Locking Patella/Stifles

I have a 17 hh 16 year old TB that has shivers, but also locking stifle/patellas. The horse is retired from competition, but a sweetheart that anyone can ride and great for going out on hacks or foxhunting. His Chiropractor, also a very good equine vet, feels that is his major issue and has suggested that I get the surgery for my horse. (he does not do the surgery, my regular equine vet is actually the one he suggests to do it.)

I don’t doubt the diagnosis one bit. I just want to know if anyone has had a horse that has had that type of surgery on their horse and their thoughts. It is frustrating watching him as he seems uncomfortable and leary of his back end. I want to make him more comfortable. He works forward fine, but is losing alot of muscle now and seems frustrated in his stall or cross ties. (FYI, he has a stall attached to a paddock so he can come and go at night besides regular pasture turn out).

I have read up on it, but always like people with personal experience. Thoughts?

PLEASE NOTE I HAVE DONE ALL DUE DILIGENCE ON DIAGNOSIS AND CARE AS THIS HAS PROGRESSED FOR 4 YEARS. I AM STRICTLY ASKING IF ANYONE HAS EXPERIENCE WITH THE SURGERY AND THEIR THOUGHTS.

What surgery is being recommended? My understanding is that there are some different procedures that can be done.

I don’t know the technical name, but its done while the horse is still standing. in Simple terms: the offending tendons around the stifles have some slices made into them to get them to stretch out.

first, before surgery - what has been done to try to correct the stifle issues?

what has been done in terms of MGMT for the shivers?

IMHO, any horse with shivers or a stifle issue should never spend more time than they need to in stalls - i prefer shivers horses out, 24/7. they seem to do best if they are kept in work.

in your post i was not sure, has he been kept in consistent work or retired?

there are lots, and lots of things to try before slicing or blistering, IMO. estrone, 24/7 TO, vit e additional, PSSM type diet, hill work/pole work regime, etc.

Gah I was trying not to go into it all. I have done the research and due diligence with various vets.

He gets almost 24/7 turn out with in/out stall and regular pasture turn out.

Retired from a lot of riding, ridden 3 times a week, does hill work etc, poles etc do not help. Mostly 2nd flight, hound walks, staff back up that doesn’t need to do a lot of jumping (not fit enough).

His shivers is not from sugar issues but from injury developed after he fractured his neck in his stall 5 years ago. His hind end slowly became worse, even though he has been on consistent turn out. He is not PSSM, He gets high amounts of Vit. E (platinum performance). Chiro vet doesn’t doubt he has shivers either, but said due to his size and conformation is a predecessor to stifle problems.

[QUOTE=bigbaytb;8804344]
Gah I was trying not to go into it all. I have done the research and due diligence with various vets.

He gets almost 24/7 turn out with in/out stall and regular pasture turn out.

Retired from a lot of riding, ridden 3 times a week, does hill work etc, poles etc do not help. Mostly 2nd flight, hound walks, staff back up that doesn’t need to do a lot of jumping (not fit enough).

His shivers is not from sugar issues but from injury developed after he fractured his neck in his stall 5 years ago. His hind end slowly became worse, even though he has been on consistent turn out. He is not PSSM, He gets high amounts of Vit. E (platinum performance). Chiro vet doesn’t doubt he has shivers either, but said due to his size and conformation is a predecessor to stifle problems.[/QUOTE]
respectfully, shivers is not caused by injury or past trauma – shivers, the disease, is a cerebellum disorder/neuromuscular disorder. it’s believed at this point that it’s inherited.

my post wasn’t meant to say you were jumping in, but i wanted to figure out what you were doing first to manage the ‘shivers’ and stifle issue.

how much pole work? hill work? how close is “almost 24/7” turnout? how much vit E?

the reason why i parsed apart your text and asked these questions was because the “shivers” and locking stifle together raised some flags for me - it’s totally possible, but usually locking stifles can be somewhat alleviated/fixed by a very strong work regime and estrone. it has to be a real regime, not just walking over poles 2-3x a week. for my horses with stifles, it is 20-30m of polework a day W/T while on estrone, w a 20m hack on hills to warm up/cool down. you’ll see a difference in 6 months, not 6 days.

