Mysterious Hind End Tripping - whole back end feels like it falls out

I’ve mulled over posting this because I’m worried everyone is going to tell me my horse has some sort of catastrophic injury or disease (torn ligament, EPM, etc.) but I’m at a loss.

My horse is a 19 year old Dutch Warmblood gelding who campaigned in the 3’-3’6 for over ten years very successfully and soundly. We always did any maintenance he needed in terms of joint injections and he seemed to stay very comfortable. From the day we bought him (10 years ago) he had always had a slight “catch” behind on occasion- kind of felt like a flat tire for a second. It was very subtle and only happened occasionally. We always chalked it up to being “him.” Recently though, he feels as though his whole back end is falling out from underneath of him. This happens most frequently at the trot. Sometimes it’s so bad that he recovers from it shaking his head and going into the canter. Picking up speed is not common for this horse- he is a very lazy hunter type. We’ve also noticed that when he jumps he lands from the jumps very short, shallow, and “stabby” which is uncharacteristic for this horse. He’s a big stridey horse that typically lopes over the jumps.

We’ve had the vet out and did a full lameness exam. She saw him do it on the lunge line but I feel as though he’s worse under saddle. In the past three months he has had his hocks and coffin joints injected, which seemed to make no difference with the tripping. According to the vet he travels well behind and did not flex positive enough to have his stifles done. He’s also a cushings horse so we have to be careful with steroid injections. Our most recent experiment was a 5 day bute trial. I gave him off for a over a week before starting the bute. On Day 4 of the bute trial I hacked him. The tripping had not improved and was even worse/more frequent in my opinion, which leads me to believe it could be related to his fitness or conditioning. However, he was doing the 3’ earlier this summer, so he’s really not “out of shape” per se. I asked about him being neurologic, but she said since he rarely does it at the canter, that seems unlikely.

I’m at a loss. I’m staying off of him until the vet come next week to reevaluate. I don’t want to keep riding him if he has some sort of injury or is uncomfortable. In July I showed him in the 3’ and he felt wonderful and now he feels awful. We moved barns in March and switched farriers so a part of me wonders if it could be related to that, but he was going well in July. The farriers at this barn are also very good and well respected. My main priority is keeping the horse happy. He certainly doesn’t need to do 3’ anymore; I just want him to retire comfortably.

have you tested for EPM?

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Since it’s not new, I wouldn’t be inclined to blame the farrier, but it’s worth looking into just in case. My first suspicion would be cervical arthritis… I had a horse who exhibited similar issues and my vet strongly suspected CA, but we never got as far as doing diagnostics to confirm.

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If time off makes it worse, I’d lean towards stifles. Also known some horses with sore stifles to get cranky landing from a jump. IRAP is good for stifles and no steroids.

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Mine has very mild early KS and gets very trippy when his back is sore, which tends to happen when he can’t have turnout or he’s out of work for more than a couple days. His treatment is PT for conditioning, acupuncture, and steroid injections for the affected joints.

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A very nice hunter horse at our farm has had minor off and on lameness or NQR symptoms for the last few years. Back, sacrum adjustments, injections, etc. Nothing seemed to last for long. Finally took up to a university for FULL evaluation. Horse has cervical arthritis in the C6/C7 area. Vet told us in clear terms DO NOT RIDE this horse again…ever. We were all stunned because even on his worst day, he never felt like he was going down or neurological. We thought hocks, stifle or sacrum issues. Though the dx was a shock, we are glad to know…

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I agree with Heinz, I would think again about neck arthritis

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The overall presentation is very much stifles (slipping), but the slipping so badly that the horse headshakes and goes to a different gait is something I’ve seen in horses with neck arthritis.

I hope you can get some good answers when the vet comes next week. You may want to consider finding a vet experienced with neurological disorders. The gelding I put to sleep for cervical arthritis could canter fine - it was the walk and trot that was scary. I don’t think that’s a good litmus test for ruling out neck issues, as they can vary so much based on location and severity.

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It’s my understanding that cervical arthritis can sometimes be helped w Adequan or a joint injection (per my vet). I understand your concern over joint injections due to PPID. I hope you can get some good diagnostics from someone.

The trouble with any sort of hind end pain is that it causes loads of secondary issues.

If he’s had hock trouble off and on, his SI is probably quite sore. I have dealt with SI problems and I FEEL it so much more than anyone can see it. It’s hard to describe but you certainly feel it.

