Stifle Issue?

[laurenvpd11]

This is going to be long, sorry…

Anyways, my mare is an 8y/o Percheron TB cross. I purchased her two years ago from her breeder. She was halter broke when I purchased her and I have done all her further training myself. She is a very sweet and willing mare. Throughout our training process she has never offered to be mean or aggressive.

Mid August 2016 she started kicking out in the trot. I didn’t think much of it and continued to ride her as usual. At that point she had been under saddle for about a year. I was riding her 4-6 a week, jumping 1, and very occasionally 2, of those days.

In September I had her saddle fitted because she was still “acting out” and had become sensitive to being brushed on her back, neck, and girth areas.

She seemed to be better for a little while. Around November we were scheduled to have a lesson from an upper level event rider. Within 5 minutes of me w/t in the arena she could see my mare was off. She hopped on and my mare acted the same way with her (kicking out at the trot, mostly tracking right). She suggested I have my mare checked thoroughly to see if we could pin point the issue.

Fast forward to December 2016…she was now kicking out much more “dramatically” at the trot and also hopping (occasionally bucking) into the canter transition. (She very consistently kicks out with her right hind)

The first vet I took her to watched me lunge her and ride her, then he told me he was certain it was her hocks. With no further investigation he told me I should have her injected. I was skeptical of his diagnosis, given that he had not really performed a lameness exam on her. He prescribed Equioxx and said that would clear things up. I followed his instructions, but the medicine did not help at all.

The second vet I took her to did a full lameness exam. She passed, so we did x-rays of hocks and stifles. Everything x-rayed clean so he suggested chiropractic work. I had two sessions with the chiropractor over a 2 month period and did not see any improvement whatsoever.

The third vet I had see her also did a full lameness exam. She passed again. He watched me ride her and saw how she kicked out consistently with her right hind at the trot. He suggested we try putting her on ulcer meds to see if that would clear things up. Ulcer meds did nothing for her, the kicking out was still present. I decided to try time off, I gave her the whole month of January off and there was still no improvement. After waiting a month I called the third vet back out. He suggested this time around that we try blocking her right stifle to see if that would help. After the injection had time to work I got on and gave her a test ride. It was obvious to me, and those watching, that her trot had improved. She was moving forward willingly and was stepping under with her hind legs. Trot to right lead canter was still quite sticky. The third vet is convinced there is something else going on other than just a stifle issue, he is thinking it may be an SI issue. He suggested either injecting her SI and seeing if that is the issue or getting a bone scan done.

Also thought I would mention two things
1 - I have rode her in a halter and lead rope and she acted the same, so it should not be a teeth related issue.
2- She is not fond of holding up her hind legs for the farrier. My initial farrier scolded her (she has a lovely rasp mark on her side :()for yanking her leg away from him. My current farrier is very patient and said he thinks she is in pain and that is why she try to pull her legs back. When I pick up her legs (to pick her feet and to test my theory) she was fine. Also when my third vet went to pick up her right hind for her lameness exam, she violently kicked out trying to avoid picking up her leg. I was surprised because she had never done that before. (Since that incident she has not kicked out violently when asked to pick up her right hind.)

I have plenty of videos and pictures of her if anyone is interested in seeing them.

[JB]

Her breeding and her symptoms all scream EPSM/PSSM to me, right down to being unhappy holding her hind legs up for the farrier - that was the final “nail in the coffin” for me.

[HunterRider84]

I second JB’s opinion. I have two epsm/pssm horses or at least one and the other is incredibly sensitive to starch & sugar so he stays on a similar epsm diet. My one guy who is a definite epsm horse had all of the symptoms you described. I’m not going to list everything I’ve done but feel free to message me if you would like to bounce ideas. Good Luck!

[Groom_amp_Taxi]

I like the vet’s idea of injecting the SI.

[laurenvpd11]

[QUOTE=JB;9042056]
Her breeding and her symptoms all scream EPSM/PSSM to me, right down to being unhappy holding her hind legs up for the farrier - that was the final “nail in the coffin” for me.[/QUOTE]

I had done some research on EPSM/PSSM but wasn’t sure if she had it since she didn’t completely match up to all the symptoms. I am going to get her tested to see if that is what our problem is.

Have you dealt with EPSM/PSSM before? Do you know if the prognosis is fairly good? I am wanting to compete on my mare, I am just wondering if that is a possibility still.

[IPEsq]

Can I see a video?

Sounds like SI area more to me than stifle. I don’t think the kicking out really fits stifle. Although with a friend’s horse they have been chasing everything on one limb for months. Certain it was stifle (similar block results to yours), then maybe hock, then maybe soft tissue, then back to stifle. Got a bone scan and the hip lit up. Blocked relatively well to that area too. So, they injected and horse has been resting from that…waiting to see what will happen.

