What do I look at first? NQR young mare

[blue_heron]

My 5-7 year old (not quite sure) sensitive and hot-ish mare has come up NQR for the latter half of the summer. Initial symptoms were just being very behind the leg at the canter and challenging canter transitions which have not improved. Sometimes likes to hang on the left rein and counter bend right. At first I thought she was more sensitive during her heat cycles but that doesn’t seem to add up toward the end of the summer. I gave her some time off thinking she was growing and feeling a bit dull (she has definitely grown some more) but she didn’t come back better. I’ve asked a few horsey friends to look at her and they didn’t really see anything. Trainer, who knows her a bit better and familiar with young horses, can see what I see. Mare and I will move to trainer’s place for the winter but would like to figure this out first.

Symptoms:

• Crummy canter (her natural canter is very big), worse left than right, sometimes 4-beating under saddle, she can also really sit behind and do almost pirouette canter but has difficulty galloping on
• Sore lower back (have seen this before) and sore over the point of hip (this is new)
• Sometimes seems dull or low energy in work
• Doesn’t want to back up on the ground
• Crossing jaw and some teeth grinding (experienced previously when she had diagnosed ulcers and pretty much went away earlier this summer) mostly on longe

That’s really it for symptoms. She is crazy smart and a try-hard. Mare has a history of ulcers-- behavior is somewhat consistent with last round of ulcers. Last saddle fitting was early July and saddle fitter is coming back out next week. She has always been very sound and is not lame but maybe 1/5 hind end weakness (this is pretty new). Shod all around; she has thin soles and grows a lot of toe but otherwise good feet. UTD on other routine vet care and she had clean x-rays of back and front legs/feet ~18 months ago. Usual vet was out earlier this week and said she looked great. She eats very little grain (just a ration balancer) and gets pretty much free choice hay from a slow feeder and long stem alfalfa with each meal. Her weight is good, maybe a little chubby. We are in the northeast.

I am putting her back on the Ulcergard and sucralfate-- first dose of Ulcergard was this morning. If this clears things up, what do I look at next? Lyme, EPM, and vitamin E?

[Simkie]

It’s lyme season. Since you’re in lyme country, I’d start with lyme and epm titers. Sure, toss in vit e and selenium, too, might as well take a peek.

If that’s all clear, my next step would be a lameness exam.

[Posting_Trot]

I would ask the vet to pull some blood for a Lyme test. It might not be Lyme, but those symptoms would be consistent with Lyme, and it would be good to at least rule it out.

[fivestrideline]

Thirding a Lyme test. It’s cheap.

Also, lameness exam with a good sporthorse vet. With blocking. I had a stifle injury present like this - head twisting and teeth grinding went away with stifle treatment. Usually it’s the opposite hind to the twist - in your case it sounds like left hind would be my first guess. It certainly could be multiple things, but I wouldn’t rule out an actual injury just because she isn’t “more” lame.

It sucks to have to do a lameness exam on a 1/5 and NQR, but canter issues often come with hind end issues like suspensory or hock or stifle. You wouldn’t want to make something worse by fiddling around. Pull blood for Lyme and vit e/selenium while you’re there.

Good luck!

[Ottbaxel]

Commenting to follow along…these symptoms are similar to my gelding.

[Warmblood1]

My first thoughts are ulcers (before you mentioned ulcers) and hocks, esp with sore lower back and not wanting to back. Ulcers cause issues through the whole body like dominos.

Thin soles and grows a lot of toes makes me think of laminitis. Also possible NPA on the hinds. That can cause a lot of issues in the hind end which trickles up to the back. May not be the case here but something to think about. Sometimes I throw pads on if a horse is NQR and feet may be sore. It’s an easy and cheap test for improvement.

Also, I’d consider chiro. I find when horses get stiff or difficult to one side, chiro can help quite a bit.

[GreyDes]

In addition, you could try a magnesium supplement like MagRestore. Magnesium deficiency can show up as very tight muscles and a sore back.

[islgrl]

You might also consider PSSM

[GoodTimes]

Have you tried pads or pour ins? Have you done a bute trial? Any slow motion videos to see if she’s landing toe first?

Bilateral ouchy feet can definitely produce the symptoms that you’re describing. I’ve got two horses with totally different feet who have run into issues.
Gelding has big flat feet that want to run forward, thin soles. He needs a stiff pad, usually with a pour-in and he gets immediate relief. He’s 15 now, we’ve played with different set-ups over the years, different farriers as I’ve lived in different places, and it’s very obvious to me when his feet are happy or not. Even if he’s “sound”. When those feet are ouchy he’s stiff through the neck and jaw, and doesn’t want to move out.

