Hi all,
This is my first time posting here, and this is going to be a long one (sorry in advance!) but I am nearly at my wits end at this point and have found excellent information, tips, and advice here in the past, so decided I would give it a shot. If you’re up for a long read about intermittent stifle lameness and different treatments that should be working but aren’t, read on!
(Perhaps some helpful background info: this post is about my 4 year old reining horse who competes at the AQHA and NRHA levels. She lives with my trainer and is ridden 5 days/week. She gets daily individual turnout and is also walked on a hot walker for ~1 hour per day.) The issues first presented upon arrival home to our barn after a 4 day long show about 6 hours away from home. The horse was perfectly sound up until the show, showed great and never took a lame step. Got on the trailer and came home. Had one day off (Monday) and the following day rode in a lesson (Tuesday) and was still sound. On Wednesday, the horse was off at the trot and canter in both directions and was given 4 days off work.
After those initial days off there was no change in lameness. Vet was called, horse was flexed and vet confirmed stifle was the area of concern, worse on the left leg than the right but showing signs of lameness in both hind legs. Radiorgraphs were taken on both stifles, no lesions or OCD’s were found, no bone chips or any other factors of concern - clean joints. Horse was injected (large stifle joint only) on both sides. After 3-5 days of stall rest she was slowly returned to full workload over the course of three weeks. By the end of the three week period she seemed improved but still not back to 100% - for the majority of every ride she would go around just fine, but then out of nowhere take 2-3 bad steps. She also wasn’t turning around quite the same, just felt uncomfortable and like she wasn’t using herself correctly. Vet was called again, she watched the horse under saddle and also flexed the horse again and determined she was still positive 2/5 after flexion. From watching her under saddle the vet advised that this was probably UFP (intermittent upward fixation of the patella) and both stifles were internally blistered. Horse was given the rest of the day off, but was then put back into normal work (as is common procedure with stifle blistering).
After two weeks, little improvement was seen. Now instead of only taking a few bad steps during a ride, she will begin the ride at the jog looking almost completely crippled, sort of hopping on the hind end and not wanting to bear much weight. After a lap around the ring she is back to jogging like normal. However, every now and then she will take 6-8 strides where she looks completely crippled again, and you can almost see where the joint just sort of looks like it locks up. These bouts come out of nowhere and are not predictable - they don’t happen when going into a corner, or a spot where the footing might be deeper, or follow any similar predictable pattern. The come completely out of nowhere and then vanish again, and the horse goes back to jogging around very normally. Again, vet came out, watched her work, flexed, and this time recommended shockwave treatment instead of blistering again right away (shockwave treatment can provide similar results to blistering but on a smaller scale). Again, one day of stall rest followed by a return to normal work.
After another week and a half, little improvement was seen and the same symptoms persist under saddle. Vet is out again. The vet is slightly perplexed because the normal courses of treatment that usually work for these symptoms are not working on this particular horse. We take radiographs of the hocks just to rule out any issues, and both limbs are perfectly clean. She decides that since the most improvement was seen after the first round of injections (not the internal blistering injections) that we should re-inject the stifles, this time doing both the large joint and the small joint on both legs. Horse is given three rest days and then slowly brought back into work. After day 4 or work, vet returns to watch horse under saddle and flex and is happy with some improvements in the horses way of going. After another 4 days the vet returns, notices little improvement but since not even a full week has passed decides not to treat anything more and wait until the following week to come back and re-assess. I was just out to ride yesterday (4 days after vet had been there last) and the horse is still on and off uncomfortable under saddle (only rode for 10 minutes max.) but still unpredictably so. She will start out looking slightly off at the jog, go into the lope and take a few bad steps but then lope around just fine. After switching directions she will look great at the jog but then going into the lope looking lame again.
So I guess I’m just looking for ideas or input if anyone might have any. My next steps from here will probably include trailering to our state clinic and consulting with a lameness specialist. We have not done ultrasounds of the ligaments because the vet did not feel they were necessary - if it were an injury to a ligament the likelihood that it would happen simultaneously in both limbs is very low. I also asked if perhaps this was an SI issue manifesting as a stifle issue, to which the vet said that the type of movement with the intermittent hopping on the hind end that suddenly clears up and the resurfaces isn’t consistent with SI pain and more clearly points to a locking stifle/patella. I just wish we had a bone chip or something that would show up on a radiograph to point to as the cause of all these issues, but this far there hasn’t been anything we can pinpoint that would have caused the lameness.
Thank you to those of you who read that entire novel!
You’re right on point! Keep us posted with the outcome, will you please?