Lameness Help

[RedWingedBlackBird]

Seeking help on persistent lameness issues with my 16 year old mare. The issues began 3 years ago. We’ve performed extensive veterinary diagnostics with nothing much to show for it.

Summary: She stumbles in the front and collapses in the back. The lameness has shifted around on her multiple trips to the vet hospital (tested for Lyme, it’s not that). The vets have been uncertain on whether the hind end issues are just about conditioning, and if not, whether the hind end issues are causing the front end issues or vice versa. There are three videos at the bottom of this post.

I could write a novel on her history but will try to be concise. Her issues started in 2020 (age 13), after our state’s Covid lockdown. When I was able to return to the barn post-lockdown, she was lame under saddle and while being led. We tried multiple rounds of rest and bute to little effect. We also began shoeing her in the front, which helped with the lameness on the ground but did not resolve the under saddle problems. I do not ask her to do anything particularly strenuous under saddle. After periods of rest, she would feel sound for an amount of time proportional to the length of her rest period, but the lameness always returned.

Over the next two years, she had multiple visits to the vet hospital, where they did a bone scan, numerous x-rays, tested for Lyme and EPM, had neurology look at her, and probably other things I’ve forgotten about. On the first visit, they said the lameness was in the hind end; on the next visit, they said front end. We injected her hip and SI, which seemed to help at the time, but in hindsight, I think was only because the doctors had ordered 2 weeks off after the injections. We put her on Equioxx, which she is still on, and although that seemed to help for ~3 weeks, her lameness returned. The one thing that the diagnostics revealed was an injury to one of her stifle tendons, but the vet felt that it was an old injury and didn’t seem consistent with what we are seeing.

In summer 2022, I decided to just give her a long vacation. She was turned out in her usual pasture for 8 months (in at night), and I started riding her again in spring of this year. We took things very, very slow, partly because of her problems and also because of my own injuries (…see my other thread if you want details…): no more than 30 minutes at a time, 3 days a week, mostly at the walk with a little bit of trot, gradually increasing the amount of trot. We’ve done a very small amount of cantering. She had been doing very well (for approximately 4 months), but again this week started showing signs of lameness.

What it looks like:
Intermittently, she will stumble in the front. This happens at the walk and trot (I’ve done so little canter since this started that I can’t speak to that). On good days, this won’t happen at all. On bad days, it will happen every 5-10 minutes. Her demeanor is overall very good and she is happy to work. She’s always been a high-energy mare with a great work ethic, and there were times when she was clearly not feeling well, but for the most part, she seems happy. Sometimes the lameness feels like a bad step, as if there was a dip in the footing (except that this happens even when the footing is very nice, and she was not like this pre-lameness); other times, it feels like her leg buckles. She hasn’t fallen on her face but it has felt close. Afterwards, she will carry on as if nothing happened.

Prior to her vacation, she was also collapsing in her hind end (video 3). This has not happened post-vacation and may simply have been lack of conditioning. It seems to improve the fitter she gets, whereas the front-end problem seems to get worse over the days/weeks.

The stumbling in front happens on both sides; the hind-end collapse is only on the left, which is the side where the old injury was found, but I’m less concerned about this because it does seem to improve with work. (Unless it’s causing the stumbling somehow?)

Some other notes:

1. She’s on Equioxx daily.

2. Her farrier has a very good reputation and has done a lot for other horses in the barn with special shoeing needs.

3. A saddle fitter okayed her saddle-- said it was decent but not perfect-- and the vet hospital said the same thing. I haven’t ruled out a saddle fit issue but am not sure how to go about diagnosing it.

4. I don’t think she’s bored or not paying attention. She’s usually very engaged with me and is a smart, sensitive horse. There have been times when we’ve been going beautifully at the trot with her clearly focused on work, and then she stumbles.

5. A few people who have seen this have said, “it almost looks like she just forgot what to do with her leg.” She was seen by neurology and they said that it was not a neurological problem.

