Treating stifle problems in an older horse?

[Mountain_Trails]

Hi all!

I have a Missouri Foxtrotter mare in her early 20’s whom I am thinking has stifle problems. She fell with me twice a couple of years ago, where her back end just seemed to give out, at a walk, on trails. I hauled her to a vet who did a brief lameness exam, didn’t see anything wrong with her, and said it could be her back, but he wouldn’t be able to diagnose that at his office due to his minimal x-ray capabilities and I would have to haul her several hours away to a larger vet facility. So I took her home, kept riding her, and she didn’t have any further issues for about a year.

Fast forward to about 6 months ago, while trail riding, she seems to “knuckle over” with a back foot, groan, and almost go down. Or just simply knuckle over on a hind foot, and keep going like it’s no big deal. She has been doing that almost every ride now.

So I did some research and learned that sounds a lot like a locking stifle. Which is theoretically treatable-yay! I called a different vet and she is going to come out in about a week. When I described the problem to this vet, I never mentioned I thought it was her stifles and she immediately said “That sounds like stifles.” She said she can inject the stifles with steroids or make something out of the blood (I forgot what it was) and inject that back into the horse. The later is much more expensive. To complicate matters, my horse has Cushings and is on Prascend, so the vet wants to check her insulin/glucose levels before she possibly injects steroids. I think doing bloodwork again is certainly a good idea.

So the vet will do an exam and we will have a better idea of what is going on in about a week, but I guess what I am wondering is, if I try the less invasive/cheaper option of steroid injections, is that high risk for my Cushings horse? She was diagnosed 3-4 years ago with chronic low-grade laminitis as her main symptom. She’s been doing great since then. I am even riding her completely barefoot. But if the stifle is catching, will steroids even help? Or does that only treat arthritis?

Any other ideas for stifle problems in a 20 something trail horse?

[RedHorses]

The main hesitation in use of steroids in horses with PPID is the risk of causing laminitis. If low grade laminitis is your horse’s PPID symptom…

If steroids are your personal-situation best option, before getting the injection figure out where the hard stop will be should your horse develop laminitis. Be prepared to call it.

My senior PPID horse has stifle issues, but his are injury related so I can’t help you with treatment options/experience. I hope whatever you choose works well.

[Mountain_Trails]

Thanks so much for your response. I am a little disappointed I only got one response. Not sure if my post was worded in a way that discouraged people responding or what. But anyway…

I would rather retire her than cause her any harm. So if the vet feels laminitis is a risk, I won’t do the steroid injections. I am already leaning away from the steroid injections.

I wonder if bute or Equiox would help? I can certainly try corrective trimming as well. I hear that sometimes helps. I just really don’t know if it’s a pain issue or a mechanical issue with the stifle catching.

Hopefully I will learn more at the vet visit.

[RedHorses]

Once you know what the issue is, ask about experiences treating that issue.

The other thing about senior horses is that they can be slower to heal (PPID tends to make that worse too) and sometimes don’t fully heal. My horse’s stifle (meniscus injury) has healed enough to do walk with a very little bit of trot hacks, but it’s fragile. I’ve been doing gentle strength exercises, and being cautious about footing because I know it’s one bad step away from reinjury. He has two other health issues that require exercise as a key part of their management. If he gets to the point that exercise is too much, I will have to let him go.

At some point we do have to switch to pain management. My guy is on Previcox and has been for the last two years. We tried Osphos for his general, minor arthritis last year with some good results, but I think it might have worn off too fast to be worth doing it again. I’m looking at other options before making a decision.

You do what you have to do to keep your horse comfortable, until you can’t do anything more and it’s time to help them go. Sometimes the options aren’t great. Sometimes they don’t work as hoped. 11-12 years ago I made a decision about my horse’s scarred eyelid that didn’t work out as hoped. I wish I had chosen a specific other option, but if I had to make the decision again, with the knowledge I had at the time, I would make the same decision I did then. It really was the best option. That eyelid has been no end of trouble, and it’s been getting worse over the last couple of years. I just have to do my best to manage it.

See what your vet thinks is the issue, and discuss treatment options, costs, and risks. Don’t feel like you have to rush into a decision if it’s not obvious.

[TWH_Girl]

At 20, and given her co-morbidities, you can manage her stifle issues if that’s what it is, but you may also need to scale back her work and what you are doing with her if she’s buckling that often.

Injections and equioxx are good options but you still need a diagnosis yet so that’s probably why there aren’t more responses.

[joiedevie99]

It’s hard to give any advice until you know what problem you are dealing with. Arthritis, loose ligaments, tight ligaments, bone chip, torn meniscus, etc. Once you have exam, x-rays, and ultrasound, you can formulate a treatment plan.

If you are headed down the arthritis road, there are so many options now. Yes, giving steroids to a PPID horse does increase the risk of laminitis. Your vet can look at your horse and his bloodwork and give you more information about how great the risk is. If you don’t want to go that route, there are so many good options to ask about on the market now - PRP, IRAP, ProStride, Arthramid, Noltrex, A2M.

