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Maybe SI problems - vet coming | Update: flat palmar angles behind

Horse Care
#1

I’m looking for input as the vet will be coming out soon for my coming 5yo mare. Background:

  1. She has always had bad posture. Her feet were terrible when I got her as a 2yo. Good trimming on a 5wk cycle and rasping her toes in between trims helped her feet tremendously. Improving her feet helped her posture, and when she is in work her posture is a lot better too. But she got about 6wks off from December through early Jan and her posture has reverted to just awful. She stands very camped under, sometimes both her front and her back legs at once but often just one or the other. She does not stand square on her own when her posture is bad like this. Generally looks uncomfortable. She also has a hunter’s bump. Right now she’s shod up front and on a 6wk cycle.
  2. When she trots she goes around in an inverted U-shape. This also was getting better before she had a 6wk break but now when trotting in turnout her neck and back are braced.
  3. This past weekend, her SI area was sore when I palpated it, especially on the left side of her back. I gave her a massage. KT taped it, and we did stretches. When we did groundwork this week, it was walking over poles and backing up. When I would back her up, her body would invert and her head would go all the way up in the air and brace her neck. This is unusual even for her being out of work, because she’s always been able to back up with a low headset and round her back.
  4. Yesterday, she was lame on her hind left. She’s standing very narrow behind and tracks narrow. Not tightrope walking but quite close. Doesn’t want to step under herself as much when usually she tracks up nicely with her hinds landing in the same impressions her fronts made. She was standing with her hind left all the way underneath her which is what initially flagged my attention.

I inspect her every day and she’s never been warm or swollen anywhere. When she was in work before the break, it was about 4x a week of 2x riding (90% walking, 10% trotting) and the other 2x being ground work or long lining. She looked wonderful — she muscled up very nicely and her posture was a lot better.

She gets bodywork by a talented PT about every 6wks and is dramatically improved afterwards. Every time, the bodyworker says her hamstrings are very tight (suspected due to posture) but has never found any back pain.

I took X-rays of her hooves last in August 2022 (fronts) and December 2023 (hinds). Everything looked great then, but with the vet coming out I’m going to ask for all hoof films and look for any imbalances or NPAs. The doctor that’s coming is a lameness specialist so I’m sure she will have her own ideas, but is there anything else I should ask for? I think it is an SI issue but I am not the professional so any ideas are very welcomed!

#2

I’d start with a full lameness eval and it may be worthwhile to ultrasound both hind suspensories, and get new x-rays of all the feet to check for NPA as yours are over a year old or more. It can be a chicken and the egg between sore SI, NPA and a hind suspensory injury.

FWIW, when I got my horse, he also had a hunter’s bump. Later on, he injured one hind suspensory, then 18 months later, the other hind suspensory. During the rehab of the second one, I changed farriers and medicated his SI, and worked, generally, on stretching and strengthening his back and the hunters bump isn’t noticeable. Now correlation isn’t causation, but all I know is between all the treatments and changes and massive farrier improvements, I have a new horse. I mostly credit the SI injection and my new farrier whom I love dearly.

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#3

Thank you. For sure the lameness exam and X-rays will be happening, I’ll ask about the ultrasound as well. I hope it doesn’t come to injections because she isn’t even 5 yet (foaled May 2020) and 4 seems really young to start injections. But if that’s what the vet suggests then I will do it. Unfortunately for my mare her conformation is working against her- she’s pretty cow hocked.

My farrier is also really good. Wouldn’t NPA be more likely to develop on a longer cycle? She was on the 5wk cycle from September 2023 to August 2024. Was shod in September and moved to a 6wk cycle.

#4

She may be going through a growth spurt and trying to figure out how to get comfortable. Even if you inject something now, it doesn’t mean she will have that issue forever.

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#5

SI injections tend to be one-and-done in most cases, it’s not the same as hocks etc. We did SI injections on my young horse who was just having trouble building strength in his hind end, the injections basically loosened him up enough that we could do the correct strengthening work we needed to. The injections made a huge difference in how he moved. He was never lame though, just out of shape, stiff, and a little uncomfortable in his body. We did PRP which I highly recommend, it’s a little more expensive but the results were worth it.

We did neck x-rays as well before we injected the SI, just to rule out anything obvious on that front. From what you describe I might throw that in the mix along with the lameness exam from a competent lameness vet.

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#6

PRP has given better results for my mare than steroids did, for SI injections. However, my experience has not been ‘one and done’. But, mine is an OTTB so likely has underlying pathologies.
6 weeks is not a “long time” for a horse to be off and revert to previous posture, not for a horse that’s been working - doesn’t have to be hard - but steady. If I’m understanding correctly. Makes me think there is much more going on.

FWIW: NPA, SI, KS… they all seem to go hand in hand. Not always, but often enough. If this horse already has conformational challenges, keeping her ‘correct’ 100% of the time is your goal. It’s tough. Takes a good team for these types.