he’s going to lose condition if he is not worked like he was before.

shivers horses are usually treated on a ‘PSSM type diet’ even though they are not necessarily PSSM. the high fat/high vitE/low starch diet can do a world of good for a horse with shivers, but if yours has an old injury you’re likely looking at some sort of cervical arthritis, not shivers.

for a horse with CA, well, i’d be looking back at that injury to see if that is what is causing the locomotion issues - i’d be upping vit E to at least 5000mu, (our neuro is on 8000, if that is any indication), swapping for a lower than low starch grain, high fat, MSM, and cetyl M and would be talking to the vet about the possibility of injections and inspecting the neck before going to the stifle.

i guess my question would be what have you done so far to fix the stifle, and how long/how much?

locking stifles is sometimes a lack of fitness issue - condition the horse and the issue resolves. it can also be a saddle fit issue. if you guy lost condition, he lost fitness which may have made it worse which may have made the saddle not fit… it’s all an intricate puzzle and makes the guesswork and problem solving that much more frustrating :wink:

so a horse with a genuine locking stifle problem, and not a stifle slipping problem, i put hind shoes on, load them on estrone for 5-10 weeks, and do poles, hillwork, check saddle, add msm and increase vit E. if that doesn’t work, we try injections.

i have RARELY, RARELY seen a horse come back to full work with either the blister or the splitting, so it’s not something i would do on a horse that is semi-retired.

unfortunately, stifles and shivers are two issues near and dear to my heart, having had to bring a few back from such issues and dealing with shivers from both a management and friend aspect.

he is getting 6500 my of vit e and he is on the correct diet, but 3 vets do not feel he is PSSM/starch resistant.

I have done all the due diligence for shivers and thus why looking at locking patella as I have done nothing for that as of yet. Thus why looking at surgery but have not talked to my vet about it yet. I did have his hocks injected as he was fairly sore a few weeks ago. As you can tell, I am doing a lot for a horse that is not my primary riding horse, but I love him am willing to make his life comfortable, more than most people would, I suspect.

Please note, I have excellent vets and Shivers can be caused by injury, like a fall, genetic, which my vets did tell me .

I know several horses who have done well with estrogen. One friend has a horse who has done well since she had surgery 20 years ago. No one I know has needed surgery recently as the estrogen and hill work have been effective.

i wasn’t saying/suggesting he was a PSSM possibility, i was just sharing that horses with shivers do very well on a PSSM type diet.

actually, most horses do well on a PSSM diet.

anyway, from what you’ve posted it doesn’t sound like shivers at all. when a horse has shivers, there isn’t something wrong with their stifle or their back - there’s something wrong with their brain – so blistering or slicing the stifle would do nothing.

in shivers, it is not a proprioceptive deficit which is, essentially where a horse “doesn’t know” where their legs are (think EPM or other neurological diseases) – so if your horse is uncoordinated or uncomfortable, that’s not shivers. in shivers horses, they’re fully aware of where each limb is and have full understanding of spatial relation, they just cannot get the leg to ‘comply’. they’re fully coordinated and capable of doing athletic endeavors, but activities such as holding up a hind limb or moving after extended rest are very challenging for them.

it is possible that your horse always had shivers and that the injury and stress of the injury finally brought it to the surface, but the injury did not cause it.

anyway, when you see a smoking gun (in this case, the neck fracture) you should examine it. my money is on some sort of cervical arthritis. being ‘leery’ of his back and uncomfortable on the crossties to me sounds like a completely different ballpark than ‘shivers and stifle issues’, but YMMV. i’d still want to know how that fracture healed up, and maybe inject it if needed, and i’d still want to make sure the saddle fits before i blistered or split a stifle.

in the end locking stifles are usually a fitness/conditioning issue. slipping stifles, the inverse, are a problem and harder to resolve.

I’d at least ask the vet about the estrogen injections.

I have an older gelding that essentially overdid it in turnout one day, which led to x-rays revealing severe arthritis in the LH. Soon afterwards, the RH started locking (likely due to lack of exercise, and in hindsight, the RH probably had a slight stifle issue for quite some time).