6. Her dam is a Missouri Foxtrotter. She has never gaited for me under saddle, but people have mentioned seeing her do it in the pasture. She’s always had a bit of a swing to her head, and we’ve attributed this to her gaited breeding.

Any suggestions would be appreciated. Thank you!

Videos (all taken in 2022, prior to 8-month rest).
Video 1 (front end, bad quality but clearest side view of buckling) https://imgur.com/a/vQnyiAh
Video 2 (front end, much harder to see-- it happens as she comes around the corner. Lots of tail-swishing in this one): https://imgur.com/a/h5ZfvDm
Video 3 (hind end) https://imgur.com/a/X5rlPbw

[Bonnie2]

She does not look like a happy camper. The hind end could just be common catching her stifles since she hasn’t been able to be worked enough to get strong. The front would worry me as a rider. Does she “trip” on both front? Have her feet ever been blocked? Has her neck been imaged? Does she do it longeing or turned loose? Good luck and be careful!

[RedWingedBlackBird]

I should mention that since being on the Equioxx, she is much happier. These videos were pre-Equioxx. Her tail swishing has been eliminated and her overall demeanor is much better.

The vets blocked her hind legs all the way up starting at the feet. They found something in her hip and SI, which is why they injected those areas; but later on, after the injections didn’t really do help, decided that maybe that wasn’t the problem after all.

She trips on both fronts. She used to do it while being led, but not since being shoed. I haven’t seen her do it while loose in the pasture, but that doesn’t mean she hasn’t. I haven’t seen her doing it while being lunged.

[WildGooseChase]

If you have the option getting these videos will help immensely, all should be done in hand, not on a lunge circle:

1. Walking straight towards and then away from the camera on a hard surface.
2. Trotting straight towards and then away from the camera on a hard surface.
3. Repeat both gaits on a soft surface.
4. Side views, both at the walk and trot, on both a hard surface and a soft surface. Have the person filming stand in one spot and go by and past them. Make sure to document both sides.

With videos like these, it’s generally easier to pick things out than being under saddle, especially the more illusive, subtle lameness.

For reference, DressageHub on YouTube has their Lameness Lab video series that is pretty good. Equitopia also has a great series on subtle lameness. Equitopia membership is pretty affordable, the resources there are really good!

Surface type can help determine if it’s skeletal or muscular/soft tissue, although it’s not a guarantee.

[RedWingedBlackBird]

I can get the videos, though I probably won’t have a helper to do it with til next weekend.

[Shagyas_Rock]

You mentioned numerous x-rays; did they x-ray her knees, fetlocks, patterns? Has she been on a joint supplement?

[Posting_Trot]

This sounds like a frustrating situation, and I really empathize.

I’m curious about how long you’ve owned the horse–did she begin to exhibit the lameness shortly after you bought her or did you have several years of riding together before this came up? The reason I ask is that if she became lame shortly after you bought her, it’s more likely that she came to you with some underlying injury or history that you don’t know about.

After seeing the front-end stumble in one of your videos, as well as the comment of a barnmate about the horse seeming not to know where the leg is, I’m interested in whether the horse could have been nerved at some point in the past.

Also, did she become lame while you were still riding her (pre-COVID) or during the lockdown period when you weren’t visiting the barn? If the latter, maybe she sustained what the barn thought was a minor injury but that ultimately has proven to be more problematic over the long-term.

I wonder if you’ve tried doing some in-hand exercises with her, leading her over groundpoles, up and down hills, in patterns around poles, etc. and whether that’s helped at all? Have you tried supplementing her with significant doses of Vit. E (on the theory that there some kind of nerve damage)?

I commend you for trying to get to the bottom of this and wish you luck!

[starsandsun]

Looking forward to other videos, but I’m going to speculate that the front end issues are the result of discomfort behind, which is creating tension/tightness over her back and limiting how much her withers/shoulders can move. To me (not anything like an expert) it looks higher up, so I would consider how she is using hamstrings/glutes/biceps femoris and whether there is muscle tightness under saddle area and just behind. Have you tried muscle relaxers or massage?

