Biomechanic question w/ stifle/hock issue
 
 

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Biomechanic question w/ stifle/hock issue

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  • My mare drags her back leg in the summer
  • Hock and stifle flexion

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  • 1 Post By RunSlideStop

 
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    08-17-2012, 03:04 PM
  #1
Foal
Biomechanic question w/ stifle/hock issue

Hi,
I have a mare who drags her hind feet terribly. I've been fighting it for years. We do dressage, train at about 2nd level. I had a chiro out recently, and he said to have a vet look at her for kissing spine in the withers. Had the vet out, she saw something in stifles. She also has a pretty sore lower back and croup area all the time. So i'm trying to figure out what my next step is, whether I want to get into taking xrays and doing injections, or try some message therapy.

My question however, relates to my background picture on my computer. It's a canter shot of us, and I was looking at it, I noticed her hind leg placement and never really noticed how stiff it looked. I'll show you what I mean by comparing 2 photos, my background picture of us from the spring, and a picture I found online of a fairly normal horse cantering under saddle. Tell me what you think. It looks as though she will land directly on the back of her heal, she doesn't bend her hocks or stifles enough to get her foot under her.

Could it be her hocks? Could it be her stifles? Obviously i'm not expecting a diagnosis, but I am curious to hear what people think of her straight hind leg, and what that would indicate. And maybe if people have had similar issues? Experiences with injections?

As a side note, the one time she ever felt FANTASTIC after she had work done was many years ago after a woman performed a message using trigger point myotherapy. She had the most uphill canter i've ever experienced on her. So I am getting another trigger point woman in to take a look and see if she has a big change again. Thanks!
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    08-17-2012, 03:26 PM
  #2
Trained
It is tough to tell by a picture as depending on the horse's conformation they will all move differently. A video is definitely more useful in gait analysis as far as for lameness.

However the other symptoms you have described (dragging toes, sore back, etc..) all describe classic hock soreness. She may well also have something going on in the stifle, either independent of the hocks or caused by the hock soreness.
Were it my horse I would have the vet out to palpate the legs, do basic flexion tests, possibly some nerve blocking (whatever the vet felt is necessary to isolate the problem area) and then move to x-rays to pinpoint the location and cause of pain. From that point a course of action could be discussed and depending on the findings could include everything from a complete lifestyle change for the horse or some minor injections.
Joint injections can work very well to alleviate pain and swelling in the joint, but ONLY IF they are done in the needed area (ie not just pincushion the horse everywhere for no reason - one well placed injection based on x-ray findings is better than 5 "shot in the dark" injections), if they are done with the needed drug (ie Legend versus corticosteroids, which kind of corticosteroid, etc..) and if the after care is done correctly (the horse MUST be confined in order for the drug to work for a few days).

I think, based on what you have said, that there is likely some moderate to severe hock arthritis (spavin). If you are "lucky" it will be in the lower, fusible joints of the hock (bone spavin) and the hock can be assisted in fusing with some injections or surgery, or simply left to fuse on their own and likely won't cause that much of an issue after fusing. If you aren't so lucky, the arthritis will be higher up in the hock (bog spavin) and you're going to have some tough decisions on whether to treat (lots of joint injections, regular maintenance with Adequan and Legend, etc..) or to retire the horse.
Your other option is "The Ostrich" which is what a lot of people opt for. Get the farrier to put hind shoes on the horse so she doesn't rub her toes off and just keep riding and never even call the vet. Eventually she'll be so sore she keeps bucking you off, at which point you can sell the horse with no known medical issues and you're scot free.

But good luck and as far as treatment options, know that it's going to take a large chunk out of your wallet to treat regardless of what's wrong. So decide now a price limit and after that figure out whether you're going to "Ostrich" or re-home/retire when you hit the "vet bill limit".
     
    08-17-2012, 03:45 PM
  #3
Weanling
I think anebel is very accurate here. Unfortunately without extensive xrays or the like (seeing INSIDE the leg, not just flexion tests/etc and feeling the leg), it is hard to tell exactly where the problem is.

To me, it looks like she has problems in her hocks CAUSING problems elsewhere. Things like iliosacral (sp) problems, tightness/cramping in the psoas muscle, stifle problems etc can all be caused by hock arthritis.

If she shows to not have hock, stifle, or hip problems as the root, I would advise having her pelvis xrayed. Sometimes hairline fractures from a slip or fall in the pasture even can cause a great deal of grief.

Sorry to be unhelpful. With hind limb problems unfortunately the source could be any number of things, and really requires a lot of patience and thorough examining to figure out. I suggest xrays to start.

Cheers!
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~*~anebel~*~ likes this.
     
