When is enough enough? Lameness

[clippityclop]

This is my first time posting, but I am a long-time reader of COTH and the COTH forums. I always read such good advice here, so I hope that you all will be able to help me, too. I only ask that you all please be kind; I am heartbroken and I don’t know what to do.

I bought my first horse a little more than a year ago. Just a few weeks into owning her, she went lame and was on stall rest for a month. We did everything right: We immediately spoke to two trainers, the previous owner, the farrier, and the vet; we did a lameness test, did nerve blocks, took x-rays, etc. We also tested different shoes - front and back - and have kept a very regular trim/shoeing schedule. I believe we are doing our best.

After that first month, we were able to very slowly bring her back into work. But that fall she started showing stiffness in the hind end, and it was recommended that we do a regimen of bute for a few weeks to see if it would help. We did that, and another vet (there are two vets where I keep her) ultimately recommended hock/stifle injections.

She seemed okay after that, but then we had to stop riding this past spring when our state went on lock-down for COVID-19. When we were able to start riding again in June, she went lame within just a few weeks. (I should note that she was still being lightly worked by a professional while the barn was closed.) She was intermittently lame in June and July, so she saw the vet again, and this time they injected her coffins and fetlocks. I had hoped that would solve the problem, but here we are, limping lame again.

I just don’t know what to do. We did a PPE with x-rays when I bought her; I know that’s really only good for what’s going on at the moment, though. She isn’t in heavy work; we used to ride 4x/week (2x flatting, 2x low level jumping), now only 3x. We don’t jump higher than 2’3" or 2’6". We only ride for 30-45mins at a time. She spends more of her life in the pasture than under saddle. We’re not riding on bad surfaces. She gets good care - regular vet and farrier appointments. It just seems like no matter what I do, I can’t get her sound.

Maybe I’m venting as much as asking for advice, but here goes:

• Is injecting eight joints as big of a deal as it feels like to me, especially given the kind of work she's in?
• At what point do you retire the horse for their comfort? (She only just turned 10, although one of her vets called her an "older" horse...)

I am just at my wit's end. She was supposed to be my special first horse - the pony I'd always, always dreamed of, but then busted my butt to buy her myself - but it just seems like the whole thing has been a nightmare. Yesterday she came up lame again, and when I got home, I just cried and cried. So I guess I'd just really appreciate some good advice - not medical advice (as you can see, we have plenty of vets to give their opinions) - and a little kindness.

[bathsheba8542]

I can’t offer a ton of ideas to consider, but I feel your pain.

It would be helpful to know how lame she is.

Honestly I can’t comment on the injections, but I would want to do more detective work to understand what else is in play. I know people who do that many, so while I would not be entirely thrilled with it, it has extended their horses’ comfort significantly, so there is that.

I wonder if you might post the xrays you have here; so many on this forum are really knowledgeable about trims, angles, etc. and that might help (not me). Not a dig on your current farrier(s), but often they just don’t quite make the right adjustments for the horse. I know I’ve had to do annual xrays for adjustments for my farrier to keep my guy in balance. As good as my farrier is, this information is critical to the tiny adjustments required.

Also, I would recommend you consider getting a vet out who is trained in chiro/accupuncture to give her some relief. My horse absolutely demands treatment once per month or his hind end gets tight and he is uncomfortable. I find that we often focus on feet and joints, when the pain source is higher up. Posting some video might be helpful also.

Don’t give up yet … you’ll find some great people on here who can share some solid advice.

[walkinthewalk]

It could be anything and she may never be anything more than a pasture pet, or hopefully have the ability for light riding only.

My suggestion is to find a quality holistic vet who is well versed in chiropractics and acupuncture. I know that will grate on the strictly scientific folks who believe injections and drugs are the only absolute way, but I can speak from experience to say a combination of treatments often has much better results than the narrow, black and white, path our vets learn.

My IR horse severely foundered in the past and lives with the residual affects. He has also fractured his sacrum TWO times. He miraculously pulled thru thanks to my holistic vet/chiro who has studied Eastern medicine for the last 20 years, and also my therapeutic farrier who keeps his hooves happy.

i have posted videos of him on here before, so it is not like I don’t have the backup for my anecdotal claims.

