Assessing Lameness

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  • March 28, 2011 at 5:25 pm #42566
    TimB
    Member

    My 4.5 year old, gelded Percheron has been lame for the past 3.5 months. I have had a vet out numerous times – paid for vet visits, xrays and nerve blocks – and we’ve not yet been able to diagnose the cause. Quick background:

    In late October 2010, JD (the horse) got some barbed wire cuts on his front knees (from a hidden strand of wire in one of their pastures). I rested him for 5 weeks while cleaning the cuts, using an antibiotic right after the incident and I got him a tetanus shot. The cuts healed well, but shortly after I worked him again it was evident that he was walking strangely. Basically, he is short stepping with his front left, not extending it more than a foot – or less than a foot – in front of his body. He is also criss-crossing his front legs, placing them on or past the midline of his body (occassionally interfering). And he is placing his left foot down mostly toe first. Nerve blockers in his navicular region showed no change in lameness and xrays of his hoof and pastern show no bone issues…

    The vet doesn’t seem to think the barbed wire cuts are related (though I have my doubts about that), and he’s interested in looking into the fetlock joint for potential problems. Depending on how that goes, if nothing is found in the fetlock, he would want to continue working up the front left leg to look for the problem’s source. My questions are:

    1) Has anyone had/heard of a horse that was short stepping a front leg and criss-crossing the front legs while they walk? Any ideas about possible causes – joint damage, tendon issues, shoulder problem…?

    2) I’ve already spent almost $500. on vet visits and I can’t keep spending that kind of money for uncertain results (and, as of yet, no diagnosis). Any recommendations on alternative treatments (i.e. massage, stall rest, etc..) and/or how to decide between continuing to spend money on trying to get a good horse better versus other options (whether those are alternative treatments, doing nothing but waiting to see what happens, or looking for someone who is willing to take, pasture and care for a draft who can’t work…)?

    At this point, my plan is to stall rest JD for a week or so to see if there’s any change in his condition (he’s been rested for the last 5 months, but not in a stall). Otherwise, I’m at something of a loss. If anyone has any advice, or wants any more information before venturing a suggestion, please get in touch with me.

    Thank you.

    March 28, 2011 at 8:05 pm #66483
    jac
    Participant

    Hi Tim.. What does your farrier think ?? vets and lameness dont often mix in my experience… Is it at all possible a small piece of the barb has broke off in the knee ?.. might sound daft but if a friend has a metal detector it may be worth giving the leg the once over.. good luck with this and I hope your horse comes on the mend..
    John

    March 28, 2011 at 8:43 pm #66476
    jen judkins
    Participant

    Tim, is there any chance he got the wire wrapped around one or both of his front legs during the incident? How did you find him?

    Sounds to me like nerve damage high up in the leg. They can get a neuropraxia (nerve injury) from injuries that apply alot of pressure around a leg. The front leg is particularly vulnerable. You might not even see a cut where the pressure was but he would have most likely lost some hair there a few days to a week later.

    If so, he will likely recover, but it might take alot of time. Time, you may not want to invest. Where are you located?

    March 29, 2011 at 1:49 am #66475
    tsigmon
    Participant

    Can you get pictures? A toe first landing can be associated with heel pain which can be the result of too long of a toe. Feet landing across the midline usually is a result of a combination being toed in( fairly common in wide chested horses) and poor medial/ lateral ( inside and outside of the foot ) balance. Post or e-mail pictures and I’ll try to help.

    Tim

    March 29, 2011 at 6:06 am #66479
    CharlyBonifaz
    Member

    Nerve blockers in his navicular region showed no change in lameness

    then the problem should originate higher up

    March 29, 2011 at 7:14 pm #66481
    TimB
    Member

    First, thanks everyone for the comments and questions. I’ll try to respond individually and succinctly:

    Jac: I don’t think there’s any barbed wire in him. He wasn’t found tangled, rather he had gotten the cuts and extricated himself… I walked him in in the dark of early morning, noticed that he walked in strangely and found the cuts on inspection, while he was in his stall. I had the vet out to see him immediately. The vet cleaned and inspected the cuts that day. I think they are clear of any material – I also cleaned them and inspected them closely for the two weeks following the vet’s cleaning. As to the healing, the cuts healed well with only a small amount of scarring; the vet felt they looked good.
    As to a farrier, we do our own trimming so I haven’t gotten a farrier’s opinion. However, we’ve been pretty on top of his trimming, so I don’t think his problem is in his feet (of course, I could be wrong about that…).

