HELP! Lameness in my dressage horse!

My 16 year old horse who was training at 4th level dressage prior to his lameness has be off for 4 1/2 months.

It started in September, on a Monday he was completely sound and happy to work. My sister took him for light trail ride (literally just around a flat hayfield < 30mins nothing more than a walk) and he was fine the next day. By the Wednesday when my coach was back in the saddle IMMEDIATELY he noted that his left shoulder felt really stiff. He walked around the arena a few times and gently warmed him up, and he 'worked out' of the stiffness. The next day my horse was romping around in his field and tore his blanket. A few days later the massage therapist was at the barn to take a look at him. She noted that he seemed to be very uncomfortable in the shoulder and tight.

We gave my horse 1 week off and had our vet come out to assess him. Our vet couldn't find anything wrong and we gave him 1 more week off. He was turned out in his paddock and not stalled. At no point during these 2 weeks was he visibly lame. (not lame when handwalked or trotted)

After the 2 week break my coach was back in the saddle to see how he was doing. At this point we noticed my horse was not sound under saddle and it was only noticeable during the first few steps of trot. He was striding longer with the left front (more time in air), no bobbing of his head. It wasn't visible in the walk. It was worse going to the left (only visible in trot). He wasn't trotted in the corners or on circles (just down the long side). As the lameness was not every stride and only for a few steps when it did appear my horse 'worked out' of it after 15 minutes of a very very gentle warm-up.

We surmised that he still could use more time off and maybe he had strained a muscle is his shoulder. We had the massage therapist out again to work on his shoulder and gave him 2 more weeks off, and just handwalked him for 20mins/day.

After the other 2 week holiday (total 1 month 'rest'). We tried him under saddle again. Same problem occurred: sound when hand walked & trotted, sound when ridden in the walk and 'off' in the trot for a few strides on and off for the first 15-20mins of the warm-up. After this we had the vet out again for an evaluation. He couldn't find any ligament/tendon problems, on the hooftest he was slightly sore on the left. He did a nerve block to the left foot and my horse DID NOT improve.

We took xrays of both front feet thinking he may have osteoarthritis or that there could be something worse going on. The xrays showed moderate calcifications of the cartilage of BOTH FRONT FEET consistent with sidebone and his joints looked great. He was prescribed 20 days on a NSAID and 1 month on a vasodilator. We had bar shoes put on the same week.

Overall, he's been off for 4 months now with just handwalking for 20 mins/day. He never showed any signs of improvement on the NSAIDs (finished the prescription).

I have searched a lot electronically for information on sidebone both on the internet and equine veterinary journals and I know it's not a common cause of lameness in horses. I would LOVE to hear any ADVICE regarding management of sidebone and if you have any other thoughts based on the history you've just read.

I absolutely adore my horse and have owned him for the last 10 years. He has never had any major health problems. I really want to do what is best for him and am fully willing to acknowledge that might mean he never goes back to work and no more flying changes. But right now we just can't make him happy.

Hi,
Sidebone - ossification of the lateral cartilages - is unfortunately common in domestic horses, but it doesn't generally appear to cause lameness. If the vet discovered nothing from the nerve block and the bodyworker said he has shoulder problems, what makes you still think feet? Could it be an injury further up or pressure from an ill fitting saddle or some such? Why have you had bar shoes put on him?

Thanks for your post!

I know sidebone is common and in the absence of lameness is not pathological in the majority of cases; however, my understanding is that sidebone in the context of lameness could be causing the problem. I talked to my vet about the nerve block and was told that it is a great test when the horse is acutely lame on the limb and then after the nerve block improved. And in the case of my horse where he is off only in the trot for a few strides it's less likely to assist in making a clinical diagnosis.

Why the bar shoes? -to redistribute the weight to alleviate part of the discomfort of sidebone. We were told to try it to see if it helps.

Possibility of saddle problems? That's an excellent point. Fortunately/unfortunately it's not going to be an issue, he has a custom fitted saddle.

Knee, fetlock (above the foot). So far there have been no findings on physical exam to suggest the problem is higher up. No heat, tenderness, or swelling. No lameness on flexion tests...

My horse is incredibly sensitive so the shoulder tightness didn't surprise me, but the tightness and discomfort has resolved according to the massage therapist.

Any ideas? Thanks in advance. :)

You might want to consider keeping the horse shoeless & using hoof boots when necessary for work instead.

Not assuming you don't know this, just worth saying I reckon.. Even a saddle that is a perfect fit when first tried needs regular checking, as horses & saddles both change with the seasons. If the horse is uneven for some reason - perhaps has a clubby foot - or the rider is uneven - has a back or knee problem for eg - this can also make for saddle fit problems.

Definitely also recommend getting the saddle re-evaluated every so often. Horse's backs change so much when they start filling out or gaining and losing weight or topline.

Thanks!

We definitely considered the saddle as a possibility. We regularly have it assessed every 2 years (religiously). He didn't improve when ridden bareback on a few occasions both with myself or my coach. He doesn't have any tenderness over the thoracic vertebrate or muscles over his back, this was also confirmed by the massage therapist & my vet. But definitely a possibility we considered initially. :)

My gelding has a bit of sidebone in one of his front legs (PPE x-rays showed it) but he has not experienced any lameness from it.

The Vet who did his PPE said that in the past, sidebone was basically considered a "non-issue" but in the past few years, she's seen lameness in multiple horses associated with it. She said she's seen everything from 6mo of stall rest "curing" it (obviously it's not a cure but it has resolved after that time period) to horses being retired to moderate pleasure use.

Anyways, she seems to have quite a bit of experience in treating this issue and an extremely thorough and knowledgeable Vet. If you'd like, I can give you her contact information and perhaps she might be able to assist you?

Thanks Delfina,

I really appreciate the offer. I am actually very happy with my vet. I would love any sage old horsemanship advice though. I've often found that vets are superb at diagnosis and acute management but the long-term management always relies on the owner to try and work-out what seems to keep the horse comfortable.

My vet is coming out again next week to re-assess him after being on the NSAIDs and vasodilator, I'll try and ask management related questions then!

But your gelding has stayed sound then? If so, that's great!

Yes, completely sound but seeing as he's all of 5, he's still got plenty of time ahead of him!

Well it seems like you've ruled out that possibility, but for future reference, you should check saddle fit AT LEAST 6-monthly, not leave it for 2 years.

Geepers Delfina, what's happened to the poor boy to have developed sidebone already when he's still a 'kid'?? Was he started &/or shod very early or some such?