[IPEsq]

What kind of imaging of the hip and SI were done apart from the bone scan?

[fivestrideline]

I don’t have a ton of input (besides owning a horse that is EXACTLY like this).

I just wanted to tell you to be VERY CAREFUL riding this horse. She doesn’t look super comfy at all, but more than that I’d call her a fall risk under saddle. I have one that was like this at one time, and he’d trip pretty regularly but would catch himself, until he didn’t. Twice he’s fallen with a rider, both times he tripped to his knees and then got up. It’s a very sudden, impossible to stop catapult to the ground. You won’t be able to predict it, and he was fine just “clumsy” for years before someone came off of him. It’s a very dangerous type of fall.

That said, both from your description of her improving a bit with shoes and from my own horse’s experience, I’d be curious to see her feet. Have you X-rayed her feet or done any blocking up front?

I say this because you’ve done a ton of digging like I did, and my horse is very particular about his feet. Even the “best” sporthorse farrier that does all the fancy stuff couldn’t seem to get the horse right, but the super old-school, been around forever guy has fixed him completely. This horse has to be managed pretty specifically, and if his feet aren’t perfect the whole thing falls apart.

Here’s what I do to keep this horse sound, if only to maybe give you some ideas:

• 24/7 pasture turnout. This is essential for him.
• barefoot with 4 week cycle + rasping by me in between
• 4000iu E a day, minimum
• monthly bodywork. This and the farrier have made the BIGGEST difference
• low NSC diet, with lots of fat
• working in the EquiCore, doing hills and poles, and working 6 days a week to keep fit. If he has to have more than like a week off, we back up a lot and get him fit again. He gets fit fast, but can’t seem to hold it long

Good luck. Stay safe, and I’d seriously be careful riding her until you get some improvement. Even an airvest won’t help, because the falls that happen when they trip like that take both of you down, and the rider doesn’t separate until after they hit the ground.

[RhythmNCruise]

Hmm. My horse does this too from time to time. I know he’s got some NQR-ness about him, and his issues seem to stem from the hind end and over the back. I think he’s much like @fivestrideline’s horse. I bought him some hoof boots several months ago to protect his thin-soled feet when we’re in the woods, and I noticed that the “stepping-in-a-hole” thing that he’d do occasionally pretty much never happened when wearing the boots. I halfway expected him to be a klutz in them and fall on his face, but it was quite the opposite.

He’ll also do the backend thing now and then too. I think that’s just a weakness behind, and he does better if he’s fitter.

He definitely thrives on 24/7 turnout. I had him on daily Equioxx, but it makes him ulcery and anxious. He’s gotten Adequan in the past, and that seems to help, but it’s so expensive and I hate giving shots. I try joint supplements now and then (he’s on one now that SEEMS to help). He eats a forage diet with a ton of flax and some CocoSun oil. I will say, I used to hear him “click” in his hip area when walking and he no longer does that. Hasn’t since we moved barns from one where he was stalled part of the day to his new 24/7 set-up.

I’ve never investigated my dude that much. I’ve had horses in the past that have tripped, stumbled, and even fallen on me. It’s scary, but I’ve developed a pretty good habit of leaning back like the Man from Snowy River as soon as I feel them drop out from under me in the front. Still, they can bulldoze down and somersault all the way over if they’ve got enough momentum, and that’s dangerous. Whenever mine surprises me with a stumble/trip, I usually growl at him to “wake up and pay attention” and do a few transitions to get him listening. I know if it’s lameness or something he can’t help that doesn’t really help him, but it scares me enough that it’s my reaction.

Best of luck to you!

[RedWingedBlackBird]

A major issue with the blocks they did there is that they were never able to replicate the stumbling in the hospital. Although they saw lameness in the front, they only ever rated it a 1-2/5, and that was after multiple days of lameness exams in a row, so they suspected that it might be soreness (given that she’s a middle-aged horse with mild arthritis who, by that point, was badly out of condition).