Mare was far more complicated to figure out. We’re still figuring it out. 7 yo hunter. Very slowly started going NQR, hack winning trot started disappearing, didn’t want to go forward. Started randomly stopping at jumps for no apparent reason. Every few months would come up dead lame towards the end of a ride, but would be “sound” by the next day. Tried shoes with no obvious improvement. Tried pads and pour ins, slightly better. X-rayed clean. Finally sent her for an MRI which showed bruising of the navicular bone on the LF and bruising of the coffin bone on the RF. Never reacted to hoof testers. Her feet look good and strong, no obvious bruising of the sole, angles look good. But she’s built upright enough that the forces don’t seem to dissipate well. Was prescribed three months of stall rest and keep her in shoes and pads. We’re 5 months out from the MRI and are slowly bringing her back to work. She just returned to normal full turnout with friends this week. I still don’t think we’ve found the perfect shoeing setup for her, may try aluminums next cycle to get rid of some of the knee action.

[blue_heron]

She seemed more “tuned in” yesterday evening just with one dose of ulcergard and the sucralfate in the AM and right before I longed her. Increased flexibility left and didn’t look so tight behind. She will have today off and I will reassess this weekend. If I don’t see continued improvement I’ll do the blood draw and Lyme test early next week.

@GoodTimes I thought about this. She’s gone through a lot of shoulder development this year and the walk work is really improving. Then she loses the reach in front in the trot and canter and her hind end looks “floaty” or like she doesn’t have a lot of grab behind, especially in the trot. Ive been addressing it as a growth and strength issue. Her hock and stifle articulation is normal. My farrier set the hind shoes back slightly which did improve things. I’ve always thought she lands flat-footed and would like her to land more heel first. Our footing can be hard and it’s rocky here.

[Pico_Banana]

I went through some similar things with my mare at that age. One of the things we did to help was give her a round of Adequan. My vet suspected that she was a bit sore (particularly in the hocks) from the newly added workload. It did help amazingly well.

[blue_heron]

Did you do any imaging prior to the Adequan or just did it on a hunch? How did you feel about starting maintenance on a horse that young? This girl has only been under saddle ~18 months.

[ATXmom]

I was just thinking about you and your mare the other day. Glad to read she is back out with her friends! How is the rehab going?

[ATXmom]

Everyone has different thoughts on this but our vet is a strong proponent of starting supportive therapies early on. His feeling is that if you can break the discomfort cycle early, it will help avoid lingering or compensating issues and prevent more serious problems down the road.

YMMV, of course!

[Demerara_Stables]

All good advice here, but personally I’d start with massage/chiro/acupuncture. Maybe I’m really lucky with my body workers, but one of them is a vet and also rode in my discipline for a long time. She can feel and see a LOT (for instance, if a horse is painful on their ulcer points). If body work doesn’t solve the issue, at least she will give me a direction to look in when I call the vet. And sometimes it’s just soreness from work that can be resolved with body work! I’ve done enough going down the rabbit hole to start straight with the vet. Although mine is very good, it gets pricey very fast. I’m always looking at the cost/benefit ratio. Chiro/acupuncture is $300 max. It’s almost $300 just to get my vet to my farm and do a cursory lameness without blocking or rads.

[Pico_Banana]

I’d say it was more than a hunch, but no imaging because he didn’t think anything would appear. He said it’s not uncommon at that age. My girl was five for sure so she hadn’t been under saddle very long either. And then I didn’t do Adequan again until she was 12.

[TWH_Girl]

@blue_heron

Sore lower back (have seen this before) and sore over the point of hip (this is new)

What has been done to address the sore low back? Crummy canter, being behind the leg with no obvious lameness points strongly to SI issues IME.

[Bogie]

@TWH_Girl

What has been done to address the sore low back? Crummy canter, being behind the leg with no obvious lameness points strongly to SI issues IME.

My first thought, too.

[blue_heron]

Addressing saddle fit has cleared up the lower back soreness in the past and greatly improved the under saddle work. She is shorter in the back so finding a saddle she likes that is also compact has been an ongoing challenge.

[RJC]

Except for the teeth grinding, this is how my horse presented with hind end soreness due to NPA behind (particularly SI and stifles). He started kicking out in left lead canter as well when we tried to push him through it (two coaches told me he was just being a brat about harder work and looked sound). Does she react when you palpate over her SI? I think a lyme test is fair, but I’d want flexions done sooner than later, partially informed by my own regret that I didn’t do a lameness workup sooner.