Improved canter after stifle blistering?

[VTMorgan06]

I’m hoping to hear from some folks who can share their experience with their horses canter after having iodide injections in their horses stifles.

A little background on my horse:
Horse has always been weaker traveling to the right. Likes to pop his shoulder, struggles with bending and flexion on the right side, always had a less balanced canter on the right lead. About a year ago his downward canter transitions got really bad. Like falling apart, legs everywhere, totally lacking coordination, but only to the right. We tried a course of Previcox, shoes, ECP injections, chiro and acupuncture but nothing improved. We did a lameness eval and took stifle films but they were clean, flexed him, also fine. Vet suggests blistering the stifle but wants to ultrasound first to make sure there’s no injuries that the injection would make even worse. Sure enough, we find a small patellar ligament tear. We rehab it through the winter, vet wants him still in light walk/trot work, he heals. Ultrasound shows that the tear is much better, though still visible, horse goes back to work but the canter is no better. We go to a clinic for a body scan In March and really find nothing significant. A few things light up that the vet addresses in addition to still seeing the stifle ligament tear injection, PRP and shockwave for the stifle ligament and he gets 3 months totally off. Reultrasond In June and the stifle ligament looks great. Vet gives a plan for bringing him back to work walk trot and building up to cantering. Horse goes back to work and completely shuts downs refuses to trot under saddle at all. We do loads of tests and find that he has type 2 EPSM and likely the 3 months off caused it to flare up. We make some big diet changes and he improves greatly under saddle, much more willing. He goes through the summer walk/trot and we tried cantering this week and the canter is still as terrible as ever. I reach out to my vet and he mentions that we could do the stifle blistering that he originally suggested a year ago at the start of this whole saga. I’m hesitant to do to because it seems so invasive and uncomfortable for the horse. I’m conflicted because this is a very good vet who I trust and is extremely experienced in sports medicine. I don’t think he would suggest something that would hurt my horse, but I also don’t like the idea of blistering him.

for those who have done it, do you regret it? Did it help your horse? What problem was your horse having that the blistering addressed? I read a lot online that says it’s good for horses who we slip their patella or have locking stifles, but my horse has never had this problem.

Thanks in advance!

[JB]

If I read this right, in June (3 months ago, if this was early June) after 3 months off, after some period of time with an undiagnosed patellar ligament tear and rehab over the winter, he was diagnosed with PSSM2, you made diet changes, and you’re expecting a decent to good canter?

It doesn’t sound to me like he’s gotten strong enough, and/or his diet change hasn’t had long enough to REALLY do its job, and/or the diet needs tweaking.

Without seeing the trot work it’s even possible his trot isn’t as good as you feel it is. Personally, I’m not sure he’s gotten strong enough, or the canter is just the next thing to work on. You just tried cantering after a long of not, working to overcome both an actual injury and a muscle disease.

To answer your direct question:

I’ve never heard of blistering for this issue, BUT, if the tear has essentially resulted in a ligament that is now a bit too long, I can see the value.

What about the procedure don’t you like the idea of? It’s not comfy for the horse, for sure. And he has to go right back to work, this isn’t a lay-off procedure.

My thought? Give the diet more time to work, see if it needs tweaking (like more and/or better quality protein), make SURE you are really solid in that trot work, and then simply work on canter transitions for a while, not the canter itself.

The re-evaluate in 3 months and see where you are

[NancyM]

Yes, have done an internal iodine blister. It was 20 years ago, and not my horse, the owner wanted it done. Yes it did help the horse. Did not produce any pain issues, horse was apparently comfortable afterwards… I know it sounds “icky and invasive”, but in practice, it wasn’t. It’s worth a try. But know that what you are trying to treat is often due to OTHER issues effecting what you are seeing. With this horse, it was his feet that were the underlying problem, IMO. He was back sore as a compensatory problem. Good luck. Trust your vet with this one.

[mmeqcenter]

My vet and farrier swear by them. Did a stifle blister on my mare the end of June, we’d been rehabbing a small stifle strain since March (best we can tell was a pasture injury). She came out great. No huge change like “ermahgawsh wow!”, she was going fine before, just still a teeny bit “stifle-y” from the injury in March. She is noticably free-er in her hind end movement. She never indicated any discomfort during the process (and she tells you for sure), trotted around for our 30 mins per day for a week beautifully and happily, played in the field, etc. It’s pretty important that they are able to move a lot with a blister, though, so if your horse only gets an hour of turnout a day or something it might not be the best choice. My mare is out 24/7 anyway, and that’s what is typically recommended while it’s tightening up the tendons/ligaments.

[TheHunterKid90]

I’ve used an internal iodine blister on several horses with very good results.
Some horses react more severely to the blister than others (read: very stiff in hind end for the week that you trot them). Others just stiff in comparison to how they typically moved.
If you do go ahead with it, be prepared for some work the first week. My vet loves with I can just let mine live outside for the week after the blister and then brought in two or three times a day to trot for 20 minutes.

