Unwilling to keep the right canter lead suddenly

Discussion in 'Horse Health' started by Ziast, Oct 1, 2018.

  1. Ziast

    Ziast Senior Member

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    "Walk- Slightly short stride both front. RH limb circumducts more at a walk compared to LH
    Trot in Straight Line- Very mild intermittent right sided head nod.
    Trot in a Circle- Decreased tracking up of RH. Very mild intermittent right sided head nod.
    Canter in a Circle- Decreased tracking up of RH when cantering to the right. Stifle "slipped out" a few
    times. hesitant to pick up right lead compared to left."
    "RH lameness characterized by abducting the limb before swinging it underneath himself
    and a prominent hip hike. Flexion of RH upper limb revealed a 3/5 positive flexion"

    A few quotes from the history I received, two different visits. First visit it was noted that he swings it out, said it was minor and could be an artifact of him being windswept. Subsequent visits determined it was not, as it got more pronounced as his lameness worsened. Its definitely been consistantly commented on. I don't recall if there has been any specific theorycrafting over the why of the leg moving like that, down to specific structures, given the entire stifle is pretty ugly. I'm hoping the ultrasound tomorrow might be able to shed some more light in that.

    When I watch the video this time around, the step almost looked like it has a hock wring as well. He places it and twists the whole leg weird. Trails the hips to the right consistantly, too. Not sure if I just didn't noticed that when watching him be flexed in the past, or if that's new.

    As for ulcers, he's not even girthy. The closest he comes is sometimes he might turn and look at me when saddling, but it's not consistent nor does he act irritated. I do have 30 days of pop rocks if I want to give it a go, but it's not the top of my list at the moment.

    I did some inhand work with him last night, just easy stuff to see how he feels. No chomping or getting upset except when doing a SI on the diagonal to the right. It's like a leg yield, but emphasis on the shoulders crossing, not the hind legs, but does still need to take weight on the right hind. Reaction overall may be lessened as he hasn't been ridden since Tuesday.

    Things I'm going to ask the vet tomorrow:
    - ultrasound stifle
    - chance of neck involvement
    - bute vs previcox for long term pain management
    - shoeing package, and if xrays of hind feet are needed
    - possibility of confounding ulcers, to be thorough
    - anything else I can think of between now and tomorrow morning
     
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  2. Rhythm 'n Blues

    Rhythm 'n Blues Senior Member

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    Ziast, I think really think you're doing all that you can do. It's frustrating as all get out, I have no doubt,.

    Given the flexion grade, and the way that limb moves...even when on pain meds. I'm really not sure that even if you found the cause of it, that it would make much of a difference in the diagnosis.......I'm sorry that's likely not what you want to hear at all. Giant hugs! :loveflag::heartbeat:
     
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  3. Ziast

    Ziast Senior Member

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    Yeah... :( I've been considering that I'll have to find some cheap pasture board for him, throw him out for a year or two, see where that gets him... depends on what's wrong...
    Never thought I'd be facing retiring him at 9...
     
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  4. ginster

    ginster Senior Member

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    Pardon my french but this is all kinds of ****ed up... all these problems due to his conformational weaknesses. I know how much he means to you @Ziast and I am jingling like mad that there is something to be done to help him...
     
  5. Ziast

    Ziast Senior Member

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    Significant tear of the right lateral meniscus.

    Poor guy is just a mess everywhere.

    Vet used a cool set of sensors when watching him move. Attached one to his poll, another to his croup, and one to his right front foot. They pick up how he pushes off with each leg and if he lands lighter. Most of the findings were the same; markedly lame on the right hind, moderate on the left hind and slightly on the right front. Interestingly enough, he said that when the right front was flexed, he actually trotted off more lame on the left front. He has a lameness on the left front that is not impacted by weight-bearing, but is worse when the leg is on the outside of the circle.

    Vet took a whole new series of xrays. Front feet, hind feet, both hocks, and right stifle, 27 in total, a whopping $1400 worth of xrays. He only charged me for 8 of them at half price, thankfully.

    Vets are always equal part shocked and amazed when they first see rads of his front feet and pastern angles. He wants Jules put into wedge shoes sooner rather than later to try and help the angles. Doesn't think it will make an impact on the rest of his body soreness to do it now. Plus frog support, so he'll go in either a leather pad or heart bar. He said he might call my farrier and discuss it, then he can share the xrays with the farrier too. Hind xrays were fine, when I looked at them closer when Bluemoon wanted pics, I noticed they were looking bullnosey, but based on the rads there is no NPA, just looks like it from the outside. Vet said if the farrier can get them up a few degrees it would be great, but not necessary to shoe to get it done. Also wants an extra roll on the toe of the hind feet.