    Jen: As I mentioned above, JD was already disentangled when he was found. I expect that the wire was on or wrapped around both forelegs as both of those knees had cuts (but only on the front of the knee) and he had a minor cut on his left shoulder, but the deeper of the cuts was on his left knee (which is the leg on which he’s showing lameness). There was no hair loss on the legs, except where the vet shaved for inspection and cleaning.
    I am willing to put time into his healing since he is a good horse and so young, and especially since it is getting to grazing time (i.e. not having to spend money on hay for him). I’m located in Upstate NY, at Essex Farm. What would you check to indicate nerve damage and what would you recommend (i.e. stall rest?)?

    Tsigmon: I don’t have a digital camera, so i don’t have any pictures to show. However, I don’t think that his toes are too long because we’ve been pretty on top of that in our trimming. My thought is that he’s landing toe first to compensate for pain that is originating somewhere other than his foot. However, I will look into getting use of a digital camera and, if I can, post pictures to get opinions on his feet.
    As to his conformation, he’s not very wide chested but is fairly base-narrow.

    Charly: I agree. The vet’s next step, though I’ve not yet scheduled it because I’m not sure how much money I can spend on vet bills, would be to look into the fetlock joint and then continue moving up the leg. Our vet is very caring and is a good vet, but he’s not a horse specialist. I’m not sure how wisely I’m spending my money by continuing with his diagnostics…

    March 31, 2011 at 1:44 am #66477
    jen judkins
    Participant

    @TimB 25986 wrote:

    Jen: As I mentioned above, JD was already disentangled when he was found. I expect that the wire was on or wrapped around both forelegs as both of those knees had cuts (but only on the front of the knee) and he had a minor cut on his left shoulder, but the deeper of the cuts was on his left knee (which is the leg on which he’s showing lameness). There was no hair loss on the legs, except where the vet shaved for inspection and cleaning.
    I am willing to put time into his healing since he is a good horse and so young, and especially since it is getting to grazing time (i.e. not having to spend money on hay for him). I’m located in Upstate NY, at Essex Farm. What would you check to indicate nerve damage and what would you recommend (i.e. stall rest?)?

    You would have to have a equine vet with expertise in lameness to pick up the nerve damage. Good news is it is a clinical exam, not a pricey procedure. I tend not to stall injured horses and if my vet tells me to do it for 6 weeks, I generally do it for 3:rolleyes:. I would let him move around as much as he wants, as long as he is not doing anything really stupid. Let nature run its course.

    March 31, 2011 at 4:25 am #66478
    near horse
    Participant

    Hi Tim,

    Have you just had him walk or have you tried to getting him to move out – maybe even have someone else do it while you observe from the side. IMO sometimes the lameness is more pronounced with an extended gait and might help pinpoint the region.

    What happens when you try and flex his knee joint for him – manually? Does he seem to have pain? Does the joint bend as easily as the opposite side? Any chance you’re seeing the result of built up scar tissue around the injured area interfering with flexing of the joint?

    Just some quick thoughts that you and your vet have likely explored but thought I’d ask.

    April 3, 2011 at 8:35 pm #66480
    Rod44
    Participant

    He could have pulled his shoulder a little while tangled. Had a friend of mines horse get in a fence and throw himself. An Amish chiroprator friend of mine adjusted the shoulder and he walked much better right away.

    April 9, 2011 at 12:22 pm #66482
    TimB
    Member

    Jen – Thanks for the advice and the comments. At this point, I think I might try the stall rest because he’s been resting in pasture for over 3.5 months now with no improvement. I’m just groping for something that might help him to heal and I wonder if being confined to a stall might help him to stay off whatever is hurting him enough to let it heal a bit… It’s a longshot, maybe, but I don’t think it will be harmful to him so I’m going to try.

    Nearhorse – We did do flexion tests on both his front legs and neither seemed particularly different. His fetlock might have been more sensitive on the front left, but nothing very noticeable. I’ve also lifted his front left leg and pulled it forward and to the side and he seems fine with either… As to scar tissue, there isn’t much around the cuts, they seem to have healed well.

    Rod44 – I do wonder if he didn’t hurt himself either getting into or out of the barbed wire. Or he might have injured himself during the healing phase, maybe he was walking funny to avoid pain and ended up causing some injury…

    All in all, I’m just not sure what is wrong, what caused it or what to do. I’m going to have the vet out again; I’m going to have someone who does horse massage spend some time with him; I’m going to stall rest him (and probably give him butte, or something like that while he’s in the stall to see if it helps) and I’m going to spend some more time with him…

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