Mystery lameness?-horse standing funny and poor behavior

[OceansAway]

Hi everyone,

*Picture of resting leg below.

I come again on behalf of my friend and her horse. Long story short (and I probably have a very incomplete version anyway) her horse started displaying some behavioral issues last fall, like bucking, spooking, and bolting in particular. Her horse also has a challenging personality (as in will challenge his rider) to start, but had never been unsafe until they point. Horse was scoped for ulcer and nothing was found. My friend sent her horse to a trainer over the summer, and the trainer expressed the horse also gave her a hard time, but she was able to cut the nonsense pretty early on, and then he did great. As far as physically, the only thing she noted was she felt his left stifle would get a little hitchy periodically, (so it was x-rayed with no findings, injected with estrogen or estradiol, I am not sure which) and that the farrier felt her needed shoes (which was what the other post was about.) He came home early fall, did fine for a while, and the bucking and bolting started again. Even before that started, she would mention regularly that he would stand funny on his left hind pretty constantly, and rarely rested the other leg. Sometimes it would out to the side or on the tip of his toe, and she was concerned about his stifles again.

Fast forward to winter when he hurt her pretty badly, and the vet same out again, after many correspondences about how he was standing oddly. The vet found the horse had some SI arthritis on the right side, which was discovered along with bilateral suspensory strains that were deemed extremely mild and more like just a little inflamed than a true strain. He also ultrasounded his stifles and found nothing. Her horse had his SI injected and shockwave was performed on his suspensories. After the first round of shockwave, the soft tissue had already returned to normal, tough the vet did finish out the series of 3 or 4. Throughout, he continued to stand funny. When it came time to start his rehab, he began acting out immediately, even with hand walking, which would be spooking and pulling away from her, which progressed to him bucking on the lunge, kicking out, and pulling free once again. He is much better with me, but he has even gotten me a couple of times. It seems like he starts getting very tight, tense, fussy, and then will explode. It can happen at any point- begining, middle, or end, or not at all. Ace does not seem to help except for making him more cranky since he needs to be pushed forward more, and still results in an explosion. He also counter bends when tracking right. Once trotting was introduced, we both noticed frequent stifle slips on downward transitions and when walking downhill and more on the leg he’s always resting. Around the same time, he started getting very grouchy about the saddle pads and saddle being placed on his back, but not when the girth was tightened. It seems to be associated only with his back, though I did mention ulcers. My friend wasn’t convinced, since this behavior was happening even when he scoped clean prior, though the back stuff is more new.

My friend was at the end of her rope because the vet keeps saying it’s fitness related, but she feels it’s pain, so she had him out again. He took x-rays of hocks and stifles which showed almost nothing except for maybe a tiny inflammation in the left stifle. He did find the horse was extremely reactive behind the wither, so they did full back rads, and found nothing. Saddle appears to fit fine and doesn’t make contact with the reactive area. Ultrasound shows the suspensories still looks great, as vet thought perhaps those were being aggregated with being reintroduced to work. He feels like the horse is still just unfit and that’s what is causing the stifle issues, but that doesn’t explain the poor behavior, grumpiness with saddle pads and saddle, or the resting of the hind leg, which really is pretty constant (and was happening even after coming home from the trainer when he was in peak fitness.) So, after all that, my poor friend was wondering if any of you have any insight into what could be going on, or where to look next. She’s put a lot into this guy, and is very frustrated at this point. I am sure I am missing a lot, but I might not be able to answer more questions but feel free to ask. Thank you all so very much. Picture of how he rests his leg is attached below.

[StormyDay]

His leg resting doesn’t look weird to me. Maybe it’s the angle the picture is at.

Has she tested for EPM or Lyme?
I’d probably do a course of EPM meds even if it came back negative as the test is sometimes unreliable. EPM sometimes manifests as them having body soreness, bad behavior, and standing funky.

[OceansAway]

Thanks so much! I also didn’t think this particular photo looks odd, but he will frequently hold it out to the side as well. I think she sent this to me to show how frequently he’s standing like this, meaning he is CONSTANTLY resting this leg either in this position or with it off to the side. We both were shocked last week when he was resting his right leg, because we hadn’t seen it happen since last summer. The horse is at my friend’s house, so she’s got her eyes on him very often.

I personally like the EPM suggestion, and I did mention it. I think she’s hoping to rule out something more objective, so to speak, before going that route.

[StormyDay]

The new EPM med is like $300 and easy to give; it’s a liquid you squirt into their mouth once a day. It’s probably worth trying even while she’s looking for other causes.

[Fiesta01]

Is there a good chiropractor and masseuse in the area? I would also want them to look over the horse. They could look again at saddle fit when they’re there. Experts can sometimes see problems with fit that we don’t.

[OceansAway]

Wow, I have not heard of this! What’s it called?

[OceansAway]

Yes, we have access to both. I am pretty certain she said she already has them out back before she sent the horse for training, but I can check. She did have a saddle fitter out before spring.

[Fiesta01]

I think it would definitely be a good idea for a re-check. Their skeletal and muscular comfort can change quickly depending on their activity/behavior. One of my mares (OTTB) could be fine one day, go out and do something silly in the field and feel totally not right the next day. Not lame, just NQR.

Even though she wasn’t lame, canter departs would really show off her discomfort through bucking fits. She could feel like a segmented worm with the head going in one direction, the middle in another and the hindquarters in a third. My chiro and masseuse could always fix the problem in one visit. She was a very rambunctious girl, though, so I did keep them on speed dial.

