Stifle issue in young horse

[ratchet]

I recently had my rising 6 year-old gelding evaluated for an ongoing period of NQR. He flexed fine; the specialist narrowed it down to his right stifle, and x ray imaging revealed a small amount of remodeling and a flatter tibial head than what one normally sees. Ultrasound found fluid/signs of inflammation but no tears or anything crazy, thank goodness.

We opted to inject this joint since conservative therapy (weeks of rest with some pain management) have failed to help it resolve. The issue seems conformation related, although it’s possible he hurt himself goofing off and may be more prone to stifle problems in general due to how the joint is built.

He’s been doing nothing but w/t/c in the arena with some easy trail rides. Is/was intended to be a low level all arounder (no jumping) and archery mount.

We are going to slowly bring him back into work to ascertain the effectiveness of this injection. I am also considering Adequan and maybe some sort of feed through support in the future? Horse is turned out 24/7 and I already plan to be meticulous with warm up/cool down in the future, if I can get him sound.

I’m curious it anyone here has dealt with something similar and what ended up working for you? TIA!

[Gardenhorse]

My horse is in her teens, but had similar findings on x-ray/ultrasound a few years ago. Although mine also had SI issues (possibly compensatory) and didn’t return to 100% until we also injected SI. I always do at least a 10-min walk warmup and have found exercises such as backing in hand, hills (start with slight inclines and walking sideways across hills rather than straight up/down), and walking over raised poles useful. Transitions (done well) are also supposed to be good for strengthening stifles. Jec Ballou has a useful website/book on corrective exercises for different issues.

Mine is on Legend and has gotten steroid injections yearly in stifles and SI since her diagnosis but this year we are trying Arthramid in the stifles for the first time. Just did it Tues so can’t say how it compares yet.

[TWH_Girl]

Oh geez, I could write a novel on stile issues. OCD lesions, upward patellar fixation, arthrititic changes. Old horses, young horses, Middle ages horses. Adequan, Legend, cortisone /HA injections, Prostride, Noltrex, Arthramid.
Equioxx.

Actually I feel quite confident managing and recognizing stile issues and even though they often need long term management, I actually would take stifles over some other refractory issues I have seen over the years.

I always started off with regular/cortisone injections and then only changed to other products as the horse got older or developed conditions where steroids couldn’t be used or were no longer effective.

I tend to keep my horses on a joint supplement though it probably doesn’t do much tbh.

Adequan and Legend can be very helpful so I would consider those as needed. Stay on top of it and watch for the signs that led you so call the vet in the first place. Strengthening can be helpful but you have to be careful not to overdo it with stifle sore horses either.
Other than that, sounds like you have all your bases well covered and have put a lot of thought into things. I also have a horse turning 6 and TWH notoriously have stifle issues. Probably why I have had my share.

[sparkygrace]

Yes! My seven year old was diagnosed with some remodeling in both stifles. It also may be confirmation related. I opted for Pro-Stride. My vet didn’t give me a long-term prognosis, but suggested doing Pro-Stride once a year.

From the way he was passaging, galloping and going nuts today, I think the soreness is gone.

[Demerara_Stables]

Oh yes lots of stifle experience! Mine had badly locking stifles as a baby so I learned early how to manage them and we’re sound and happy at 21!

Full rest is your enemy. Walk, walk walk. Walk on flat ground, up hills, down hills, back up hills!, walk over poles, walk until you’re blue in the face. Trot poles are your friend also - a few in series are best.

I did steroid injections for a few years but did PRP a little over a year ago and we’re still going strong, I’d highly recommend that over steroids. I also have mine on Platinum CJ and adequan - both help immensely.

IANAV but most stifle issues I’ve had come through my program can be managed, if not resolved, with the right amount of strengthening.

Good luck!

[TWH_Girl]

@sparkygrace

My seven year old was diagnosed with some remodeling in both stifles. It also may be confirmation related. I opted for Pro-Stride. My vet didn’t give me a long-term prognosis, but suggested doing Pro-Stride once a year.

We did Prostride on my young one too. It has helped as well. Vet suggested it over steroids due to his young age.