As far as blocks: in the left front they blocked at the heel, top of pastern, above the fetlock, top of cannon bone. The block above the fetlock showed 75% improvement, but x-rays showed only mild osteoarthritis in the fetlock. They did other blocks in the hind end, which suggested hip/SI.

We did a round of Adequan without any significant improvement. She’s not on a joint supplement now.

[RedWingedBlackBird]

I owned her for 3 years before this began. I observed the lameness immediately after returning to the barn post-lockdown. As you suggest, I suspect that something happened in the pasture, and because the lameness is only pronounced under saddle, none of the staff noticed.

I don’t know everything about who nerves horses or for what purposes, but my gut feeling is that she was probably not? She was a broodmare before I bought her, and from what I have found of her history before that, was ridden by a young girl who rode her through apple orchards and took cute pictures. Although she is precious to me, she is not an expensive horse or a serious competition horse.

I haven’t done much groundwork with her at all. I can try. She was a bit low on Vitamin E, so we are supplementing that with SmartPak’s SmartOmega 3 & E Ultra (1500 IU Vitamin E daily).

[RedWingedBlackBird]

I’ve tried chiropractic work-- is that equivalent for purposes of diagnostics in this situation? It has not resulted in noticeable improvement.

[RedWingedBlackBird]

I think none. There was some reason they couldn’t do anything else-- too much muscle/fat in the area?

[RedWingedBlackBird]

This is exactly my fear. My challenge is that every vet she’s seen wants me to keep riding so that the problem becomes regular enough for them to actually see in person. My approach so far has been to walk her for at least fifteen minutes and see if she’s stumbling (it happens within the first five-ten minutes if it’s going to happen at all), and only trot her if her walk seems perfect. I’d been doing a bit of cantering if the trot seemed great, but will probably stop with that.

I listed out the blocks to the left front in a reply to another commenter, but they did block at the heel. X-rays were done of both front feet with nothing significant to report. She showed a huge improvement in comfort, general condition, and gait while NOT under saddle after we began shoeing her. The vets have said her feet look great (though I know that vets aren’t farriers).

Thanks for sharing your experience with your horse. It is helpful to see the list.

[RedWingedBlackBird]

Thank you!

[RedWingedBlackBird]

The only neck imaging we did was the bone scan, which showed nothing of significance. Would neck arthritis be seen with a bone scan?

[RedWingedBlackBird]

I just had a thought: the initial lameness was the typical head-bobbing at the trot kind of thing. No stumbling. We treated with rest and bute over a period of a couple months. During this time, the saddle fitter came out to look at her. (The fitter comes from a different state and I’d already scheduled the appointment, so I just kept it.) The saddle fitter has a good reputation-- she’s not associated with any brand and I’ve seen her recommended many times on these forums.

I didn’t ride during the appointment-- because lameness-- but the fitter said that the previous saddle I’d been using was a very poor fit for my mare. She didn’t have one at the time that was any better, but after we dug around in my instructor’s tack room, we decided on the one I’m currently using. The fitter thought it was okay (not perfect), and the vet thought it was okay (not perfect). Maybe it isn’t? Is it possible that her initial acute lameness has actually been resolved, and the stumbling is because of the new saddle? Could someone more knowledgeable than me take a close look at Video 1 in my first post and let me know if you think something like this could be caused by poor saddle fit?

[Bluey]

Possibly you have more than one thing going on there?
I would suggest, for the front end touchiness, checking for PPID and starting on Prascend if she needs it.
Her front end may be a low grade hoof pain from Cushing starting?
Why I think that? We had a 15 year old with a similar off story in front and, once diagnosed and on Prascend, he was sound again for a few years.
Maybe your vets have already gone over that, but if not, one more possibility …

The hind end could be from a pasture misstep, looks like stifle, but not a vet and they already have looked, so that is a wild guess.

Good luck finding some way to make her more comfortable and if possible safer to ride for you.