Sudden onset of resistance in 4yo - Update #73, rib fractures

[beowulf]

Thanks for the tag, IPEsq. Yes, my personal horse had multiple rib fractures in conjunction with three fracture locations on his pelvis.

The good news is rib fractures typically have a good prognosis for return to sport. It really depends on location and involvement of other ribs/vertebrae. While my guy was healing my vet was talking to me about how often he sees “incidental” rib fractures in his practice. Clients would bring in their horse for XYZ behavioral/pain issues and in the diagnostic process they discover the horse has cracked or fractured ribs as well as whatever else was bothering them. He said it is common in horses that jump and race, and that sometimes owners don’t even know, they just think Dobbin is going through a phase of crankiness. The number one symptom is resistance under saddle and there is not always as significant a limb lameness as you’d expect.

The heal time my vet cited was 6-8 weeks of stall rest to heal, but can take longer if the fracture is up high close to vertebrae. T18 is the most commonly fractured if I remember correctly.

In my guy’s case the ribs were the least of our concern, so it wasn’t discussed when he could go back to work. The ribs have been a non-issue since.

Most practices want to sedate the horse for ultrasounds. Even my super chill, quiet guy is sedated. This is for the safety of the machinery and the technician/vet as well as producing the best possible diagnostic image. If you explain your concern about how he impacted and you think it may be related to sedation, they may try without it - but they may not. It’s difficult to cleanly ultrasound that area of the horse because of all the meat it has to go through, so it may affect the clarity of your rads too.

Fingers crossed for you. It sounds like it may have been a perfect storm of bodily discomfort, new place, traveling, and medication.

[Lunabear1988]

Critter, you are such an amazing owner. What a lucky horse. This is a really interesting turn of events and I hope you get everything figured out and then can get your guy feeling better.

[Critter]

OMFG!!! My poor guy.

So this morning I get a call (thinking the dentist saw him)…nope…he didn’t eat his breakfast and they did some checking and now he is running a 102 fever!!! UGH. They check all the usual sites for potential infection…run some blood. He comes back positive for anaplasmosis. Really!!! Okay…so we live in tick mecca and anaplasmosis is relatively common. But, it’s been drought dry and I’ve not seen a tick on any of the horses for the past month.

So…we are skipping the dental exam and ultrasound for this visit. He is getting IV oxytet today and tomorrow. If the fever is controlled and he looks stable, I will bring him home tomorrow. I think being home where he can go out and chill will be the best thing for him. They will send him home with minocycline as well. We will then go back up for the ultrasound and maybe dental in 2-3 weeks once his system has time to recover. The dentist was going to look at the scans and maybe give us feedback on what might need to be done/evaluated further.

I feel so sorry for my boy and hoping we can get him home tomorrow for some much needed TLC!

@IPEsq and @beowulf thanks so much for that info about the rib fractures. T17 and T18 lit up on the scan and at the vertebrocostal junction, which is why they want to do the ultrasound…so they have a better idea of what is actually going on there. With the type or resistance he was doing, this definitely would make sense. I will be glad to give him the time off to heal…I’m just glad I kept insisting his resistance was pain driven and not behavioral (when they are 4 yo it’s easy to chalk it up to being a green baby horse). Hopefully they will at least let him be turned out instead of stall rest…he’s out by himself (others nearby) and is generally pretty mellow outside.

[atr]

Oh dear. Poor horse! I hope he makes a rapid recovery.

Sounds like you are on the right track with everything else, though.

[sparkygrace]

I’ve read through your posts and didn’t see a mention of testing for EPM. If you did, sorry I missed it. I went through something similar with my six year-old. Suddenly resistant, slightly off, no real indication of injury. My vet injected his hocks, treated him for ulcers, did blood tests for laminitis (numbers were perfect), and blocked his feet. There was some improvement with UlcerGuard, but he was still not right.

Another vet came out from the practice and immediately thought his problem was neurological. She tested for PSSM 1 and EPM. He was negative for PSSM1, but his EPM numbers were super-high. I would have never guessed. I’m treating him and there has been improvement. I hope he can get back to normal.

I didn’t test for PSSM2 because I can manage him for that and already have made changes to his feed and exercise.

[Critter]

We didn’t test for EPM…mostly because this seems to be pain mediated. He seems totally fine (now that the ulcers are gone) on the ground…the issues all start related to tack and working. Plus, he did get the full neuro exam at NBC and they didn’t feel we needed to check EPM (and that’s with the top neuro doc in the US). After this week the vet even said to me that we can put neuro way down on the list for potential causes…we definitely know that there are multiple rib issues and something with the mouth after the testing. I think the rest is just bad luck.

