Tuesday, June 7, 2011

Let's Play "Armchair Vet," Shall We?

Beloved Pasture Ornaments -- at the moment, Salem is a member of this exclusive club. As many of you know, last year we discovered that Salem has some sort of underlying back/right hind issues. This was a few weeks before he left for Chicago and I had faith that Raffie would have the issues diagnosed and treated. Unfortunately, that didn't happen, and Salem was ridden both on the flat and over fences without  having his lameness issues addressed.

So, here we are a year later. I've been spending money like it's going out of style, both getting Salem down here and bringing him back to the condition he was in last year. And unfortunately, I can't just ship him up to the University of Florida and have them run every diagnostic known to man on him, much as I would love to do that! I honestly don't think Salem is in pain when he's not working, so it isn't a pressing issue. My plan is to start saving money, and in the meantime I'm getting his hooves back in shape (I know a lot of vets start with hooves, so I want to make sure Salem's are in tip-top condition).

But, just to organize my thoughts and get some feedback/ideas from you guys, I'd like to go over the symptoms, possible causes, and diagnostic/treatment options.

Symptoms
  • Occasional bronco bucking at the canter
  • Stepping slightly short in back on the longe
  • Stepping short in back under saddle
  • Lack of muscling in the topline and hindquarters
  • Unwillingness to round and use his back under saddle  
  • Reluctance to pick up the right lead      


Granted, Salem is not standing completely square in this pic.
However, you can see that his right hind muscles are lacking


Right hip


Left hip (this is a bad angle & I caught him while moving, so it's a bit deceiving)


Possible Diagnoses
  • Sacroiliac issues
  • Arthritis in the back (lumbar vertebrae and/or sacral vertebrae)
  • Kissing spines (I'm not too convinced this is the problem, but I'll throw it in there)
  • Trochantric bursitis
  • Arthritis/pain in the hocks and/or right stifle
  • Some kind of trauma in the right hip/stifle



Diagnostics
  • Full lameness exam with blocks, flexions, etc.
  • Xrays of all 4 hooves (I am willing to bet that the problem is much higher up, but I know most vets like to start from the bottom and work their way up from there)
  • Possibly Xrays of hocks
  • Ultrasounds(s)
  • Bone scan
Possible Treatments
  • Ultrasound-guided injection of sacroiliac junction
  • Inject area surrounding the sacroiliac with Sarapin
  • Inject trochanteric bursa with steroids/HA, possibly PRP (Platelet Rich Plasma)
  • Tildren
  • Adequan/Legend/Map-5/polyglycan
  • Chiropractic
  • Acupuncture
  • Inject hocks and/or right stifle
  • Massage
  • Shockwave therapy
  • Mesotherapy
I will try to get a video soon, as I know that would be helpful. My trimmer knows a great chiro/acupuncturist who isn't ridiculously expensive; we might be able to get her down here (she works on the TBs @ Calder Racetrack) so I'm thinking of starting there. My gut feeling is it's right hip/stifle, with maybe a bit of lower back issues thrown in.

And I just want to say: I will not ride Salem (even at the walk) until I have his issues diagnosed and treated. Doing otherwise would not be in his best interest. I won't ask him to do anything that would require him to really use his back. In fact, at the moment I'm hardly asking him to do anything; I'll have him trot around maybe 2 or 3 times each way, and canter once each way about twice a week, just so he's doing something.

So, what do you all think? Any ideas, suggestions, stories, and support will be greatly appreciated!

13 comments:

Barbara said...

Are we voting? I vote for both hocks and right stifle. I want to see video and I may regroup, but normal wear and tear on hocks and a problem in his stifle would account for all his symptoms. Of course, a hundred other things could also, but you invited us armchair vets.
I hope it is nothing dramatic and you can get it resolved. The acupuncture sounds like a great place to start.

Denali's Mom said...

I think that after spending SO much freaking time with Denali's vet I should be able to send in some paper work and get a Vet Tech degree.... Seriously?

So Salem. Let me actually think about it. What I've learned is that the problem is often in the last place you look.

Do you have video of him walk/trot/canter? Does he ALWAYS buck at the canter or only when being ridden? Is it worse one direction than the other? You never know with horses.... How flexible is he with his front end (neck)

See just like a good arm chair vet I answer questions with more questions....

Kate said...

Two things to check out - a lot of top line/rear end problems start with the feet, and metabolic issues can be top of the list - top line wasting is often associated with this and these things often show up in the RH foot first. He could be pre-Cushings and a bit IR which would make him a bit foot sore. Check heat in feet and digital pulses and if there's anything there you might want to try him on a chromium/magnesium supplement.

If that's not the issue, I'd suspect sacroileac with stifle also a possibility, perhaps not as a primary problem but as a result of how he's carrying himself. Get a good chiro to look at him - the American Veterinary Chiropractic Assoc. has a list of practitioners by state - they're both vets and chiros. I've found most traditional vets are pretty poor at diagnosing subtle lameness - they think everything's the joints and it's often muscular/myofascial as well which they don't address.

Good luck and let us know how it goes.

eventer79 said...

You need Dr. Bob's magic fingers! Flexions are pretty easy to do yourself if you have a friend willing to help jog, as well.

I really have mixed feelings about all the fancy diagnostics. I suppose they have their place, but having a seen what an experienced vet can do with a pair of hands on multiple occasions, you can learn a lot without having to run up enormous bills.

SprinklerBandit said...

Salem is so freaking lucky to have you. I like your plan--get him reorganized from the ground up, then see what's going on.

Ha, and with all the equine health drama that blogger land has experienced, you can get all kinds of good ideas and recommendations.

Unfortunately (for you), all my EHD has been mare-related, so I'm no help with a gelding.

Frizzle said...

Thank you for all of the quick responses, my fellow archair vets!

Barbara, I REALLY think that the right stifle is involved, as well. Hocks are definitely something to check out, but I suspect they're not the MAIN problem.I could be wrong, though.

DM, he doesn't always buck @ the canter, but he does it pretty often. When he got a massage a few weeks ago, his whole right side was all locked up. His front end is pretty flexible, I do carrot stretches with him often.

Kate, the good news is that he's already on a very low NSC diet, but I don't think he's IR or Cushings (although I certainly won't discount that). When Dr. Bob adjusted Salem last spring, he said that Salem has some kind of a back problem, as well as something in his right hind leg. Of course, I'm already planning on having his hooves Xrayed, but they're not hot & no digital pulses. He IS slightly footsore, but that's most likely because he came down to me with horribly overgrown hooves and we've been slowly working on getting them back to where they should be. I think we're finally to the point where my trimmer can stop taking off sole & frog, and just leave them alone to callous. But I am keeping a close eye on those hooves! I agree that most vets are not so great with subtle lameness, I am hoping that this track vet who does chiro/acupuncture will be the ticket!

eventer, can you send your Dr. Bob down to me? Just put him in a Fed Ex box with a bunch of holes punched in it. He should be fine. :-) I would LOVE to get a treatment/diagnosis without having to sell 1.5 kidneys!

SB, I cracked up over "EHD." Yes, yes, we have all had quite a bit of EHD in horsey blogger land, haven't we? Glad that your pony is healed and healthy; now please send that karma around here to Salem! :-)

Again, thank you, thank you, THANK YOU, everyone! I will be making a huge list of notes for my eventual vet visit (hooray for looking like a complete nutcase!). And, yes, I will certainly work on getting some video for you all to scrutinize.

Justaplainsam said...

I vote for Chiropractic work with increased maintance of his feet. What kind of scedual is he on feet wise?

Frizzle said...

Sam,
Salem's hooves were so bad that we've been doing them every two weeks. Now that they're looking pretty good, we're pushing it back to every three weeks. Last year when Salem was with me, he was trimmed every five weeks; however, I never had him in the summer, and since his hooves have been growing like weeds, I don't think we'll be able to push it back to five weeks until the fall.

Michelle said...

I found your blog through Sweet Horses Breath and I noticed that we might be neighbors! I live in the Orlando area, where are you? I hope you find out what's up with Salem soon without too much expense.

Frizzle said...

Hi Michelle,
LOVE Sweet Horse's Breath! Kristen and Laz rock. :-)
Well, we're kind of neighbors, but I'm all the way down in Miami. Actually, the southern tip of Miami, not quite Homestead -- so probably about 4 hours. Salem is oiriginally from Orlando, from Hunter's Edge Equestrian.
Oh, and to answer your question about the fly spray -- I get the eucalyptus oil @ Walgreen's, and the rest I ordered...I think from Puritan's Pride (?). I just Googled "essential oils" and picked one of the first sites.

Frizzle said...

Oops, I meant he's from Ocala, not Orlando...ya know, that other Florida "O" town. ;-)

Kristen Eleni Shellenbarger said...

We rock..!? Well, (blushing) thank you!
Ok, so here's my two cents along w/ what I emailed you.
With Laz-his foot sore lead to pelvis being out of whack, etc etc and that lead to him carrying himself differently, thus making it worse which I would suspect that this past year Salem had been doing, now making it also a stifle issue if he wasn't using his body properly.
I'm JUST reading more about hind issues stemming from liver issues and doing detoxes may help tremendously but I am entering with caution. That would tie in w/ top line issues which both our boys have too..so again, just dipping my toe in this research right now.
All i KNOW for sure, is that boy is damn lucky to be in your hands.
Open up your boarding facility and we'll come down. We pay in horse kisses and poop. I have plenty.

Frizzle said...

Hhhhhhmmm. Well, I know he had these problems last year despite his great feet, BUT I don't know how they were maintained up in Chicago. I'm sure that the state of his hooves when he came down here could have exacerbated his problems, for sure. In fact, now that his hooves are getting back into shape, he's looking more sound (but not completely sound, unfortunately!).
The whole liver detox thing is fascinating and I will definitely look into it.
Aaaaawww, thank you, I'm lucky to have him. And, um, my boarding facility at the moment would consist of several carboard boxes and comforter-tents. But the horses would have the best hay, grain, and shavings that $$$ could buy!