[Renn_aissance]

My horse has stifle arthritis that significantly impeded his mobility. He also has Cushings. The vet and I discussed a number of options for injections, given that he was already on Previcox and his management was appropriate for his condition. He had previously not responded outstandingly well to PRP in other joints. Ultimately we injected the stifle with Polyglycan and a small amount of depo-medrol (steroid) and did a loading dose of Adequan at the same time. Excellent results as far as mobility, ability to regain strength in hind end, comfort standing for farrier, etc. The current plan is to repeat these treatments every 6 months and so far, so happy horse. (Horse is coming 30 this year- we are looking at quality of life.)

Once you know what you’re treating, you’ll know more about the options that may be therapeutically viable.

[just_shoot_me]

I bought medium red light therapy pads from According to Gospel as a just in casement for my coming 18 yo Missouri Foxtrotter gelding. He also has a BOT mesh sheet when he works hard. He injured his right stifle as a 5 yo because of a bad instructor (multiple people told me about this instructor after the fact). If anything develops now, I would add homeopathy to vet recommended treatments. I was trail riding him mostly at the walk (until I got hurt) unless footing was stellar (because of his stride he slips more than non-gaited horses).

Gaye DeRusso has a FB page Gaited Horse Training with Gaye DeRusso The Majestic Rider. She also has a bunch of videos on YouTube. Maybe search there for information?

[beau159]

@Mountain_Trails

Hi all!

I have a Missouri Foxtrotter mare in her early 20’s whom I am thinking has stifle problems. She fell with me twice a couple of years ago, where her back end just seemed to give out, at a walk, on trails. I hauled her to a vet who did a brief lameness exam, didn’t see anything wrong with her, and said it could be her back, but he wouldn’t be able to diagnose that at his office due to his minimal x-ray capabilities and I would have to haul her several hours away to a larger vet facility. So I took her home, kept riding her, and she didn’t have any further issues for about a year.

Fast forward to about 6 months ago, while trail riding, she seems to “knuckle over” with a back foot, groan, and almost go down. Or just simply knuckle over on a hind foot, and keep going like it’s no big deal. She has been doing that almost every ride now.

So I did some research and learned that sounds a lot like a locking stifle. Which is theoretically treatable-yay! I called a different vet and she is going to come out in about a week. When I described the problem to this vet, I never mentioned I thought it was her stifles and she immediately said “That sounds like stifles.” She said she can inject the stifles with steroids or make something out of the blood (I forgot what it was) and inject that back into the horse. The later is much more expensive. To complicate matters, my horse has Cushings and is on Prascend, so the vet wants to check her insulin/glucose levels before she possibly injects steroids. I think doing bloodwork again is certainly a good idea.

So the vet will do an exam and we will have a better idea of what is going on in about a week, but I guess what I am wondering is, if I try the less invasive/cheaper option of steroid injections, is that high risk for my Cushings horse? She was diagnosed 3-4 years ago with chronic low-grade laminitis as her main symptom. She’s been doing great since then. I am even riding her completely barefoot. But if the stifle is catching, will steroids even help? Or does that only treat arthritis?

Any other ideas for stifle problems in a 20 something trail horse?

In my experience, injections just aren’t as effective for stifle issues. I’ve had two horses with stifle issues over the years. One I ended up putting down because of it - his was severe and I couldn’t get him comfortable. The other started at a young age and with some careful management, he kind of “grew out” of it.

I think you first need to confirm that it is indeed stifles, so start with your lameness exam and diagnostics. If this were my horse, I would absolutely xray the hocks and stifles, as well as ultrasound the stifles. And see what else the lameness exam turns up.

Your vet probably has AlphaEQ, PRP, irap, or some other biologic option which yes is more expensive but if you are worried about steroids for your horse, it’s lower risk for Cushings.

And you’ll also have the weigh the expense of everything on if it’s worth it for your horse, or if you need to reduce how much you use horse, or perhaps retire her all-together.

@Mountain_Trails

I wonder if bute or Equiox would help?

If it is stifles, the pain/inflammation will not go away quickly. Bute would likely not be a good solution due to its side effects and you’d likely need to have her on it for a longer period. Equioxx may be an idea but you’ll also need to visit with your vet on how that would affect the Cushings.

[risky_business]

I am currently 4 months into treating my 21 yr old and finally seeing some progress. After multiple steroid injections which only worked for about a week we injected with Prostride and Arthramid. After a month he was standing on all 4 legs again!! His progress since then has been amazing. Still on stall rest but now we are walking as part of rehab. Did a 2nd Prostride injection a month later and I am feeling hopeful that he may get to return to being a horse by summer.
I was looking at putting him down, this was our “one last try’” and it worked!!

[TWH_Girl]

I’m assuming the Prostride and Arthramid were injected separately? Sounds like a pricey but potent combo.

[risky_business]

The first series was Prostride and Arthramid combined in 1 injection . Second one was just Prostride.
Yes pricey which is why I went with 1 injection to see if we had any results and then followed up with another since it worked so well.