Lame Horse for months Vet Care and possibly putting the horse down update wrong diagnosis

[candyappy]

@babalina

Oregon Co

I am straight North so really far( sadly) but maybe someone will see where you are and be of help.

[babalina]

@fivestrideline

Meanwhile, I have some questions (the wall of text and jumping around was a bit hard to understand so apologies if some of this is answered in the OP):

• how long have you had this horse? What was her workload like before she came up lame?
• do you have an actual diagnosis? Bone spur, chip, etc? It is usually on your discharge paperwork from the clinic. Or you can call.
• what did the first vet inject, and what is she planning to inject next?
• any improvement on the Equioxx?

I have had the horse for about 3 years now. She has a very light workload. I ride maybe only 30 minutes or so. I walk trot and when I canter I go round max 3 times. I do some online showing. Usually, just get on, do some warmup, and film for the show and then get off. I just found my discharge paper from the clinic. I want to say that the experienced vet there has a good reputation an excellent reputation. One experienced horsewoman told me that ‘‘he is remarkably talented with lame horses’’, and that ‘‘you should bring Princess in to see him’’, and that ‘‘people from all over haul their horses in to him’’. I found the discharge paper and I do not see a diagnosis on there. Just this ''Lameness exam, intermediate 100.00, Palmer Digital block Low LF no change 35.00, Fetlock Block IA Sound at 8 minutes,65.00, Radiology Fetlock Series 165.00, 5 Way vaccine, Rabies Vaccine,IV Sedation. Since the young vet is coming tomorrow I will ask her but I will also call, regarding the ‘‘diagnosis’’. Regarding the injections, I will get to ask her tomorrow. She is not actually on Equioxx per se, the vet said like previdoxx …it isn’t on the bottle… she said it was ‘‘like equioxx but cheaper’’. 1/4 tablet daily in a handful of grain. Both vets told me the horse needs to lose weight, and I have cut her grain to one handful and the smarkpak vitamins, and she did lose weight already. Hard to get the horse to lose weight with no exercise.

[Alterwho]

I might be totally out there with this but has she been checked for EMS and or PPID? Given her age and breed and being overweight it jumped out at me right away. I would love to see photos of her feet if possible

[IPEsq]

That is helpful that they did the block inside the joint and there was improvement. Hopefully new vet will actually get some medicine in the joint tomorrow. If it doesn’t work then you may need something besides steroids for longer term results. Having other things going on like obesity definitely doesn’t help (been there with my horse—his joints have been much happier since we got some weight off. It did take some medications to address metabolic issues not just exercise in his case.)

[SharonA1]

@babalina

it is an absolute desert for anything. I am crying about it all, and we are considering now to move to a better area.

Good for you for coming to COTH to ask questions and get yourself educated. As you know, the true horsewoman doesn’t let “being in desert” stop her; she educates herself and is proactive and takes on ownership of her horse’s health. If she doesn’t feel like she has a good sense of what the vet is telling her, she asks the vet to repeat it, or add more context, or explain why the vet is making the choices they are making. Good on you, OP. Many hugs for the tears, but after you let the tears have their moment, you get on back to asking questions and researching the options, so you can make the most-educated decisions for your horse.

[SinMiedo]

I don’t know the name off the top of my head, but my folks have been using a vet in West Plains. There is also a clinic in Ava that sees a lot of Fox Trotters, but it’s sometimes hard to get an appointment. I believe there’s an equine only practice in Mountain View as well.

[DiamondJubilee]

I was going to say the same thing. Maybe pull some blood and see what her insulin and ACTH levels are? Possible IR/EMS/PPID I would think the vets would have suggested this though when you went for a lameness exam.

Being lame on and off could be a sign of founder. Through the winter months insulin levels can spike, especially if she is overweight and not moving around much. Plus her breed is susceptible to EMS.

Good luck OP. What a beautiful girl!

[babalina]

3/17/24 My mare received noltrex injection. Procedure went very well and by the book. Yes, I researched it before and clear synovial fluid is supposed to come out of needle if in right place. Stall rest 24 hrs, tomorrow i take bandage off. Move her to dry lot indoor arena. Wait for paddock to dry up from rain, but her in super small paddock, no riding for 7 days, wait and see. May actually wait longer… I am reading up on the noltrex documentation. … I asked Vet if this doesn’t work should I think about putting her down, and she said i was ‘’ a long way off from thinking anything like that’’ . So I just wait, pray, and see. Asked vet if I should take her off the previdox, i said it wasn’t doing anything, and she said ok. Have her on 2 pumps a day on osteomax. Was 564.12 cents today FYI. And I was also thinking I wouldn’t like to haul her in and give her the injection, and then put her on a trailer and haul it home, because you need to keep the joint very still. At least that is what I am thinking…

[babalina]

I have an update. Please see front of original post. Vet came and injected Noltrex. Procedure went very well. My mare is resting in stall. Sticking around the house like glue to watch for reactions

[ATXmom]

I hope the Noltrex helps!