Best wishes in your quest:)

[MsM]

I would go in a different direction from the other posters. I would head to the Big Clinic - the one with specialty vets and all the diagnostic tools. They can evaluate and get you a more definitive diagnosis and prognosis. It hurts to spend lots of money that doesnt even cure anything, but my hard-earned wisdom from experience is that it is a better option than spending more time and money with “cheaper” options.

[Equisis]

I tend to agree with MsM. It sounds like she has a lot of different stuff going on, and I would want a comprehensive picture of what is bothering her, what the root cause may be, and what sort of treatment could be done (and the cost) to get her sound again- if it’s possible. I would be looking to a lameness specialist with the diagnostic capabilities to give me those answers. If she was in very hard work before you bought her and they didn’t give her a lot of support, I may not be overly concerned about the injections. If she was sitting in a field not working, and light work makes her sore enough to need injections, then I would be more concerned. Without knowing her history and the specifics of her lamenesses, it’s hard to say.

I am so sorry you’re going through this. I had to retire my first horse very early because we couldn’t keep him sound, and I know how devastating it is. Please keep us updated.

[mvp]

Wait a sec.

1. When you did all that diagnostic work, what, exactly, did your vet find?

2. Inject eight joints? Which ones? And just a year into owning her, no one saw anything on the xrays you took in the PPE?

I’m posting about this because it’s really important that you don’t inject all 8 joints at once and I’m not sure anyone has discussed this with you, but vets put steroids into joints in order to stop the inflammatory process there (albeit temporarily). Putting steroids in high-motion and low-motion joints (e.g. a fetlock or coffin joint versus the lower joints of the hocks) are different propositions. But THE BIG DEAL about doing many joint injections of steroids close together is raising the total blood levels of steroids too high. That can cause horses to founder.

I hope you have more and better vet help than your initial post suggests. You have more heartbreak and less precise information than you need. So I’m hoping that I’m wrong and that no one has offered you vague treatment advice without the all the information you need.

In order to know what to do, I’d have to know way more about what they found. If you can’t get that from your local folks, then follow MsM’s advice and go to a bigger clinic where they can unravel the various sources of pain for you.

Good luck! My first horse was a bit this way, too. I feel your pain.

[Kirikou]

OP, I don’t have an actual response but I do feel your pain and I am sorry you’re going through this with your horse.
I can share my experience with my OTTB who also was a little ‘off’ a few months into my getting him. I did the whole “big clinic” thing (with the significant bill to go with it), they injected his hocks, prescribed daily meds for his athritis and wanted me to come back every 3 months for more injections (where I come from injections really are a last resort not a regular “maintenance” strategy as they seem to be with the Hunter/Jumper crowd). He actually slipped on the ice before the 3 months were over, and he sprained his fetlock so I didn’t re-inject. We did the stall rest/rehab, etc, took him to another of the “Big clinics” where they did a full lameness exam and I was told he’d never be sound again - oh and that he was navicular (I shared the X-rays with my childhood vet who disagreed about the navicular diagnosis).

So I - tearfully and after much wine - decided to turn him into a pasture ornament (he was 10 at that point as well) and found him an - affordable - retirement pasture board at a farm a little ways from my regular boarding situation at the time.
Fast forward 1 year as I was doing my weekly visit to him to groom him and give him carrots, I looked at him playing with his pasture mates and then seeing me at the gate and coming towards me at a full extended trot - totally sound. So I found a more holistic local vet (who does chiro as well), had him checked and she gave me the green light to slowly get him back into work - starting with flat work only. He’s now 18 yo, sound, and working about 3x/week (he would do more if I had the time) and giving the odd lessons to kids. I never jumped him as much as I had hoped - because I didn’t want to “chance it” (I had gotten him as an eventing prospect originally) but we have fun with lower level dessage (and if I hadn’t had fun with that - or couldn’t afford to keep him + my other ponies -, I probably could have leased him for lower level dressage).

I remember coming on COTH after his fetlock sprain/“navicular” diagnosis and someone recommending “Dr Green” (aka pasture) as a last resort. It worked for us.

