SI Pain

[jennycash]

Barrel horse came back after fall/winter off. Started out strong with 1D wins right away, after couple more races he started going by barrels and now doesn’t want to use himself and really turn the first at all. I noticed SI soreness after his run this weekend. He has had history of SI injections a (once 4 years ago) and necessary chiro every 6 months. For those of you who dealt with SI soreness, are injections the only way to go? Shockwave? Would adequan be helpful in the long run?

I am going to be making a vet appointment, just trying to get an idea of which route to go. Have to travel multiple hours to see vets and each has a different specialty (legs, lameness, general).

[Abbie.S]

Well, I hate to ask a silly question…but given the horse had the fall and winter off, was there any kind of conditioning done to get the horse back into racing shape?

Otherwise, that’s an awful lot to expect from an animal that’s taken a vacation from work, and your problem would probably lie with lack of fitness and soft tissue injury resulting.

[jennycash]

Yes of course he had the proper conditioning.

[Winding_Down]

Shockwave is ineffective for SI issues because SW does not go deep enough. And the SI joint is not really a joint per se and is not responsive to adequan or other similar joint treatments. My experience is that if chiro has not worked, the best option is SI injection.

However, SI pain is often due to problems in the stifles. I would flex the stifles to rule that out before going with the SI injection. The former is an easier and less complicated treatment.

[jennycash]

[QUOTE=Winding Down;8124602]
Shockwave is ineffective for SI issues because SW does not go deep enough. And the SI joint is not really a joint per se and is not responsive to adequan or other similar joint treatments. My experience is that if chiro has not worked, the best option is SI injection.

However, SI pain is often due to problems in the stifles. I would flex the stifles to rule that out before going with the SI injection. The former is an easier and less complicated treatment.[/QUOTE]

Thank you for the info about SW and Adequan. He has an appointment with a new out of state vet tomorrow, unfortunately all the vets here say he is 100% and its behavioral so hoping this new one will give me some answers. :-/

[slp2]

An SI injection will also not help if your horse has a tear or injury to the ligaments around the SI joint. Injections help with bony involvement—they don’t heal ligament fibers. So you really need to figure out what the specific injury is to determine the treatment that will work. From my experience (but I am not a vet) I haven’t seen SW therapy work well in an area like the equine back.

[jennycash]

[QUOTE=slp2;8125407]
An SI injection will also not help if your horse has a tear or injury to the ligaments around the SI joint. Injections help with bony involvement—they don’t heal ligament fibers. So you really need to figure out what the specific injury is to determine the treatment that will work. From my experience (but I am not a vet) I haven’t seen SW therapy work well in an area like the equine back.[/QUOTE]

How do they check the ligaments that deep down?
If it is a ligament injury would it be sore to palpation? Is recovery the same as other ligament injuries.

[slp2]

While it’s not the easiest—or the cheapest–you can find the area that is inflamed in the back with a bone scan. If the problem is in the joints–the bone scan will identify that. If it just shows inflamation–then they can ultrasound the ligament fibers in that area and you can see the torn fibers (or scar tissue) on the ultrasound.

And yes—if there is ligament damage, they horse would be sore to palpation. There was a good article on identifying back issues in The Horse recently (sorry—I don’t remember the exact name of it) and a vet who is an equine back specialist lists some tests that vets can do to evaluate the back.

One of the easiest tests is to walk you horse (while your vet observes) in a serpentine pattern. Walk them away and then walk them back (in the serpentine). The vet needs to be observing what the horse does with it’s hind feet (does it cross over comfortably in the serpentine pattern? or does it try to keep it’s legs tracking side-by-side and avoid crossing over? Does it cross over going one way and not the other?) The article lists a few other tests that can be done by a knowledgeable vet that don’t involve diagnostic equipment.

Ligament healing time is longer than bone. But it does heal with rest followed by progressive rehab exercises.

[slp2]

Found it! Here’s the article: http://www.thehorse.com/articles/35554/six-signs-of-sacroiliac-disease-in-horses

[SolarFlare]

I’m dealing with this too right now. Mine was blocked toe to stifle first to rule out any contributing issues. We did inject the SI without further diagnostics (my choice) and that did help immensely…for a few months. Then I was right back to square one, and in fact it was getting worse.

We did also do a repeat block of the hind suspensory (his symptoms did mimic that issue somewhat) but that was not the problem. We x-rayed the stifle too just to be sure (clean as a whistle) then off he went for a bone scan.

Mine turned out to be soft tissue as slp2 mentioned, not bone involvement, so that explains why the injection cleared up the soreness temporarily but as we continued to work, he continued to get worse.

The university that did his bone scan did not ultrasound - they told me it wasn’t able to penetrate far enough down, although slp2’s back-specialty vet did diagnose hers. Therefore, mine can’t be 100% confirmed, although they said they were very confident that’s the issue based on his presentation of symptoms and the thorough workups he’d already had done.

We’re coming near the end of our 3 months stall rest (hand walking allowed, and turn out into a tiny pen for a couple hours a day so he can only stand, roll, and walk ). Fingers are crossed we can begin the under saddle rehab next week after our vet re-check!

Oh, and the university believes mine had an old more minor SI injury from the track (his left SI sits lower than the right always), and he does have a bit of lower-joint hock arthritis. They think he’s gotten himself into a cycle of inflammation and compensation between the hocks and back, so although we had been treating both issues, perhaps our timing wasn’t good (we had done hocks but not SI, then did SI but not hocks, etc) and he finally couldn’t cope any longer.

[Jumper_girl221]

My gelding with SI issues you could see the tear in the ligament on an ultrasound. He was helped with injectons following pasture rest.

[jennycash]

Thank you everyone for the replies. Wanted to update you on our vet visit.

He again flexed completely sound. She said he does not feel that he needs joint injections. He is however severely tight and sore in his lumbar area. And his hamstrings were rock hard. He nearly dropped to the ground when pressure was added to lumbar. She gave him multiple shots in the muscles to try and relax/relieve the tension (sorry can’t remember the exact name at the moment). She also added DMG and Selenium to his diet to see if it will help soften everything.

I pray this will make a difference! I haven’t dealt with muscle issues like this. Has anyone else had a horse with Selenium deficiencies or severe muscle spams.

[Jumper_girl221]

Did she test for selenium deficiencies before adding the supplement? Se is very easily overdosed and that’s not something that should be added to their diet without a blood test. magnesium might be something that would help.

Just as a FYI, my gelding had severe lumbar pain with his SI issues.