I just had the vet out to my horse for this exact issue.
X-rays revealed - hock arthritis with spurs forming.
Devastated doesn’t cover it.
@Obsidian_Fire if you are still here, what was your horse’s outcome?
@LadyDelightful & @Old_Mac_Donald (yes I’m still here!)
I’ve chimed in on a number of NPA and KS threads, if you search by my user name you’ll come across them. That might be helpful to you.
Short version is: I fired the original farrier and got a new one who has been with us and for us, every time. Comes to vet appts, whatever we need. Love him to pieces, and so does my mare. I did end up using dorm to help her with her hind end. We have tried just about every possible shoeing package on her hinds that is available. Flip flops, wedges, pads, now she’s just barefoot and on a shorter trim cycle. Last films show she maintains about 0 degrees, she is positive right after a trim.
Vet-wise, at the time of this (older) thread, we ended up testing for EPM (negative) and then doing back injections. Just back injections helped, but not enough. Ended up doing SI along with her back. Doing mesotherapy with steroid in the back was the best combo. At our vet visit in February '24, more diagnostics showed her hocks are fusing. At this appt she got the book thrown at her due to multiple issues: PRP in the SI and hocks. Meso/steroid along the back. Osphos.
I took her back just a couple weeks ago as I felt her SI was problematic again, and it very much was. Vet felt her back was pretty good, and wondered if we just did SI & hocks, what would the outcome be? So, we did PRP in the SI & hocks. I gave her the following week off, as directed, started her back on the lunge. She looks amazing. I’ve been riding lightly this week, she feels really good.
Does that help? Honestly the “outcome” is this horse is never going to be the horse I bought her to be. It’s okay. I’ve grown so much in other ways with her. It’s an ongoing battle of short farrier cycles, expensive shoeing, expensive vet visits regularly and a lot of frustration and very few answers. When the day comes for this horse to cross the rainbow bridge, I am hoping I can have a necropsy done. I’d like to know what is actually wrong, and if I could have done anything different or more, to help it.
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SO MUCH BETTER! How has she been doing in terms of movement, behavior for farrier?
I’m sure others would also love to know how much you had to “peel the onion” for her body to get her going well again 
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There are quite a few bone-and-body people doing investigative necropsies now in Australia, at least two that I know of (not counting Sharon May-Davis) so you might be in luck. I’m sure there would be a few in the US, if you didn’t want to go down the university route.
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Love the wrap up posts no matter how late. They really help if you’re searching and not familiar with the OPs entire story.
It’s never just one thing wrong- that’s what I’ve learned. Always a cascade of issues.
We had wellness appt yesterday and vet did Chiro. I asked for hind hoof X-rays to check NPA just in case. He’s 4 weeks out/due in 2 but his X-rays looked great and vet was happy with his progress and how he looked. Well I hope so because we did a lot!
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Completely different situation, but maybe some of this could help?
Over 50 years ago, our riding center received a ten year old dark brown trail mare to rehab.
She had been in a bad trailer wreck and survived, was fine all but she would/could not lift back feet.
They were riding her and she was not lame, just picking back feet was not happening.
She had an old deep horizontal depression halfway between hip and tail all the way from side to side.
I had been shoeing some of our horses and she was assigned to me.
First I addressed all I could, big flares causing vertical cracks on walls, with her feet on the ground.
Since there was no way to pick her feet, I taught her to give them to me herself, front feet first. She could lift back feet on her own to leave toe touching ground, but that was all.
It was sufficient for me to do a bit more trimming.
Don’t know how things went after that, owners took her home at that time.
I expect you have tried that already and have the farrier not move the leg around, work with whatever horse can give.
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JB, thank you. I didn’t realize how big an improvement it was until this thread resurfaced! I showed my farrier the before/after, his comments were 'her feet look more substantial and strong, hairlines look better, less bullnosing." LOL, pat yourself on the back dude, it’s all you…
Okay, it seems like some folks want some sort of update to this. Bear with me, I started this thread 6 years ago!
First, we worked on the NPA, because that was the thing I knew was wrong. At the time, I wasn’t thinking about KS because I’d had her back filmed at PPE and it was clean. Something I noticed in time was it helped her stance. She used to stand somewhat camped under, and it made her look a bit sickle-hocked. She would also be standing on her heels, and they were always crushed. She doesn’t do this so much anymore; still does it somewhat, and I wish I could completely fix it, but I can’t.
She could not back out of the trailer to save her soul. I put it down to stifles, as they were weak and wobbly and slightly catchy. There were many ‘fall in a hole’ moments. I used Estrone a couple times. However, we haven’t had a stifle bobble in so long I’ve basically forgotten about it. I think that besides shoeing and injections, fitness plays a big part in that. Anyhow, after she got her first back injections, she could ‘miraculously’ back out of the trailer just fine. It’s a step down, not a ramp, for reference.
Shoeing, we started with the flip flops. I did use dorm on her, she needed to be very still and quiet during application. We used the flip flops for over a year. They helped, but were not a magic cure-all. I think (but I can’t really remember) we tried to transition to steel shoes next, but she regressed. I know we used wedges on her at one point, made things worse. Came to a head a couple years ago? I think? when in the pasture doing her best reining horse imitation she managed to slide right out of BOTH hind shoes. Farrier said, let’s just leave her bare behind and see how she does. She’s been bare ever since. I do need boots for trail riding.