OP, what symptoms did your guy have?

I think that conditioning is helpful but there is a difference between arthritic changes and ocd issues vs weakness and upward patellar fixation. Just make sure your conditioning program is appropriate for what the issue is and gradually work up to something so you don’t overdo it and have a setback.

[Ghazzu]

@Demerara_Stables

Full rest is your enemy.

That depends entirely on the etiology of the lameness.

[Unfforgettable]

@Ghazzu

@Demerara_Stables

Full rest is your enemy.

That depends entirely on the etiology of the lameness.

Exactly. With a horse that was in my program a mis-step in the warmup at Nationals resulted in a stifle injury, severe enough to be career-ending according to the several vets who evaluated him. On radiographs the meniscus looked like a mountain range and he was clearly unsound.
A year and a half later, after stall rest and careful rehab that same horse was back in the ring and was regional champion his first time out.

[Djones]

I would collaborate with the vet on each unique case.

One horse of mine needed esterone injections, modified hind shoeing, and lots of straight lines in a good walk frame.

Another needed ice, rest, injections, and we also applied cold laser. We tweaked his hind shoes as well.

[Angela_Freda]

Thanks for saying this.

I am no pro, and have only dealt with a very limited stifle issue in a couple horses.
It seems to me, as with many issues horses might have, the etiology/diagnosis of the issue would dictate appropriate therapeutic approach, wouldn’t it?

IOW ‘stifle’ is not a one size fits all ‘issue’ therefore the treatment ‘depends’.
.

[Demerara_Stables]

@ratchet

x ray imaging revealed a small amount of remodeling and a flatter tibial head than what one normally sees. Ultrasound found fluid/signs of inflammation but no tears or anything crazy

@ratchet

I’m curious it anyone here has dealt with something similar and what ended up working for you?

I have dealt with something similar to this horse, this is what worked for me.

[TWH_Girl]

@Ghazzu

That depends entirely on the etiology of the lameness.

Amen to that. People think stifles = hills and strength and this may or may not be the case.

[sara78]

This, prp worked really good on m’y young horse with stifle issues

[ratchet]

It sometimes manifested as a very subtle limp trot on the circle only, and also the vet pointed out that he was slow to bring his right hind up. Not toe dragging but a delayed movement forward, which makes a lot of sense because posting at the trot felt super weird with him and was the only gait where you could really feel something very wrong.

Initially we gave him a week of bute and paddock rest, followed by two weeks paddock rest and handwalking. He returned to work (gently!) feeling sound for one day only. Then the symptoms reappeared and it was noticeable at the walk too. He has never had any overt signs of swelling or other trauma, either. At that point we figured less likely a muscle strain and sought out the lameness specialist.

Thank you so much for the replies everyone, I wish I had the mental bandwidth right now to respond to everyone. I’ve been a bit down that my young horse has this problem but, I’m starting to feel more optimistic now.

ProStride was talked about if this initial injection fails.

[TWH_Girl]

When was the injection and have you been able to tell if it has been effective? Did the vet just address the right stifle? Typically, trouble comes in pairs and joints are done bilaterally in horses because they do tend to comprise one side of the other is sore. I’ve done one joint only to return a few weeks later to address the other side.

My stifle horses typically present as lacking hind end engagement, maybe a little short strided, mild toe dragging but no limping at any gait. It’s usually more of a flat tire feeling and they may give out in the hind end occasionally too.

[ratchet]

Flat tire definitely describes it. The limp wasn’t like a head bob, just kind of a noticeable oddness on the front diagonal. But the short striding — yeah, super apparent.

Vet only injected the one stifle although I asked about the other one, but we didn’t image it and he wasn’t gimpy on it. The injection was this past Wednesday and I was told to start doing gentle walks under saddle beginning this week. Although he can be silly sometimes so, hopefully just walking is all that will happen. lol

I will be able to visit him tomorrow and do some handwalking at least. No clue yet how effective it has been…the doc told us it could take upwards of three weeks to really know if it was successful. I’ll keep this updated! He’s an arab/appy cross and a bit straight behind so the confo thing doesn’t surprise me too much.