@RhythmNCruise that’s interesting - my chronic SI gelding also goes barefoot behind and has since I laid him up initially. I felt like the more we messed with the hind shoes, the more we created bigger issues. So we pulled his hind shoes and have never put them back on. Fortunately he has decent feet and we are sand/grass. He’s quite able to do FEI work being barefoot behind. He also gets a Mg supplement which was a big help when I started him back to rehab.
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LATEST UPDATE BASED ON VET VISIT 1/20:
So vet came today and we scoped for ulcers and did xrays of back and hind feet (since she had mild soreness in her hinds at first vet visit).
What we found:
Ulcers - fairly severe grade 3 ulcer with quite a bit of general stomach irritation throughout
Back xray - some closeness in her spine behind the wither with signs of mild inflammation (note: horse has not been worked, saddled, or ridden in ~4-5 weeks at this point)
hind feet - very mild angle changes possible but nothing glaring here
First course of action:
- Treating the ulcers with gatroguard + misoprostal + a probiotic (and incorporating alfalfa into her diet)
Once we start her back into work we’ll put her on a muscle relaxant for her back and work her up slowly with lots of long and low back-strengthening work.
Question to Cothers:
- What is a good program for bringing her back into work (dressage, low level jumping) - how long do you lunge / longline / pessoa for? Do you incorporate poles? When do you start ridden work again? (horse is 5)
- Favorite probiotic?
- For horses with mild kissing spine, have you found other therapies or exercises beneficial for maintenance?
Hey OP, how did things turn out?
I ended up treating her ulcers with Nexium with a couple weeks on misoprostol and then a couple weeks on Sucralfate. I found the Sucralfate made a huge difference and once she started on that is when I saw the biggest improvement in her demeanor and willingness to be handled / worked.
I started her back in work after ~10 weeks off (stopped work in Dec, started ulcer treatment Jan, started back in work end of Feb). Did several weeks of ground work (lunging & long-lining) and then light walk / trot work. Started cantering under saddle again after ~6 weeks.
There is clearly an underlying stiffness / inflammation / something that must have caused the ulcers as she’s still very tight through her lower back (although not where the mild kissing spine was detected) and SI, drags her toes, and swings out a bit with her hind. Not sure what it is exactly (difficult to determine what’s primary vs secondary) and now isn’t a good time to throw $$$$ at diagnostics.
So in discussion with vet, farrier, and bodyworker we’re going with a slow muscle strengthening approach to see if that works. We are doing cavalleti walk work, hill walk work, and pole trot work to try to teach her to use her pelvis underneath her. She’s getting chiro/acupuncture regularly and we’ve also put her in magnesium and that’s made a HUGE difference. So far we’re seeing slow progress in her willingness to tuck her pelvis and a reduction in toe dragging (though not gone completely). If she continues to improve we’ll continue on our path as is, if she starts to show signs that she’s not enjoying the work or that we’re pushing too hard - we’ll slow down. If she starts to deteriorate, we’ll revisit diagnostics and potentially injections.
So no 100% answer yet, but vet doesn’t think the mild kissing spine is the root cause - but instead something further back and that general strengthening will help everything all around.
So far mare is going the best I’ve ever had her go - lovely floaty trotwork, quiet canter, soft into the bridle, willingly forward…So we’ll see what the coming months bring!
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I’m going to continue to update here as I found it helpful in researching mare’s symptoms to read other’s stories through to their conclusion.
Over the two weeks since I posted my last update, mare’s work under saddle began to deteriorate. Not hugely, but the ‘NQR’ signals began to reappear - heavy on the left rein, trying to evade asks in the trot that required loading her hind end (e.g. half halts) by bracing or breaking to canter, shortening strides going down hills. Nothing super obvious or glaring, but subtle early signs that we were once again headed down the same path as before.
Had a lameness specialist out and on walking through her history he said it all screams hocks. We xrayed and found mild changes, nothing that he thinks warrants injecting at this point so we’re going with Adequan + Equioxx to see if that gives improvements.
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I would not dismiss the hocks as “not needing to be injected”. I had new films taken last August, vet didn’t think they were “ready” for injections and to keep on as I had been - with Adequan, etc. Fast forward to March, and no matter what I do, mare is dragging her LH and then suddenly I have no left lead canter anymore - not even on the lunge line. Bunny hopping swapping leads and flat refusing to bend left when ridden. I figured was time for her back to be worked on, took her to vet. Different vet saw her this time, reviewed the films that were taken in August and felt that yes, she probably did need her hocks injected. Had that done, along with her back (lower lumbar area) and I now have a sound horse again.