My take-home message throughout those 2 years we battled with lameness is that so many “big clinics” are quick to use injections as the “fix all” and over-diagnose navicular when they’re not totally sure what’s going on. I recommend getting multiple opinions and a good farrier (my gelding has been barefoot since we pulled his shoes 8 years ago to send him to his “retirement” pasture and he’s now sound hacking on gravel).
I remember feeling guilty for chucking him in a pasture at that time. Was I a bad horse-mum? I couldn’t really afford to keep injecting him but everyone seemed to be doing it and the vet school people kept recommending him? etc.
But truthfully I couldn’t afford more trips to the vet school or the daily meds vets were recommending for the rest of his life. I wondered if I had failed him and if I should just euthanize him rather than having him in a pasture without what I had come to think as “needed maintenance” (injections, MSM, etc). I gave us a year to see and if he was obviously in pain during that time or still unsound at the end of the year I would have humanely euthanized (it wouldn’t have been fair on the horse to keep him in pain obviously but thruthfully - and that may be an unpopular comment here - I also couldn’t see myself paying board on a lame pony for the next 10 years and not being able to ride anything else if I couldn’t swing 2 boards).
So long story OP to tell you there is “hope” and suggest “Dr Green” as someone did for me on here years ago. I hope you find a way to make your horse more comfortable and to keep riding. Good luck!

[Chall]

I had a visibly-lame-at-canter-while-at-turnout horse become sound at gallop after years of retirement.
No I never rode him again, but he eventually healed (probably fused bones) and enjoyed his life in a herd.

[Lunabear1988]

Op, first off I’m so sorry. I know how soul crushing this type of thing can be. And so frustrating when nothing is working. I’m euthanizing a horse I haven’t had even a year. So I truly understand.

But like MSM said, it is wise to see a clinic in your area. I’ve learned this many times over. It saves you money in the end. The nickel and diming over to time from smaller, more conservative vets has only ever cost me money.

Good luck. I hope you figure her out and she feels better.

[Bluey]

Here, when very good local vets are not getting a horse sound, as yours is not, we head several hours away to a specialist.

Has worked great, a friend had a 17 year old competition horse that was on and off lame.
Local vets did all regular stuff, s-rays, ultrasound, injecting, etc., nothing worked for long.
Friend was about to retire him, first took him to the specialist hours away, that found a little hard to see chip on an ankle.
He took it out and horse was sound after that and winning again.

After several stories like that, I would say, let your vets have a chance as you have.
Then, if things are not resolving, get the specialist on board, sooner rather than later.
A specialist may find something that can’t be fixed, or something simple others are missing.

With horses, you just never know what will happen, don’t get discouraged, enjoy what you can enjoy now, even if it is only hand grazing and caring for your horse, not fulfilling your dream of riding off into sunsets, is ok to change goals as our needs change.

[Redlei44]

So sorry you’re dealing with this, OP. I think this depends entirely on how much money and mental bandwidth you have left at this point. You could turn her out for a year and reevaluate at that time. You could take her to a specialty lameness clinic and have them throw everything they’ve got at diagnosing the underlying issues given her history and current state, then decide whether you want/need to treat and rehab, throw her out in a pasture for a while, or euthanize due to quality of life issues. Etc. Have your current providers done neck/back xrays? Neurological evaluation? Lyme testing?

Agree with previous posters that it would make a big difference to me what her history is. If she had a lot of miles doing as much or more that you are doing before you bought her, that’s very different than having bought a prospect who you’re now finding out may not stand up to the workload (light as it seems).

[Bluey]

@Redlei44

So sorry you’re dealing with this, OP. I think this depends entirely on how much money and mental bandwidth you have left at this point. You could turn her out for a year and reevaluate at that time. You could take her to a specialty lameness clinic and have them throw everything they’ve got at diagnosing the underlying issues given her history and current state, then decide whether you want/need to treat and rehab, throw her out in a pasture for a while, or euthanize due to quality of life issues. Etc. Have your current providers done neck/back xrays? Neurological evaluation? Lyme testing?

Agree with previous posters that it would make a big difference to me what her history is. If she had a lot of miles doing as much or more that you are doing before you bought her, that’s very different than having bought a prospect who you’re now finding out may not stand up to the workload (light as it seems).

That ^ and keep in mind, she was for sale for some reason.
Given that she has been off practically since you got her, maybe previous owners could possibly have felt she was not performing and decided better let her go?
Or they had a go-round or three of that, thought she was over and sold her?
Now you may be in their shoes, she is off and can’t find why.

Something to consider, since she has been off so much of the time since you bought her and has not even been in hard work.

