at him and see a clunky stock horse and expect a certain type of movement. I know how he can and has moved both undersaddle and free and I know he’s not right.

For those who suggested he might not be cut out for dressage, I do think there’s some merit to that. I think he’s capable, but maybe not willing. Although it has definitely changed his build, musculature and way of moving. He’s a completely different horse than his sales videos. I had planned to go back to hunt seat with him and introduce some jumping but I’d like him to be sound and more comfortable first.

I definitely do have limitations with budget. MRI or a carte blanche vet workup are not realistic options. And I agree shockwave without a definitive diagnosis doesn’t make sense.

Can you show these vets the before and afters to help them see the difference? Sometimes watching the normal video can make a subtle thing much more obvious.

I agree with you that something is NQR… good luck.

[vxf111]

Me too (re mixed bag at NB). I prefer Dr. Keane unless I need some diagnostic beyond his clinic’s capabilities.

I do feel riding helps “bring out the lameness” when it’s subtle. They’re not talking about 20 mile endurance rides. They’re talking about normal ringwork. I figure a week or so of discomfort is worth years of soundness and comfort, if riding helps get the lameness diagnosed.