Long, long story made short, my vet really didn’t think that the estrogen would do much for an older horse. Neither did the chiropractor who is also a vet. I pressed the issue and got the estrogen and it stopped locking after the first injection! He’s not on an exercise program at the moment, because the LH was quite sore (and it’s nearly 100 degrees here every day right now). But the estrogen alone has completely stopped the locking. The vet was very surprised and impressed at the difference. Some days it would catch every other step. Now, there might be a slight delay if he’s been standing still for a bit, but that is all.

It’s cheap, it’s an IM injection, and it has been a miracle for my older gelding. Once it cools off, we will start a walking program (I moved to a barn with some small hills for just that purpose) but we are somewhat limited by the arthritis on the LH. But once the RH stopped locking, we re-injected both stifles and I am very optimistic that we will get more benefit out of this round of injections because it was quite obvious that the locking right was contributing to the soreness on the left.

I know my vet does injections too and I will ask him about it also.

The fracture on his neck…which was 5 years ago at a barn where he had a small run w stall. He was at the end of few day of stall rest for a popped splint (he and another pasture buddy came in w/ the same one popped, think they both ran into a low xc jump in the pasture) . I received a call from one of my barn friends that she thought he was acting weird in his stall…when I got there, neck swollen and he was stumbling… fast forward…was able to get xray and could see a fracture I think around c4. Not awful and the vet at Rood and Riddle (since my vet and Purdue didn’t have a machine that could see it) said it was not life threatening and just slowly healed. My Vets feel that when his neck swelled up, is when that would have been when the spinal cord was inhibited. His neck movement now is fairly normal.

Had his hocks and ankles xrayed to compare to older pictures, and very little arthritis. Vets were impressed.

He does work well, Leg yeild, haunches/shoulder in, shoulder in/out… just on occasion, he’ll misstep with a back leg.

Just curious, what does his turnout look like, is it mostly flat? My guy with locking stifles did wonderfully turned out on a sidehill with his food at the top and water at the bottom. I realize this isn’t always the easiest situation to find, but I just wanted to post an option.

Although I have never had a horse that had the surgery, I have not seen favorable results in others.

[QUOTE=besttwtbever;8806202]
Just curious, what does his turnout look like, is it mostly flat? My guy with locking stifles did wonderfully turned out on a sidehill with his food at the top and water at the bottom. I realize this isn’t always the easiest situation to find, but I just wanted to post an option.

Although I have never had a horse that had the surgery, I have not seen favorable results in others.[/QUOTE]

Turn out is rotated. All fields either have a gradual to large slope. Facility has rolling hills, lots of up and down for us to ride. paddock attached to the stall probably has the least amount of slope, but still not 100% flat. He’s rarely worked on the flat, I take him out to the hills and work all gaits up and down hills.

As I said, all due diligence has been done, thus why looking at other options.

I’m suspicious of the shivers diagnoses too. What I suspect, since you said “injury” is that the injury caused fibrotic myopathy, which can present similarly to shivers.

They are not the same thing. They are not treated the same. Shivers IS a neurological issues, either genetic or caused by eating something like false dandelion.

There is no surgery for shivers. There IS surgery for fibrotic myopathy, and it works best if the issue is not terribly old.

The UFP might be related to not using his hind end well enough, or it might be its own issue.

I’m not clear - is the surgery you’re asking about for the UFP? That’s my assumption. If you are talking about the splitting technique, where several slices are made into the ligament - through it, but not fully across it, then that tends to work very well. But if the issue is currently caused or exacerbated by the relatively little work, I would not expect miraculous results with the surgery. As little work as the horse is in, I wouldn’t even DO the surgery until he’s in more work. The horse has to be in daily work for a few weeks following the surgery.

I’d far rather spend the money (first) on the fibrotic myopathy surgery.

Yes, that is the surgery I am thinking about. I am just looking at options and just trying to make my horse a little more comfortable. I would not think of it if they chiro hadn’t mentioned that he didn’t think all the issues were shivers for what he could feel when working the stifles.

