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Neck OA, SIJD, hock and navicular help needed!

I have a 15 yo Arabian that was diagnosed with Sacroiliac Joint Disease shortly after I purchased him 9 years ago. He had a pre-purchase history of pulling out in the cross ties and landing on his ass. Also had a major downing in the cross ties. He was okay walk/trot but could not canter to save his life; ran straight into jumps. I moved him to free roam on a 50 acre ranch with 40 geldings. Sometimes his back end would just drop out but he was mostly fine on W/T. So it went for a couple of years.

Trying to move him to SoCal, he had two complete flips (reared and flipped onto his back) on trailer training (this was AFTER he worked for a whole month with a BLM-certified emergency rescue hauler) and arrived in SoCAl with a goose bump on his forehead. So, more trauma. (Note, I was never properly advised after these traumas. He should have been stalled for 45 days post-trauma. I think no vet thought he was worth it.) He was on Adequan and in time Prevacox. I injected his hocks, stifle, SI and a bone chip in his pastern. I continued to do lite trail with him until last May when something seemed to change. He became an “amazingly calm” trail horse. At first I thought he’d just become a great trail horse but then I discovered his calmness was unnatural, guarded. He was also calm in the wash rack whereas normally he was a nutcase in the wash rack (I’d given up using it altogether). Normally, he hated his feet being touched by water but all of a sudden he didn’t mind. Then in May he and my fat pony escaped and ran all over town for two hours with their halters and lead ropes dragging. They were found without their halters, so probably additional neck injury there.

We spent the summer dealing with suspensory injuries from the escape (my vet initially under treated the suspensory injury.) So when all the suspensory injury stuff seemed resolved, I started riding him a teeny bit on a flat, smooth trail but he was a wobbly wreck. My vet said he’s just out of condition. His stance became more and more distorted (both right legs pulled together under him), began to limp and “porpoise” with his head (that was not new but it got worse.) Vet tried blocking everything and finally said that we had to do a bone scan. (Vet notes indicated: unblockable front end lameness and shifting lameness.) Nuclear scan showed hot neck C5/6/7, SI bi-lateral, navicular bilateral, and right hock was the worst. I had everything IA injected and also did Adequan, Osphos and got X-rays of the feet and hock. Hand walked him for weeks and he seemed to be getting better. Then I added a walk under saddle every three days. After a few weeks, he got WORSE under saddle, not better. The last day I rode him, he was barely walking, avoided the slightest incline, walked like he was on ice over a paved driveway, and moaned. I got off after 40 yards.

I called the vet out for a post-injection follow-up. We had the vet tech ride him walk, trot and canter. The vet tech fell off at the canter! I could tell my horse would be in a lot of pain afterward. To my astonishment, the vet told me to get him working W/T and even canter! Vet insists the horse is not neurological but I’m not convinced. Since the exam, I’ve had my horse on Prevacox and he seems painful (we also had a blast of cold weather.) Low head position (very uncharacteristic), standing with right hind limb under him and right forelimb behind (so his right legs almost touch). I think he stands with his back leg under to relieve the sacroiliac. (My dog stood like that as his hip arthritis worsened.) I think his right front leg behind with his left front leg in front is his neck pain. He also doesn’t want the pony to come near him and he’s not eating out of his hay net (ok eating off the ground.) He stumbles on hand walks.

Soooo, should I believe the vet and ride him to exercise him? It seems cruel! Will exercise HELP? Should I believe my experienced friend who tells me that he could collapse from the neck arthritis impinging on his spine? Should I get a neck x-ray? Should I do shockwave therapy? I don’t know what to do. I don’t think my vet even sees pain and he’s a bit too hard on horses for my taste.

I’d get radiographs of the neck to definitively diagnose the arthritis. But be aware that this is a progressive disease. If he did not respond to the original injections, you aren’t going to have a lot of options if his current issues are all stemming from that problem.

With his laundry list of problems, I’d be tempted to have a full neuro and lameness workup done. Possibly by a referral center. He has so much history that is makes it difficult to sort it out. Could be his neck, SI, re-injury to his suspensory, navicular pain, the bone chip, or any combination of the above. Or a new injury. And since it was all treated at once (with injections) it makes it even more difficult to know what treatment worked.

I’d also look into adjusting his shoeing for the navicular, if you have not done so already.

You may be in for a long road in terms of getting him sound, both in terms of time and money. And you may very well not have a rideable horse at the end of it. I honestly would be considering retirement if he was my horse, considering his extensive lameness history and his need for pretty aggressive maintenance with both injections and NSAIDs, and the fact he is still uncomfortable at the walk despite these treatments. Sometimes you can’t fix them, although I know you’ve put a lot of time and effort into his soundness.

Personally i think he needs to be PTS to many issues and he’s suffering.