[RedHorses]

Enough is enough when you can’t reasonably afford to do more. It’s when your heart can’t face grasping at another straw and finding only more disappointment. It’s different for everyone. It’s different for every horse.

Our culture is one that pushes people to beggar themselves seeking a solution that may not exist. The guilt inducing offering of possible solutions and the implications that one is a bad person if they don’t follow them to the bitter end is a horrible part of our society and culture.

You get to decide. You get to say enough, I’m done. And whatever you choose is right for you. (((hugs)))

[fordtraktor]

If you can afford it, take her to a big clinic and inject all the things they tell you need injecting, yes, it is a lot, but if you want more usable years, it is the best place to start. Consider Adequan/Legend too.

but it is enough if that is too much for your pocketbook. Retiring or euthanizing a chronically lame horse is not wrong and don’t let anyone make you feel guilty about it. Just don’t sell her down the road, for her sake.

[Gardenhorse]

I would be worried about injecting that many different joints. That doesn’t seem normal for a 10 year old in light work. It seems like either she has advanced arthritis in all her joints, or there is something else wrong that is manifesting in these various lamenesses. Have you looked at her neck or SI at all? Also, I understand Lyme disease can manifest as intermittent lameness in different legs.

But it is mentally exhausting to deal with this sort of thing. If you just need a break, finding a pasture board situation and just turning her out for a year or so and then re-evaluating might not be a bad idea.

[hoopoe]

It does not really sound like you have a diagnosis. Lameness is not a diagnosis, it is a symptom. I agree with others in wondering if this is Lyme or a complex neurological issue. Arthritis high in the neck will cause limb abnormality.

I suggest getting a good solid work up at vet school or large vet hospital with lameness specialists.

[mmeqcenter]

Your OP doesn’t provide a lot of details as to what went into the decision to inject so many joints.
Hocks
Stifles
Coffin - just hinds?
Pasterns - just hinds?
How were each of these joints chosen to inject? X-rays on all of them? Ultrasounds? Flexions? Blocks? A vet watching the horse go and saying “yep needs its hocks done”?
Yes, IMO, this many joint injections for a 10-year-old doing 2’6’’ is not normal. Unless maybe she was pounding the 1.40s-1.50s before you bought her.
Was there an actual diagnosis after that first lameness where you said you did block, x-rays, etc.? What joints were x-rayed, what were the findings?

What was x-rayed in your PPE?

Have her feet been x-rayed? Intermittent lameness is common with Navicular Syndrome, though it is certainly more prevalent in the fronts than the hinds.

Also agree with neck issues as a possibility.

What’s her breed - has PSSM been considered?

Yes, there’s more diagnostics you can do, but it only gets more expensive and more wearying. Many people opt instead for a year or two of Dr Green (pasture 24/7 no riding/working) and then bring the horse back in to see what they have. Also what fordtraktor said.

[Alex_and_Bodie_s_Mom]

I know you did x-rays, but what exactly did they show? Did they show arthritis? Signs of navicular? Did the vets think the hocks needed to fuse? (One of mine was on again/off again sound until his hocks fused at about the age of 13.) Did they think about kissing spine, or Lyme? Was the reason for injecting the joints ‘just to see what happens,’ or was there something on x-ray that indicated this was necessary?

I would not jump this horse until I knew for sure what was going on. Flat work, maybe, but only if she’s sound. Is she getting plenty of long-and-low warm-up time in the arena, as opposed to lunging? Have you had the saddle fit checked? (Note: not all professionals know enough about saddle ft to check - have you had a saddler come fit her?) Does she display any lameness in the field, or just under saddle?

There are many reasons why she could be lame. I’m sorry you don’t have answers for her. But there’s no shame in retiring her to pasture board, or turning her out for a year. Sometimes, they just need time, and sometimes they need something more.

[4horses]

No jumping… You don’t jump a lame horse, especially if you don’t know what is wrong. I talked to a friend. They bought a beautiful paint to ride endurance with. After 5 miles of riding the horse turned up lame repeatedly. The horse was found a better home, with a semi-retired lifestyle. Navicular in one front foot.

[Horsegirl_s_Mom]

In addition to the PPE results, I’m wondering what the prior owner told you when you were looking at her to purchase. Did the prior owner disclose any history of lameness? You also said you spoke to the prior owner after the first episode of lameness. What did he/she say in response to that?