    08-17-2012, 03:50 PM
  #4
Foal
Thanks for the reply. I think i've been "ostriching" (where did that come from?) for years. She's only 14, and has been dragging her toes pretty much since I bought her. Not so much at the beginning (when she was probably 5 or 6) but when I began dressage, that's when it started. Which to me seems to mean that it's conformational. My numerous trainers over the years never seemed to be worried about it, and even the message therapists were never too concerned about her back soreness.

THe only reason I recently started questioning it again is because in January I injured my tailbone, and realized my saddle was irritating it terribly, so I rode bareback (as you can see my the picture) for the entire spring. She goes so much more beautifully bareback than with a saddle. So when I started using my mom's treeless which didn't irritate my tailbone, I wanted to make sure it fit, hence the chiro/saddle fitter. (he said it's the best saddle for her).

I would also like to advance in our training a bit now that I have a consistent schedule, so if injections is what she needs to have the problem go away, i'de be willing to do it (obviously I have price limits).

As for hocks vs stifles, i've had the opposite info where dragging toes and back pain is directly associated with the stifle, and stabbing toes are usually hocks. As you can see, she reaches under herself very well, but she doesn't support as much weight in the hind end as she should, or obviously flex the joints as much, and has a very post legged feel in the back. She doesn't have any reluctance to going over poles, which we do a lot of. SHe doesn't like hills very much, but i'm not sure if that's just because it's a lot of work to walk up the hill and walk down.
     
    08-17-2012, 04:03 PM
  #5
Yearling
+1 on what anebel said. My horse has hock issues (known hock issues) and they crept up on us this summer. He was dragging his hind toe on the leg with the worst hock. My trainer took some video and we could really see it - and I could also see where his toe was worn a little square on that side.

Since we already knew about the hock issue, where it comes from, etc. I didn't have to have the full lameness evaluation. I have a chiropractor come regularly ever several months to adjust him, and she observed that he had some painful spots on his croup, probably because he'd been compensating for the hock that was bothering him by engaging those other muscles.

So in our case, it was stiff/achy hock *first* and lower back soreness *after*, and caused by the hock. She also observed that his stifle area was soggy (underdeveloped) also probably as a function of some biodynamics where he was protecting that hock.

As I said, this is a problem we already knew about, and once it got to the point where my trainer could *see* it causing him to use his body oddly, it was clear that the time to act was now. I had the vet out, showed him the video, asked him to make sure that the problem wasn't coming from something other than the hock (which we were pretty sure it was the hock, but best to check) and then I had both of his hocks injected with a combination of Legend and steroids.

I do not think it is an exaggeration to say that now he rides like a different horse. His gaits are SO much smoother, and it's obvious now that he must have been in some low-level kind of discomfort for quite a while. He's got a ton of energy, and in fact, I've been having to lunge him before riding because he's now wanting to throw out a couple of WOO-HOO kicks/little bucks when he canters, and I'd just as soon he got that out of his system before I am on his back.

I had to pay about $500 for the injections (including sedation and the farm call). Given what a huge different it has made in his comfort and way of going, it is maybe the best $500 I've ever spent on anything. I will not hesitate to do it again - my only quandary now is 1) how to stretch out the beneficial effects of the injections as long as possible, and 2) how to know exactly when to get it done next time.
     
    08-17-2012, 04:11 PM
  #6
Trained
The story is that ostriches stick their head in the sand to avoid predators - "it can't see me if I can't see it" type mentality.

A few injections aren't going to make anything that's been going on for 8 or so years "go away". It's always going to be there, you have to treat and manage it. Doing one shot joint injections will never work in a management program, they might be a good initial starting point to "jump-start" the treatment regiment but it's likely there is going to be lots of long term management. And it well get worse, and cost more and more money to even maintain what you are doing now, let alone move up the levels. So set a price limit is my advice, because it gets really easy to rack up tens of thousands of dollars of vet bills in a year.

Toe dragging is very rarely conformational, unless the horse is a real train-wreck in which case they wouldn't have made it to 14 years old while being ridden without severe soundness issues. A horse with stifle issues is more likely to "short stride", where as a horse with hock issues is going to over use the stifles and swing the hind legs like pendulums while keeping the hocks as straight as possible (giving the post-legged feel). They are also more prone to cross cantering and would be quite adverse to going down a hill. (Think about it in terms of people - if you have sore hips you're not going to take a big stride, and if you have sore knees you're going to overcompensate in the hips to keep your knees straight)

A lot of trainers are reluctant to say anything and are happy to keep teaching you and keep riding your horse as long as the checks are getting signed. Don't depend on your coach/trainer to do the job of a vet. IMO anyone seriously interested in doing dressage with a horse should have a full PPE type exam done at least yearly to find, diagnose and treat small things before they become full blown problems. Massage therapists are also a great line of defense. Mine tells me whenever there is anything tight, and what she thinks it might be related to. Absolutely every time my horse doesn't check out 100% with my RMT it has been because of poor farrier work or an injury. If multiple RMTs are pulling up the same issue every time, there should be a bunch of red flags flying up.