He is definitely achey but his spirits are good and likes his hand walks to the grazing pasture. He likes to visit with horses over the fence but pony is too aggressive in the same paddock. Seems like as long as I don’t ride him, it’s manageable but I just do NOT know what to do with the vet’s instruction to exercise him. I know it’s better to exercise when you have arthritis (I have arthritis) but maybe riding is just too much?

Thank you. I am going to get rads of the neck next and probably a full neuro exam on digital and send it all to referral center. Shoeing for navicular was done. I wouldn’t mind retiring him, truly. I’m just flummoxed by the vet’s advice to work him. The vet insists its good for arthritis. And I’m sure my horse wold love to get out - IF - it didn’t hurt. But when your horse is so dang sore and stumbles and limps on the long line, how do you saddle him and ride him? It seems crazy to me. The neck arthritis scares me. Vet says people inject necks and continue competing. Confusing.

Your vet is nuts.
I would not sit on a horse who stumbles and with possible neck arthritis. We just put down (in November) our gelding with neck arthritis due to a trailer accident more than 10 years ago with his former owner. He started stumbling with my daughter, once made a face plant… and she decided to never get back on him again.
The vet watched him and said he was dangerous to ride and would become dangerous to handle. On double dose of Previcox, he did ok for a few months, but the stumbling started again. xrays showed arthritis at C4-5-6 and 7.
The vets at the equine hospital warned us about winter, snow and ice. Less than a month later, he started swaying in the x ties and in stall, stumbling more and his shoulder muscles atrophied almost overnight. He was in pain and stressed.
We sadly made the decision to let him go.
The neck arthritis is a strong possibility in your case too and I would not ride him, for your safety and for his comfort.

IMHO you need neck radiographs to see the extent of the OA there and to do the measurements for possible narrowing (stenosis) of the spinal column plus a neuro exam.

Good luck. I am dealing with issues possibly related to cervical stenosis in a coming 7 y.o.

Update- we did neck X-ray. The vet was surprised to find an “impressive” bone spur. He repeated twice that it was significant. I could tell he was really surprised. And yet despite this, he insists the stumbling isn’t neurological, that the horse is lazy about picking up his feet. Lazy! The poor guy has SI,navicular, cervical and hock arthritis. I don’t even want to talk to the vet anymore. Talk about adding insult to injury!!!

Vet called later to say that the measurements on the canal were all high 50’s 60’s . Doesn’t matter, I still don’t want to talk to him.

I haven’t had neuro done because the best guy here is personally close to my vet. In fact, I’m wondering how I can get a second opinion at all when it seems like every vet is afraid of stepping on another vet’s toes. ??? And is there any point in doing a neuro exam when I know he’s got these neck issues? I mean, if he’s not neurological, now, that doesn’t mean that riding him won’t exacerbate his problems and potentially cause a soft tissue swelling that will impinge on the cord. I guess I just do not get the significance of the bone spur. Big deal, or no?

Now my main issue is changing to a vet who believes me when I say he hurts.

I am not riding my horse. :frowning:

I’m impressed by the thousands you are spending and will continue to spend for diagnostics and treatments for this poor guy…he really needs a full workup at a clinic before you spend more on treating anything to really pin down what’s going on.

If you cannot get him in to a clinic fir that workup, Id retire him and turn him out, there are retirement places out there with enough land for that. See how he does. If he keeps having trouble, PTS would be the kindest release from his pain.

And change vets. Get one that can educate you on exactly what is wrong and your options…that would not include forced exercise without a complete diagnosis.

Shifting lameness, attitude changes, and wobbliness sound like EPM is a possibility. There are a few tests you can do, but I’d at least rule EPM in /out.

I’ve spent thousands chasing lameness issues on my guy too. Sometimes you’re so far in you just keep going. I hope you do find an answer for him and can help him because there is no better feeling in the world!

I’m sorry for you and your horse’s situation. Sometimes we put too much trust in vets and so I’m glad to hear you are sticking to your guns and listening to your gut and not riding. If it were me, I’d likely stop chasing a diagnosis and turn him out to be retired as long as he is safe and happy. By all means, continue with hand walking if he is safe to handle and not a danger to himself. Best wishes to you.

I also commend you for your dedication to this horse and the effort you have put in to finding out the root cause of his many issues. It sounds like your vet is the “practical” kind and that for many of these issues, his rehab recommendations are kind of minimal. It seems to me like you need the more “technical” kind of vet who wants to get to the root cause of the issue and then do the most thorough rehab possible. Do you have a teaching vet hospital or referral center accessible to you?

You need a second opinion, if you’re considering trying anything for this animal other than euthanasia.

I’d also venture some suspicion wrt the navicular dx, as


Vet notes indicated: unblockable front end lameness and shifting lameness.

b) navicular dz is quite unusual in Arabs.

The bony changes in the cervical vertebrae would be my main concern.