    Hock xrays showed some very active sites at the front of each hock where the spurs are. Those will be painful as well.

    Right stifle xrays showed more of the same. Nothing as acutely active as the hocks. There is a spur off the fibula that I'm not sure was seen in the previous xrays, I'll have to go back and look. Its minor and not likely an significant player in the current lameness.

    We ultrasounded his left shoulder to investigate the left front lameness. Jules has always had an indent in his shoulder, like tonnes of other horses do, but the vet suspected this was causing some discomfort when lifting the left leg forwards. Ultrasound showed the surface of the bursa had a significant dent in the gliding surface. Should be a smooth curve but half the surface is cratered. So that's another problem.

    Stifle ultrasound told a larger story. Some minor roughening and inconsistencies in the cartilage and articular surfaces, nothing alarming there. The joint capsule was twice the size it should have been. He was surprised to see how big it was. His meniscus also has a significant amount of scar tissue. When he first started, he was pointing out structures to me and said "this is the edge of the bone", then moved a bit more and had to do a double take. Nope, that wasn't the bone, it was scar tissue. One side of the meniscus is also bulging.

    Star of the show was the large tear in the lateral meniscus. Based on the amount of scar tissue and the distention of the joint capsule, this was an injury that became very swollen, stretched the joint capsule, tore the meniscus, partly healed, then was reinjured, then partly healed, ect. He probably tore it again in September when this started. No idea when this first injury would have happened, must have been before I bought him? You would think that something that significant would have made him noticeably lame when it first happened, but if he was young and not undersaddle, it could have gone unnoticed I guess.

    We didn't treat anything today, but talked about what we would do ideally.
    • Get him in different shoes
    • Inject the shoulder bursa
    • Inject both hocks(lower joints, upper are gone)
    • Inject the SI again with a posterior approach, plus look for any bony changes with the u/s while in there
    • Inject the lumbar facets
    • Mesotherapy for the back
    The vet is going to a conference in a couple weeks and is going to do more digging and investigation on what to help the meniscus. The jist of everything at this point is that there isn't anything tried and true to fix it. You can't surgically repair it either. Regenerative therapies are at the front line at the moment, generally some mix of stem cells and growth factor, some fairly experimental. We'll wait until we get some more ideas about the meniscus until doing the rest of the stuff.

    I don't know if I can afford stem cells after all this. :(

    He was guarded in his prognosis. It's a severe tear, but given all the other things going on in Julius' body, the vet doesn't think the lameness is solely based on the stifle. If we can get even a 75% reduction in pain everywhere, then we are way further ahead than if it was only the stifle hurting and we fixed that 75%. He also has age on his side.

    He sent me home with a fecal occult blood test. I'll run that sometime this week when I can time it right. It will check for blood and albumin which will tell us if he has ulcers and what type.

    Asked about bute vs previcox for long term and robaxin. Bute knocks out all pain, but is harder on the body. Can be managed if split into two doses morning and night though. Previcox is generally better tolerated, but doesn't work for all pain. He said he's not a fan of robaxin and used to used it but has been generally underwhelmed by it's performance. He suggested Mesotherapy for pain management, and if he's not going to be working, then he doesn't need anything.

    He said handwalking and in-hand work will not make him worse, so I'll keep doing those things. Won't ride him for the near future.

    So yeah. At least it's not a tendon/ligament injury.
     
  6. Ziast

    Ziast Senior Member

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    He has a fancy new haircut now. 20190205_131439.jpg
     
  7. LoveTrail

    LoveTrail Senior Member

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    I'm so sorry.

    Foxy, at four, before I bought him tore his deep flexor tendon on his left front and must have at the same time spit his meniscus in his right hind. He has to be in wedge pads for that deep flexor. We tried only wedge shoes last year, but it didn't work and then tore some fibers in his deep flexor of his right. He is now probably doing his last year of showing at 17. As I posted above he got a severe case of ulcers from bute. Much improved in the last five days, but still a ways to go.

    Good luck with your horse.
     
  8. BluemoonOKy

    BluemoonOKy Senior Member

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    I just want you to know i am thinking about you and sending Julius healing love from me and my gang. You are awesome for taking care of your horse so well. Kudos to you, I only liked your post for the thoroughness and getting some answers...of course I do not really "like" it.. hugs.
     
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  9. Rhythm 'n Blues

    Rhythm 'n Blues Senior Member

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    Oh no!!! Ziast I’m so so sorry to hear this. I’m glad you finally have a proper and clear diagnosis of what is going on. Now time to see what other ideas the vet comes up with & if you want to move forward with it.

    I’m sending giant hugs your way! I can totally empathize with you. I know exactly where you’re at.
     
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  10. ginster

    ginster Senior Member

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    I am so sorry to hear this!! Poor Julius and poor you!
     

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