Glad your guy is improving with the EPM treatment - hope he makes a full recovery! It’s so hard to sort out these vague resistance type issues and figure out the causes!

[Turntable]

I would be looking for a foxtail or similar splinter/ seedhead type wound in the mouth before teeth. When he’s home and quiet you might look yourself.

[sparkygrace]

Thank you! I’m happy to hear you may have found what is causing your horse’s issues. The frustration and stress make it so hard. Good luck with him!

[rubygirl1968]

Oh my goodness! Poor guy and poor you!

Jingles for you both

[Lunabear1988]

I’m sorry to both you and your horse!! What terrible luck. At least you are starting to get answers though.
Best wishes!!

[Fiesta01]

Keeping you and your boy on my official Jingles List for the foreseeable future, just to be safe.

[Critter]

Thanks everyone for the support…he seemed stable and came home today! He will be on minocycline for the next 2 weeks. Temp was normal and the vet gave the okay for him to get turned out tonight. He was very happy to go out and nibble some grass. Monday I will work on setting up the appointments to follow up on the ribs and dental. Meanwhile, I am relieved to have him home and fingers crossed he stays comfy after a rough week.
I mean how could you resist this cute face!

[Critter]

Updating again…just because I think it may help someone else eventually (and I know I get curious when others have complex issues and want to know if they found answers!).

Went back up to the vet clinic yesterday to do the ultrasound to see what was really going on with the hot spot at the ribs. Guess what - he had two fractured ribs!! How the heck did he even manage to do that (he’s not out with anyone right now and has had no sign of cuts/tore up field/etc.).

Ultrasound showed that on the left side, T17 and T18 ribs had fractures, T18 was worse with a clear fracture line through the cortical margin. They were not complete/displaced, so that’s good. But, they were “kinked” as the vet put it - where the normal curvature of the rib cage was definitely changed…so basically cracked/bent. Good news is the vertebra look okay, no arthritis there. They can’t really tell if any of the soft tissue is impacted because of the depth (ie can’t see the underside of the ribs).

So, at least 4 months of no riding/work and we will reassess with ultrasound to make sure we have complete healing. He’s allowed to get turned out as usual. Basically just Dr. Green to allow the fracture to heal completely.

This at least makes complete sense as to why he didn’t want to move and would not turn left and wanted to launch me. Happy that we were able to find out the issue…and happy that the prognosis seems to be very good (fingers crossed).

[JB]

Whoa, that’s amazing! I mean, ugh, horses! But what a relief to have a pretty reasonable (relatively speaking) diagnosis

He could have been running and slipped and body slammed to the ground, or run into the side of a doorway or something similar (like a tree) just right

I hope your Winters are the “ugh, so cold, don’t want to ride” as that makes this easier to swallow

[beowulf]

While it sucks that he’s out for the next few months, rib fractures are probably the best fracture if you have to have one! Glad you have an answer, and jingling for a speedy recovery.

I do not know if it helped at all, but my vet insisted my guy be put in BOT blankets for the stall rest.

[Lunabear1988]

Thank you so much for updating. I hate it when people have these weird cases and never really update with what happened and you were always left wondering.

It sounds like you should be okay with a few months rest. He’s lucky to have you as an owner!! I hope the healing process goes well and quick.

[vxf111]

Your poor guy! If/when you ever circle back to the dental issues I’ll just add that Dr. McAndrews is the BEST and is basically a miracle worker.

[Critter]

@JB

I hope your Winters are the “ugh, so cold, don’t want to ride” as that makes this easier to swallow

I am in NJ, so winters do get crummy by Jan/Feb for certain…so I won’t mind him having those months off. Kind of stinks that we’ve basically lost the summer trying to get to a diagnosis and will lose the fall…but he’s 4 and as long as he heals and can be back to himself, I will try not to whine too much!

They did not recommend any stall rest - said he could do normal turnout (he’s currently out solo but with my other gelding in a nearby field). No riding or lunging, but could do easy ground work.

@vxf111 The dental follow up won’t be until November…but since it wasn’t so urgent, we can wait. The dental vet wasn’t available for a few weeks…then the specialist I use (who wanted to be there) was away, then I will be away. So that was the first time all 3 of us could sync schedules…since the dental appointments are only on Thursdays.

Definitely happy to have an answer that also makes sense…and that prognosis is good. We will also take him back up to recheck healing before we start back to work.