My point is, just because an xray doesn’t “look” that bad, doesn’t mean the horse is okay with it. There are lots of stories where on film the horse should’ve been dead lame but was going fine, and on film the horse looked fine but was lame.
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Completely agree! Hoping that the Adequan + Equioxx regiment gives us improvement but if she tells us that it’s not enough then we’ll inject.
So unfortunate update: No improvement seen with Adequan + Equioxx regiment 
If anything, she’s looking worse on the left hind, gone from toe dragging and circumducting but looking totally comfortable / willing to trot to looking generally uncomfortable with some short steps behind when asked to trot.
No improvement in back soreness and if anything seems to be spreading (creeping forward). Saddles both checked yesterday and fitter was shocked that the front right was significantly more broken down vs left…especially since he was just out in February! This is a new development so he doesn’t think that my riding suddenly got THAT crooked and it’s probably linked to her asymmetries in movement.
Called the vet to discuss next steps but at this point the amount I’ve spent, I may just throw her on 24/7 turn out for the next 6 months and see what we have come fall
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That’s disheartening I’m sure. Sounds like you have gone above and beyond with this horse.
Are you quite sure there’s no room for improvement in her farrier work? I know it can be difficult to think that your good, reliable farrier that you like and enjoy working with might not be able to do the work that your horse needs. I’m just throwing that out there. Please don’t be offended as that is definitely not my intention!
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Not offended at all - all suggestions welcome!
I don’t think it’s the farrier, she’s really teamed up with my vet (they have a call scheduled together to review latest round of x-rays and discuss potential next steps). We’re also discussing putting her in shoes at her next appointment but again, will discuss with vet.
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That sounds good! I hope they will be able to get her some support!
Glad you didn’t take offense!
IME some horsewomen are crazy loyal to their farrier and can get real defensive so I sure didn’t want to start any drama especially when it’s obvious you are going all out trying fix this horse up!
Just another suggestion…have you had a neuro vet do a work up?
I only ask because inconsistently lame is actually an early neuro sign. My coming 5 year old dealt with stifle issues all last year with some occasional switching front leg lameness to make it more confusing. He saw a top sports med doc…we thought we had him sorted out (and they do look for neuro stuff…but he didn’t present as neuro at the beginning). Months later, the lameness stuff again returned and he got very anxious and explosive. He never really looked neuro until the very end and even then it only showed up when his balance or movement was really challenged.
He ended up diagnosed with EDM back in Feb. He had ulcers on the patho…despite being treated (with ulcergard). My guess was from the stress and pain he was having…his patho report found brainstem axonal degeneration. He lost a lot of topline in the last month…I should have known something was up when his saddle suddenly wasn’t fitting. I chalked it up to baby horse development changes. It was only once it progressed enough you could see it was really muscle wasting.
Hopefully, your situation is not like that…but sometimes the strange ortho stuff that you can’t seem to get a handle on is actually something totally different.
The back soreness could all be coming from the left hind. Which, it sounds like, may very well be her hock region. Either inject her or block her. Or both.
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To me, it sounds like SI issues. They can be hard to diagnose, because it’s difficult to block the SI, but sometimes you can see issues with a transrectal ultrasound.
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Can you just try injecting the hocks and see what you get? The lameness may move at that point, but it’s worth a try.
And learn from my mistake - waiting too long to inject hocks can result in not being able to inject them at all and having to resort to far more invasive things.
Any news? I was reading through and I’m very interested to see how it’s going and if you’ve found a solution!
You know, this sounds a lot like type 2 pssm. Bucking at the canter, swapping leads behind, dragging the toes, stiffness…
Canter problems that look like SI issues look very similar to type 2 pssm to me.
Actually @lenapesadie ended up being pretty spot on - it was her feet.
It wasn’t actually her farrier (who I still really value), but vet farrier and I together decided to shoe her all around and see if this additional support helped. 3 weeks later the tightness in her back and bucking in canter was gone.
Now she still slightly drags her toes and slightly circumducts her hind legs (left more than light) – but you need to be looking for both. So I think there likely is something underlying that may flare up again later but we’re hoping that strengthening and correct training will mitigate. For now she’s doing great - we even just placed at our first show!
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That’s great news! Thanks for updating us!
That’s great to hear, thanks for the update!!