Is there a reason he can’t be put into more work to do the strengthening that is really, IMHO, a required first step towards resolving UFP?

he is the same when fit or unfit, there is no change. So any amount of work doesn’t make a difference. He doesn’t get as much work as a guy that rode him often no longer works at barn. I will ride 2/3x week, he’s used on the hound walks 1 or 2x week and I also hire a person to ride if he is not used and I am out of town. He’s the go to horse for anyone who has a friend/family member who wants to ride a horse that is kind and willing and “Mr. Perfect”, just him hiking up his back legs scares the beejeebers out of them because they think he’s going to kick when he’s just stuck for a moment.

[QUOTE=bigbaytb;8804317]
I have a 17 hh 16 year old TB that has shivers, but also locking stifle/patellas. [/QUOTE]

[QUOTE=bigbaytb;8805488]
He does work well, Leg yeild, haunches/shoulder in, shoulder in/out… just on occasion, he’ll misstep with a back leg.[/QUOTE]

Can I ask when his UFP started? Especially in relation to when the guy who rode him more often left?

Like I said earlier, this newer surgery has a very high success rate, compared to the older desmotomy which completely severs the ligament. I’m just confused as to the real situation - you say he’s not comfortable, but then it seems like the UFP situation is pretty occasional, and sometimes just a hitch, not even a lock. That UFP as described doesn’t cause muscle wasting like you described either, so it sounds like there’s a lot more going on, and the surgery may well not address most of it.

But yes, if you want to do the surgery, go for it. It’s old enough, been done on enough horses and ponies, to prove it’s pretty effective, and it definitely does not have the arthritis risk down the road that the old surgery does.

[QUOTE=JB;8813700]
Can I ask when his UFP started? Especially in relation to when the guy who rode him more often left?

Like I said earlier, this newer surgery has a very high success rate, compared to the older desmotomy which completely severs the ligament. I’m just confused as to the real situation - you say he’s not comfortable, but then it seems like the UFP situation is pretty occasional, and sometimes just a hitch, not even a lock. That UFP as described doesn’t cause muscle wasting like you described either, so it sounds like there’s a lot more going on, and the surgery may well not address most of it.

But yes, if you want to do the surgery, go for it. It’s old enough, been done on enough horses and ponies, to prove it’s pretty effective, and it definitely does not have the arthritis risk down the road that the old surgery does.[/QUOTE]

NO, its not occassional. When ever he moved around, the legs will hike up and sometimes get stuck. It’s almost impossible to clean out his back feet. I have it down, but it requires patience. If he’s standing still, it takes a bit to get him forward. Once moving, he does very well, feels good with occasional slip/trip with a back foot. It’s hard for him to back up. He can step and cross under himself. If I can video it, I will and try to post it.

The guy who rode him just hacked out with a trainer or by himself and would go out on the trails, long and low most of the time. This started about a year after the horse fractured the neck. he was on 24/7 turn out and would on occassion just hike up one leg. It did get worse about 2 years ago when I moved barns and he was put on a high protein diet (made my calm horse nuts too), I then put him on the equine senior barn liked, and he dropped alot of weight. So I put him back on his feed that he has always done well with. (High forage, high calorie and Hi fat).

Hiking the leg up is a neurological issue, not UFP. Either shivers as a genetic defect, or from EPSM/PSSM, or nutritional, or something else that isn’t shivers but presents similarly.

I asked about occasional, because you said “just on occasion, he’ll misstep with a back leg.”

feels good with occasional slip/trip with a back foot.
sounds like a slipping/catching stifle, which is not as severe as UFP, or actual locking. Contrary to how it sounds, Upward Fixation of the Patella" is not the leg “fixating” in the up/flexed position. It is the patellar ligament getting stuck over the patellar hook, causing the leg to not be able to flex at all, it’s rigid, it’s stuck with the hock and stifle in the extended position.

Having difficulty backing up is also a symptom of shivers, or shivers-like issues. Unless a stifle is locked (which keeps the foot on the ground, leg unable to flex to take a step) a horse with purely UFP issues has no issues backing up.