[laurenvpd11]

Here is a link to a video compilation I made

https://splice.gopro.com/v?id=Vw9PLK

The first video is from August 2016, right around the time I first started noticing a difference in her
The second video is from early December 2016
The third video is from late December 2016

Very interesting about your friend’s horse. I am considering getting a bone scan done, I just want to make sure it is really necessary before I spend that much money.

[tulachard]

I vote for the bone scan. I just spent big $ on tracking down a mild lameness but wish I had started with the bone scan instead of jumping to injections, etc. Would have saved $ in the long run and led to a faster diagnosis. In the future, I’ll opt for a bone scan for any lameness that doesn’t have an obvious cause.

[laurenvpd11]

What did the bone scan reveal for your horse? Did you have to do further diagnostic investigation, or did the bone scan confirm things for you so that you could then proceed to treatment?

[IPEsq]

There’s short tracking behind for sure, but despite the kicking being predominantly with RH (a couple of times, I’d say it’s LH), it just looks to me like the horse is saying NO, not that there’s necessarily a lameness in the RH itself. With the overall behavior, it could be a number of things… back, neck, SI…

I think you’d wind up in tulachard’s scenario if you keep taking guesses. Ask me how I know…

[JB]

A horse doesn’t have to match all symptoms to have PSSM (or ulcers, or Lyme, or EPM, or any number of things)

I think you are FAR better off testing for that before doing things like invasive work, and spending $$$$ on MRIs and bone scans.

What is her current diet and turnout?

A blood or hair test will tell you if it’s Type I. You’d need a muscle biopsy for Type II (unless something’s changed, and for some reason I seem to think maybe you can now also do blood or hair?). But the draft blood makes Type I the more likely culprit anyway, and among Percherons, some tests show as much as 62% of the breed is affected.

Given that she’d be heterozygous, management is much more doable. It’s about lowering the sugars in her diet (treating her as if she’s insulin resistant), and greatly increasing the fat in her diet.

[JB]

Oh, and the video won’t play for me, so I can’t comment on that

[SCI]

I would look into hormonal issues as well. She may have an ovarian cyst or some other reproductive issue.

[tazycat]

[QUOTE=laurenvpd11;9042714]
Here is a link to a video compilation I made

https://splice.gopro.com/v?id=Vw9PLK

The first video is from August 2016, right around the time I first started noticing a difference in her
The second video is from early December 2016
The third video is from late December 2016

Very interesting about your friend’s horse. I am considering getting a bone scan done, I just want to make sure it is really necessary before I spend that much money.[/QUOTE]

This video link works…horse is obviously sore in hindend.

[laurenvpd11]

Is it odd that none of the vets that I have seen have brought up PSSM? I am not saying that it is not something worth checking into, just seems so strange that they would not even suggest that could be it. I am in the process of filling out the form and will be mailing in a hair sample asap

Regarding the muscle biopsy test, is that something that my vet can come to my barn and do on site?

Currently she gets 3 quarts of Seminole Wellness Perform Safe and soaked beet pulp (not sure the exact measurement of beet pulp, it is just a small unlabeled scoop) daily. She is turned out during the day and is stalled at night. I would personally prefer her to be turned out 24/7 like she has been all her life. (I am fairly certain if I show the barn owner that my mare needs constant turnout for health reasons that she would comply.)

[laurenvpd11]

I have mentioned that to my vet as well…he didn’t seem concerned. He said that could be an issue, but is “low on the list of things to investigate”

Would an ovarian cyst only present cyclical problems or would it present consistent problems?

What kind of diagnostics would be involved to find out any hormonal issues?

[JB]

IME, not odd at all. It is not uncommonly poo-pooed as not possible because “he doesn’t fit all the symptoms”.

I’d think it very unlikely you’d need to test for Type 2, but yes, if you wanted to thoroughly rule that out altogether, the vet would come and do that.

The Seminole Wellness Perform Safe is 13% NSC, so not too bad. If she’s indeed PSSM positive, she’ll need more fat. She’d also possibly need to be muzzled on grass, and maybe only have tested low NSC hay. But cross that bridge if you need to. The forage situation is harder to control. The hair test will be a great place to start.

[Proffie]

I also thought EPSM based on your original post and her breeding, but after watching the video I’m thinking kissing spines and/or SI issues. She’s definitely inverted, protecting her back. And you said she was grumpy to brush and tack.

Any vet with a decent portable Xray machine could shoot her back to rule that out.

Good luck! She’s very cute.

[laurenvpd11]

The grass in our area is quite lacking so hopefully she would not require a muzzle. For the life of me I cannot remember what type of hay she is on now, but at my last barn she was on coastal round bales. She is a hay burner and will eat as much as she can get a hold of.

Here is a link to the video, I uploaded it to youtube for you
https://www.youtube.com/watch?v=VkPfr7D2Acs

[laurenvpd11]

Interesting! Once I get my results from the EPSM hair test back (if it is negative) I will probably be making an appointment for her. I am considering getting a bone scan done just to see what all is going on.

Thank you!! She is such a wonderful horse; good attitude and also athletic. I am ready to have her back to 100% again.