Odd upper limb swelling + atrophy

For past 3 months - 20+ year old horse has dragged right front toe (only noticeable in the arena), at walk and trot, hesitant to pick up right lead canter. At start of 3 months, noticed the toe dragging, then 3 days later: knee swollen/ upper leg swollen (lower leg not swollen). Sweat wrapped for 3 days, swelling went down and has not returned. No heat. However, the dragging toe has continued. Did not like knee flexed. Trips often.
Vet came out, blocked the leg starting above hoof, then above ankle, then above knee. No change in gait/toe dragging.
Started equinox

Had feet x-rayed. Angles fine, just shortened the toes. Has had a massage and chiro treatments with shoulder adjustments that did not change anything.
A week 1/2 ago injected the shoulder joint and shoulder bursa. Has a remaining bulge (not hot, painful, allows leg to be stretched forward) at the top of leg and atrophy of extensor muscle.

Anyone seen a budged leg or atrophy like this? Currently walking under saddle, leg occasionally “buckles” or small trip forward. Toe is still dragging at both walk and trot. Anyone with experience with this?

Have someone ultrasound his lateral digital extensor muscle. Possibly xray his humerus.

I suppose it’s possible he has had some sort of injury to the radial nerve, too. That is not uncommon in horses that have been under anesthesia. I’ve also seen it happen for unknown reasons in horses who have never been under anesthesia.

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I’ve had similar injuries (it is supposedly rare!) in two horses. Both damaged the radial nerve as it crosses the shoulder blade. In the first one it was a severe injury that nearly severed the nerve (an observed slip in the pasture) that caused immediate three legged lameness and resulted in permanent atrophy of several muscles in the upper limb and shoulder. He always dragged his toe at the walk after the accident even when he was no longer ‘lame’. But at the trot and canter appeared sound (he was never ridden again) He was a happy pasture ornament for almost another decade, though very prone to laminitis in the other forelimb (I think we had two bouts). He was 24 when the accident happened, lost him to colic at 33.
The second horse presented with mild toe dragging lameness, was unwilling to stretch the limb forward and had some atrophy of the muscle. That resolved after a few months and the horse is perfectly sound today. The suspected cause was also hyperextension of the forelimb at some time.
To me, the muscle atrophy suggests nerve damage.

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Thanks for your reply – what did you do (in the case of your second horse) to help heal? We are going on three months. This horse hasn’t been head-bobbing lame, just toe dragging. She allows the leg to be stretched forward, but fights when the knee is bent up really high, like something is being stretched in the upper leg and hurts (but knee joint blocks awhile ago did not change anything). Did your horse ever trip or buckle under saddle on that leg?

Thanks for your response – it seems like nerve damage and or muscle injury.

To be honest, the second horse’s injury was the least of my worries with him at the time. He had done something out in the field and had torn his DDFT in his right hind and at the same time had damaged that radial nerve in the left forelimb. In other words he was a mess. The fact that he had to put weight on that forelimb, because he couldn’t put any real weight on the hind on the other side might have helped force recovery but I certainly wouldn’t recommend it! I know the muscle atrophy was gone in a few months because it shows on photos being taken of the whole recovery to track it. How long it took the toe drag to completely disappear, I am not entirely sure. He wasn’t sound for almost a year plus, but that was due to the hind leg.
He was turned out all that time, so he gave himself mild exercise. Otherwise, I was just very patient.
It does sound like something up towards the elbow/ulna area.

I’ve only seen one of these. Diagnosis was radial nerve injury and bone bruise, likely resulting from slip and fall in the pasture.

Horse is about 8 months out now. I believe they did shockwave, laser, PEMF, and Osphos over that time. The joint was injected early on but it did not help. He’s increasing his exercise time now, and seeming fully healed, although they’re still hand walking/long-lining because they don’t want to risk putting a rider back on him until they’re sure he’s trotting sound without tripping for a decent period of time.

Wow, I’m sorry that happened! Such awful injuries at the same time. I’m hoping time will heal as well.

Thanks for your reply – sounds like it is a long recovery time.

It was a mess. But, the thing that I learned from all that was patience. I was lucky enough that the fact that I might have just ended up with a pasture pet wasn’t the end of the world (they live at home, so no board bill). What I realized was I am blessed, and so lucky, to have horses at all; even though the horses are supposed to be earning their keep, and in my situation that really is the case: the wood they pull should pay for their hay and winter feed and it isn’t at the moment. That is a strain. But, I am blessed to have them out there, blessed to be working with them. And the big guy, against all odds, is sound again. Yes, it took almost two years; but in those two years I learned to know him in a different way. I guess what I learned is that I have and work with horses, not for the awards, not for the money, but because I love horses.
Only took me till my forties! :slight_smile: