Young horse swapping behind

[IPEsq]

Just to add to what gumtree said…nuc scans also only look for active bony remodeling. Some soft tissue related issues will show up this way, such as ligament problems, because there’s often strain put on the bone it connects to. However, there is an art to interpreting the results, as has been said.

For example, my horse didn’t have a very large latissimus dorsi muscle when he went in for his scan. So, some normal “noise” on some of his ribs made the resident conclude we had fractured ribs, possibly more than one. Until the head radiologist took a look and said no way and downgraded that finding by a lot. A note was put in regarding the lack of overlying muscle. This is also why some SI diagnoses are missed on bone scan (some are not)… I think it depends on the horse here. It was missed on mine, yet a friend’s horse lit up like a Christmas tree in the SI area.

There’s also an art to running the scan. The horses are in and out of the gamma camera pretty much all day long. They give them breaks, let them go pee in an area prepped for the radioactive material. It takes some time for uptake to happen throughout the body, and I think it’s possible sometimes the imaging of one area is timed wrong. But, I do agree that if you are going to go through the expense of a bone scan, just do the whole horse.

Don’t let anyone sell you on the so-called “soft tissue scan”–it’s far less reliable.

And then even if you have some places of concern on bone scan, you’ve then got to go look for actual pathology. Bone scan won’t really tell you any of that. So, if there’s something in the neck or hocks or feet or whatever, you then have to go Xray and do your typical workup.

A couple of my vets like bone scans for vague performance problems. Or behavioral changes where there is no clear lameness. But blocks can also show performance improvements…if you have an inkling of where to start blocking. I think with this horse you probably could start there, and I’d want to do blocks in hand and ridden to see if there’s a change. With the lead swapping type stuff of the causes of it can be exacerbated by a rider (SI issue is a good example of this), so say you’re blocking the hocks first or stifle, be sure to ride to make sure the problem doesn’t appear improved just because you’ve alleviated a secondary compensatory problem which is good enough to draw false conclusions on the longe.

[Libby2563]

@MapleLeaf

Between Virginia Equine Imaging and New Bolton, does anyone have experiences or preferences? I could probably also make it to Rood an Riddle, but it’s a bit more of a hike. Any suggestions would be appreciated. Thanks.

I second Gumtree’s recommendation of Kevin Keane in Cochranville, PA, for the same reasons. I’ve also found he’s a bit less expensive than some of the alternatives. He has limited mobility right now after a bad fall, but he’s still seeing patients, with the help of associate vets to do hands-on stuff like the actual blocks or x-rays.

If you choose VEI, I’d ask to see Dr. Susan Johns.

[Lord_Helpus]

My horse did exactly the same thing, in both directions. We looked at a lot of stuff, but what has made him sound was injecting the hock joints.

The difference between mine and yours is the age. Mine was 100% sound for 13 years. Then he got t/o for 3 years because there was no one who wanted to ride him (he is a huge mover and you need to be an advanced rider to use the talent that he has).

Last summer he went back to work. He was happy and sound — so, unwittingly, we rushed him and he has not been sound for 8 months.

Your horse, OTOH, has never been totally sound, so you have a bigger problem. Have you tried blocking him and done flexion tests? I assume you have. So you are the next level. Ask your vet about hock and/or stifle injections. I came across a great video called “diagnosing subtle lameness”. Search for the thread. It has a good explanation of back v. hind end lameness.

[Emily_amp_Jake]

What is SI?

My 5yo mare is having the same problem swapping her back leads, and she does it mostly when going to the left.

[tbchick84]

My horse swaps behind (only one way) whenever he’s experiencing tightness/soreness in his SI area, so I agree with those who have said SI.

Considering his young age, I would do the less invasive things first. Chiro/massage first to get the neck addressed. If the horse is still swapping after a week or so, then maybe try a guided SI injection. Once it has taken affect, use that time to do lots of long & low work, hill work, hacking, whatever you can do to strengthen that hind end. At 5 years old, the last thing you want is to end up on a yearly hock/SI injection cycle. That stuff is only effective for so long.

[MapleLeaf]

I’ve tried massage and chiro by good practitioners. Of course he felt nice and loose afterward, but it did not help the swapping.

I spoke with my trainer who agrees it is time for a vet check. His vet likes Rood and Riddle best of my proposed options, so that’s the plan for now.

[Simkie]

@Emily&Jake

What is SI?

Sacroiliac.

[Lord_Helpus]

@MapleLeaf

I’ve tried massage and chiro by good practitioners. Of course he felt nice and loose afterward, but it did not help the swapping.

I spoke with my trainer who agrees it is time for a vet check. His vet likes Rood and Riddle best of my proposed options, so that’s the plan for now.

You cannot go wrong with any of the three. If R&R is too far away for you to do easily, then go to one of the closer vet clinics.

You can always send the radiographs and sonogram results to the neurologist at R&R for a second opinion. That is what we are doing with a young horse’s x-rays and MRI’s.

[raisethebar]

@MapleLeaf - keep us all in the loop! I am hoping for the best for your horse. Very curious to see what it turns out to be! Fingers crossed for you!

[Emily_amp_Jake]

@Simkie

Sacroiliac.

Thank you Simkie! I googled it and found some more information as well. Very interesting.

[raisethebar]

@MapleLeaf

Between Virginia Equine Imaging and New Bolton, does anyone have experiences or preferences? I could probably also make it to Rood an Riddle, but it’s a bit more of a hike. Any suggestions would be appreciated. Thanks.

@MapleLeaf I just wrapped up 6 months long of figuring out what was going on with my NQR horse at VEI. I am now back to restarting my horse over fences and I cannot say enough about Dr. Allen and the team at VEI. They are wonderful and they truly gave me my horse back and came up with a plan to keep him comfortable. Of course, the initial work ups were pretty expensive. but they worked with my insurance really well. For what did come out of pocket, I found that they were extremely reasonable as well.