Good luck!

ETA: Thursday in response to your questions about prolonging the effects and when to inject next, these are things to talk to your vet about re: a management program. Have you asked him/her about Legend IV or Adequan IM in between the hock injections? Management changes such as increased turnout? Working with your farrier to get the feet/shoes "helping" the hocks? Etc.. there is a lot that can be done to help keep a horse sound and comfortable while very sparingly using IA Legend/corticosteroids and your vet is your best resource, as well as a farrier who is well versed in corrective and supportive shoeing and will work with your vet. As well you might look at feeding a well balanced vit/mineral supplement, possibly some MSM (glucosamine and all that other junk is overmarketed and doesn't work) as well as working up a detailed conditioning plan to get the structures around the joint stronger to support it.
     
    08-17-2012, 08:09 PM
  #7
Yearling
Thanks anebel! I haven't talked to the vet about the possibility of the IM or IV drugs. He gets a lot of turnout already - any time he doesn't *have* to be in the barn (because of inclement weather or really bad bugs) he's outside. He likes it that way. :) He's on the SmartFlex Senior supplement, so he's getting glucosamine, MSM, and a bunch of other joint goodies. This is an old performance injury - he was a GP show jumper, and had some kind of colossal wreck that left a bone chip in his hock (which no one seems to think is a good idea to operate on) and knocked out a couple of front teeth permanently. It ended his GP jumping career. Now he's learning low-level dressage (very low level...) which he seems to enjoy.

Now that he's not in pain, we're going to start doing some hill-work with him to condition. I've been talking to the farrier about the possibility of winter shoes so that I don't have to lay him off entirely for three or four months, just maybe 6 weeks or so. An indoor ring would be ideal, but there isn't a good boarding facility with one close enough to me that I can visit every day.

I'll be starting up the conversation with the vet about the Legend or Adequan, for sure. I know the injections aren't a cure, but I'd be satisfied with a good "management" program, and now that we know he responds, maybe we can put one together.
     
    08-17-2012, 08:18 PM
  #8
Trained
Quote:
Originally Posted by ThursdayNext    
Thanks anebel! I haven't talked to the vet about the possibility of the IM or IV drugs. He gets a lot of turnout already - any time he doesn't *have* to be in the barn (because of inclement weather or really bad bugs) he's outside. He likes it that way. :) He's on the SmartFlex Senior supplement, so he's getting glucosamine, MSM, and a bunch of other joint goodies. This is an old performance injury - he was a GP show jumper, and had some kind of colossal wreck that left a bone chip in his hock (which no one seems to think is a good idea to operate on) and knocked out a couple of front teeth permanently. It ended his GP jumping career. Now he's learning low-level dressage (very low level...) which he seems to enjoy.

Now that he's not in pain, we're going to start doing some hill-work with him to condition. I've been talking to the farrier about the possibility of winter shoes so that I don't have to lay him off entirely for three or four months, just maybe 6 weeks or so. An indoor ring would be ideal, but there isn't a good boarding facility with one close enough to me that I can visit every day.

I'll be starting up the conversation with the vet about the Legend or Adequan, for sure. I know the injections aren't a cure, but I'd be satisfied with a good "management" program, and now that we know he responds, maybe we can put one together.

Just a note about the feed through supplements, the Devil's Claw is great (as long as you are not showing - and on that note if you are already feeding Devil's Claw you might as well feed Yucca as well because both show up on drug tests), as is the MSM, but the glucosamine and HA are actually unable to be absorbed by the horse's digestive system and are just ending up in a pile a manure somewhere. Even my vet admits he feels bad selling these products in his clinic (because they don't work) but people are naive enough to buy them. As well the glucosamine in a lot of supplements comes from shark fins - so by feeding it you are contributing to the worldwide shark decline :) It's definitely better to save your money and spend it on an IM or IV program to get glucosamine, PSGAGs or HA into your horse's system far more effectively.
     
    08-17-2012, 08:20 PM
  #9
Yearling
Yikes. I got him the "herb free" one because I know Devil's Claw can upset sensitive stomachs, and didn't see the point in taking a chance. I'm not showing him yet, but plan to, so that's good there as well. Is the MSM a problem for showing too?
     
    08-17-2012, 08:25 PM
  #10
Trained
Quote:
Originally Posted by ThursdayNext    
Yikes. I got him the "herb free" one because I know Devil's Claw can upset sensitive stomachs, and didn't see the point in taking a chance. I'm not showing him yet, but plan to, so that's good there as well. Is the MSM a problem for showing too?
MSM is fine as long as it is not a herbal MSM.
     

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