I'm gathering "evidence" for a vet school trip - is this weird or not?

[fivestrideline]

Long story short, Mr NQR needs more than a piecemeal approach from local vets who rarely get past the “look at him in the cross ties and ask if we’ve scoped him recently” part of investigation. A valid concern, but there’s more to him than ulcers (biggest evidence: a dramatic improvement on gabapentin and a dramatic regression off of it). Off to the vet school we go soon, but I know this horse and he’s the master of having a mental breakdown if he has to haul and it covers up his “weirdness”. Hence the collection of pics and videos in my phone.

Anyways, this horse grazes like this about 90% of the time and I’m wondering if this is a red flag or just him:

This is the horse with the stubby toes and tripping issues, as well as KS and now some funkiness behind that I’m unsure is “just” lack of fitness.

Normal? Yellow flag? Glaring red flag?

[fivestrideline]

Re: the ulcers - he’s been treated recently with no change, and this horse has been pretty loud about it when he’s had them before. He’s fat, shiny, lets me groom his belly (BIG nope when he’s had ulcers before) etc etc. I’m in the camp “he could have ulcers but I think they’re a result of something else, I’ll scope if we investigate other things first and come up empty”. If that makes sense.

[Inimitable]

Has he ever been tested for EPM?

[fivestrideline]

Yes this year. Negative - also negative for Lyme

[Inimitable]

Oh good! Beyond that, hard to say if that grazing stance is a red flag or not. I wouldn’t call it normal, but horses are weird. I’d keep it in your arsenal of evidence in case it becomes relevant during the appointment. Good luck. It’s so hard to know what to throw at vets during a NQR exam. I never know if I’m providing helpful info or just muddying the waters. Gah.

[fivestrideline]

Right?! I never know what’s helpful

[lenapesadie]

Does he also point that toe when he’s resting with a back leg cocked? Either way, I’d certainly mention to vet that he grazes this way

[fivestrideline]

No, he stands square for the most part up front unless grazing.

He’s always grazed with that right leg back, but the crossing is new. Or, recent enough to be “new”.

[sascha]

Yes, it’s weird. Print images so they’re handy or at least put them on a stick/disk or have them ready to email directly to the inbox of whoever is looking at your horse.

I cannot stress this enough - write down everything you can think of (from feed to medications to medical history - everything weird, just everything - breed, age, etc etc) and take it with you. Have it out in your hand from the get go. You will have everything you need and anyone asking for a history will get exactly what they need and nothing will be missed.

If you have any prior diagnostic imaging of anything take that too.

If a neurologist is not on the list of docs to see, you may wish to discuss that maybe one should be that grazing stance is weird

[fivestrideline]

@sascha

I cannot stress this enough - write down everything you can think of (from feed to medications to medical history - everything weird, just everything - breed, age, etc etc) and take it with you. Have it out in your hand from the get go. You will have everything you need and anyone asking for a history will get exactly what they need and nothing will be missed.

Thanks for this! Not sure why I forgot that “printing things” exists I’m a digital everything person.

I thought it was weird. He does it in his stall to a lesser degree

Hard to tell from the angle but the feet are almost crossed

I feel like he didn’t always do this, which is what makes me go hmmm. I’ve had him 8+ years, I THINK I’d recall lol

[Simkie]

I don’t think you’ll need to convince a referral clinic that there’s something abnormal neurologically, and that this guy is experiencing nervy pain. The response to gabapentin is very clear, and doesn’t he already have a diagnosis of “severe” kissing spine?

I’d think more on what answers you want from this visit, and what sort of diagnostics you’re willing to sign up for. What’s the goal, ykwim?

[fivestrideline]

What I want from the appointment: I’d LIKE answers as to what the cause is - his KS? Neck? SI? Literally just hocks and bad farrier? From there I can make some management decisions.

If it’s neuro, I want to know. More specifically, I want to know if this is going to get worse without treatments, how effective and expensive those treatments might be. Basically, I want to know if continuing to retire this horse is fair to him, or if I need to make some tough decisions. I want to dx in hand partially for myself and partially (as bad as it sounds) for “proof” - to a casual observer the horse is sound and not unhappy (but if you knew him, you’d know. Especially pre-gabapentin). If I don’t get some sort of vet validation, I’ll ALWAYS wonder if I could’ve done XYZ better

[Texarkana]

The vet school should be able to give a complete neurological examination.

As far as specifics like, “what is causing this,” they are going to need to do more diagnositics (myelogram, etc.). But the neuro exam should at least give some clues of what to pursue.

What you’re most likely to come home with is a list of observed deficits and options for what to pursue diagnostically.

[Inimitable]

Since it’s new-ish and he hasn’t done it all along I’d move it to red flag territory.

[fivestrideline]

That would work for me - I do hope to get neck X-rays and potentially SI ultrasounded if indicated, since these need the big machines. I have a budget, but I want to know what we are looking at.

[fivestrideline]

@Inimitable

Since it’s new-ish and he’s hasn’t done it all along I’d move it to red flag territory.

My thought as well. I’m guilty of staring at him until he’s lame and also actually a camel, so… validation is nice

[sascha]

@fivestrideline

If it’s neuro, I want to know.

This is why you should double check that the/a neurologist has specifically been booked for your appointment. It would suck to not have that level of doc available because they are off or tied up with other neuro appointments.

[Texarkana]

@sascha

@fivestrideline

If it’s neuro, I want to know.

This is why you should double check that the/a neurologist has specifically been booked for your appointment. It would suck to not have that level of doc available because they are off or tied up with other neuro appointments.

Definitely.

I worked at a vet school for years. I don’t know if they all function like the one where I worked, but I would make sure to specify in your appointment that you think this is a neuro problem. Because otherwise you might just be on the mercy of the resident surgeon or internist on call that day.

[fivestrideline]

Good to know. This is news to me!

[barnesthenoble]

Agreed that you definitely want to make sure they know you want to see the neurologist team. At least at the vet school near me (UCD), the team that does neuro stuff (internal medicine) is separate from the team that does equine lameness (surgery and lameness). If you’re concerned about neuro deficits (which I think is a fair concern–I would be concerned about that grazing stance, too), you want to get in front of the folks whose bread and butter is neuro horses.

Hopefully they have a setup where you can have both the lameness team and the neuro team working together at the same time. It can be super helpful to have both sets of eyes, but sometimes they’re pretty siloed so you end up waiting around for so-and-so to be free.