If I were to go back to nail-on shoes for the hinds, I am pretty sure I’d need to sedate her again. It’s only her left hind. Something hurts, but we don’t know what. It’s possible it is her hocks, and now that she’s had injections a couple times maybe she’d be okay? But that’s only a guess.
I’ve never been able to really put a “butt” on her. The top glutes, on each side of the croup, if she was a person she’d have a flat butt, lol. She’s got good hamstrings tho. So what does that tell me? Compensating somewhere? Different exercises? Both? Or just who she is physically?
Saddle fit… I have purchased 2 completely different saddles for her. I can’t emphasize enough how important it is to have the saddle fit the horse very, very well. With a horse like this, the saddle needs to fit the rider also. Both of the saddles I purchased were fitted to her and fit her like a glove, but only one fits me also in a positive, helpful way. I mean, I can ride in anything, but there’s a difference in a saddle you ‘get by’ with, and one that actually helps you.
This mare is an absolute ‘princess and the pea’, but fortunately for me she is painfully honest. If something is wrong, she tells you, and she’s not making up stories. I have learned to really listen to her, even when it seems so impossible.
I don’t remember how long it was in between back injections maybe a year the first time? but I think the second time I had them done I asked for a different vet and this was when she wanted to take new films of her spine and that’s when we found the KS. It’s not “bad”, as in the processes are not overlapping, but they have been touching/rubbing. At that appt is when we first had SI injections also. I had suspected SI for quite some time, but getting someone to believe me was a different story.
What else… When I look at this mare, and consider her hind end issues, I don’t know that all or even a majority of this was caused by NPA. She’s OTTB, so what happened on the track? Sure, she vetted clean, but she’d been off for 2 years between the track closing, being bred, foaling… so was she sound when she came off the track? Are her issues conformational combined with the stress of racing? Or, did she do the splits when she was younger? Reason I think of that is I knew somebody with a horse who had done that as a foal. It damaged her SI region, she was rideable up to a point but NQR, ever. As she aged, it became worse for her, and she was eventually PTS. I knew this mare, remember her hind end conformation, and it makes me wonder.
Anyway, continuing to peel the onion, as JB put it… yeah, it makes me cry. I’ve cried a lot over this mare. My farrier and I, and even my vet, have had long conversations about ‘which came first’; did her hind end problems cause her to stand camped under which eventually led to NPA, or has she been NPA all along and putting her into actual work made everything worse? She’s been very, very difficult to teach to use her back. All her resistance in the beginning likely helped the KS along… even now, 7 years later, I’m not riding anywhere near like I used to. She’s in what we all would call light work, roughly 2 days on/1 off, lots of walking, some trotting, little canter. Then there is the constant on/off game we play: is she lame, do I need a vet, if we do injections it’s a week off, a week lunging, then back u/s. Is she sore… do I ride today or give it a day? Things like that. I don’t feel like I’ve ever truly established a good training rhythm for us. A month after I got her my trainer moved away. So basically I’ve been on my own with her. I had a very knowledgeable friend thankfully, who helped me a lot. But still, you don’t know what you don’t know! Thank goodness for COTH. Eventually I ran into the person I ride with today, he’s been enormously patient and helpful and I truly believe we would not be where we are right now without his guidance.
There is some kind of ‘pinch’ going on, every so often, and it seems to correlate with her being ‘too compressed’, she’ll jump and shake her head like something zapped her. So I ride her on a loose-ish rein with a lot of seat/leg and pay a lot of attention to letting her nose stay out, and not letting her compress herself incorrectly.
She’s good about being trimmed on both hinds these days, no problems anymore, but like I said if I were to nail on a shoe again, I think I’d still need the dorm. She loves my farrier tho, and he loves her, and she’s the type that responds very well to that energy. That helps.
She drags her LH toe, I no longer think that’s a stifle thing, I am pretty sure it’s because of her hocks. That LH hock has always been stiffer than the right, long before it started fusing. I use poles off and on, but again, going back to not being able to stick to a routine of sorts…
What else… Osphos, I’ve used because she has mild navicular in her RF. It has not changed over the 7 years I’ve had her, but occasionally she is ‘off’ on that foot. We don’t find any other reason for it, and she’s sound afterwards.
The short answer in all this is, she will need ongoing and regular vet intervention for the rest of her riding life, and probably even in retirement. How long she will be rideable is something I can’t know, and frankly don’t want to. I have dumbed down, adjusted, and rethought my goals in so many ways, it’s the best I can do and still actually ride. She seems okay with it and my vet doesn’t see any reason to not continue as we are. I’ve learned more about fitness and rehab fitness and soul-searching horsemanship and trusting my intuition with this horse than all my previous ones combined. I’ve also learned just what a precious gift it is when a horse gives themself to you, all in. Trust issues have been huge with this mare, nobody rides her but me. She doesn’t “let” anybody else ride her. I know that sounds all woo-woo, but every time someone else has tried to, she locks up mentally and that’s the end of it. You get nowhere. I am pretty darn sure that all started with her being forced to work thru a whole lot of pain.
Anyway, this is plenty long enough. Happy to answer questions.
@LadyDelightful does any of my story help you? Patience patience patience… and more patience. And LOTS of thinking outside the box. Lots.
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