I’d try some chiro, maybe massage. You could also talk to your vet about a 1 or 2 week course of anti inflammatory and light work to see if he improves. The horse can get very tight due to compensation so even when the primary issue as been found they are sometimes sore in all the other places still.

Also – SI problems tend to be worse with rest.

Good luck!

I live in the orthopedic spine world. C6/C7 have no nerve roots associated with the hind limbs. Not sure how a vet could make that connection. They affect the forelimb proprioception and function.

Thoracic and lumbar nerves are hind end.

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Thank you everyone for your responses. The vet is coming Thursday to do a neuro work up, test for EPM and shoot some rads of his neck. She though cervical arthritis seemed consistent with his behavior.

The fact that it got significantly worse with time off still makes me suspect stifles or maybe something SI. Not sure. If all else fails we scheduled an appointment with sports medicine at New Bolton for the beginning of November.

He is very special to me so I hope I can figure out how to make him comfortable. From my (little) research cervical arthritis unfortunately does not seem to have a great prognosis whereas stifles and SI are more treatable.

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PSSM?

I had a TB who was diagnosed at about 21 with cervical arthritis. C5-C7. First symptom was inability to maintain correct lead behind particularly on a circle. Also showed some neuro symptoms. Had neck injections done, they helped for quite a while, then began noticing the one hind would get left behind; mostly at trot and only when under saddle. Free lunge in the round pen, he was fine. Corresponding to that he was mildly worse on neuro exam, so he was retired.

Fingers crossed and jingles for you that it’s something minor and manageable! I hope I didn’t scare you mentioning neck issues - we weren’t able to definitively confirm the diagnosis in my horse, but my vet was pretty confident. He had a lot of the same symptoms you mentioned, with a lot of the same treatments and the same lack of results after several exams.

RAyers, I bow to your infinite scientific wisdom - that said, I was reading this paper from New Bolton on ataxia, particularly the parts that refer to general proprioceptive ataxia and cervical vertebral changes in the older horse (even more particularly, that it is often more pronounced in pelvic limbs, especially in milder cases). It was quite an interesting read.
https://www.vetfolio.com/learn/article/approach-to-the-ataxic-horse

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No I really appreciate everyone’s insight. I have fortunately never had a neurological horse and to me, my horse isn’t what I think of when I think of a horse that’s neurological. Aside from the slipping behind he seems very functional…he holds both leads well, does a beautiful change both directions, navigates trot poles and jumps without an issue. He seems like he knows where his feet are. He also isn’t unpredictable and spooky like I think of a horse with neuro issues would be. For his age he looks great. He’s willing to drop his head and accept contact easily and I would expect a horse with neck arthritis wouldn’t be as willing to do this? Maybe he’s a trooper or maybe whatever condition he has is just very mild at this point.

sorry to say, it does sound neurological to me too. Many, many neruo horses aren’t consistently lame, spooky, or unable to jump.

My KS mare was showing in the AA hunters and some lower level USDF dressage successfully. Then she started to have a very occasional stop or refusal from a deep spot. She had some time off, and when she came back to work it was even worse. A full workup showed KS in a few places, and the time off made it worse, because her topline was helping hold everything stable, and when she lost that muscling, things began to hurt more. She’s now retired from jumping, but a solid flat work program keeps her sound and comfortable.

I had a nice WB gelding who started having some hind end issues that were similar to what you describe. One vet thought SI, another swore EPM. We gave him 4 months off and did the full Marquis treatment. When the horse came back into work, he was fine. I have no idea if the EPM was resolved, or he the time off let his SI strain heal.

BL, with your horse’s age and mileage, I think some sort of cervical arthritis is very possible.

Good luck, and let us know what the vet concludes!

It sounds like slipping stifles to me. Hill work will help if that is what it is. Good luck!

Many cranial cervical disorders cause pelvic limb abnormalities. I could see a vet making that connection very easily, considering.

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It sounds like he is in wonderful hands! The “tripping behind” description sounds like exactly what my horse does when her stifles slip. She has been diagnosed with upward fixation of the patella a few years back.

Things that help - specific strengthening exercises such as backing up, hills, cavaletti, lateral work, etc. Continuous movement (24/7 turnout is ideal), and a regular exercise schedule along with proper trimming for ease of breakover.

Things that exacerbate it - sitting without work or turnout for too long, long toes that slow or alter breakover

Where you say it got worse at the new barn with new farrier, did the turnout schedule or exercise change at all? Possible if his breakover changed with farrier that could make it worse too.

I would definitely have the vet evaluate stifles, not for soreness but for slipping. They are not one and the same. Best of luck!

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