Good luck and best wishes to your friend and her guy.

[StormyDay]

Ponazuril. My vet prescribed a liquid dosage from Wedgewood. There’s a powder too, but my vet personally prefers the liquid because you know the horse is getting it all.

[TWH_Girl]

My 19 yr old with stifle issues stands a like that and often rests his leg; sometimes points his toe outwards. If the horse has had prior stifle issues why not look further into that? It’s rarely a one and done deal.

[IPEsq]

I would start looking at neuro related things. EPM, Lyme, neck arthritis, vitamin E and Seleneum levels. The owner has either ruled out most other things or gotten little response to treatment/improvement of those things.

From personal experience I think that the behavior escalating with the owner and the rest of you at home likely is because he’s either discovered you all are listening to him plus or and/or some frustration with it all to where he is yelling at you. With a more I’m not your mother, calm but firm approach from the trainer, he might have just shut down some because he can’t outsmart or out power the trainer. But there’s also possibly something different with the management (schedule, footing, turnout, other stress triggers) and work where he did feel a bit better in the trainer’s program or at least able to relax some even if he was NQR. Perhaps as simple as trainer made him feel more stable and balanced where he didn’t feel as vulnerable to a neuro deficit.

[GoodTimes]

When the horse was at the trainers did they use the same saddle and girth?

My second thought is that the SI and lumbosacral region are the source, and you’re seeing compensatory issues. I’m not saying that the SI should be injected again, but there are a number of muscles throughout that region. Iliopsoas comes to mind. Is there any asymmetry? Does he carry his tail to one side?

[greywithchrome]

@TWH_Girl

My 19 yr old with stifle issues stands a like that and often rests his leg; sometimes points his toe outwards

My mare with also rests one leg constantly, similar to the photo, and it is due to stifle issues.

[IndysMom]

Hmmm. I’ve owned my boy for 15 years. He has always stood with one hind resting. And 90% of the time it’s the left hind. He had OCD surgery on his right hock as a 3yo. We know he has arthritis in his left hock. However, my vet targeted his right FRONT as an issue. And, the day she saw him he was footsore due to a shoeing issue.

So, you may want to consider that it’s not behind but up front and he’s compensating.

[Pally]

@IPEsq

From personal experience I think that the behavior escalating with the owner and the rest of you at home likely is because he’s either discovered you all are listening to him plus or and/or some frustration with it all to where he is yelling at you. With a more I’m not your mother, calm but firm approach from the trainer, he might have just shut down some because he can’t outsmart or out power the trainer.

I’m quoting this and leaving this here, not just for the OP and her friend, but for anybody who thinks, “Well, I doubt it’s physical because he doesn’t do it with my trainer.” Sometimes, the trainer can make the horse look/go better because of more accurate riding. Sometimes the horse is more willing to work through some level of pain for the “scary teacher” than for “mom”. Just because the horse goes better for the trainer, it doesn’t mean the horse is free of all discomfort.

For the actual question of the horse at hand, I’m sorry I don’t have a ton of new ideas to offer. Has soft tissue around the stifle been explored? There is lot of “stuff” in those joints with potential for injury. One I took care of pops to mind… didn’t have the exact same presentation as your friend’s, but every diagnosis + treatment + rehab attempt would eventually lead to her saying, “Eeeh, no.” Eventually it was found she had a torn meniscus in that stifle.

[IPEsq]

That is a good point. Although you’ve done xray and ultrasound, it can be hard to appreciate some things like a meniscus tear without exploratory scope.

[OceansAway]

Thanks, everyone! I know he was tested for Lyme, had back rads including the cervical spine, and his stifle was already ultrasounded as well as x-rayed. I am not certain about the Vit E/selenium. The vet just rechecked him last week, so aside from getting another opinion, I don’t think there is too much more he can check in terms of the stifle itself. Perhaps I’m wrong. I will check to see if there is any muscle atrophy, or if he carries his tail to one side. I have not noticed, but since he’s not mine I probably don’t analyze as closely as his owner. It seems like a Neuro exam would definitely be worthwhile, along with checking the angles in his feet.

Yes, he did have the same tack when he was with the trainer. I agree that trainers can often “convince” horses to work though pain better than the average AA, so perhaps that’s what was happening. I think she is also a no nonsense type, so he might not even attempt to act out in discomfort.

Would meniscus issue be seen as lameness, though? I’ve never seen him off, aside from those stifle slips. I only know one person who had a horse with a meniscus issue, and he was obviously lame. I have also heard of issues inside the stifle joint that can’t always be seen until the joint is cleaned out. Either way, something is making him super uncomfortable and cranky, and it’s making my friend feel very torn about pushing him in his suspensory rehab program, because she feels like she is making him feel worse elsewhere. I feel her pain, as I am sure many here do!

[TWH_Girl]

Honestly at this point, I would find a vet to inject the stifles. The way he stand and the falling out behind especially going downhill are classic stifle symptoms.

[OceansAway]

I think she might as well try it and see. He’s young, so I get being hesitant to compromise the joint so early in life, but it is probably worth it as this point. If he was mine and I had $, I would want a bone scan. When I look back at all the thousands I’ve spent on workups, I could have saved thousands if I had just gone to a bone scan early on, rather than 5+ inconclusive vet visits. We have several good hospitals right near us.