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

Looking for some ideas from the Coth crowd.

I’ve got a 7yo warmblood mare who every few months comes up dead lame while I’m riding or just as we finish. W-T-C both ways, sometimes jump, and then when we come back to a walk to cool out or take a break she’ll shorten right up and by the time I hop off and get her back to the barn she can barely walk. She’s weight bearing, no sweating or cramping. No heat or swelling. Just very short steps. Usually the left front steps shorter, but on one occasion the right front was short (videos of multiple episodes). Within about 12 hours she’s almost completely sound again. And then she can go months without an episode. Because of this I’ve never been able to get a vet out to block or do an exam when she’s actually lame.
This first happened two years ago when she was 5. I do feel that she doesn’t move as well now as she did as a 3yo, and she can be pretty nappy at the beginning of a ride. Tends to be stiffer tracking to the left.
We don’t suspect tying up as there is no visible cramping, no sweating, and doesn’t seem to be related to the actual amount of work that she’s done.
Her left front is borderline clubby, it’s smaller and more upright than the RF. She’s been barefoot most of her life. We tried shoes back in 2022 for two cycles, no change, so pulled them going into winter and left them off.

Late December 2023 she had an episode so I had my vet out the first week of January for x-rays of her feet. I unfortunately couldn’t be there. Report from the vet was that she was sound but “lazy” on the lunge. No reaction to hoof testers. In person she said that the x-rays were normal. In her report she said mild navicular bone changes on lateral view (LF), 65 degree navicular image within normal limits. RF was normal.
Vet suspected caudal heel pain, but the intermittent and short-lived nature of the lameness has made it impossible to block so far. We had farrier take her heel right down on the LF and then shoe with a very small wedge. RF just had a regular shoe.
She had another episode Monday evening while I was riding, she had her feet done Saturday, coincidence?. Staff said she was still slightly off Tuesday morning so I had a different old school vet come out. She was 1.5/5 lame, visible trotting on a small circle to the left, not visible on a straight line on hard ground. Vet said it wasn’t obvious enough to block. His working theory is that she’s faking it. I personally don’t think horses can fake a lameness to get out of work. I certainly don’t think they would still be faking it an hour or two later.

Anyway, hoping someone here has an idea? If we want to get an MRI done we would need to do it within the next month if we want it partially covered by insurance.
I’ve attached the x-rays, and I’ll figure out how to post a couple short videos.


Video from Monday evening.

Video from December showing her moving short on the right front.

Very interesting - it almost makes me think it’s in the shoulder, rather than the foot

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Wow. That’s concerning.

Can you get a second opinion from a different farrier? I wonder if that might not be the root of the issues. But I can not diagnose squat from x-rays, etc. I just would look closely at farrier options in my area if it were my horse, and maybe spend money on someone exceptional who works closely with top tier performance horses or local vet practices.

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Can you get yourself a set of hoof testers, and really go to town trying to find the ouch in the feet, when she’s actively gimpy? That would eliminate that possibility for you.

I would be inclined to think it was higher up, like a shoulder or elbow OCD or something of that nature. I would take her to a clinic for a workup while you still have coverage. I would personally disregard everything a vet had told me about a lameness as soon as they suggested the horse was scheming to get out of work. That is absurd and makes me question their workup.

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IME, tying up can be pretty sneaky. If this latest episode happened 2 days ago, I think you’re still within time to do a blood draw to check and that’s a cheap and easy diagnostic.

Second point, if it’s even partly related to the club foot, I have had good luck with bar shoes as opposed to regular plates for club feet.

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No vet here, but my understanding that cervical arthritis issues can show up as front end lameness. Obviously only one of a number of things it could be…Agree with railbird, get the horse to a clinic, along with the video, and xrays.

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Can you post pics of hooves from all angles including a conformation shot, plus straight on sole pics of both fronts.
My first thought is foot pain and
you may need a better trimmer.

I knew of a horse who would suddenly become (quite) lame and then sound again. Had a small chip in the knee that would occasionally move and cause pain - I’d X-ray higher…

Good luck

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@JB it has certainly crossed my mind that it could be up higher. The vets and I don’t really think it’s muscular since there is rarely any soreness 12 hours later. Her being slightly off 24hrs later was unusual. @sascha this is also why tying up or any of the muscle disorders were pretty far down the list.

@endlessclimb we have tried hoof testers in the past. She’s not a patient horse so I’d characterize her as always being randomly reactive. But basically we were never able to find an area that caused a consistent reproducible reaction. Unfortunately with the wedge pad (recommended by the vet that did x-rays, not the old school vet), we can’t really use hoof testers effectively.

@Railbird old school vet who suggested she was faking didn’t really do a work up. It was a different vet from a different clinic who did the previous workup with x-rays. I only reached out to the old school guy Monday night because it was late and I had hoped he could come out while she was still sore, he’s usually pretty flexible that way, unfortunately it didn’t work out. There’s a reason he isn’t my primary vet…

@2tempe I have also wondered if it could be something in the neck. Especially given the lameness has shown up on both sides.

@Marla_100 I don’t have any good recent images of her feet. I’ll get some next time I’m out. Can’t do sole pics since she’s got pads on now. The upright foot does have deeper collateral sulci compared to the other foot, and is slightly smaller, but the heel isn’t contracted and never has been. When the first vet came to do x-rays she felt the trim was good, she was just thinking that based on the mares conformation it might help to lower the heel on the LF and support with a wedge. This seemed to help for a cycle.

@millerra I wouldn’t expect the lameness to flip sides if it was a chip in one knee though?

Perhaps we should be thinking about a nuclear scan instead of an MRI?

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I have never, in 3 tries, found anything worthwhile with a nuke scan

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In the sense that multiple things lit up? Or everything was within normal limits?

Weird stuff lit up. Points of hocks, fibrous masses. Nothing of use in finding a lameness lit up, though.

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The deep Central sulcus on upright hoof is usually an indication of an unhealthy frog,
any chance there’s infection/thrush brewing under the pad?
Also with upright hooves, heels are usually extra long and the
normal mechanism is interrupted, especially with shoes on.
I’d still zero in on hoof problems.

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I would probably be xraying the neck. The way she was placing her feet, almost crossing over, makes me think possibly neurological. Cervical issues could cause this.

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My horse’s numbers were shockingly high days after the ‘event’ we figure caused the invisible tie up and she had no soreness to palpation anywhere, just vague NQR in the front end.

My EPSM horse was never sore to palpation.

A friend’s EPSM horse was never sore to palpation.

Others I’ve known practically fall down if you look at them wrong.

Muscle diseases/syndromes are weird and don’t always fit the textbook description.

Also, this caught my eye, "

[quote=“GoodTimes, post:11, topic:794890”]
there is rarely any soreness 12 hours later. Her being slightly off 24hrs later was unusual.
[/quote] You did mention earlier that she doesn’t move as well now as she did when she was a few years younger.

A blood draw is a cheap way to rule it out, but if you’re still firm that you don’t want to do that now, (and YOUR horse after all!) keep this most recent slightly off 24 hours later in mind and perhaps start keeping a log to see if the 24 hours thing becomes more frequent or not.

All that said, I’m hoping you find a super simple explanation that is easily remedied :slight_smile:

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I would look higher. Shoulder and knee ( if you haven’t already). In that first video it looks like she is almost dragging the leg along and like it is coming from higher up, not foot soreness. I am no expert obviously but that was my first impression.

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Same suggestion.

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I vote neck and muscle disorders. That doesn’t look like hoof to me, at least not mainly.

I’m no vet. But that’s very strange.

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