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Intermittent significant front end lameness during/after exercise - Update post 50

I generally like to start with the hooves, and I still think you should, but I agree that you should look higher. She doesn’t seem resistant to bear weight, it appears the range of motion is interrupted. From the videos, I’d day shoulder, but if it switches between left and right, I’d go straight for the neck.

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The central sulcus is not deep, it has always looked like the nice “thumb print”. The medial collateral groove/sulcus is the one that tends to get deep. There was no evidence of thrush when her feet were done this past Saturday. She has had thrush in the past that was treated successfully, and did not coincide with any lameness.
I do agree that her heels have gotten too long in the past on that upright foot. But special attention has been paid to that since having the vet out in January.

I would find a different vet to work with if this is the best he has to offer. Your horse is definitely not faking this. Wish I had more ideas. My horse who moved like this had some nasty pedal osteitis but your X-rays don’t show that. Poor girl. I sure hope you get some answers. I will be following.

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I was wondering if anyone was going to comment on her crossing over. That wasn’t really something that she did during previous episodes. But it was significant enough on Monday that she was stepping on her other foot at times.

@sascha I certainly haven’t ruled out tying up. Unfortunately we’re in an area with a shortage of vets, getting someone out quickly when it isn’t an emergency is nearly impossible. Old school vet that was out last night was not interested in pursuing anything. I seem to recall my regular vet saying that bloodwork probably wouldn’t be conclusive if it wasn’t done within 24hrs of an episode. She seemed to think that for that level of lameness we would be seeing spasms, cramping, sweating and she would be stiff for several days following due to muscle damage - if it was a muscle disorder.

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Thanks. He isn’t my primary vet (thankfully), it’s just difficult to get vets out on short notice in this area.

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Can you get her to a sports medicine vet?

I definitely noticed the rope walking. I would look at the neck and also do a pre- and post-workout blood draw to check muscle enzymes.

If that fails, MRI both of those feet. Maybe block first to see if at least the early balky behavior is changed, since you never know when one of the end of ride episodes will occur?

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If it changes sides, go straight to the neck. I would want x-ray and ultrasound. From the video, I’d also think floating chip in the shoulder/elbow, but that seems unlikely if it changes sides.

I would also start keeping a journal of anything you can think of in hopes of identifying a pattern. It’s free, and if it isn’t neck, you really need to find a way to get a good vet out while it’s going on. And the easiest way of doing that may be predicting it. Is it always after rain when the fields are muddy, always on days you jump, always on days you ride after diner, etc.

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I used to ride a horse that had a similar sounding/looking lameness. It did end up being a form of tying up, but not in the way you normally think if it and it took years for a vet to figure it out. The horse was made functionally sound using a medication that is normally used in people who have seizures. I remember it was a white powder with a longish name, but this was 30 years ago…I don’t recall the name of it.

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The walk reminds me of my gelding who was ataxic. Have you done a home neuro exam?

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I’ve watched the videos a number of times before and after reading and thinking on the posts here and keep coming back to tying up. I’ve had lots of tie-up horses over the years at the track. I’ve only had one that went into a full-blown sweat/cramping situation. Some who were much less noticeable to where you couldn’t really tell at first that there was anything wrong at all—it took a few months to realize there was, and that they were tying up. Most seemingly started out of the blue and looked just like your horse here (Including one who had a severe club foot, coincidentally).

Most of them were fillies or mares. They tied up worse when they did tighter kinds of exercise—a physically ‘easy’ day like jogging was the worst, a ‘harder’ day like breezing was the best, because the freer they could move the better it was for them. The first day back after a day or two off was the worst situation. Stress from fighting the rider, anxiety, or pain caused or worsened it.

Some horses could avoid or minimize tying up if you (1) briskly walked them when you returned to a walk after work—no letting them putter about but keeping after them to walk fast while you (2) loosened the girth. We jumped off and untacked while they were walking and kept them walking fast for 30-40 minutes and didn’t stop (unless they started shortening, and then we’d put them in the stall and treat). The chronic severe ones would tie up no matter what preventive measures you used, and it tended to get worse as they aged. The mares’ heat cycle was an event that triggered it or made it likely they would tie up.

We once had an older gelding who would ‘want’ to tie up and you could talk him out of it. It kind of was in his head. I don’t think that’s what’s going on with your mare, but thinking of all the old tie-up horses and your vet’s comment about your mare faking it reminded me of that horse. With him it was like it was psychosomatic and you could distract him from doing it.

Anyway, sorry for the long post. I hope you can find some answers.

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Sounds like a chip. X-ray the whole front end.

Also if she’s not moving as well as she did as a 3 yo at 5 she’s always lame. That’s backwards, they should significantly improve in the movement between their two ages. If you don’t find a chip I’d block anyway and see is she moves better.

And your old school vet sounds like an idiot fyi.