[beowulf]

@VTMorgan06

I’m hoping to hear from some folks who can share their experience with their horses canter after having iodide injections in their horses stifles.

A little background on my horse:
Horse has always been weaker traveling to the right. Likes to pop his shoulder, struggles with bending and flexion on the right side, always had a less balanced canter on the right lead. About a year ago his downward canter transitions got really bad. Like falling apart, legs everywhere, totally lacking coordination, but only to the right. We tried a course of Previcox, shoes, ECP injections, chiro and acupuncture but nothing improved. We did a lameness eval and took stifle films but they were clean, flexed him, also fine. Vet suggests blistering the stifle but wants to ultrasound first to make sure there’s no injuries that the injection would make even worse. Sure enough, we find a small patellar ligament tear. We rehab it through the winter, vet wants him still in light walk/trot work, he heals. Ultrasound shows that the tear is much better, though still visible, horse goes back to work but the canter is no better. We go to a clinic for a body scan In March and really find nothing significant. A few things light up that the vet addresses in addition to still seeing the stifle ligament tear injection, PRP and shockwave for the stifle ligament and he gets 3 months totally off. Reultrasond In June and the stifle ligament looks great. Vet gives a plan for bringing him back to work walk trot and building up to cantering. Horse goes back to work and completely shuts downs refuses to trot under saddle at all. We do loads of tests and find that he has type 2 EPSM and likely the 3 months off caused it to flare up. We make some big diet changes and he improves greatly under saddle, much more willing. He goes through the summer walk/trot and we tried cantering this week and the canter is still as terrible as ever. I reach out to my vet and he mentions that we could do the stifle blistering that he originally suggested a year ago at the start of this whole saga. I’m hesitant to do to because it seems so invasive and uncomfortable for the horse. I’m conflicted because this is a very good vet who I trust and is extremely experienced in sports medicine. I don’t think he would suggest something that would hurt my horse, but I also don’t like the idea of blistering him.

for those who have done it, do you regret it? Did it help your horse? What problem was your horse having that the blistering addressed? I read a lot online that says it’s good for horses who we slip their patella or have locking stifles, but my horse has never had this problem.

Thanks in advance!

A. How was the PSSM2 diagnosed? Biopsy?
B. Even a small stifle tear can have a significant impact on their comfort.

What kind of management changes, besides diet, have you done to manage both? How much turnout is the horse getting, and do you have a video of him under saddle?

I would not blister a horse, personally. It was an option thrown around for one of my horses that had a small tear in his collateral ligament, and I went with Dr Green for a full year + injections instead. I just have not seen blistering be successful long term (the horse ends up having issues again a year or two down the road), but my pool of experience is small, and it could very well be related to their management.

Both PSSM and stifle horses benefit from not being stalled. I am not sure if that is something you can do. My gelding with the stifle tear healed well, but any amount of stalling for more than a day and he was always tight especially over his back.

[dressageponyperson]

About Improved canter after stifle blistering? I have done blisters a number of times. I have a welsh cob who couldn’t maintain canter. After years of fitness we decided to blister. It made a huge difference in his ability to canter. Now, a few years later, he was unhappy picking up the right lead from walk. Our vet injected both stifles this time. Suddenly, the stifles started buckling again and he is falling apart at all downward transitions. Re-blistered and no real improvement yet… although, it has only been a week. Anyone have experience with an internal injection (not the blisters) causing stifle weakness? We are super worried about his lack of improvement and major pop/buckling in the downward transitions. Have reached out to the vet again tonight and awaiting “next step” instructions. Would welcome any feedback…
As an aside and more feedback on the blistering question, I have a second cob, also blistered his stifle. Very minor improvement. Lots of buckling during downward transitions. This one is in a major rehab/strengthening program and fingers crossed, we can improve him.

[ndirish07]

I have not heard of blistering for this particular type of injury. I did it on my horse recently. He had a soft tissue injury and was on stall rest for several months, which exacerbated a sticking stifle. Prior to the injury I had the sticky stifle under control through estrone injections and hill work. Once he got fitter I didn’t need the estrone. Anyways, I went ahead and did the stifle blistering when his stifle was catching during his rehab, and was making him really sore. If I could do hill work, I would have not done it. My horse didn’t act terribly crippled by it, but I know it’s painful. About a week later, I could tell that he was feeling a bit better, but it definitely took a lot longer to come back from that than what I thought it would. My friend’s horse had it done about a week after mine for a sticking stifle, and he was very lame after it even at the walk for awhile. They ultrasounded it to make sure any other structure wasn’t injured during the procedure–it wasn’t thankfully. That’s all to say, I don’t think the procedure is necessarily the end all be all and it works for some horses, but not for others. If you have another option, I’d hold off. Especially in your case, it sounds like the horse hasn’t had a chance to develop the conditioning and muscling to have a good canter at this point. If it was my horse, I’d work on transitions, hill work, pole work, and long slow distances for several months to increase strength first and then see where you’re at.