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#7

Well, I sure hope it isn’t an KS-SI-NPA onion. I will ask about neck rads. I’ve deliberately been mindful with her conditioning and haven’t asked too much too soon, so I hope it is something simple and not a systemic issue. She wasn’t as lame on her hind left (ETA and her posture was a lot better) yesterday but was holding her tail in a strange way, up in the air like she was going to poop and to the left.

Hoof rads to check for NPA and imbalances
Neck rads
Hind leg ultrasound
Lameness eval

Worth it to recheck EPM titers? Her titers were low (450) in the fall but we went ahead and treated since she was acting spooky and tripping more.

#8

How do you keep your mare correct?

#9

Well… it’s tough. Good farrier work, followed with regular xrays of angles. Good lameness vets, injections as needed. Turnout, as much as possible, with room to really move, is helpful especially if you aren’t riding to keep the horse moving. Good riding, groundwork exercises that help keep the horse using its core.
Even doing all of that, it’s not perfect and it won’t fix what’s already broken, so to speak. It just manages it in the best way possible for the longest ‘sound’ outcome, I guess is how I would put it.

Whatever you do, just be observant and not afraid to speak up about what you see. You know your horse best.

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#10

Is there any way you could have his feet done by the farrier every four weeks?

When I did my own horses after 4 weeks the real problems would start and I had to be proactive with the hooves to keep them in decent shape. But there were times in which my horse profited from a real farrier doing a more frequent trimming schedule and that saved my own back from wear and tear.

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#11

I asked about keeping her on the 5wk cycle after she was first shod, and the farrier said he doesn’t like to reshoe horses sooner than 6wks bc it is tough on their hoof wall/horn. I personally think her feet start looking too long at the 4 to 5wk mark, even in winter.

She had very long toes and underrun heels. They’ve improved but she still doesn’t have much heel. I’ve asked multiple farriers and vets about it and none of them have expressed any concern beyond “that’s just how she’s built.” She seems a lot more comfortable with plain steel shoes on up front and her feet look balanced, but we’ll see what the X-rays say. Unfortunately the vet is coming out literally one day before the farrier comes out this week so her feet aren’t going to look fabulous.

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#12

Thank you!

#13

This type of thinking was why I had the shoes taken off my horse and investing in a rasp and the US Cavalry manual for horseshoeing. I just trimmed, no shoes.

One farrier practice that puts my teeth on edge is when they take the rasp to the outside bottom third of the hoof to get it to conform to the shoe or their ideal of what the hoof should look like. This just totally destroys the protective outer layer of the hoof and leads to increased chipping, cracks and significant lumps coming off especially on a 6 week schedule.

But I no longer own horses so I do not have to worry about this any more.

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#14

Certainly was the case for my KS horse. Found flat angles behind (not yet negative but not great), and ended up injecting the SI.

#15

You have a QH right? My mare is a stock horse too. What has your experience been keeping him correct? I will be really surprised if we end up finding KS but we’ll find out this week.

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#16

Yep! Kissing spine was low on the list of potential concerns but after some inconclusive flexions we x-rayed the back on a whim. It still surprises everyone! He is a sweet boy, never girth or palpated very sore.

He’s had two injections in his back and I did some mesotherapy for extra support (and he gets bodywork as often as I can afford.) We have also added hind shoes which seems to have helped him. He built up a ton of muscle and his back and hind end(croup) look so much better than they did. We do dressage and exercises on the ground for rehab.

It’s been kind of a journey of me pushing to keep finding what was going on with him. It’s all been very subtle so nothing stood out to the vets at first until I kept pushing.

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#17

In my experience SI pain is usually from compensating from something else so def keep looking even if the SI palpates sore. Let the vet guide you. If they’re not thorough try to haul to the best lameness vet in your area.

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#18

You said she’s a stock horse… has she been tested for PSSM?

Are you in an area where Lyme is possible? Any time I have anything unusual go on here, I always test as a rule out because we are in an endemic area and Lyme can do so many weird things.

#19

The vet came out. My horse was moving beautifully today and was clearly feeling good. The vet said her conformation is working against her (hind right toes out, cow hocked) and she will likely need stifle and hock injections as she gets older. And that PT and proper conditioning and not giving her extended amounts of time off will be important for keeping her comfortable.

She’ll be tested for PSSM.

We took shots of her hooves and everything up front looked great. Her hinds do not have NPA but the P3 is flat. They’ll have to measure the angles back at the clinic. Which has me scratching my head — I’ve had her on a 5-6wk cycle for 1.5yrs to avoid this exact issue.

The farrier is coming out on Friday so she’s at the very end of a 6wk cycle. Is it possible for angles to change with one trim?

Texted my farrier and he said to shoe all around. Is it dangerous to have her with my other horse in turnout with hind shoes on? Are there other options?

I’m guessing the flat palmar angles in her hinds are why she stands so poorly and is sore in her hamstrings and SI. Though the vet wasn’t concerned with her SI today.

#20

Depends on how much foot there is to work with.

It’s only dangerous if your horse is aggressive or a known kicker. If not, I wouldn’t stress over it.

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