Having just gone through this, I would do the ECVM neck x-rays. All the symptoms are typical of a horse with cervical issues, possible extending to first rib. I’m attaching the x-ray protocol created by the ECVM experts on the FB support group. Many vets don’t know to take these specific views.
ECVM INFO & X-RAY PROTOCOL.pdf (3.1 MB)
I may be overreacting, but if it was my mare, I wouldn’t be riding her until I had neck x-rays done. I may be getting more cautious as I age, but I’m concerned for your safety. Yes , my advice is worth exactly what you paid for it 
but seriously, after watching that rope walk…
I hope you find answers and that whatever is causing this will be an easy fix. It’s so odd.
UPDATE
We went ahead and did a standing MRI while the insurance claim was still open.
Mild bruising of the coffin bone and navicular bone in both front feet. No degenerative or soft tissue injuries. The bruising is more evident in the left front.
The other significant finding was a focal injury to the subchondral bone and overlying cartilage of the left front fetlock.
All things we couldn’t see on x-ray or ultrasound.
We suspect the NQR feeling I was getting was from the bone bruising in her feet, and probably why she initially felt better when we added shoes and pads.
The intermittent severe lameness is likely the result of the fetlock injury getting angry and irritated.
I haven’t spoken with my vet yet. But based on the recommendation of the vet who did the MRI our plan will likely be to give her most of the summer off. Starting with stall rest and then small solo turnout. We’ll keep shoes and pads on since fly stomping season is almost here. We may also do osphos and a biologic in the fetlock. And we’ll bring her back slowly in the fall.
Glad you got some answers! Jingles for a good recovery
I’m glad you got a diagnosis and that it wasn’t a muscle disease. Although it did look like lameness to me.
Can you use soft ride boots on her rather than shoes to ease some of the bruising? What sort of footing do you ride on? Perhaps she needs a softer footing?
My mare who ties up is mostly lame at the canter. Mentally she always wants to go which means you can’t trust her to not overdo it and make herself sick. We rode for 50 minutes the other day and she went right past the trailer on the way back and wanted to keep going. Mentally she’s great. Physically she can’t do it and she was already getting stiff from too much continual movement.
It’s absolutely a very odd disorder because I don’t think she is acutely painful. She just runs out of energy and slows way down. It feels like a mechanical lameness unless you keep going and then it may turn into a recognizable tying up issue. She doesn’t seem painful, just moves a bit stiff. She’s 20 this year. As a young horse she never recognizably tied up. It took years for me to figure out what was wrong and when it did present it looked a lot like colic. A horse that colics on rides may actually be tying up as they don’t always present with muscle fasciculations. I probably should do a video on her just for educational purposes. It’s a shame because she is incredible on trails and really is an amazing horse if you work around her limitations.
The footing is good where we ride and where she was turned out. I suspect the bruising has more to do with her short pasterns. She has good strong feet with good sole depth, but it looks like there’s too much concussion coming down the leg.
I’ll speak to my farrier and trainer about shoes/pads vs boots while she’s on stall rest. Still waiting to talk to my vet about some treatment options.
There were just too many things with her lameness that didn’t fit with a muscle disease. NQR being more obvious to me while on a circle vs straightaway. The initial improvement when we first put shoes and pads on. Her being happy to eat, drink, do stretches even while dead lame. Definitely not anything resembling colic.
Don’t forget fly boots. They can really reduce stomping.
Ah thank you! This hadn’t even crossed my mind. Any recommendations? I’ll usually be out 5 days/wk to handwalk and can ask the staff and some friends to keep an eye out for rubs.
I got annoyed at lack of shipping to Canada, and then giant shipping charges within Canada, so I went for cheapies that looked fairly sturdy off Amazon. They seem ok, but I’ve not used them long enough to give a fair recommendation.
Her left front has always been a struggle (we bought her as a weanling, coming 7 now). She grows a lot of heel on that foot, and she has always had the habit of grazing RF forward, LF back. We had to pull her shoes off for the MRI so this is the first time I’ve gotten a good look since we put the shoes/pads on in January. She was barefoot prior.
They actually look quite good, the vet who did the MRI was happy with the trim.
We’ll certainly have to work to keep her feet healthy going forward.
There’s no evidence that she ever interferes.
Shoofly all day. Had them for years, no rubs with 24/7 wear on some thin skinned red heads! I usually get a new set each year but I have some from last season still in use. Despite the stays ripping through parts those boots still stay up and no sharp edges.
There are some knockoffs floating around but the shoofly legging style are the only ones I’ve found to work.
Shoo Fly - you can get them in Canada at Sharpe Farm Supplies, Bahrs, Pleasant Ridge, Greenhawk among other options.
I use ShooFly boots and my guy literally does not stomp at all.
Here is a copy of the report and one of the MRI images for anyone interested.
Findings:
Left front:
Foot/pastern:
Fetlock:
Right front:
Conclusion:
Left front
Right front
Thank you for sharing - wishing you and your mare a quick and complete recovery!
My daughter’s horse recently got a similar left fetlock dx via CT and is currently back at the rehab facility (his home away from home 
) for 2 months. He’s allowed full turnout with aquatread and hot walker therapy. For back ground, he was laid up back in July of last year with a bone bruise in his hock, stall rest with therapy for 6 months, came back in January and promptly injured himself again 
I would caution you to bring your mare back very slowly when she returns to work. Our saga has convinced me that stall rest is actually not good as it weakens their bones and muscles. I understand that it has its place but they are not as physically strong as they were when they return to work…
I’ll also vote for Shoofly leggings. We had them on both donkeys last year - donkeys are very hard on things - and they lasted all season. We can even use a couple of them again this year.
Adding to the Shoofly love. I just got a new pair last week. I didn’t realize how rough last year’s pair looked (still thinking I may have pulled out year before last’s pair and have misplaced last year’s). Regardless of how rough they may look, and they will slouch a bit (just normal from being worn a lot, they still do their job), they are TOUGH and never leave a mark on my sensitive-skinned Appy. I love them, he loves them, they’re the best. The ONLY issue I have with them is he occasionally poops in one of the back ones! I check them for poop every day. He’s out 24/7 and wears them 24/7 during fly season. To me, they’re a non-negotiable part of his summer care. I’m more fanatical about his boots than his mask (which he tends to leave wherever he rolls anyway, lol).
OP - how’s your mare doing?
Good, thanks for asking.
We’ve strictly been doing stall rest with a handwalk and hand grazing each day. We also opted to leave her barefoot until we start turnout again.
She’s tolerating stall rest really well, small hole hay nets are helpful.
She has a big relaxed forward walk and I’ve noticed that she’s getting more comfortable putting that left front forward while grazing.
There was a mix up with appointments so we’re still waiting to get IRAP done. We decided not to do Osphos as breeding her in the next year or two is on the table.
Rabbit Run (in Ontario) makes a shoo fly type legging.
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