[GraceLikeRain]

@babalina

I asked Vet if this doesn’t work should I think about putting her down, and she said i was ‘’ a long way off from thinking anything like that’’

@babalina

She doesn’t have an acceptable quality of life now, she walks with a bad limp.

Is the vet that came out aware that the horse is limping at the walk? That’s incredibly lame and I do think that quality of life conversations are very reasonable and needed if the injection doesn’t fully resolve the discomfort.

[babalina]

May 23 2024. Handwalked my mare for the first time for 5 minutes after last Noltrex shot. She still has a slight limp at the walk and a nod at the trot. Completely disheartened. Will wait 30 more days and then make a decision on what to do next.

[barnesthenoble]

Sorry to hear she’s still NQR. Would you say it’s an improvement, at least? It can take awhile for the inflammation to subside.

[ATXmom]

I would give it more time. It can take a few weeks for the hydrogels to reach full efficacy.

[cayuse]

I’m seconding those who said get an ACTH and Insulin level drawn, you might find the answer there. I went through this with my welsh pony, he would go intermittently lame, vets thought it was joint related, we did equioxx and adequan with no results. Then he ended up with laminitis which evidently had been brewing all along. Tests showed he was metabolic and I have the guilts for not insisting he be tested.

[TWH_Girl]

Noltrex takes 2-3 weeks to help and in severe cases, a second injection is sometimes necessary. This product does not have a quick effect. I would hope the vet would have explained all of that. Hopefully it will take effects over the next week. Have you placed this horse on bute vs equioxx? It is more potent.

[SolarFlare]

@TWH_Girl

Noltrex takes 2-3 weeks to help and in severe cases, a second injection is sometimes necessary. This product does not have a quick effect. I would hope the vet would have explained all of that. Hopefully it will take effects over the next week. Have you placed this horse on bute vs equioxx? It is more potent.

Yes, we’re both experienced hydrogel users and my horse takes about 2.5 weeks to respond to Noltrex, and this horse’s issue sounds more severe.

OP, don’t give up yet. Follow the rehab plan for the Noltrex injection carefully, and wait at least a month to see what you have. You can follow up with a second dose as suggested by the manufacturer if the results aren’t as good as hoped.

[babalina]

No SolarFlare, the vet did not explain that at all. She said I could ride the horse after 7 days as before. I read the Noltrex FAQs myself and found out it takes a while. If you are experienced Noltrex users, please, do you start handwalking the horse at all after x amount of days or let them sit in the paddock? How big of a paddock do you let them sit in? No, i did not put her on bute. I stopped the previdox right before the injection, and the vet said it was ok. Actually, I was thinking today of putting her back on. i didn’t want to mix all kinds of drugs. I also have the mare on osteomax. I am thinking of taking a video tomorrow of her walking and putting it online or I could take one today freewalking in the paddock… So basically, my questions is do you do any type of exercise at all for your horse apres injection? Do you wait till they are 100 percent sound? I feel that my horse is so damn depressed now. I have her in the back paddock, which is breaked off, with 24/7 access to my small indoor arena so she can get out of the bugs and sun.

[SolarFlare]

Noltrex has a suggested rehab protocol. It has changed a bit over the years as they’ve done more research but here’s the current plan I follow and have had excellent results with:

After injection: 2-3 days total stall rest (no handwalking or turnout)
Day 4: turnout
For the next week: walk under saddle, 20-30 minutes a day
Following week: add trot and start increasing time under saddle
Following week: add canter
Following week: add jumping or increase exercise intensity if you don’t jump, back into regular work

Basically, it’s a controlled exercise program to allow the hydrogel to set properly so you don’t squeeze it all out of the joint where it’s supposed to be.

Noltrex isn’t a drug so you don’t have to worry about interactions with it, but as to the Bute/Previcox, you can certainly pick one if you feel she needs more.

Let me know if you have any other questions about the rehab.

[OzarksRider]

@babalina

I live in the boonies and no support system here at all.

@babalina

I live in the ozarks in missouri and it is an absolute desert for anything.

I live in the Ozarks too, so I get what @babalina is saying about the scarcity of resources. Yes, it’s true that we don’t have a grocery store on every corner or a Home Depot within 100 miles or even high quality internet service. But only 15 miles from OP’s home is an equine clinic staffed by two veterinarians, and for me as a horse owner in the boonies that’s a diamond. Even better, unlike some practices, they still do farm calls and the head veterinarian has a stellar reputation with lameness issues.

I know this clinic. In fact this is where I have been taking my horses for more than ten years, and I would highly recommend them to anyone. The vet I use for my cats and dogs says this is where he takes his horses, and he would know where to get quality care. @babalina, your mare is in good hands. I know you’re worried, but like others have said, give it time for the medication to work. Give the vets time to do what they’re good at. If you have questions about the diagnosis or prognosis call and talk to one of the vets.