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I’ve been jotting down notes every time it happens. So far I haven’t found a pattern. Seemingly no relation to her heat cycle, can happen during any season, can happen after she’s been stalled or turned out, can happen any time during a trim cycle, can happen after a day off or after being ridden multiple days in a row, has happened during/after an easy flat ride (like Monday) or during a jumping lesson (like the episode in December). She gets chiro/massage on a semi-regular basis, nothing of significance has ever been noted. We’ve had the bodyworker out several days after an episode and she couldn’t find anything.
Nutrition wise she’s an easy keeper so she gets the same low sugar hay that the chunky ponies get, and Mad Barn Omneity and vitamin E with a handful of grain for palatability, wears a muzzle during the summer when she’s on grass.

I should clarify that the balkiness is very, very subtle. It isn’t every ride and only lasts a lap or two, and doesn’t happen if she’s the least bit spooky. I would say that it isn’t physical except that I always notice it more tracking left. I don’t think it’s significant enough or predictable/reproducible enough to block. And it had disappeared almost entirely when we put shoes and a small wedge pad on. Through most of Feb and all of March she’s felt great.

The changing sides, but usually the left, is what has us stumped. And is part of what led us to think it was likely coming from heel pain, being that navicular or whatever you want to call it usually affects both feet. But the neck would also fit. Tying up is on the radar, just further down the list.

I’ve got a call in to my regular vet. It’s a mixed practice and I’m going in tomorrow afternoon with my dog anyway so I might be able to pick some brains if it’s quiet. The short-lived nature is the tricky part. I might have to beg them to treat this like an emergency next time so we can pull blood and block. But by then we’ll have probably missed the insurance deadline. Or we refer to a lameness specialist down south and run a gamut of tests to see if we can narrow it down.

And yes, old school vet (not my regular vet) makes some interesting comments, definitely not a specialist. But it’s nice to have a back up if there’s an emergency.

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I was thinking more along the lines of a foot/navicular type issue as well.

Wishing you the best getting her figured out! You will it just may take a bit.

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I have a friend whose mare presented with similar symptoms. General balkiness/resistance undersaddle and on the line that progressed to severe lameness after exercise, but in her hind end. She seemingly ‘recovered’ after these episodes. It ended up being a blood clot. During exercise the clot was blocking bloodflow to the extremity, causing significant pain. It wasn’t an easy diagnosis, but I believe it was found via a transrectal ultrasound. The clot mercifully dissolved after several weeks (months?) on blood thinners; otherwise a very risky surgery was the only other option. Not my horse, so I can’t provide more info, but it seemed similar enough to mention as a possibility. Good luck, OP!

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If this were my horse and insurance was still covering the issue for a little bit I would schedule an appointment with the larger haul in clinic. Up until that appointment I would really try to see if I can trigger this response. What if you give your horse a few days off and then have a really hard/long ride…what happens?

I’d also video document everything you can. Every single time this happens find anyone at the barn or call out a friend to hold your camera/phone. Get video of your horse walking in a straight line away from the camera and back. Do the same at a trot. Put your horse on a lunge line and get video of w/t/ canter if possible. Try walking down and up a hill and video it. Basically gather as much video information as possible for the clinic even if you show up with a perfectly sound horse.

At the very least hopefully your insurance would cover a neuro exam, neck xrays etc. Then you can at least eliminate some things. If they think it might be tying up then you can pass that information to your current vet (not the guy who said she was faking it) and maybe they’ll be able to rush out to draw blood at the next episode.

Overall I’d try to get insurance to cover at least some of the elimination process to figure out this issue.

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She’s had lots of long hard rides with zero issue. She’s been out 24/7 with no issue. She spent two weeks stalled at WEC Ohio being ridden, lunged, or shown every day with no issue. She goes months in between episodes.
I’ve got a few other videos that I didn’t post here that other people took for me, but they’re long. And once she comes up sore I’m not sure I’d be able to convince her to trot or canter. The only hill on the property is in a field with 24/7 boarders. Monday night it was a long slow walk from the ring to her stall. I gave her bute immediately, after untacking I tried to bring her out of the stall and she wouldn’t budge. I gave her some hay and rode my other horse. After that I brought her out of her stall, but she was still just as lame as in the video. She’s normally turned out overnight but I opted to leave her in.

Hopefully not a blood clot. I imagine that would be difficult to find.

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If you think it might be foot/navicular, then even if mild, I would push for a block. Bilateral lameness can look subtle just because they are lame on both legs, and stops looking subtle when you block one.

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I knew one with something similar.Vet suggested a pinched nerve type of scenario and horse responded to gabapentin

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In the second video, there appears to be muscles twitching in her chest. My initial thought is something muscular, and possibly also foot pain, but those muscle twitches are interesting. Actually, I see it in both videos, just more in the second one.

Sure is odd!