Long term, I will 100% be using them for any issues that come up with this horse. I have not had any experiences with NB (thankfully my horse never needed their aid) but I would totally recommend VEI!

[MapleLeaf]

Raisethebar – thanks for the feedback on VEI. And that is wonderful that you had such great results for your horse! Since I have the appointment at R&R and I got a recommendation for a vet there, I’m going to stick with it for now. Hopefully there is no “next time,” but I’ll certainly keep VEI in mind. Appointment is for Monday. . .

[raisethebar]

@MapleLeaf fantastic! keep us updated!

[MapleLeaf]

So after horsey had about 10 days off due to my commitments, I lunged him twice and rode him twice before seeing vet. Both rides were great with hardly any swapping and total acceptance of half-halts and adjustability in the canter. I’ll be honest that I was a bit gobsmacked and totally hopeful that he felt so much better after a short break.

I decided to keep the appointment regardless, so we started with a lameness exam and neuro exam. He passed the neuro checks with no problems. He flexed with very little reaction to any flexions, but maybe a 1 on the hocks. No lameness but he took a bigger first step. He did not like his suspensories being checked, but did not take any bad steps.

During lunging, he really did not do much cross-canter but he showed a bit when he tried to play in the canter. He moved very well. Vet commented during the jogging and after lunging that he moves very base narrow in the trot and canter. Based on his conformation and history, he was betting his hocks were a bit sore.

One the farriers took a peek at his feet and commented that the inside of both hind feet are a bit high and could be lowered and to offer a bit more lateral support to the outside to encourage the foot to step out.

We took x-rays of the hocks and hind feet. He has some very mild arthritis in his hocks, but nothing concerning. Feet looked fine. We also ultrasounded the suspensory that got the bigger reaction and it was totally normal.

So we opted to just start with hock injections. If no improvement in a few weeks, try stifle injections. If no improvement, we’ll do a bone scan. Because of the drive, he offered the bone scan today, but it would’ve been a longer stay than I planned. I figured we’ll try this progressive route and see how it goes. We also put him on adequan and a short course of bute.

This vet said that sometimes these horses get a touch sore and need help to reduce the inflammation. He said this seems particularly likely given how much he improved after a bit of time off. He also said just because a horse is injected does not mean it needs to be repeated or put on a schedule. He said sometimes a horse may just need help with inflammation relief and they are good to go. He used a steroid in the lower joint and Hyaluronic acid only in the upper two joints.

Overall, I like the work-up and the plan. I am very hopeful that this will be the right plan to get my boy feeling 100%.

[drafting_dots]

Great news, so glad you updated!

[raisethebar]

Thanks for the update!!! Sometimes rest does help.

I also wanted to chime in - I am on my second shot of Adequan after using Pentosan for my young horse and already I can tell it made a huge difference! It could be a combination of everything but I totally think he has been feeling better.

Good luck!

[MapleLeaf]

So I’m at a little over two weeks post hock injections and I’ve not seen any improvement. First real ride after the injections felt very good. That was day 7. Rode two days later and he cross-cantered all over the place. Horse then had a week off between my work travel and then pulling both of his front shoes. Got shoes replaced and hopped on last night for light ride and he again struggled to hold his lead both directions. I’m disappointed, but I scheduled the stifle injections for next week. I am very tempted to inject the SI while there, even though I know I may not know what helped if the issue resolves.

If no progress after that, we’ll do the bone scan. Trainer thinks if the bone scan doesn’t strongly point to something, we turn him out for a while since he’s big and young.

[IPEsq]

If he didn’t flex positive on the stifles, I’d be inclined to do SI first. Is there still any difference versus longeing and riding as far as the lead swapping? With my horse and his SI issues, he found it much easier to do cantering of any kind without a rider up and was less likely to swap on the longe as well. Stifle issue I would be able to see on the longe. Although, the narrowness of movement behind does suggest more stifle than SI (SI issues tend to cause a wider stance, but I suppose it could depend on the overall body type, a young gangly horse might be able to compensate easier by narrowing the base).

With the front shoe pulling as well and age, he may well be going through a phase of not knowing where his parts are very well. Is there any back soreness currently? Or near the SI area?

[drafting_dots]

@MapleLeaf

Trainer thinks if the bone scan doesn’t strongly point to something, we turn him out for a while since he’s big and young.

Does he still seem willing and comfortable under saddle? If bone scan doesn’t point to anything, if he were my horse I would keep him going just with really light work, fun trail rides (but why not a canter out here and there), bareback, etc. for a few months to let him grow up. I am still strongly in the camp of he needs to grow into himself physically and maybe even mentally.

[MapleLeaf]

He is super willing and forward under saddle. Really good to the connection. He went through a period in the spring where he was kicking out at the canter transition, but he has not done that for months. I think it was a bit of baby sass when he was feeling fresh.

I haven’t thrown him on the lunge line since having his hocks injected. It was usually about the same as under saddle – some days better than others but usually some cross-cantering, especially if I asked him to bend (stay on the circle!) and he lost his quarters to the outside.

He is definitely built base narrow – very long legs, short back and fairly narrow all around in my opinion.

His back has had on and off soreness, which is not terribly uncommon with a young dressage horse coming into condition. I initially chalked it up to bode soreness, but the fact that it was persistent did worry me that it was secondary to whatever else is going on – hocks, stifles, etc. Upon exam, the vet did not think it seemed particularly sore.

There is a part of me that is now thinking this is all related to the front feet and his high/low issues. I’m anxious to see how he will be after injecting the stifles next week.